Benchmark $646/mo · +28.8% approved · Get Covered Illinois
Prefer to talk? Call (713) 575-9904
Licensed Independent Agent · NPN #22052447 · 23 States
A 40-year-old occupational therapist in Illinois faces a benchmark premium of $646/month for 2026, up from $474 in 2025. That is 3% above the national benchmark of $625. Carriers were approved for an average increase of +28.8%.
Illinois runs its own exchange, Get Covered Illinois, rather than healthcare.gov. CMS therefore excludes it from the Qualified Health Plan Landscape file that powers most of this site, so there is no public plan-by-county premium table for Illinois the way there is for Florida or Texas. What you get instead — approved rate changes, carrier concentration and the benchmark series — comes straight from state filings, and in some ways says more, because these are rates a regulator actually approved rather than rates an insurer filed.
Illinois launched its own exchange for plan year 2026, making it the most recent state to leave healthcare.gov. Several carriers revised filings upward after the initial submission: Celtic went from a requested 18.7% to an approved 38.6%.
| Illinois — 2026 | Figure |
|---|---|
| Benchmark premium, age 40 (2026) | $646 |
| Benchmark premium, age 40 (2025) | $474 |
| Year-over-year change | +36.3% |
| Approved average rate increase | +28.8% |
| Versus the national benchmark ($625) | +3% |
| Rank among your 21 licensed states | 15 of 21 |
| Counties | 102 |
| Carriers on the exchange | 6 |
| Exchange | Get Covered Illinois (state-run since 2026) |
| Carrier | Network | Members | 2026 approved |
|---|---|---|---|
| Ambetter (Celtic) | — | — | +38.6% |
| Molina Healthcare | — | — | +21.5% |
| UnitedHealthcare | — | — | +20.8% |
| Oscar | — | — | +10.4% |
Three carriers left the Illinois individual market for 2026 — Aetna, Health Alliance Medical Plans and Quartz Health — so the county-level choice set narrowed in much of the state.
Sources: Illinois Department of Insurance 2026 rate approvals, finalized September 8, 2025. KFF, “Marketplace Average Benchmark Premiums,” 2026. Benchmark is the second-lowest-cost Silver plan for a 40-year-old, weighted by plan selections.
Steady, predictable utilization means copay design and network breadth drive annual cost more than the sticker premium.
Occupational context: Lifting and transfer injuries; repetitive strain.
None of that changes your price. Plans in Illinois are community rated — premium varies by age, ZIP code, tobacco use and household size only. Occupation cannot be used to rate, decline or exclude you.
Ranked on the benchmark premium, the one measure published on the same basis for every state. Cheaper: North Carolina ($638), Utah ($640), Alabama ($645). More expensive: South Dakota ($655), Texas ($661), Kansas ($670).
You buy where you live, not where you work, so treat this as context rather than a shopping list. A genuine move does open a special enrollment period.
Expense categories that typically apply to this trade: Licensing, equipment, malpractice insurance, CE. Health premiums are generally deductible above the line under IRC §162(l) when no employer plan is available to you or a spouse. The deduction lowers your AGI, and AGI sets your premium tax credit, so the two calculate against each other — worth raising with your CPA before you enroll rather than after.
Illinois carriers were approved for +28.8% on average for 2026. Increases were large across the country because the enhanced federal premium tax credits expired at the end of 2025.
The 2026 benchmark premium in Illinois is $646 per month for a 40-year-old, up from $474 in 2025. That is full price before premium tax credits; most buyers pay less after subsidies.
Carriers in Illinois were approved for an average increase of 28.8%. Filings across the country cited the expiry of the enhanced federal premium tax credits at the end of 2025, rising medical and drug costs, and expectations that healthier people would drop coverage.
No. Exchange plans are guaranteed issue and community rated. Price varies only by age, ZIP code, tobacco use and household size. Occupation is not a rating factor.
No. Illinois runs its own exchange, Get Covered Illinois, state-operated since 2026. You enrolll there rather than on healthcare.gov.
Above the cliff. At this income a single-person household receives no premium tax credit for 2026 and pays the full premium.
This occupation is above the cliff in all 21 states reported.
What this figure is. It is the median annual wage BLS reports for Occupational Therapists (SOC 29-1122) in Illinois. BLS surveys wage and salary workers and excludes the self-employed, so it is a benchmark for the occupation in this state — not the income of a self-employed occupational therapist. Premium tax credit eligibility is set by household modified adjusted gross income and household size, not by occupation, so treat this as a reference point rather than a determination of what you qualify for.
Why the cliff is back. The enhanced premium tax credits expired on 31 December 2025. For plan year 2026 the 400% FPL limit applies again, so household income above $62,600 ends premium tax credit eligibility outright.
This page compares states. For Illinois specifically — county-level carriers and enrollment help — I publish that on Coverage by County, including a page written for Occupational Therapists in Illinois and a blog covering deductibles, subsidies and special enrollment.
← Occupational Therapists in all 21 states · All occupations
Because Illinois operates a state-based exchange, its 2027 data is published separately from the federal landscape files. If you are an occupational therapist here, the national summaries are usually either late or simply wrong about this state.
Nobody can tell you your 2027 Illinois premium yet. Filings nationally cluster around a 15% median increase, with the full spread running −1% to 54% — and until this state signs off, a specific local number is invention.
The window opens November 1, 2026, and December 15 is the date worth writing down — it is what secures January 1 cover in Illinois and everywhere else. You will find later dates quoted; they stem from a 2025 rule that was vacated in June 2026 and is under appeal.
Illinois publishes its 2027 plan data on its own schedule rather than in the federal files, so the earlier you get a read on your options the less you are relying on national summaries that may not apply here.
Give me a ZIP and I will tell you three things:
Two Occupational Therapists on opposite sides of Illinois can be quoted very different premiums for the same plan. Your ZIP is what decides it.