Can I get health insurance if I'm self-employed in Tazewell County?

Yes, self-employed individuals in Tazewell County can purchase health insurance through GetCoveredIllinois, the state's official health insurance marketplace. You may qualify for significant subsidies based on your household income, making coverage more affordable. Plans include HMO, EPO, and PPO options.

What are the income limits for health insurance subsidies in Illinois?

There is no upper income limit for marketplace subsidies in Illinois. Eligibility for tax credits (subsidies) is based on your household income relative to the cost of a benchmark Silver plan in your area. If the premium for the benchmark plan exceeds 8.5% of your household income, you will qualify for subsidies to reduce your costs, regardless of how high your income is.

Does Illinois Medicaid cover self-employed individuals?

Illinois expanded Medicaid in 2014, making it available to adults, including the self-employed, with household incomes up to 138% of the Federal Poverty Level (FPL). For 2026, this threshold is approximately $20,783 for an individual. If your income falls within this range, you may qualify for comprehensive, low-cost coverage through Illinois Medicaid.

What types of health plans are available for the self-employed in Tazewell County?

In Tazewell County, self-employed individuals can choose from Health Maintenance Organization (HMO), Exclusive Provider Organization (EPO), and Preferred Provider Organization (PPO) plans through GetCoveredIllinois. PPO plans are available on-exchange in Illinois, offering more flexibility in choosing providers without a referral.

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

Self-Employed Health Insurance in Tazewell County, Illinois

Self-employed individuals in Tazewell County can access health insurance through GetCoveredIllinois, the state's official marketplace.
In 2026, 5 carriers offer marketplace plans in Rating Area 7, which includes Tazewell County, providing HMO, EPO, and PPO options.
Illinois expanded Medicaid, offering coverage to adults with incomes up to 138% of the Federal Poverty Level (approximately $20,783 for an individual in 2026).
Subsidies are available to reduce monthly premiums and out-of-pocket costs, with no income cap for eligibility, based on the cost of a benchmark plan.

Navigating health insurance as a self-employed individual in Tazewell County, Illinois, offers a range of options, primarily through GetCoveredIllinois, the state-based marketplace. Unlike traditional employer-sponsored plans, self-employed health insurance requires you to select and manage your own coverage. Fortunately, the Affordable Care Act (ACA) provides robust consumer protections and financial assistance, making quality health insurance accessible and often affordable. Whether you're a freelancer, small business owner, or independent contractor, understanding your choices for plans like HMOs, EPOs, and PPOs, as well as potential subsidies or Medicaid eligibility, is key to securing the right coverage for yourself and your family.

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How Do Self-Employed Individuals Get Health Insurance in Tazewell County?

For most self-employed individuals in Tazewell County, the primary avenue for obtaining health insurance is through GetCoveredIllinois, the official state health insurance marketplace. This platform allows you to compare various plans, determine your eligibility for financial assistance, and enroll in coverage. Marketplace plans are mandated to cover essential health benefits, including doctor visits, prescription drugs, mental health care, and maternity care, without annual or lifetime limits. When you apply through GetCoveredIllinois, you'll provide information about your household income and size. This data is used to calculate your eligibility for two main types of financial assistance:

Premium Tax Credits (Subsidies): These reduce your monthly premium payments. Eligibility is based on a sliding scale, and there is no income cap if the cost of a benchmark Silver plan exceeds 8.5% of your household income.
Cost-Sharing Reductions (CSRs): These lower your out-of-pocket costs like deductibles, copayments, and coinsurance. CSRs are only available if you enroll in a Silver-tier plan and have an income up to 250% of the Federal Poverty Level (FPL).

If your income is below 138% FPL, you may qualify for Illinois Medicaid, a free or very low-cost health program, as Illinois expanded its Medicaid program in 2014.

What Health Plan Options Are Available for the Self-Employed in Illinois?

In Illinois, self-employed individuals have a variety of plan types to choose from through GetCoveredIllinois. Tazewell County is part of Illinois Rating Area 7, which covers Adams, Bond, Brown, Calhoun, Cass, Champaign, Clinton, Fulton, Greene, Hancock, Henderson, Jersey, Knox, Logan, Macoupin, Madison, Mason, McDonough, McLean, Menard, Morgan, Peoria, Pike, Sangamon, Schuyler, Scott, St. Clair, Tazewell, Warren, Woodford counties. The available plan types include:

Health Maintenance Organization (HMO): These plans typically require you to choose a primary care provider (PCP) within the plan's network and get referrals from your PCP to see specialists. HMOs often have lower monthly premiums.
Exclusive Provider Organization (EPO): EPO plans offer a network of doctors and hospitals, but generally do not require a referral to see a specialist. However, they typically won't cover care outside of their network, except in emergencies.
Preferred Provider Organization (PPO): PPO plans offer more flexibility. You don't need a PCP referral to see a specialist, and you can usually get care outside the plan's network, though you'll pay more for it. PPO plans ARE available on-exchange in Illinois, including options from Blue Cross and Blue Shield of Illinois, providing marketplace shoppers in Tazewell County with diverse choices.

Plans are also categorized by "metal tiers" (Bronze, Silver, Gold, Platinum) which indicate how you and your plan share costs. Bronze plans have the lowest premiums but highest out-of-pocket costs, while Platinum plans have the highest premiums and lowest out-of-pocket costs. Silver plans are unique because they are the only tier eligible for Cost-Sharing Reductions (CSRs), which significantly lower deductibles and copays for eligible individuals.

