Your Guide to Illinois Medicare Plans and Eligibility
Explore Your Illinois Medicare Options
If you’d like to know what options you’re eligible for, please contact us so we can explain how the program works.
Key Parts of Illinois Medicare
Medicare Part A
(hospital insurance) helps cover inpatient care in hospitals, including critical access hospitals and skilled nursing facilities (SNF), hospice care, and some home health care.
Most people do not pay a premium for Part A.
Medicare Part B
(medical insurance) helps cover medically necessary services like doctors’ services, outpatient care, durable medical equipment, home health services, and other medical services. It also covers some preventative services to help maintain your health.
You pay a monthly premium for Part B.
Medicare Part C
is also known as Medicare Advantage Plans. These are health plan options approved by Medicare and run by private insurance companies. Medicare Advantage Plans provide all of your Part A and Part B coverage, but Medicare Advantage Plans also cover certain extra services.
You pay a monthly premium for each Medicare Advantage Plan.
Medicare Part D
helps cover prescription drugs. These optional prescription drug plans are approved by Medicare and run by private insurance companies.
You pay a monthly premium for each Medicare prescription drug plan.
Who Is Eligible for Medicare?
People under 65 with disabilities who receive Social Security Disability Insurance (SSDI)
People of any age with End-Stage Renal Disease (ESRD) or amyotrophic lateral sclerosis (Lou Gehrig's disease)
People under 65 with certain medical conditions affected by environmental exposure
People under 65 receiving Social Security retirement benefits based on a spouse's work record
Medicare Advantage Plans in Illinois
One option for Medicare coverage is a Medicare Advantage Plan. There are several types of Medicare Advantage Plans to choose from, including HMO (Health Maintenance Organizations), PPO (Preferred Provider Organizations), and MAPD (Medicare Advantage Prescription Drugs).
Medicare Advantage Plans provide an alternative to original Medicare and may offer additional services like vision, dental, or health and wellness programs. You must use the plan’s network of providers, except in emergencies.
Popular Medicare Advantage Plans in Illinois include Aetna, Humana, and UnitedHealthcare.
Medicare Supplement (Medigap) Plans in Illinois
A Medicare Supplement insurance policy may be a better option for those who want the flexibility of original Medicare but would like help paying for out-of-pocket costs like deductibles, copays, and coinsurance. Also known as Medigap policies, these are private health insurance plans that fill gaps in original Medicare coverage.
The ten standardized Medigap plans (A, B, C, D, F, G, K, L, M, and N) provide varying degrees of coverage. Illinois residents are eligible for guaranteed issue rights for Medigap plans within the first 63 days of enrolling in Medicare Part B.
Popular Medigap insurers in Illinois include AARP, Blue Cross and Blue Shield of Illinois, and UnitedHealthcare.
Prescription Drug Plans (Part D) in Illinois
Part D, commonly known as the Medicare prescription drug benefit, provides coverage for prescription medications. You must have a Medicare prescription drug plan or Medicare Advantage plan with prescription drug coverage to receive coverage under Part D.
Comparing Medigap (Supplement) Plans
Reviewing what each plan covers is essential when choosing between the ten standardized Medigap options. Our advisors can help you determine the benefits and costs of each Medigap plan to select the one that best meets your budget and coverage needs, either for the long term or a transitional period when first enrolling in Medicare.
We can also help you understand how Medigap policies work with Medicare Advantage should your needs change.
Medicare Savings Program in Illinois
Gym membership discounts for staying fit
Dental and vision coverage enhancements
Prescription drug programs minimizing medication co-pays
Health incentives like low-cost routine preventive checkups
How Does Original Medicare Work?
Original Medicare consists of Parts A and B, fee-for-service plans that provide excellent coverage but have gaps. Under original Medicare, you can see any provider that accepts Medicare nationwide without referrals. However, you’ll likely incur deductibles, copays, and coinsurance.
Medicare Eligibility in Illinois
Your Initial Enrollment Period allows you to sign up for the Medicare parts you want. It begins three months before your 65th birthday and ends three months after your birth month. This is a seven-month window.
If you don’t enroll when you are first eligible, your premium may permanently increase for each 12-month period during which you could have had Part B or Part D coverage but didn’t sign up for it.
Choosing the Right Medicare Coverage for You
Our personalized guidance considers factors like whether you still work, have retiree or veteran health benefits, want to choose a doctor or don’t mind networks, and want to minimize out-of-pocket costs.
We work with multiple carriers, so you can select a Medigap, Medicare Advantage, or Part D plan, knowing it is the choice that makes Medicare work best for you.
Learn More About Medicare in Illinois
At Smart Insurance Agents, our friendly team will take all the guesswork and stress out of signing up for Medicare. Contact us today for a free, no-obligation consultation to explore your Illinois Medicare options.