Medicare in Illinois

In this article...
  • Discover everything you need to know about which Illinois Medicare plans you can choose in this guide.

What Illinois Medicare Plans Are Available? 

Residents living in the state of Illinois can qualify for Medicare Part A, Medicare Part B, a Medicare Advantage Plan, Medicare Part D and privately offered Medicare Supplement plans. Since the cost of Medicare is mitigated by Social Security, the cost for coverage might vary depending on your personal situation. Understanding your financial responsibility is important so that you are able to make appropriate financial plans for your medical care. The Medicare plans available in Illinois are the following. 

  • Medicare Part A: Offered under the original Medicare, Part A covers the cost of emergency treatment, such as visits to the emergency room or hospital visits. It covers inpatient services and the cost of nursing care or home health care as well. Hospice care is also covered under Part A. 
  • Medicare Part B:Also provided under traditional Medicare coverage is Part B. This covers the cost of your preventative care, physical examinations, diagnostic testing and medical transportation services. Your medical supplies and any prescribed medical equipment are also covered under Medicare Part B. 
  • Medicare Advantage:In 2006, Congress passed a law allowing Medicare recipients to choose a private insurer as an alternative to traditional Medicare. A Medicare Advantage plan is required to cover everything offered by Medicare Parts A and B but may provide additional coverage. Addons can include dental and vision coverage. 
  • Medicare Part D:This is your prescription drug coverage under Medicare. Some Medicare Advantage plans do cover the cost of your medications, so it is important to check your plan before enrolling in Medicare Part D. If your Medicare Advantage plan does not cover your medicines, you can still enroll in Medicare Part D. 
  • Medicare Supplement Plans:Commonly referred to as Medigap plans, these are privately offered insurance policies that cover your co-payments for services and medications covered by your Medicare plans. Medicare B only covers 80% of your expenses after meeting your deductible, for example. A supplemental plan would help you cover the difference. 

Medicare Advantage plans are not nearly as popular as traditional Medicare in Illinois. During 2020, 1.6 million Illinoisans were enrolled in traditional Medicare plans compared to 600,000 who selected a Medicare Advantage plan. Your personal needs and any underlying health concerns determine which plan is right for you. If you have a health condition that requires ongoing care, you may want to enroll in a Medicare Supplement plan to lessen your long-term financial burden. 

Who Is Eligible for Illinois Medicare? 

Most people who are enrolled in traditional Medicare are enrolled automatically upon their 65th birthday. If you did not contribute to Social Security for long enough during your career or have not started receiving Social Security benefits yet, you might not be enrolled automatically, however. It is important to check the status of your enrollment, because if you do not enroll quickly enough, you could face penalties.  

As long as you meet all of the requirements, you will receive Medicare Part A as a part of your Social Security benefit. Medicare Part B might cost you up to $150 per month as of 2021, but this is usually deducted from your pension or Social Security checks. You will not be required to mail in a monthly premium if that is the case.

While Medicare Advantage plans are administrated by private insurance companies, part or all of your premium is paid by the government. This means that you might be able to select a Medicare Advantage plan that doesn’t cost you anything. For plans that include extra coverage, you should anticipate paying a monthly premium beyond the allowance you receive. Medicare Part D requires a monthly premium and the amount is determined by the level of coverage you are seeking. 

To avoid penalties, enroll in Medicare during your Initial Enrollment Period. This runs from 3 months before you turn 65 to 3 months after. The penalties you will receive for not enrolling during this period could impact the monthly cost of your Part B plan, requiring you to pay more for coverage for the rest of your life. 

The General Enrollment Period begins on the first day of the year and lasts until March 31. It is when you can enroll if you missed the deadline for your Initial Enrollment Period. If you missed this deadline due to being covered by a work insurance policy, having a disability or caring for someone with a disability or volunteering or serving overseas, you can avoid the penalty by waiting for a Special Enrollment Period. 

It is important to decide quickly whether you wish to enroll in a Medigap policy. If you do so within 6 months of turning 65, your insurer may not turn you down for coverage, raise your premium or inflate your deductible. Factors such as your age or medical history may not be used as justification for these practices, in accordance with the law. 

How Do I Enroll for Medicare in Illinois? 

If you are unsure of whether you are enrolled in Medicare or wish to alter your coverage, you can do so easily by visiting medicare.gov. Simply follow the instructions on the webpage and you can enroll electronically. You will not be able to enroll in a Medigap plan through the Medicare site and will need to do so with a private insurer that offers these plans. 

Contact Information for Illinois Medicare, Medicaid and Insurance Help 

More information about Medicare services in the State of Illinois can be found below. 

Illinois Medicaid Eligibility and Enrollment 

Senior Health Insurance Program 

Medicare Cost Sharing Expenses 

Illinois Cares RX