Oscar Health Insurance in Herrin, Illinois

Updated July 2026 · IllinoisPlanFinder.com — Licensed Health Insurance Producer (NPN #21249133)

Oscar Health is one of 5 carriers offering marketplace plans in Herrin, Illinois, for the 2026 plan year.
Herrin is part of Illinois Rating Area 4, which includes Grundy, Kankakee, Will, and Williamson counties.
Illinois expanded Medicaid in 2014, covering adults up to 138% of the Federal Poverty Level (FPL).
Marketplace plans in Herrin include HMO, EPO, and PPO options, with PPOs available on-exchange.
The uninsured rate in Herrin is 4.6%, per U.S. Census Bureau ACS 2024 5-year estimates.

Navigating your health insurance options in Herrin, Illinois, involves understanding the plans available through the state's marketplace, GetCoveredIllinois. If you're specifically looking for Oscar Health coverage, you'll be pleased to know that Oscar Health is an active carrier in your area. Herrin residents, part of Illinois Rating Area 4, have access to a variety of health plans from Oscar Health and other insurers, including Health Maintenance Organizations (HMOs), Exclusive Provider Organizations (EPOs), and Preferred Provider Organizations (PPOs). This guide will help you understand your options, eligibility for financial assistance, and how to enroll in an Oscar Health plan that meets your needs.

Get Your Free Health Insurance Quote

A licensed agent can compare coverage options for you at no cost.

✓

You're all set!

A licensed agent will reach out shortly.

Is Oscar Health Insurance Available in Herrin, Illinois?

Yes, Oscar Health is a confirmed carrier offering health insurance plans to residents of Herrin, Illinois, for the 2026 plan year. Herrin is located within Illinois Rating Area 4, which also covers Grundy, Kankakee, and Will counties. This means that Oscar Health plans, alongside offerings from other carriers, are available through GetCoveredIllinois, the official state-based marketplace where individuals and families can shop for health coverage and apply for financial assistance. Illinois is a state that expanded its Medicaid program in 2014, allowing adults with incomes up to 138% of the Federal Poverty Level (FPL) to qualify for coverage. For those with incomes between 100% and 400% FPL, significant subsidies are available through GetCoveredIllinois to reduce monthly premiums and out-of-pocket costs, making Oscar Health plans more affordable.

Understanding Health Plan Options from Oscar Health in Herrin

Oscar Health, like other carriers on GetCoveredIllinois, offers plans across different metal tiers: Bronze, Silver, Gold, and Platinum. Each tier provides a different balance of monthly premiums versus out-of-pocket costs (deductibles, copayments, and coinsurance). Bronze Plans: Typically have the lowest monthly premiums but the highest deductibles and out-of-pocket maximums. They are designed for those who want protection against catastrophic medical costs. Silver Plans: Offer a moderate balance of premiums and out-of-pocket costs. These plans are particularly valuable for individuals who qualify for Cost-Sharing Reductions (CSRs), which are available to those with incomes up to 250% FPL, reducing deductibles and copays. Gold Plans: Feature higher monthly premiums but lower deductibles and out-of-pocket maximums. These are suitable for individuals who expect to use medical services frequently. Platinum Plans: Have the highest premiums but the lowest out-of-pocket costs, covering a large percentage of medical expenses. In Illinois, marketplace shoppers can choose from HMO, EPO, and PPO plan structures. PPO plans ARE available on-exchange, which is an important consideration as some states only offer HMO and EPO options on their marketplaces. Oscar Health's offerings in Herrin will include these plan types, allowing you to select a network structure that best fits your preferences for physician choice and referral requirements.

Health Insurance Carriers in Herrin

Residents of Herrin, Illinois, have a strong selection of health insurance carriers available through GetCoveredIllinois. In 2026, 5 carriers offer marketplace plans in Rating Area 4, which covers Grundy, Kankakee, Will, and Williamson counties. This competitive market helps ensure a variety of choices and price points for consumers. The confirmed carriers for Herrin and Rating Area 4 are:

Ambetter
Blue Cross and Blue Shield of Illinois
Molina Healthcare
Oscar Health
United Healthcare

When selecting a plan, it's important to compare not just the premiums but also the network of doctors and hospitals. Herrin residents rely on local facilities such as Herrin Hospital and Heartland Regional Medical Center in Marion, both located within Williamson County. Checking if your preferred providers are in-network with your chosen Oscar Health plan is a crucial step. Williamson County, with a population of 66,876 and an uninsured rate of 4.6% per U.S. Census Bureau ACS 2024 5-year estimates, is served by these carriers. The median household income in Herrin is $59,975, while the county-wide median income is $65,604, indicating that many residents may qualify for subsidies to help make coverage more affordable.

