Table of Contents

Medicare Plans by State

STATE -Select-
  • Alabama
  • Arizona
  • Arkansas
  • California
  • Colorado
  • Connecticut
  • Delaware
  • Florida
  • Georgia
  • Hawaii
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana
  • Maine
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Mississippi
  • Missouri
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York
  • North Carolina
  • North Dakota
  • Ohio
  • Oklahoma
  • Oregon
  • Pennsylvania
  • Rhode Island
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Vermont
  • Virginia
  • Washington
  • West Virginia
  • Wisconsin
  • Wyoming
Page Reviewed / Updated – December 23, 2023

Medicare is a government-run health care insurance program for people aged 65 and older and other qualifying individuals. Medicare Advantage, which is sometimes called Part C Medicare, offers a highly customizable alternative to Original Medicare. Medicare Advantage is administered by private insurers, and recipients pay a single monthly premium for extensive health care coverage. This arrangement may be advantageous when it comes to managing personal budgets. Unlike Original Medicare, Medicare Advantage providers set their own annual out-of-pocket limits, which means seniors always know the maximum they may potentially need to pay for their yearly health care. Plan prices vary between providers, and companies may have different deductible and copay amounts.

Medicare Advantage Plans must include the same benefits as Parts A and B of traditional Medicare, with the exception of hospice care. Most options also feature some prescription drug coverage, meaning seniors often don’t need to obtain separate Medicare Part D coverage. Many policies also include extra benefits above regular Medicare, such as vision and dental care. 

Nationally, 51% of all Medicare-eligible individuals have enrolled in Medicare Advantage. Illinois lags somewhat behind, with 37% of potential enrollees signed up for coverage in 2023 — 860,000 out of almost 2.4 million. However, Medicare Advantage is gaining traction in Illinois, with an increase of 8.85% from the previous year in the percentage of total eligible people enrolled for private Part C plans. In 2022, roughly 774,000 out of 2.3 million qualifying candidates signed up for Medicare Advantage, representing 34%. Between 2022 and 2023, the number of qualifying individuals rose by 2.12%, and the number of enrollees increased by 11.15%. Statistics may indicate that Medicare Advantage plans are becoming more popular in Illinois.

Read further to grasp the essentials of Medicare Advantage Plans in Illinois, featuring coverage details, eligibility requirements and enrollment guidance.

The Top 10 Medicare Advantage Plans in Illinois

Illinois seniors have several Medicare Advantage providers to choose between, many of which offer a selection of plans at different price points. The table below shows the 17 most popular Plan C providers in Illinois and details costs as a range to account for plan variations. Enrollment figures include all plans from each company. Data is correct as of July 2023, and individuals can obtain further information from Medicare.gov.

Name

Enrollment

Medicare Star Rating

Monthly Cost Range

Plan Types

Humana

222838

4

$0 – $96

PPO, HMO

Anthem Blue Cross and Blue Shield

213017

3.5

$0 – $39

PPO

UnitedHealthcare

110489

3

$0 – $137

PPO, HMO, PFFS

Aetna Medicare

60708

3.5

$0 – $63

PPO, HMO

Cigna

38377

2.5

$0 – $25

PPO, HMO

Blue Cross and Blue Shield of IL, NM

28595

3.5

$0 – $187

PPO

Wellcare

25988

2

$0 – $10

PPO, HMO

Health Alliance Medicare

23225

4

$0 – $165

HMO

Blue Cross Blue Shield of Michigan

19004

3.5

$0 – $81

HMO

Essence Healthcare

11816

5

$0 – $60

PPO, HMO

How Medicare Advantage Plans Work in Illinois

Before choosing a Medicare Advantage Plan, it is important to understand how the six different types of plans work. Insurance companies will offer a number of different plan types, and Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs) are the most common.

The insurance companies that offer these plans have their own rules and regulations about everything from networks to referral requirements, so participants should carefully review the terms of the particular plan they are considering. Below are detailed descriptions of the four most common plan types in Illinois.

Medicare Advantage Plan Types Graphic

What Medicare Advantage Plans Cover in Illinois

Medicare Advantage plans must cover all of the things Original Medicare covers, with the exception of hospice which is part of Medicare Part A. Beneficiaries can receive their preventive appointments, labs, imaging and hospital care under these plans. Many plans offer additional coverage options, such as hearing aids, vision or dental services. Again, this is where plans may vary depending on the terms of the plan.



Coverage Available With Medicare Parts A & B?

Coverage Available With Medicare Advantage?

Preventive Screenings

Yes

Yes

Hospital Care

Yes

Yes

Durable Medical Equipment

Yes

Yes

Prescription Drugs

No

Yes**

Vision Care

No

Yes*

Dental Care

No

Yes*

Hearing Aids

No

Yes*

*Select plans offer this coverage

** Most plans offer this coverage

Eligibility for Medicare Advantage in Illinois

To take part in a Medicare Advantage Plan, seniors must first enroll in Original Medicare. If they are eligible for Part A and Part B, they are also eligible for most Medicare Advantage Plans, although these plans can have additional eligibility requirements.

In Illinois, only those who are at least 65 or who have a specific disability can enroll in Medicare. The law requires enrollees to have U.S. citizenship or be lawful immigrants to enroll.

Medicare enrollees must enroll during the limited enrollment periods or face delays and fines. These enrollment periods are also when beneficiaries can change their plans if they wish. The list below details the laws and schedule for Medicare enrollment.

