Is Oscar Health insurance available in Lombard, Illinois?

Yes, Oscar Health is one of the five health insurance carriers offering marketplace plans in Lombard, Illinois, for the 2026 plan year. Lombard is part of Illinois Rating Area 2, which also covers Kane County.

What types of plans does Oscar Health offer on GetCoveredIllinois?

Oscar Health, like other carriers on GetCoveredIllinois, typically offers various plan types, including Health Maintenance Organizations (HMOs) and Exclusive Provider Organizations (EPOs). Illinois is one of the states where PPO plans are also available on-exchange, giving consumers more choices.

Can I get financial assistance for Oscar Health plans in Lombard?

Yes, if your household income falls between 100% and 400% of the Federal Poverty Level (FPL), you may qualify for premium tax credits and cost-sharing reductions when enrolling in an Oscar Health plan through GetCoveredIllinois. Illinois residents with income up to 138% FPL may qualify for Illinois Medicaid.

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

You can enroll in an Oscar Health plan or any other marketplace plan through GetCoveredIllinois, the state's official health insurance marketplace. Enrollment typically takes place during the annual Open Enrollment Period, or during a Special Enrollment Period if you experience a qualifying life event.

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

Oscar Health Insurance in Lombard, Illinois

Oscar Health is one of 5 carriers offering marketplace plans in Lombard, IL for the 2026 plan year.
Lombard is part of Illinois Rating Area 2, which includes DuPage and Kane counties.
Illinois residents with income up to 138% FPL may qualify for Illinois Medicaid; pregnant women up to 213% FPL.
PPO plans ARE available on the GetCoveredIllinois marketplace, alongside HMO and EPO options.

If you're looking for health insurance options in Lombard, Illinois, Oscar Health is among the five carriers providing marketplace plans in your area for the 2026 plan year. As a resident of Lombard, which is located in DuPage County and part of Illinois Rating Area 2, you have access to a range of choices through GetCoveredIllinois, the state's official health insurance marketplace. These plans offer comprehensive benefits, and many residents qualify for significant financial assistance to make coverage more affordable. Understanding your options, including plan types like HMOs, EPOs, and PPOs, and how subsidies can reduce your costs, is key to finding the right fit for your healthcare needs.

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What Oscar Health Plans Are Available in Lombard?

Oscar Health offers various health insurance plans through GetCoveredIllinois, tailored to meet different needs and budgets. While specific plan details can vary annually, Oscar Health typically provides Health Maintenance Organization (HMO) and Exclusive Provider Organization (EPO) plans. In Illinois, unlike some other states, PPO plans are also available on-exchange, with carriers like Blue Cross and Blue Shield of Illinois offering them. This means marketplace shoppers in Lombard have a broader selection, including plans that may offer more flexibility in choosing healthcare providers outside a defined network. When considering an Oscar Health plan, it's important to compare it with offerings from other carriers in Rating Area 2, such as Ambetter, Blue Cross and Blue Shield of Illinois, Molina Healthcare, and United Healthcare. Each carrier will have different network sizes, formularies (covered prescription drugs), and cost-sharing structures (deductibles, copays, coinsurance). You can compare these plans directly on the GetCoveredIllinois website or with the help of a licensed agent.

Understanding Your Health Insurance Options in Lombard

Lombard, Illinois, a city with a population of 43,619 and a median income of $100,362 (per U.S. Census Bureau ACS 2024 5-year estimates), offers its residents a robust health insurance marketplace. For 2026, 5 carriers offer marketplace plans in Illinois Rating Area 2, which covers DuPage and Kane counties. Beyond Oscar Health, these include:

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

These carriers provide plans across different metal tiers: Bronze, Silver, Gold, and Platinum. Each tier represents a different balance between monthly premiums and out-of-pocket costs when you receive care.

Bronze plans typically have the lowest 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 moderate premiums and out-of-pocket costs. They are particularly valuable for individuals and families who qualify for Cost-Sharing Reductions (CSRs), which are only available with Silver plans and lower your deductibles, copays, and out-of-pocket maximums.
Gold plans feature higher premiums but lower deductibles and out-of-pocket costs when you use care. These are suitable for those who anticipate needing more medical services throughout the year.
Platinum plans have the highest premiums but the lowest out-of-pocket costs, covering approximately 90% of your medical expenses on average.

