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

Oscar Health Insurance in North Chicago, Illinois

Oscar Health is one of 5 carriers offering marketplace health plans in North Chicago for the 2026 plan year, serving Lake and McHenry counties in Rating Area 3.
Illinois utilizes its own state-based marketplace, GetCoveredIllinois, for enrollment in plans from Oscar Health and other carriers.
North Chicago residents with incomes up to 400% of the Federal Poverty Level (FPL) may qualify for Premium Tax Credits to lower monthly premiums.
Illinois expanded Medicaid in 2014, making adults with incomes up to 138% FPL eligible for comprehensive coverage through Illinois Medicaid.

For residents of North Chicago, Illinois, securing health insurance from Oscar Health means navigating the state's marketplace, GetCoveredIllinois. Oscar Health is a confirmed carrier in Rating Area 3, which encompasses both Lake and McHenry counties, offering various plans designed to meet different healthcare needs and budgets. Understanding your options, eligibility for financial assistance, and how Oscar Health's network integrates with local healthcare providers like Vista Medical Center East in Waukegan are crucial steps in choosing the right coverage. Illinois offers a robust marketplace where you can compare plans from multiple insurers, including Oscar Health, to find one that fits your specific situation.

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What Oscar Health Plans Are Available in North Chicago?

In North Chicago, as part of Illinois Rating Area 3, Oscar Health offers health insurance plans through GetCoveredIllinois. Typically, Oscar Health provides Health Maintenance Organization (HMO) and Exclusive Provider Organization (EPO) plans. HMO plans usually require you to select a primary care provider (PCP) within the network and obtain referrals for specialist visits. EPO plans also use a network of providers, but often do not require referrals for specialists, though out-of-network care is generally not covered except in emergencies. Illinois is unique in that PPO plans ARE available on-exchange, with carriers like Blue Cross and Blue Shield of Illinois offering them alongside HMO and EPO options. This means North Chicago residents have a comprehensive range of plan types to choose from on GetCoveredIllinois, allowing for greater flexibility in provider choice depending on the plan structure. When considering Oscar Health, it is important to review their specific plan documents to understand network rules, deductibles, copayments, and out-of-pocket maximums.

How to Qualify for Financial Assistance with Oscar Health Plans

Financial assistance is available to make health insurance more affordable for many North Chicago residents. These subsidies are offered through GetCoveredIllinois and can significantly reduce the cost of Oscar Health plans. There are two main types of financial help:

Premium Tax Credits (PTC): These credits reduce your monthly premium payments. Eligibility is based on household income relative to the Federal Poverty Level (FPL). In Illinois, individuals and families earning between 100% and 400% FPL may qualify for these credits. For example, a single individual in North Chicago earning up to approximately $60,000 annually (400% FPL) could be eligible for a subsidy in 2026.
Cost-Sharing Reductions (CSR): These are additional savings that lower your out-of-pocket costs, such as deductibles, copayments, and coinsurance. CSRs are available to individuals and families with incomes up to 250% FPL and are only applied to Silver-tier plans, making them a highly valuable option for those who qualify.

Illinois expanded Medicaid in 2014, meaning adults with incomes up to 138% FPL (approximately $20,780 for an individual in 2026) may qualify for Illinois Medicaid. This program provides comprehensive health coverage with little to no cost. Pregnant women in Illinois have a higher Medicaid eligibility threshold, up to 213% FPL, and children are covered up to 313% FPL through Illinois All Kids (CHIP equivalent). Applications for Illinois Medicaid can be submitted through ABE (abe.illinois.gov) or by calling the DHS helpline.

