If you live in Illinois and need health insurance, the Affordable Care Act (ACA) marketplace could save you hundreds of dollars a month on coverage. For the 2026 plan year, Illinois residents enroll through the new state-run exchange called Get Covered Illinois, which replaced HealthCare.gov starting in November 2025. Whether you are uninsured, self-employed, or dealing with a life change, understanding the eligibility rules and income limits can help you find a plan that fits your budget.
This guide covers everything you need to know about qualifying for ACA coverage in Illinois for 2026, including income thresholds, premium subsidies, cost-sharing reductions, and how to apply.
What Changed for 2026 in Illinois
Several important changes affect ACA coverage in Illinois this year:
New State-Based Exchange. Illinois launched Get Covered Illinois (getcovered.illinois.gov) as its own state-run marketplace starting November 1, 2025. If you previously enrolled through HealthCare.gov, your account was transitioned to Get Covered Illinois. This change gives Illinois more control over enrollment periods, plan offerings, and consumer protections.
Enhanced Subsidies Expired. The expanded premium tax credits introduced under the American Rescue Plan Act in 2021 and extended through 2025 have expired for the 2026 plan year. This means the 400% Federal Poverty Level (FPL) subsidy cliff is back. If your household income exceeds 400% FPL, you will not qualify for premium tax credits in 2026 unless new federal legislation is passed.
Fewer Insurance Carriers. Seven insurance companies are offering marketplace plans in Illinois for 2026, down from 11 in 2025. Aetna CVS, Health Alliance, and Quartz exited the marketplace at the end of 2025. You should compare plans carefully to find the best fit for your needs.
Pregnancy as a Qualifying Event. Illinois now recognizes pregnancy as a qualifying life event, allowing pregnant residents to enroll in marketplace coverage outside of open enrollment.
Who Is Eligible for ACA Marketplace Coverage in Illinois?
To enroll in a health plan through Get Covered Illinois, you must meet these basic requirements:
- You live in Illinois
- You are a U.S. citizen or lawfully present noncitizen
- You are not currently incarcerated
- You are not enrolled in Medicare
Meeting these requirements makes you eligible to purchase a marketplace plan. However, qualifying for financial assistance (subsidies) depends on your income and other factors.
2026 ACA Income Limits for Illinois
Your eligibility for subsidies depends on where your household income falls relative to the Federal Poverty Level (FPL). For the 2026 coverage year, the marketplace uses the 2025 FPL guidelines to determine subsidy eligibility.
ACA Subsidy Income Ranges by Household Size
| Household Size | Medicaid Cutoff (138% FPL) | CSR Cutoff (250% FPL) | Subsidy Cutoff (400% FPL) |
|---|---|---|---|
| 1 | $21,597 | $39,125 | $62,600 |
| 2 | $29,187 | $52,875 | $84,600 |
| 3 | $36,777 | $66,625 | $106,600 |
| 4 | $44,367 | $80,375 | $128,600 |
| 5 | $51,957 | $94,125 | $150,600 |
| 6 | $59,547 | $107,875 | $172,600 |
Based on the 2025 Federal Poverty Level guidelines: $15,650 for an individual, plus $5,500 for each additional household member.
How to Read This Table
- Below 138% FPL: You likely qualify for Illinois Medicaid instead of marketplace coverage. Illinois expanded Medicaid under the ACA in 2014, so adults aged 19 to 64 with income at or below 138% FPL can get free or very low-cost coverage through Medicaid.
- 138% to 250% FPL: You qualify for both premium tax credits and Cost-Sharing Reductions (CSRs) on Silver plans, which lower your deductibles, copays, and out-of-pocket maximums.
- 250% to 400% FPL: You qualify for premium tax credits to reduce your monthly premiums, but not for CSRs.
- Above 400% FPL: For 2026, you do not qualify for federal premium subsidies. You can still purchase a marketplace plan at full price.