Financial Assistance for Lombard Residents

Many Lombard residents qualify for financial assistance to make health insurance more affordable. This assistance comes primarily in two forms:

Premium Tax Credits (Subsidies): These credits reduce your monthly premium payments. Eligibility is based on your household income relative to the Federal Poverty Level (FPL). For 2026, individuals and families with incomes between 100% and 400% FPL may qualify.
Cost-Sharing Reductions (CSRs): These are available to those with incomes up to 250% FPL and further reduce your out-of-pocket costs like deductibles, copayments, and coinsurance. CSRs are only applicable to Silver-tier plans.

Illinois also has an expanded Medicaid program. Adults with income up to 138% FPL may qualify for Illinois Medicaid, which provides comprehensive coverage with little to no cost. Illinois Medicaid also covers pregnant women with income up to 213% FPL, providing extensive prenatal, delivery, and 12 months of postpartum care. Children in Illinois may qualify for the All Kids (CHIP equivalent) program with household incomes up to 313% FPL, making it one of the most expansive child coverage programs in the country. Applications for Medicaid and CHIP can be made through ABE (abe.illinois.gov) or by calling the DHS helpline.

Lombard, located in DuPage County, benefits from being part of Illinois Rating Area 2, which ensures a competitive marketplace with five confirmed carriers for 2026. While DuPage County itself has no acute care hospitals within its boundaries, residents of Lombard, with an uninsured rate of 4.8% and a poverty rate of 7.2% (per U.S. Census Bureau ACS 2024 5-year estimates), typically travel to neighboring counties for their acute medical needs. This context is important when selecting a plan, as network coverage for hospitals in adjacent areas will be a key consideration.

Choosing the Right Oscar Health Plan in Lombard

When selecting a health plan, whether from Oscar Health or another carrier, consider the following:

Your Healthcare Needs: If you have specific doctors or specialists, check if they are in the plan's network. If you anticipate frequent medical visits or have chronic conditions, a Gold or Platinum plan with lower out-of-pocket costs might be more economical in the long run, despite higher premiums.
Budget: Compare monthly premiums against potential out-of-pocket costs. If you qualify for subsidies, factor those into your premium calculation. If eligible for CSRs, a Silver plan can offer excellent value.
Prescription Medications: Verify that your essential medications are covered by the plan's formulary.
Plan Type (HMO, EPO, PPO): HMOs typically require you to choose a primary care physician (PCP) and get referrals for specialists. EPOs offer more flexibility than HMOs but usually don't cover out-of-network care. PPOs offer the most flexibility, allowing you to see specialists without referrals and often providing some coverage for out-of-network providers, though at a higher cost.

The annual Open Enrollment Period is your primary opportunity to enroll in or change marketplace plans. However, if you experience a qualifying life event such as losing other coverage, getting married, having a baby, or moving to Lombard, you may be eligible for a Special Enrollment Period.

Frequently Asked Questions

Is Oscar Health a good insurance company in Illinois?

Oscar Health is one of five carriers offering plans in Lombard, Illinois, for the 2026 plan year. "Good" is subjective and depends on individual needs, network preferences, and budget. It's recommended to compare Oscar Health's specific plan offerings, provider network, and cost-sharing details with other available carriers like Ambetter and Blue Cross and Blue Shield of Illinois on GetCoveredIllinois.

Can I keep my doctor with an Oscar Health plan in Lombard?

Whether you can keep your specific doctor depends on if they are part of Oscar Health's provider network in Illinois Rating Area 2. Before enrolling, it's crucial to check the plan's provider directory to confirm your preferred doctors, specialists, and any hospitals you frequent are in-network. This is especially important for HMO and EPO plans, which typically do not cover out-of-network care.

What is the Open Enrollment Period for Oscar Health plans in Illinois?

The Open Enrollment Period for 2026 marketplace plans, including those from Oscar Health, typically runs from November 1st through January 15th each year. During this time, anyone can enroll in a new plan or change their existing coverage through GetCoveredIllinois. Outside of this period, you generally need a qualifying life event to enroll.

Does Oscar Health cover mental health services?

Under the Affordable Care Act (ACA), all marketplace plans, including those offered by Oscar Health, are required to cover essential health benefits, which include mental health and substance use disorder services. This means Oscar Health plans will cover services such as therapy, counseling, and inpatient mental health care, often subject to the plan's deductible, copay, and coinsurance.