Medicare in Illinois

Resources for Illinois Medicare Beneficiaries 

Are you a Medicare nerd like we are, or just looking to see if you have all your Medicare questions answered correctly? Healthpilot can help you learn more about the different parts of Medicare, how to sign up, and how to choose a Medicare plan. 

Medicare Basics         Choosing the Right Medicare Plan         Enrolling in Medicare

Help is useful when making decisions about Medicare. As an Illinoisan, there are a number of resources, among them the State Health Insurance Program (SHIP). SHIP has counselors all over Illinois who work with local nonprofits, public health organizations, and Area Agencies on Aging (AAAs) to give people information about Medicare. 

Medicare Plan Options in Illinois  

You can choose from several Medicare options in the Prairie State. If you are disabled or over the age of 65 and qualify for Medicare, you can apply for Original Medicare. If you’re looking for more comprehensive coverage, Medicare Advantage plans are available in Illinois and can be a good substitute. Prescription drug plans and Medicare Supplement Insurance are additional Medicare plan options that should be considered when choosing the ideal Medicare plan for your lifestyle. 

Original Medicare (Parts A & B)  

The foundational form of Medicare is Original Medicare includes Part A, which covers hospital insurance, and Part B, which covers medical insurance. For instance, Medicare Part A has an inpatient hospital deductible per benefit period (every time you are admitted), whereas Medicare Part B has an annual deductible to be met before Original Medicare kicks in for payment. 

Considerations if retaining Original Medicare include: 

• Original Medicare in Illinois is a good option if you want the freedom to select and go to medical professionals who accept Medicare anywhere in the United States. 
• There are no networks, copays, waiting periods, or restrictions based on pre-existing conditions. 

Medicare Advantage (Part C)  

A commercial insurance company-provided replacement for Original Medicare is Part C, sometimes referred to as Medicare Advantage plans. The nicest part about these plans is that they typically contain additional benefits on top of what Medicare Parts A and B would, at the very least, cover. Similar to how a Health Maintenance Organization (HMO) plan functions, the majority of services are controlled by a network of providers, who may require you to have a primary care physician, need a referral to see a specialist, and prior authorization for certain services, treatments, and drugs. 

Check out our Medicare Part C Resource Page to find out more about Medicare Advantage.  

Medicare Prescription Drug Plan (Part D)  

Prescription drug coverage under Medicare Part D is a standard feature of many Medicare Advantage plans. However, a standalone Prescription Drug Plan (PDP) can also be used in addition to Original Medicare or a Medicare Supplement Insurance policy offered by independent private insurance companies that have received Medicare approval to offer Part D coverage. Depending on the plan, a deductible, copay, or coinsurance may apply to prescriptions. 

Medicare Supplement Insurance (Medigap)  

Some Medicare beneficiaries in Illinois buy Medicare Supplement Insurance (Medigap). These programs are designed to cover any gaps in Original Medicare coverage. The Medigap perks include but are not limited to coverage for Part A and Part B deductibles, coinsurance, and coverage for medical treatment received outside of the United States. 

The Illinois Department of Insurance (IDI) also offers guides that describe how Medicare Supplement Insurance coverage lowers out-of-pocket costs because Original Medicare does not cover all of your medical expenses. 

It’s also important to note when deciding the best Medicare program for you that Medicare Advantage is not covered by Medigap insurance, and you cannot simultaneously have a Medigap policy and a Medicare Advantage Plan. The Medigap policy’s effective date should begin the day after your Medicare Advantage plan terminates.  

Medicaid 

Established in 1965, Medicaid is a public insurance program that receives equal funding from the federal and state governments.  Federal laws mandate that each state manages its own Medicaid program. The broad federal regulations provide a great deal of flexibility in program design and implementation for the states. State-to-state variations in Medicaid eligibility and benefits are possible and frequently occur.  Medicaid assists low-income families and individuals, including kids, parents, expectant mothers, the elderly, and those with disabilities who qualify its eligibility requirements. 

How and when to sign up for Medicare in Illinois

Medicare is a healthcare insurance program administered by the government and supported by the federal government. There are frequent references to Original Medicare Part A (Hospital Insurance) and Part B (Medical Insurance). When turning 65, the majority of Americans are eligible for Medicare. The following circumstances also result in Medicare eligibility: 

• You receive disability benefits for at least 24 months from the Railroad Retirement Board or Social Security Administration 
• You have been identified as having End-Stage Renal Disease (ESRD). 
• You have Amyotrophic Lateral Sclerosis (ALS), commonly known as Lou Gehrig’s disease. 

Visit our resource center’s Enrollment Periods Page for more information on Original Medicare and Medicare Supplement Insurance enrollment periods. 

Medicare Advantage Enrollment Periods in Illinois and nationwide  

Here is a quick overview of the Medicare enrollment periods and enrollment timeframes in which you can elect or change your Medicare Advantage plan.  

Phew! Illinois, we know this is a lot, but we’re almost done. Healthpilot knows that figuring out Medicare can be complicated and that deadlines for signing up can make it even more stressful. 

Looking for good news? Answer a few questions, and we’ll find the best Medicare plan for you based on your specific needs. You can even skip the call if you want and sign up for a Medicare plan online in just a few minutes. We’d be happy to do all the hard work for you. 

Once you’re a Healthpilot customer, you update your profile with any health and prescription changes, and we’ll provide you with a recommendation every year for the rest of your life. When you have Healthpilot on your side, you don’t have to remember when you can sign up. 

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Key Stats

Some interesting facts about Medicare coverage in Illinois: 

• 18% of people in Illinois have Medicare, which is just below the national average of 19%. 
• About 33% of Medicare customers in Illinois are enrolled in private Medicare Advantage programs. 
• In 2023, 173 Medicare Advantage plans will be available to people in Illinois, up from 166 plans in 2022. This means that the plan options have increased by 4.2%. 
• There are 24 separate stand-alone Part D prescription plans offered to all Illinois residents with Medicare. 
• And, because we promised you a fun fact about Illinois: There are still some pretty strange laws on the books. Did you know that it’s prohibited to share whiskey with your dog? If you don’t have a dollar in cash, you can be arrested for vagrancy? Or that it’s illegal to eat inside a burning building in Chicago? Please try and avoid these scenarios!  

We both know you are eager to see your recommended Medicare plan.

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