Understanding Premium Tax Credits
Premium tax credits lower the amount you pay each month for health insurance. The credit is based on the difference between the cost of the second-lowest-cost Silver plan in your area and a percentage of your income. In general, people with lower incomes pay a smaller share of their income toward premiums.
For 2026, the premium contribution percentages range from approximately 2% of income for those near 100% FPL up to approximately 8.5% of income for those near 400% FPL. The exact percentage depends on where your income falls within the FPL range.
You can choose to apply the credit in advance to lower your monthly payments, or claim it as a refund when you file your taxes. If you apply it in advance, make sure to report any income changes during the year so your credit amount stays accurate.
Cost-Sharing Reductions (CSRs)
If your income falls between 100% and 250% FPL, you can save even more by choosing a Silver plan. Cost-Sharing Reductions lower your out-of-pocket costs, including deductibles, copays, and maximum out-of-pocket limits. CSRs are only available on Silver-tier plans purchased through the marketplace.
The savings vary by income level:
- 100% to 150% FPL: The most significant reductions, with plans that function close to Platinum-level coverage
- 150% to 200% FPL: Strong reductions with noticeably lower deductibles and copays
- 200% to 250% FPL: Moderate reductions that still make a meaningful difference
How to Apply for ACA Coverage in Illinois
Step 1: Gather Your Documents
Before you start, have the following ready:
- Social Security numbers for everyone in your household
- Proof of citizenship or immigration status
- Income information (pay stubs, W-2 forms, tax returns, or self-employment records)
- Current employer and income details for all household members
- Information about any job-based insurance available to you
Step 2: Visit Get Covered Illinois
Go to getcovered.illinois.gov to create an account or log in. If you had a HealthCare.gov account for Illinois coverage, your information was migrated to Get Covered Illinois. You may need to claim your new account if you have not already done so.
Step 3: Complete Your Application
Fill out the application with your household information, including income, household size, and other details. The system will determine whether you qualify for Medicaid, premium tax credits, cost-sharing reductions, or full-price marketplace coverage.
Step 4: Compare Plans and Enroll
Browse available plans and compare them based on monthly premiums, deductibles, provider networks, and prescription drug coverage. Illinois has four plan tiers: Bronze, Silver, Gold, and Platinum. If you qualify for CSRs, pay close attention to Silver plans, which offer the best value at lower income levels.
Step 5: Pay Your First Premium
After selecting a plan, pay your first monthly premium to activate your coverage. Your insurance company will send you payment instructions.
Alternative Enrollment Methods
- By phone: Call 1-866-311-1119 to reach the Get Covered Illinois call center
- In person: Work with a certified navigator or licensed insurance broker in your area. Visit getcovered.illinois.gov to find local help.
Enrollment Periods for 2026
Open enrollment for 2026 coverage ended January 31, 2026. However, there are still ways to get covered:
Transition Special Enrollment Period: If your 2025 HealthCare.gov coverage was automatically renewed and you had not yet claimed your Get Covered Illinois account by February 1, 2026, you have until March 31, 2026 to pick a different plan.
Special Enrollment Periods (SEPs): You can enroll or change plans outside of open enrollment if you experience a qualifying life event, such as:
- Losing existing health coverage
- Getting married or divorced
- Having or adopting a baby
- Moving to a new area
- Becoming pregnant (new for Illinois in 2026)
- Losing Medicaid or CHIP eligibility
- Experiencing a change in income that affects eligibility
Next Open Enrollment: The open enrollment period for 2027 coverage is expected to begin November 1, 2026.
Medicaid vs. Marketplace Coverage in Illinois
Since Illinois expanded Medicaid under the ACA, there is no coverage gap. Here is how the two programs connect:
- Income at or below 138% FPL: You qualify for Illinois Medicaid, which provides free or very low-cost health coverage. Apply through the ABE portal at abe.illinois.gov or call 1-800-843-6154.
- Income between 138% and 400% FPL: You qualify for subsidized marketplace coverage through Get Covered Illinois.
