Health & Benefits

If you are not eligible for Medicaid or Medicare, you can consider the health coverage options below, including the Marketplace. 

Emergency situations

If this is an emergency, go to an emergency room.  You cannot be denied emergency care at an emergency room.  

You can also go to a Community Health Center where they will help you, even if you do not have health insurance.  They will only charge you what you can afford. Find a Community Health Center near you by visiting the HealthCare.gov website. 

Also, many Community Health Centers and hospitals have someone on staff who can help you get health insurance or help you find someone who can.  These staff members can also help you with unpaid medical bills.

Once you or your loved one is safe, then you can work on getting health insurance.

Getting and keeping insurance

In general, if you do not qualify for Medicaid or Medicare, you cannot be denied private health insurance.  In other words, you cannot be turned down for health insurance based on your health, age, gender, or current sickness. The Illinois Insurance Code also prohibits denying healthcare coverage to persons with autism and other early-acquired disorders based on where you live. But, your health insurance can be cancelled if you do not pay the premiums Money that must be paid every month, such as for health insurance .

If you need health insurance, there are people trained and certified to help you apply. Their help is absolutely free. In fact, if you are eligible, you have to get health insurance. Without health insurance, your health care options are limited. 

Get Covered Illinois is the Affordable Care Act (ACA) Health Insurance Marketplace for Illinois. Read more about the Marketplace below.

The Marketplace

The Marketplace is a place where people can go to buy health insurance. Each state has its own. In Illinois, the Marketplace is Get Covered Illinois. You can visit their website or call (866) 311-1119.

Get Covered Illinois helps you shop for health insurance based on your needs and budget. Although you can start looking right away for health insurance from the website, it is a good idea to get help. There is free and good help available.

There is also financial help for some people and families to buy health insurance.  If you or a member of your family is eligible for that help, the only way to get it is by buying your health insurance through the Marketplace.  

Here is a simple guide to getting health insurance.

How do I apply for Marketplace coverage?

Visit Get Covered Illinois to learn more about health care coverage options, open enrollment dates, and applying for coverage. If you have not registered yet and missed open enrollment, you may qualify for Marketplace coverage through a Special Enrollment Period (SEP). This is when you may qualify to enroll because of certain life events, like losing health insurance coverage through your job. You have 60 days after a qualifying event to enroll.

If you are not eligible for an SEP, you can get health care at a Community Health Center until the next open enrollment period.  

You can also get temporary health insurance.  If you do, talk to an insurance agent who is licensed with the Department of Insurance. Do not buy any policy from an agent or company that is not licensed with the Department of Insurance.

What do I put on my application?

You need to be truthful when you apply for health insurance, especially about your age and tobacco use.  But you cannot be denied health insurance, or have it canceled, just because you made a mistake on your application.

What if I’m an immigrant?

You do not have to be a citizen or lawfully present to get health insurance or health care. But you need to be a citizen or lawfully present to get health insurance on the Health Insurance Marketplace. There are resources available if you are an undocumented immigrant through the Illinois Health Benefits for Immigrant Seniors (HBIS) program. Note: enrollment into the HBIS programs is currently paused, and new applications are not being accepted.    

If your household is of mixed immigration status, you can get health insurance for those in your household who are lawfully present, your children for example.  You do not have to tell anyone the immigration status of anyone else in your household who is not going to be receiving health insurance.

You may be able to get health insurance through your spouse’s employer. And you can always purchase health insurance directly from insurance companies.

If you are not eligible for Marketplace coverage because of your immigration status, health insurance might be expensive.  You should try to buy health insurance that gives you the minimum coverage. A good place to start to understand your options is to get the help of a Navigator.

See if family or friends can recommend an insurance agent to help you who is licensed with the Department of Insurance. Do not buy any policy from an agent or company that is not licensed with the Department of Insurance.

Learn more about government benefits for immigrants. 

What if I’m denied?

If you disagree with a Marketplace decision, you may be able to appeal it. 

If your health insurance company makes a decision you disagree with, you can appeal it. When you receive a denial When a court rejects or refuses to allow a request; for example, when a judge decides not to grant an attorney's objection. , you should also receive information about appealing the decision in the denial notice. If you do not receive this information, call the insurance company for appeal information or look for the procedures on the company's website. Follow all of the steps set out for appealing the decision. Pay special attention to the deadlines for appealing the decision. 

Do not pay “deposits” or “prepayments”

You should not have to pay a “deposit” or “prepayments” for your insurance. You should only have to pay your insurance premiums one month at a time.  

If a company or person wants you to prepay anything before they decide to insure you, do not buy that health insurance. Stop doing business with that person.

You can cancel a health insurance plan at any time. There is no longer a federal penalty for not having insurance.