Medicare plays a key role in providing health and financial security to beneficiaries residing in Illinois. With more than 2.2 million Illinois beneficiaries enrolled in Medicare, we’ll cover some very important information below about Medicare in Illinois. We want to help you better understand your options and make the decision-process as seamless as possible once you’re ready to enroll in Medicare or discover different coverage options.

Who Qualifies for Medicare in Illinois?

Medicare covers most Illinois residents who are 65 or older, and it also covers disabled Illinois residents. In general, Medicare enrollment in Illinois works the same way as it does in the rest of the country. If you qualify for Original Medicare, also known as Part A and Part B, it will help cover 80% of your health care costs.

When you’re first eligible for Medicare, you have a 7-month Initial Enrollment Period to sign up for Part A and/or Part B. If you’re eligible for Medicare when you turn 65, you can sign up during the 7-month period that:

  • Begins 3 months before the month you turn 65
  • Includes the month you turn 65
  • Ends 3 months after the month you turn 65

In most cases, if you don’t sign up for Part B when you’re first eligible, you’ll have to pay a late enrollment penalty. You’ll be responsible for paying this penalty for as long as you have Part B, and you could have a gap in your health coverage.

Once you reach Medicare eligibility, you can begin choosing additional coverage options to help pay for the remaining 20% of your medical expenses through Medicare Advantage (Part C), Medigap, and/or a Medicare Prescription Drug (Part D) plan.

Who Qualifies for Medicare

Illinois Medicare Enrollments

1,580,906

Original Medicare Plans
(Part A and B)

680,410

Medicare Advantage & Other Health Plans

1,715,778

Stand-alone Medicare
Part D (Drug plans)

2,261,316

Total Medicare Beneficiaries
in Illinois

Illinois Medicare Advantage Plans (Part C)

Nearly 27% of Illinois Medicare beneficiaries select Medicare Advantage plans.

Medicare Advantage plans are private, Medicare-approved insurance companies. They provide all of your Original Medicare benefits and often include extra benefits such as drug, dental, and vision coverage.

The Medicare Advantage Open Enrollment Period runs from January 1 to March 31. During this period, Medicare beneficiaries in Illinois who are already enrolled in a Medicare Advantage plan can switch to a different Medicare Advantage plan or drop their Medicare Advantage plan and enroll in Original Medicare instead.

As of 2020, 126 Medicare Advantage plans are available in Illinois. Medicare Advantage plans are for sale throughout Illinois. The average monthly Medicare Advantage premium in Illinois changed $20.17 in 2019 to $18.49 in 2020. $0 is the lowest monthly premium for a Medicare Advantage plan in Illinois. 100% of people with Medicare have access to a Medicare Advantage plan. According to the Centers for Medicare and Medicaid Services (CMS), as of May 2020, there are 680,410 beneficiaries enrolled in Medicare Advantage and other plans in Illinois.

Illinois Medicare Supplement (Medigap) Insurance Plans

Illinois requires Medigap insurers to offer coverage to disabled Medicare beneficiaries under age 65.

Medigap plans are used to supplement Original Medicare, covering some or all of the out-of-pocket costs (for coinsurance and deductibles) that beneficiaries would otherwise incur if they only had Original Medicare on its own. Typically, Medigap plans are popular for those who want little to no copay when they access healthcare services.

Illinois Medigap insurance is available to everyone with Medicare in the state, including those who are under 65 and are enrolled in Medicare. Often, Medigap plans in Illinois can be more expensive if you don’t enroll during your Initial Enrollment Period and wait for an Annual Open Enrollment Period. 

There are two initial times to enroll in a Medigap plan before and after you turn 65:

  • 6 months prior to turning 65
  • Once you turn 65, your 6 month period begins the month you enroll in Part B

During this period, an insurance company can’t use medical underwriting. 

The Illinois Department of Insurance requires all insurance companies offering Medigap plans to offer these plans to eligible individuals of all ages enrolled in Part B, including beneficiaries under 65. Yet, sometimes premiums for individuals under 65 can be much more expensive than for individuals who are 65 and older. It is recommended that you consider an Illinois Medicare Advantage plan if this happens to be the case for your specific situation.

Illinois Medicare Prescription Drug Coverage (Part D)

Original Medicare doesn’t cover outpatient prescription drugs. However, Medicare beneficiaries can get prescription coverage via a Medicare Advantage plan, an employer-sponsored plan (offered by a current or former employer), or a stand-alone Part D plan. Medigap plans don’t cover prescription drugs unless they’re covered under Part B.

As of 2020, there are 1,103,562 Medicare beneficiaries in Illinois enrolled in Part D prescription drug plans and 612,812 enrolled in Medicare Advantage Prescription Drug plans. For 2020 coverage, there are 28, Part D plans available in Illinois, with premiums ranging from about $15 to $131 per month.

Nearly 96% of people with a stand-alone Medicare prescription drug plan have access to a plan with a lower premium than what they paid in 2019. About 27% of people with a stand-alone Medicare prescription drug plan get Extra Help (also called the low-income subsidy, or LIS).

When deciding on a Part D plan, it’s important to evaluate several factors such as each plan’s premium, formulary, and copays since every plan is different. Learn how you can save money on your out-of-pocket costs with a Medicare Advantage, Part D, or Medigap plan, fill out this form or give us a call.

Local Medicare Health Plan Resources in Illinois

  • Senior Health Insurance Program (SHIP): SHIP is a free statewide health insurance counseling service for Medicare beneficiaries and their caregivers.
    Contact: Call 1-800-252-8966. Contact details for local SHIP sites can also be found on their website.

  • Senior HelpLine provides free information to seniors aged 60 and older and their caregivers throughout Illinois. Professional staff briefly assess needs, send literature, and write referrals for a range of services such as care coordination services, the Long-Term Care Ombudsman program, legal services, transportation, employment, and nutrition services.
    Contact: Call 1-800-252-8966, 1-888-206-1327 for TTY or email the service at aging.ilsenior@illinois.gov.

  • Northwestern Illinois Area Agency on Aging (NIAAA): NIAAA has been meeting the needs of older adults and their families since 1974. NIAAA serves a nine-county region consisting of Boone, Carroll, DeKalb, Jo Daviess, Lee, Ogle, Stephenson, Whiteside and Winnebago Counties. NIAAA is a non-profit organization and has been designated by the Illinois Department on Aging to be the area agency on aging for northwestern Illinois.
    Contact: NIAAA lists all the contact details on their website.

The licensed agents that are partnered with Timefor65 can help you compare the availability, benefits, and costs of Medicare plans in your specific region of Illinois. Our process makes it easier for you to access your Medicare eligibility in Illinois so that you receive personalized, affordable, and easy-to-use coverage options and solutions. Fill out the form or give us a call at (866) 327‑0148 anytime to get a free quote or to ask any questions.

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