Oscar Health Insurance in Maywood, Illinois
- Oscar Health is one of 5 carriers offering marketplace plans in Maywood's Rating Area 1 for 2026.
- Maywood residents may qualify for Illinois Medicaid if their income is up to 138% of the Federal Poverty Level.
- In Maywood, 14.2% of the population is uninsured, per U.S. Census Bureau ACS 2024 5-year estimates.
- Plans are purchased through GetCoveredIllinois, the state-based marketplace, not HealthCare.gov.
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What Oscar Health Plans Are Available in Maywood?
In Maywood, Oscar Health participates in Illinois's state-based marketplace, GetCoveredIllinois. For the 2026 plan year, Oscar Health is one of the five carriers providing health insurance options in Rating Area 1, which encompasses all of Cook County. Typically, Oscar Health offers Health Maintenance Organization (HMO) and Exclusive Provider Organization (EPO) plans. Illinois is an expansion state where PPO plans are also available on-exchange from other carriers, giving Maywood shoppers a variety of plan structures to consider. HMO plans generally require you to select a primary care provider (PCP) within the Oscar Health network and obtain a referral from your PCP to see specialists. EPO plans offer more flexibility than HMOs, often without requiring referrals, but they still require you to stay within the carrier's network for covered services, except in emergencies. Both plan types focus on coordinated care within a defined network of doctors and hospitals, which includes facilities convenient to Maywood residents.Understanding Health Insurance Costs and Subsidies in Maywood
The cost of Oscar Health insurance plans in Maywood, like all marketplace plans, varies based on factors such as your age, household size, chosen plan tier (Bronze, Silver, Gold, Platinum), and whether you qualify for financial assistance. Fortunately, Illinois is a Medicaid expansion state, and robust subsidies are available through GetCoveredIllinois. For individuals and families in Maywood with incomes up to 400% of the Federal Poverty Level (FPL), premium tax credits can reduce the amount you pay each month for your health insurance. Additionally, those with incomes up to 250% FPL may qualify for cost-sharing reductions (CSRs) when they enroll in a Silver plan. CSRs lower your deductibles, copayments, and out-of-pocket maximums, making healthcare more affordable when you need it. For example, a single person earning $35,000 per year (around 250% FPL) would likely qualify for significant premium tax credits and cost-sharing reductions, making a Silver plan much more accessible.| Plan Tier | Estimated Monthly Premium (Before Subsidies) | Potential Monthly Premium (With Subsidies, ~250% FPL) |
|---|---|---|
| Bronze | $350 - $450 | $50 - $150 |
| Silver | $450 - $600 | $70 - $200 |
| Gold | $550 - $750 | $200 - $400 |
| These are estimates; actual costs depend on specific plan, age, income, and household size. | ||
Illinois Medicaid and CHIP for Maywood Residents
Illinois expanded its Medicaid program in 2014, known as Illinois Medicaid, which provides comprehensive health coverage for adults with household incomes up to 138% of the Federal Poverty Level. This means that if your income falls within this range, you may qualify for free or low-cost health insurance through Illinois Medicaid, rather than facing a coverage gap. For pregnant women, Illinois Medicaid offers coverage with income up to 213% FPL, one of the highest thresholds among production states. This coverage includes prenatal care, labor, delivery, and an extended 12 months of postpartum care, enacted under the American Rescue Plan. Children in Maywood can receive coverage through Illinois All Kids (the state's CHIP equivalent) with household incomes up to 313% FPL, making it one of the most expansive child coverage programs nationally. Applications for these programs can be submitted through ABE (abe.illinois.gov) or by calling the DHS helpline.Health Insurance Carriers in Maywood
Residents of Maywood, Illinois are part of Rating Area 1, which includes all of Cook County. In 2026, 5 carriers offer marketplace plans in Rating Area 1, providing a competitive selection of options. Oscar Health is one of these providers. The full list of confirmed carriers for this rating area includes:- Ambetter
- Blue Cross and Blue Shield of Illinois
- Molina Healthcare
- Oscar Health
- United Healthcare
How to Enroll in Oscar Health Insurance in Maywood
Enrolling in an Oscar Health plan in Maywood involves navigating the GetCoveredIllinois marketplace. The primary enrollment period is during Open Enrollment, which typically runs from November 1st to January 15th each year for coverage beginning the following year. However, you may also qualify for a Special Enrollment Period (SEP) if you experience certain life events, such as:- Losing existing health coverage (e.g., due to job loss, aging off a parent's plan)
- Getting married or divorced
- Having a baby, adopting a child, or placing a child for foster care
- Moving to a new ZIP code or county
- Changes in income that affect your eligibility for subsidies
Frequently Asked Questions
Can I get Oscar Health insurance through GetCoveredIllinois?
Yes, Oscar Health offers health insurance plans on the GetCoveredIllinois marketplace for residents of Maywood and other areas within Rating Area 1 (Cook County). You can enroll during the annual Open Enrollment Period or if you qualify for a Special Enrollment Period.
What types of plans does Oscar Health offer in Maywood?
Oscar Health typically offers HMO (Health Maintenance Organization) and EPO (Exclusive Provider Organization) plans in Illinois. These plans require you to choose a primary care provider within their network and generally need referrals for specialists in HMOs, while EPOs offer more flexibility but still require in-network care.
Is Oscar Health a good option for people in Maywood who need financial assistance?
Oscar Health plans purchased through GetCoveredIllinois are eligible for premium tax credits and cost-sharing reductions, which can significantly lower monthly premiums and out-of-pocket costs for eligible individuals and families in Maywood. Eligibility is based on household income relative to the Federal Poverty Level.