- Income above 400% FPL: You can purchase marketplace coverage at full price or seek coverage through your employer.
For children, the All Kids program covers kids up to age 18 in families with income up to 318% FPL, with no premiums or copays. Call 1-866-ALL-KIDS (1-866-255-5437) for more information.
Illinois Easy Enrollment Program
Illinois offers an easy enrollment program that lets you check a box on your state tax return (Step 12 on the IL-1040) to share your information with Get Covered Illinois and Illinois Medicaid. If you might be eligible for coverage, the state will reach out to help you enroll. This is a simple way to start the process if you are not sure whether you qualify.
Tips to Maximize Your Savings
- Report your income accurately. Overestimating or underestimating your income could result in owing money at tax time or missing out on savings.
- Consider Silver plans if you qualify for CSRs. The extra savings on deductibles and copays often make Silver plans the best value for people between 100% and 250% FPL.
- Check for Medicaid first. If your income is near the 138% FPL threshold, apply through ABE to see if you qualify for Medicaid before purchasing a marketplace plan.
- Use pre-tax deductions strategically. Contributions to traditional IRAs, 401(k) plans, and Health Savings Accounts (HSAs) can reduce your Modified Adjusted Gross Income (MAGI), which may lower your income for subsidy calculations.
- Update your information promptly. If your income, household size, or other circumstances change during the year, update your marketplace application right away to keep your subsidy amount accurate.
- Shop around every year. Plan prices and networks change annually. Even if you are happy with your current plan, compare options during open enrollment to make sure you are getting the best deal.
Not sure which programs you might qualify for? Use our free benefits screener to check your eligibility for ACA subsidies, Medicaid, and other assistance programs in just a few minutes.
Frequently Asked Questions
Can I still enroll in an ACA plan in Illinois right now?
Open enrollment for 2026 ended January 31, 2026. However, if your coverage was auto-renewed from HealthCare.gov and you have not yet claimed your Get Covered Illinois account, you may have until March 31, 2026 to select a new plan. Outside of that, you need a qualifying life event to trigger a Special Enrollment Period.
What income counts for ACA eligibility?
The marketplace uses your Modified Adjusted Gross Income (MAGI), which includes wages, salary, self-employment income, Social Security benefits, unemployment compensation, and certain other income. It does not include Supplemental Security Income (SSI) or child support received.
What happens if my income changes during the year?
Report the change to Get Covered Illinois as soon as possible. If your income drops below 138% FPL, you may become eligible for Medicaid. If it increases above 400% FPL, you could lose your subsidy. Adjusting promptly helps you avoid having to repay excess subsidies at tax time.
Do I have to file taxes to get ACA subsidies?
Yes. You must file a federal income tax return for any year you receive premium tax credits. If you are married, you must generally file jointly with your spouse to be eligible for subsidies.
Are undocumented immigrants eligible for marketplace coverage?
No. You must be a U.S. citizen or lawfully present noncitizen to purchase marketplace coverage. Note that DACA recipients are no longer eligible for marketplace health or dental insurance starting in 2026, according to Get Covered Illinois.
Can I get marketplace coverage if my employer offers insurance?
You can always purchase a marketplace plan, but you may not qualify for subsidies if your employer offers affordable, minimum-value coverage. Use the employer affordability test to check whether your job-based insurance is considered affordable under ACA rules.
Where can I get free help with enrollment?
Call the Get Covered Illinois helpline at 1-866-311-1119, or visit getcovered.illinois.gov to find navigators and brokers in your area who can help at no cost.
Next Steps
Understanding your ACA eligibility is the first step toward getting affordable health coverage in Illinois. Check your eligibility for multiple programs at once with our free benefits screener, or visit the Illinois Benefits Overview page for a complete look at all the assistance programs available in your state.
If you need help right now, contact Get Covered Illinois at 1-866-311-1119 or visit getcovered.illinois.gov to explore your options.
