Exchange
Get Covered Illinois
State-based exchange
Medicaid Expansion
✅ Expanded
Adults up to 138% FPL eligible
Avg. Benchmark Premium
$500/mo
Age 40, Silver plan
Illinois ACA Health Insurance Overview
Illinois operates Get Covered Illinois and expanded Medicaid early under the ACA. The Chicago metro area benefits from strong insurer competition, helping keep benchmark premiums below the national average. Approximately 86% of marketplace enrollees receive premium tax credits, making coverage affordable for hundreds of thousands of Illinois families.
Illinois Income Limits for ACA Subsidies (2026)
ACA subsidy eligibility is based on the Federal Poverty Level (FPL). The table below shows key income thresholds for an individual in Illinois. For a family, multiply by the household size factor (e.g., a family of 4 at 100% FPL ≈ $50,706/year).
| FPL Level | Annual Income (Individual) | Significance |
|---|---|---|
| 100% FPL | $15,650 | Minimum income for marketplace subsidies (below this → Medicaid) |
| 138% FPL | $21,597 | Medicaid expansion threshold — above this, use marketplace |
| 150% FPL | $23,475 | Below this threshold, $0-premium Silver plans are often available |
| 400% FPL | $62,600 | Traditional “subsidy cliff” — but the ARP extension through 2025 removed the cliff, capping premiums at 8.5% of income for all enrollees |
Based on 2025 Federal Poverty Guidelines used for the 2026 plan year. Alaska and Hawaii have higher FPL thresholds.
How ACA Subsidies Work in Illinois
ACA subsidies in Illinois are calculated the same way as other states: based on your income relative to FPL and the cost of the benchmark Silver plan in your area. Because Chicago-area premiums are competitive, subsidies tend to be moderate — but they still make a significant difference for middle-income households.
How to Enroll in Illinois
Illinois operates its own health insurance exchange: Get Covered Illinois.
Visit your state's exchange website to browse plans, compare premiums, and enroll during Open Enrollment or a Special Enrollment Period. You may also find state-specific subsidies or programs not available on HealthCare.gov.
Medicaid in Illinois
Illinois has expanded Medicaid under the ACA.
Adults with household income up to 138% of the Federal Poverty Level may qualify for Medicaid coverage with little or no premium cost. If your income drops due to the subsidy cliff, Medicaid may be an option.
Calculate Your Illinois Premiums
See how the subsidy cliff affects your specific situation.
Open Calculator →See How the 2026 Subsidy Cliff Affects You
Enter your income and household size for a personalized premium comparison.
Calculate Your 2026 Premium Impact →Related Resources
⚠️ Disclaimer
This calculator provides estimates for educational purposes only. It is not a substitute for professional advice. Actual premiums, subsidies, and eligibility may vary based on your specific circumstances, location, and available plans. We are not licensed insurance agents or brokers. For official information, visit HealthCare.gov or contact a licensed insurance professional. This site is not affiliated with the U.S. government, CMS, or any insurance company.