Understanding Income and Eligibility for Self-Employed Coverage

Your household income is a critical factor in determining your eligibility for financial assistance. For self-employed individuals, "Modified Adjusted Gross Income" (MAGI) is used for ACA subsidy and Medicaid eligibility. This includes your net self-employment income (gross income minus business expenses), wages, and other taxable income. In Tazewell County, Illinois, the median income is $77,982, per U.S. Census Bureau ACS 2024 5-year estimates. Eligibility for subsidies is not capped by income in Illinois. If the premium for the benchmark Silver plan in Rating Area 7 exceeds 8.5% of your household income, you will qualify for premium tax credits. Consider these income thresholds for 2026 (approximate, based on 2025 FPLs for a single individual):

Approximate 2026 FPL%	Approximate Annual Income (Individual)	Potential Eligibility
Below 138% FPL	Under $20,783	Illinois Medicaid
138% - 250% FPL	$20,783 - $37,640	Significant Premium Tax Credits + Cost-Sharing Reductions (Silver plan required for CSRs)
250% - 400% FPL	$37,640 - $60,220	Premium Tax Credits
Above 400% FPL	Above $60,220	Premium Tax Credits (if benchmark plan premium > 8.5% of income)

For self-employed individuals, it's important to accurately estimate your net income for the upcoming year, as this will determine your subsidy amount. If your actual income differs significantly from your estimate, you may need to adjust your subsidies during the year to avoid owing money back at tax time or missing out on credits you were due. Tazewell County, with a population of 130,290 and an uninsured rate of 5.1% per U.S. Census Bureau ACS 2024 5-year estimates, is part of Illinois Rating Area 7. This rating area includes 30 counties, ensuring a competitive marketplace for health plans. The county is served by Carle Health Pekin Hospital in Pekin, providing essential acute care services to residents.

Health Insurance Carriers in Tazewell County

In 2026, 5 carriers offer marketplace plans in Rating Area 7, which serves Tazewell County. These carriers provide a range of plan options across different metal tiers (Bronze, Silver, Gold, Platinum) and plan types (HMO, EPO, PPO), ensuring competition and choice for self-employed individuals. The confirmed carriers for Tazewell County are:

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

When selecting a plan, consider not only the monthly premium but also the network of doctors and hospitals. Verify that your preferred providers, including Carle Health Pekin Hospital, are in-network with the plan you choose.

Making Your Health Insurance Decision for Self-Employment

Choosing the right health insurance plan as a self-employed individual in Tazewell County involves weighing several factors, including your income, health needs, and budget.

If your income is below 138% FPL (approx. $20,783 for an individual): You will likely qualify for Illinois Medicaid. Apply through ABE (abe.illinois.gov) or call the DHS helpline. Illinois Medicaid provides comprehensive coverage at no or very low cost. Additionally, Illinois Medicaid covers pregnant women with income up to 213% FPL and children up to 313% FPL through Illinois All Kids.
If your income is between 138% and 250% FPL: You are eligible for significant premium tax credits and cost-sharing reductions. Enrolling in a Silver plan is highly recommended, as CSRs dramatically lower your out-of-pocket costs, making Silver plans a better value than Gold or even Bronze for many in this income bracket.
If your income is above 250% FPL: You will still qualify for premium tax credits if the benchmark Silver plan costs more than 8.5% of your income. Evaluate Bronze, Silver, and Gold plans based on your expected healthcare usage. If you anticipate frequent doctor visits or needing specialists, a Gold plan might offer lower overall costs despite a higher premium. If you prefer lower monthly payments and are generally healthy, a Bronze plan combined with an HSA might be suitable.

Working with a licensed health insurance producer can simplify this process. They can help you accurately estimate your income, compare plans from Ambetter, Blue Cross and Blue Shield of Illinois, Molina Healthcare, Oscar Health, and United Healthcare, and ensure you receive all eligible subsidies. This service is typically free to you.

Frequently Asked Questions

Can I deduct health insurance premiums if I'm self-employed?

Yes, if you are self-employed and not eligible to participate in an employer-sponsored health plan (including your spouse's), you can generally deduct the premiums you pay for health insurance for yourself, your spouse, and your dependents. This deduction is taken as an adjustment to income, rather than an itemized deduction, which can reduce your taxable income.

What if my self-employment income fluctuates?

Fluctuating self-employment income can impact your subsidies. It's crucial to estimate your annual income as accurately as possible when applying through GetCoveredIllinois. If your income changes significantly during the year, you should update your information on the marketplace. This helps ensure you receive the correct amount of financial assistance and avoid owing money back or missing out on credits at tax time.

Are short-term health plans an option for the self-employed in Tazewell County?

While short-term health plans may be available, they are not regulated by the ACA and do not offer the same comprehensive benefits or consumer protections. They often have limitations on coverage, such as not covering pre-existing conditions or essential health benefits. For most self-employed individuals, ACA-compliant plans through GetCoveredIllinois are a more secure and comprehensive option, especially with the availability of subsidies.

What happens if I start a small business and want to offer employee health insurance?

If you start a small business with employees, you might explore the Small Business Health Options Program (SHOP) marketplace, or work directly with an insurance carrier. Small businesses can often qualify for Small Business Health Care Tax Credits to help offset the cost of premiums. A licensed agent can guide you through setting up group health insurance for your employees.