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More than 1.5 million people in Illinois who were uninsured in 2013 are now are guaranteed access to affordable, quality health insurance coverage. Consumers now need to understand how to navigate the healthcare system and the new health insurance marketplace in order to access coverage, and make use of the healthcare protections and benefits now available.




 Q:   Why am I receiving letters saying I have to choose a plan and a primary care physician?

 A:     Illinois state law requires that 50% of Medicaid beneficiaries are enrolled into coordinated care by 2015. This means that a managed care organization (health insurance company) or provider group will be coordinating your physical and behavioral healthcare. A primary care physician will refer you to appropriate services and will typically be the first person you go to for healthcare. If you plan to enroll and have received letters in the mail you should go to or call the client enrollment broker at 1-877-912-8880 to pick a plan. If you want to learn more about coordinated care in Illinois please visit our Medicaid Care Coordination section.

 Q:   Can a health insurance policy be purchased on the marketplace at any time?  

 A:     No. You can purchase a plan at during open enrollment or if you qualify for a special enrollment period. The next open enrollment period starts November 15th. However, if you experience a qualifying life event like having a baby, getting married, or moving, you may qualify for a special enrollment period. To find out if you qualify for a special enrollment period answer the questions on the screening tool.

More questions answered

Do you have questions about issues like how health care reform impacts people with disabilities or children with pre-existing conditions? Learn from the experiences of others—or, submit your question here.

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Individual & Family Resources


Financial Assistance in the Marketplace

This October 2014 brief explains two types of financial assistance lower and moderate income families may be eligible for when purchasing health plans on the health insurance marketplace: the premium tax credit and cost-sharing subsidies.

Medical Cost Calculator

Use the FAIR Health Medical Cost Lookup to estimate your out-of-pocket costs according to what healthcare professionals commonly charge for a wide range of medical procedures, services and supplies. This can help in picking a health plan and budgeting for possible healthcare expenses.

5 Steps to Staying Covered

Once you have health coverage through the marketplace, it is important to review your plan and your health care needs in order to decide whether you need to change your plan for 2015. This CMS handout is full of tips to help you decide by December 15, 2014 if you need to change your coverage, and to make sure you get the right coverage at the best price.

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