Private PPO Health Insurance in Illinois
Illinois has one of the largest metro areas in the country around Chicago, plus cities like Springfield, Peoria and Rockford and a lot of farm country. Independent contractors, gig workers and small business owners all over the state buy their own coverage.
This guide covers how private PPO plans work in Illinois, what affects the price, the Illinois continuation rule when a job-based plan ends, and how to confirm an agent is licensed. You can see a household estimate in about a minute.
Who shops for private coverage in Illinois
How a private PPO plan works
A PPO (preferred provider organization) plan has a network of providers who agree to set prices. You can usually see in-network providers without a referral, and some PPO plans also pay part of the cost outside the network. Four numbers decide what a plan really costs you:
- Premium: what you pay every month to keep the plan.
- Deductible: what you pay for covered services before the plan starts sharing costs. Some private plans offer $0 deductible options; others trade a higher deductible for a lower premium.
- Copays and coinsurance: your share of each covered service after the deductible.
- Out-of-pocket maximum: the most you pay for covered in-network services in a plan year.
Private plans are offered by insurance carriers, and benefits vary by plan. Applications can include questions about your household and history, so approval is not guaranteed, and some plans limit what they cover based on your answers. Always read the plan documents before you enroll. More detail: how PPO networks work and deductibles, copays and out-of-pocket maximums explained.
Chicago area and downstate networks
Network options in the Chicago area can differ a lot from those downstate. If you live in one region and work in another, check providers in both places before you apply.
Continuation applies to many group sizes
Illinois continuation applies to fully insured group plans issued in Illinois, not only to the smallest employers, so check your notice even if your employer was large.
What affects the price of a plan in Illinois
Your monthly price depends mainly on the ages of the people covered, the number of people on the plan, where you live, tobacco use, the plan design you pick (deductible and out-of-pocket maximum) and the carrier's underwriting.
Prices vary a lot by age and household, so the fastest way to see a realistic range is to run your own numbers. Get an estimate for your Illinois household. Estimates are not offers and are subject to underwriting.
Leaving a job-based plan in Illinois
When you leave a job in Illinois, compare federal COBRA or Illinois continuation with a private plan of your own.
| Option | How it works |
|---|---|
| Federal COBRA | Employers with 20 or more employees. Usually up to 18 months for the employee, at up to 102% of the plan premium. You generally have at least 60 days to elect. |
| Illinois state continuation (215 ILCS 5/367e) | Fully insured group plans issued in Illinois. Up to 12 months after coverage would have ended because of a job loss or a cut in hours. You must have been covered for the 3 months before. You request it in writing within 30 days of the later of the job ending or the notice, and never more than 60 days after. |
| Private individual plan | Your own plan, not tied to any employer. Price and approval depend on the carrier and underwriting. Many private plans accept applications year round. |
Illinois continuation ends early if you become covered by another group plan or stop paying. Compare the continuation premium with a private plan estimate before the 30 day window closes.
More on this: leaving a job-based plan and COBRA vs a private plan.
Taxes for the self-employed
If you are self-employed and not eligible to join a plan offered by your own or your spouse's employer, you may be able to deduct health insurance premiums for yourself, your spouse and your dependents on your federal return (IRS Form 7206). Illinois has a state income tax. Ask your tax preparer how the federal self-employed health insurance deduction carries into your Illinois return. See the self-employed health insurance deduction.
Check the license, know the regulator
Illinois Department of Insurance. The Illinois Department of Insurance licenses agents and insurance companies and takes consumer questions and complaints. You can verify an agent license through the department before you buy.
Illinois health insurance questions
How long does Illinois state continuation last?
How long do I have to elect Illinois continuation?
Can I buy a private PPO plan in Illinois if I am self-employed?
How do I check that an agent is licensed in Illinois?
Sources
- 215 ILCS 5/367e (Illinois continuation)
- Illinois Department of Insurance
- U.S. Department of Labor: COBRA continuation coverage
General information, not legal or tax advice. Plan availability, benefits and prices vary by carrier and are subject to underwriting. Last reviewed November 2026.
Other state guides: Colorado, Florida, Georgia, Maryland, Michigan, Missouri, North Carolina, Ohio, South Carolina, Texas, Virginia, Wisconsin. All 31 states.
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