Health Insurance Carriers in North Chicago

In 2026, 5 carriers offer marketplace plans in Rating Area 3, which covers Lake and McHenry counties, including North Chicago. These carriers provide a range of plan types, including HMO, EPO, and PPO options, ensuring competitive choices for residents. The confirmed carriers for this rating area are:

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

When choosing a plan, it is important to consider not only the monthly premium but also the plan's network, deductibles, copayments, and out-of-pocket maximums. Oscar Health, like other carriers, has a specific network of providers. Major acute care hospitals in Lake County include Vista Medical Center East in Waukegan, Midwestern Region Med Center, Inc in Zion, Northwestern Lake Forest Hospital in Lake Forest, Advocate Condell Medical Center in Libertyville, and Advocate Good Shepherd Hospital in Barrington. If you have preferred doctors or hospitals, verify their inclusion in your chosen plan's network before enrolling. Lake County, the parent county for North Chicago, has a population of 714,223, with a median age of 39.1 years and an uninsured rate of 6.9%, per U.S. Census Bureau ACS 2024 5-year estimates. North Chicago itself has a population of 30,643 and an uninsured rate of 13.2%, per U.S. Census Bureau ACS 2024 5-year estimates. Understanding these local factors helps contextualize the available health insurance landscape.

Choosing the Right Oscar Health Plan for Your Needs

Selecting the best Oscar Health plan or any other marketplace plan involves evaluating your specific healthcare needs and financial situation. Here's a decision-making framework:

If your income is below 138% FPL: You likely qualify for Illinois Medicaid. This is the most comprehensive and lowest-cost option. Apply through ABE (abe.illinois.gov).
If your income is between 100% and 250% FPL: Focus on Silver-tier plans with Cost-Sharing Reductions (CSRs). These plans offer the best value by significantly lowering your out-of-pocket costs in addition to reducing your monthly premiums with Premium Tax Credits.
If your income is between 250% and 400% FPL: You are eligible for Premium Tax Credits. Compare Bronze, Silver, Gold, and Platinum plans. Bronze plans have lower premiums but higher deductibles, suitable if you expect minimal healthcare use. Gold and Platinum plans have higher premiums but lower out-of-pocket costs, ideal for those with chronic conditions or anticipated medical needs.
If your income is above 400% FPL: You will pay the full premium, but can still enroll in any marketplace plan. It is still beneficial to compare plans on GetCoveredIllinois to find the best fit for your budget and healthcare needs.

Consider your anticipated medical expenses, prescription drug needs, and preferred doctors and hospitals. Always verify that your current providers are in-network for any Oscar Health plan you are considering. A licensed health insurance producer can provide personalized guidance at no additional cost, helping you navigate these choices and enroll in the best plan for you and your family.

Frequently Asked Questions

Can I get Oscar Health insurance through GetCoveredIllinois?

Yes, Oscar Health is one of 5 carriers offering plans on the GetCoveredIllinois marketplace for residents of North Chicago and Lake County in Rating Area 3 for the 2026 plan year. You can compare their plans with other available carriers directly through the state exchange.

What types of Oscar Health plans are available in North Chicago?

Oscar Health typically offers HMO and EPO plans in Illinois. These plans usually require you to choose a primary care provider (PCP) within their network and get referrals for specialists with HMOs. PPO plans are also available on GetCoveredIllinois from other carriers, offering more flexibility.

How do I know if I qualify for financial help with Oscar Health plans?

Eligibility for subsidies (Premium Tax Credits and Cost-Sharing Reductions) is based on your household income relative to the Federal Poverty Level (FPL). In Illinois, individuals and families earning between 100% and 400% FPL may qualify for tax credits to lower monthly premiums. Cost-sharing reductions are available for incomes up to 250% FPL, reducing deductibles and copays.

What hospitals in Lake County work with Oscar Health plans?

Oscar Health plans utilize a specific network of doctors and hospitals. While specific network details can vary by plan, Lake County is served by major acute care facilities such as Vista Medical Center East in Waukegan, Northwestern Lake Forest Hospital, and Advocate Condell Medical Center in Libertyville. It is crucial to verify that your preferred doctors and hospitals, including these, are in-network for any Oscar Health plan you consider before enrolling.