Eligibility for Financial Assistance and Medicaid in Illinois

Many Herrin residents may qualify for financial assistance to lower the cost of their health insurance. The Affordable Care Act (ACA) provides two main types of subsidies: Premium Tax Credits (PTCs): These reduce your monthly premium. Eligibility is based on household income, generally for those earning between 100% and 400% of the Federal Poverty Level (FPL). Cost-Sharing Reductions (CSRs): These lower your out-of-pocket costs, such as deductibles, copayments, and coinsurance. CSRs are available to individuals with incomes up to 250% FPL who enroll in a Silver-tier plan. Illinois expanded its Medicaid program in 2014. This means that adults in Herrin with household incomes up to 138% FPL may qualify for comprehensive, low-cost or no-cost health coverage through Illinois Medicaid. For example, a single individual earning up to approximately $20,783 per year (based on 2023 FPL, subject to annual updates) could be eligible. Illinois also offers robust coverage for specific populations:

Pregnant Women: Illinois Medicaid covers pregnant women with incomes up to 213% FPL, including prenatal care, labor, delivery, and 12 months of postpartum care. Applications can be made through ABE (abe.illinois.gov) or by calling the DHS helpline.
Children (CHIP): The Illinois All Kids program, the state's CHIP equivalent, provides low-cost coverage for children with incomes up to 313% FPL, making it one of the most expansive child coverage programs in the country.

How to Choose the Right Oscar Health Plan in Herrin

Choosing the right Oscar Health plan, or any plan, involves assessing your healthcare needs, budget, and preferred providers. Consider these steps: 1. Estimate Your Healthcare Usage: If you anticipate frequent doctor visits, prescription needs, or specialist care, a Gold or Platinum plan with lower out-of-pocket costs might save you money in the long run, despite higher premiums. If you mostly want coverage for emergencies, a Bronze plan could be sufficient. 2. Check Doctor and Hospital Networks: Verify that your current doctors, specialists, and local hospitals like Herrin Hospital are in-network with the Oscar Health plan you are considering. Out-of-network care can be significantly more expensive. 3. Understand Plan Types: Decide if an HMO (requires a primary care physician and referrals for specialists), EPO (no referrals needed, but limited to in-network providers), or PPO (more flexibility with out-of-network options at a higher cost) best suits your preferences. 4. Calculate Total Costs: Look beyond just the monthly premium. Factor in the deductible, copayments, coinsurance, and the out-of-pocket maximum to understand your potential total annual cost. 5. Apply for Subsidies: When applying through GetCoveredIllinois, accurately report your household income and size to determine your eligibility for premium tax credits and cost-sharing reductions. A licensed health insurance producer can provide personalized guidance, helping you compare Oscar Health plans and other options available in Herrin, ensuring you make an informed decision at no additional cost to you.

Frequently Asked Questions

Can I get Oscar Health insurance in Herrin, Illinois?

Yes, Oscar Health is one of 5 carriers offering marketplace health insurance plans in Herrin, Illinois, for the 2026 plan year. Plans are available through GetCoveredIllinois, the state'based health insurance marketplace.

What type of Oscar Health plans are available in Herrin?

Oscar Health, along with other carriers in Illinois, offers HMO, EPO, and PPO plan types through GetCoveredIllinois. PPO plans are available on-exchange in Illinois, giving Herrin residents a range of network options.

How do I enroll in an Oscar Health plan in Herrin?

You can enroll in an Oscar Health plan during the annual Open Enrollment Period through GetCoveredIllinois. If you experience a qualifying life event like marriage, birth, or losing other coverage, you may be eligible for a Special Enrollment Period. A licensed agent can assist you with the application process for free.

What is the uninsured rate in Herrin, Illinois?

The uninsured rate in Herrin, Illinois, is 4.6%, which is lower than the national average. This figure is based on U.S. Census Bureau ACS 2024 5-year estimates.