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

Oscar Health Insurance in Round Lake Beach, Illinois

Oscar Health is one of 5 carriers offering marketplace plans in Round Lake Beach's Rating Area 3 for 2026.
Illinois expanded Medicaid in 2014, covering adults up to 138% of the Federal Poverty Level (FPL), which is $20,380 for an individual in 2026.
Round Lake Beach has a population of 27,079 and an uninsured rate of 15.6%, according to U.S. Census Bureau ACS 2024 5-year estimates.
Marketplace plans in Illinois include HMO, EPO, and PPO options, allowing residents to choose the network structure that best fits their needs.

If you're looking for health insurance options in Round Lake Beach, Illinois, Oscar Health is one of the carriers available to you through GetCoveredIllinois, the state's official health insurance marketplace. As a resident of Round Lake Beach, you reside in Rating Area 3, which encompasses both Lake and McHenry counties. This means you have access to a selection of plans from multiple providers, including Oscar Health, with potential financial assistance to lower your monthly premiums and out-of-pocket costs. Understanding your choices and how subsidies work can help you find an affordable plan that meets your healthcare needs.

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What Health Insurance Options Does Oscar Health Offer in Round Lake Beach?

Oscar Health offers various health insurance plans in Round Lake Beach through GetCoveredIllinois. These plans typically fall into categories like Health Maintenance Organization (HMO) and Exclusive Provider Organization (EPO) plans. HMOs generally require you to choose a primary care physician (PCP) within their network and get referrals for specialists, while EPOs offer more flexibility but still require you to stay within their network for covered services. When selecting a plan, consider factors such as the monthly premium, deductible, copayments, and coinsurance. It's also crucial to verify if your preferred doctors, specialists, and local hospitals, such as Vista Medical Center East in Waukegan or Advocate Condell Medical Center in Libertyville, are included in Oscar Health's network. Illinois allows marketplace shoppers to choose from HMO, EPO, and PPO plans, so you can compare Oscar Health's offerings with other carriers to find the right balance of cost and network access.

Understanding Subsidies and Affordability in Illinois

Many Round Lake Beach residents qualify for financial assistance, known as subsidies, to make health insurance more affordable. These subsidies come in two main forms:

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

Illinois expanded Medicaid in 2014, meaning adults with household incomes up to 138% FPL may qualify for Illinois Medicaid, which offers comprehensive coverage with little to no cost. For example, an individual earning up to approximately $20,380 in 2026 would likely be eligible for Medicaid instead of marketplace subsidies. Pregnant women in Illinois may qualify for Medicaid with incomes up to 213% FPL, and children through Illinois All Kids (CHIP equivalent) up to 313% FPL.

Health Insurance Carriers in Round Lake Beach

In 2026, 5 carriers offer marketplace plans in Rating Area 3, which covers Lake and McHenry counties, including Round Lake Beach. This provides a competitive market with a variety of 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

Round Lake Beach, with a population of 27,079 and an uninsured rate of 15.6% per U.S. Census Bureau ACS 2024 5-year estimates, faces a higher uninsured rate than Lake County's 6.9%. Access to multiple carriers on GetCoveredIllinois, offering HMO, EPO, and PPO plan types, is crucial for improving coverage rates in the area. Lake County's major hospitals, such as Northwestern Lake Forest Hospital and Advocate Good Shepherd Hospital, are important considerations when evaluating provider networks.

Choosing the Right Oscar Health Plan in Round Lake Beach

Selecting the best Oscar Health plan depends on your individual and family healthcare needs, as well as your budget. Consider these steps:

Assess Your Healthcare Needs: If you visit the doctor frequently or take prescription medications, a plan with lower out-of-pocket costs (like a Gold or Silver plan with CSRs) might be more cost-effective, even with a higher premium. If you're generally healthy and prefer a lower monthly payment, a Bronze or Catastrophic plan might be suitable, but be aware of higher deductibles.
Check Provider Networks: Ensure that your preferred doctors, specialists, and hospitals in Lake County are in Oscar Health's network. This is especially important for HMO and EPO plans.
Understand Costs: Compare premiums, deductibles, copayments, and maximum out-of-pocket limits across different Oscar Health plans and other carriers. Remember to factor in potential subsidies from GetCoveredIllinois.
Utilize Digital Tools: Oscar Health is known for its technology-driven approach, offering apps and online tools to manage your health and benefits. If digital convenience is a priority, this may be a good fit.

For personalized guidance, a licensed health insurance producer can help you navigate the options, confirm eligibility for subsidies, and enroll in a plan that's right for you at no additional cost.

Frequently Asked Questions

Can I get Oscar Health insurance in Round Lake Beach?

Yes, Oscar Health is one of five carriers offering marketplace health insurance plans in Rating Area 3, which includes Round Lake Beach and McHenry County, for the 2026 plan year. You can compare their options alongside other carriers on GetCoveredIllinois.

What types of plans does Oscar Health offer in Illinois?

Oscar Health typically offers HMO (Health Maintenance Organization) and EPO (Exclusive Provider Organization) plans in Illinois, focusing on integrated care and digital tools. PPO plans are also available on GetCoveredIllinois from other carriers like Blue Cross and Blue Shield of Illinois.

How do I apply for Oscar Health insurance in Round Lake Beach?

You can apply for Oscar Health plans, and other marketplace plans, through GetCoveredIllinois, the official state-based marketplace for Illinois. You may qualify for subsidies based on your household income and size, which can significantly reduce your monthly premiums.

What is the uninsured rate in Round Lake Beach?

According to U.S. Census Bureau ACS 2024 5-year estimates, Round Lake Beach has an uninsured rate of 15.6%. This is higher than the Lake County average of 6.9%, highlighting the importance of exploring affordable coverage options through GetCoveredIllinois.