You can still get a nationwide PPO in Illinois, even though the marketplace PPO in Cook County costs more than twice what the plans next to it do. Here's how Chicago electricians are sorting it out.
Hi, I'm Sam. Health insurance is my whole job, I'm in Tampa, Illinois sits among my 36 licensed states, and the work is done by phone, which suits anyone standing on a ladder in a basement.
Picture an electrician in Chicago who spent a decade with a contractor downtown and then went out on his own. Now his weeks go to two-flats and bungalows with wiring older than their owners, service upgrades for garages getting EV chargers, and kitchen and basement remodels from Portage Park to Beverly. He's busy and he's licensed, and the first time he bought health insurance for himself, the PPO price on Get Covered Illinois looked like a typo.
It wasn't a typo, and it isn't the last word either: you can still get a nationwide PPO in Illinois, and I can set it up for you.
Illinois plan prices are filed by CMS rating area, and Cook County is Rating Area 1 all by itself. For 2026 it has rates filed for 59 HMOs, 9 POS plans and 10 PPOs from 5 insurers. On silver plans for a 40-year-old, before subsidies, the lowest-priced PPO costs 115% more than the lowest-priced HMO or POS plan, the widest gap of any Illinois rating area. HMOs generally pay out of network only for emergencies. A PPO also pays toward doctors outside its network, at a higher cost to you, without a referral. Medically underwritten private plans offer that on a national network, at a price tied to your health.
The credit decision runs on household income, and for you that means net self-employment income for the coverage year: receipts minus wire and devices, the van, tools, permits, your license and bond, and insurance. You estimate it at enrollment and correct it as soon as the year turns out differently. A single commercial buildout can do that on its own.
Above the credit range, paying more than double for the marketplace PPO is a hard sell. For a healthy household, look at a medically underwritten nationwide PPO instead. The insurer reads your health answers and either covers you, covers you with one earlier condition excluded, or says no. When the answers are clean, the premium can come in under Get Covered Illinois's full price, and the network keeps working in Indiana, Wisconsin or anywhere a family trip goes. Plans set their own benefits, so we go through them one at a time.
Next step: Ring me with your zip and everyone's birth year, and you'll have a nationwide PPO price to hold against the Cook County marketplace.
Get Covered Illinois says losing health coverage from a job may qualify you for a special enrollment period, so you can pick a plan without waiting for open enrollment. If you want the underwritten route, start a few weeks before your last day, because the insurer's review takes time. And keep workers' comp in its own lane: it pays for injuries on a job, never for illness.
Next step: Call me before you give notice, and we'll have your new coverage ready for the day the old one stops.
If someone on your plan manages a chronic illness or needs a prescription without gaps, stay on Get Covered Illinois regardless of income. Its plans have to accept everyone and can't charge more for health. And if work dries up badly, Illinois's Medicaid expansion reaches adults earning up to 138% of the federal poverty level.
Next step: Tell me the doctors and prescriptions that matter, and I'll show you which Cook County plans cover them.
Straight answers, no sales pitch.
Yes. Ten PPOs have 2026 rates filed in Cook County's rating area, but the lowest-priced silver PPO costs 115% more than the lowest-priced silver HMO or POS plan, before subsidies.
I can't speak to how the insurer priced it. What the filings show is that Cook County, Rating Area 1, has the widest PPO gap of any Illinois rating area.
Get Covered Illinois says losing job coverage may qualify you for a special enrollment period.
Yes. Adults with income up to 138% of the federal poverty level can qualify.
Your zip code, the people going on the plan and an idea of what the business netted last year is plenty. I'll set Cook County's marketplace options beside a nationwide PPO, priced, and tell you what I'd choose.
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