  • Initial Coverage Election Period: This is the initial 7-month period, coinciding with one’s 65th birthday, during which everyone is eligible to enroll in a Medicare Advantage plan.
  • Annual Election Period (AEP): Also referred to as the Open Enrollment Period, this the time of year when anyone over 65 can enroll in Medicare Advantage for the first time or change to a new plan.
  • Medicare Advantage Open Enrollment Period: During this period, those who are already enrolled in Medicare Advantage can switch to a different plan or switch back to Original Medicare.

Start Date

End Date

Initial Coverage Election
Period

3 Months Before One’s
65th Birth Month

3 Months After One’s
65th Birth Month

Annual Election Period
(AEP)

October 15th

December 7th

Medicare Advantage Open
Enrollment Period

January 1st

March 31st

Additionally, Medicare Advantage plan participants can change their plan outside of these enrollment periods under certain qualifying circumstances, such as moving to a new state.

How to Find & Choose a Medicare Advantage Plan in Illinois

Navigating the many intricacies of Medicare Advantage plan types, insurers, and the specific plan options available by region can be a difficult and time-consuming task. Below are several resources we’ve created to help you through the process.

First is a downloadable PDF that you can use as a guide to help you compare plans as you research. Finally, we have listed a number of organizations that you can contact with experts that will help you determine whether Medicare Advantage is right for you and what plans you should consider.

Choose a Medicare Advantage Plan



State-Wide Medicare Advantage Resources

Senior Health Insurance Program

The Senior Health Insurance Program (SHIP) is a free counseling service for Medicare beneficiaries and their caregivers. It hosts a range of Medicare education and application information on its website and seniors can also watch Medicare webinars. The Good Start Medicare page details the steps seniors should take as they approach their 65th birthday to ensure they can make an informed decision about their health insurance. SHIP counselors are located throughout the state to provide advice on the best plan for an individual’s needs, how to apply for Medicare and information about Medicare fraud and abuse.

Contact Info

Seniors can ring SHIP on 1-800-252-8966 to get information about Medicare and other health insurance options. Staff can also direct callers to their nearest SHIP office to arrange a meeting with a trained SHIP counselor. Contact details for local sites can also be found on their website.

Visit Website
Senior HelpLine

Senior HelpLine provides free information to seniors aged 60 and older and their caregivers throughout Illinois. The service connects seniors to local services and provides information about a range of topics, such as Medicare Advantage. Professional staff can also evaluate individual caller’s needs and answer questions that can help seniors clarify their options. Staff members have a thorough knowledge of the programs and services available to older adults in the state, including local resources. The service operates Monday through Friday from 8.30 a.m. to 5.00 p.m.

Contact Info

The Senior HelpLine can be reached toll-free on 1-800-252-8966 or 1-888-206-1327 for TTY. Seniors can also email the service at [email protected].

Email

Local Medicare Advantage Resources

Northwestern Illinois Area Agency on Aging

Northwestern Illinois Area Agency on Aging (NIAAA) has an Information and Assistance service that provides free information to older adults and their caregivers. Individual consultations can provide seniors with advice about Medicare and Medicaid programs and eligibility. Staff also help seniors apply for benefits. The service is available over the phone, in NIAAA offices or in the home, if required. There are offices in each county of the northwestern region of Illinois, so seniors can easily connect with local resources.

Contact Info

The contact number for the Information and Assistance service depends on the county the senior resides in. NIAAA lists all the contact details on their website.

Visit Website
AgeOptions

AgeOptions is the Area Agency on Aging in suburban Cook County. It has trained professionals available to help older adults make informed choices and is a central point of contact for people looking for information about Medicare and other programs. Staff can also help seniors access benefits and other senior services. AgeOptions has a number of advocacy and education programs, including Advisory and Make Medicare Work, which work to educate the professionals who work with older adults and the wider community about Medicare, Medicaid and senior options. AgeOptions can also help seniors with questions about Medicare fraud and abuse.  

Contact Info

Information and assistance can be accessed through a number of channels. Seniors can contact AgeOptions on (708) 383-0258 or via email on [email protected]. Staff is also available for in-person consultations.

Email
Central Illinois Agency on Aging

The Central Illinois Agency on Aging (CIAOA) is an independent nonprofit organization serving people in the central Illinois region. Its mission to empower older adults to control their own lives is furthered by the Information and Assistance program. The service provides information about benefits and services available in the area and connects seniors to community resources that meet their needs. CIAOA also conducts education programs about Medicare fraud and helps seniors with Medicare Part D. The staff are specialists, certified by the Alliance of Information & Referral Systems, and are available Monday through Friday, 8.30 a.m. to 5.00 p.m.

Contact Info

Seniors can contact CIAOA Information and Assistance on (309) 674-2071 or toll-free on (877) 777-2422. The service can also be reached via email on [email protected], or seniors can drop into the Peoria office.

Email
Heartland Human Services

Heartland Human Services provides a range of programs to improve the health and wellness of people in Effingham and Clay Counties. An Information and Assistance program is one of the services available to help seniors. The main focus of the program is directing clients to relevant services. Specialists also offer assistance filling out applications for different benefit programs, including Medicare Advantage, and with legal aid. This is a free service.

Contact Info

Seniors can speak to specialists or make an appointment by calling (217) 347-7179 ext. 1038.