Medicare in Illinois

Jory Cross by Jory Cross | Licensed since 2012
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This article was updated on: 09/16/2018

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Looking for Medicare insurance in Illinois can be easy with Medicare.com. Let us be your resource for all things Medicare. First, take a look at this overview of Medicare options for people living in Illinois.

About Medicare in Illinois

Medicare beneficiaries in Illinois can receive their coverage through Original Medicare, Part A and Part B, and add coverage in the form of a stand-alone Medicare Part D Prescription Drug Plan and/or a Medicare Supplement (Medigap) insurance plan. Beneficiaries may also enroll in a Medicare Advantage plan, which lets them get their Original Medicare, Part A and Part B, coverage (with the exception of hospice care) through a private insurance company that is approved by Medicare. These plans could also include routine vision, dental, and even prescription drug coverage.

If you choose to enroll in a Medicare Advantage plan in Illinois, you must continue to pay your Medicare Part B premium.

Types of Medicare coverage in Illinois

Original Medicare, Part A and Part B, is available for beneficiaries in every state throughout the nation, including Illinois. Medicare Part A covers inpatient hospital care, skilled nursing facility care, nursing home care (as long as custodial care isn’t the only care you need), home health services, and hospice care. Medicare Part B covers physician services, durable medical equipment, and preventive care.

Medicare Advantage plans, also called Medicare Part C, are required to offer the same amount of coverage as Original Medicare (with the exception of hospice care), and some plans may include additional benefits, such as routine vision, dental, prescription drug coverage, and health wellness programs. Medicare Advantage plan details and costs are likely to vary by provider.

Medicare Part D is optional prescription drug coverage. It must be purchased separately if you have Original Medicare. Illinois beneficiaries with Original Medicare can get this coverage through Medicare Prescription Drug Plans which are stand-alone plans available through private insurance companies approved by Medicare. They can also get prescription coverage through a Medicare Advantage plan that includes drug benefits (known as a Medicare Advantage Prescription Drug plan); in this case, they would get their Medicare Part A, Part B, and Part D coverage all under a single plan.

Medicare Supplement insurance is available in Illinois to beneficiaries enrolled in Medicare Part A and Part B who are looking to cover “gaps” in their health-care costs. Medicare Supplement insurance, also known as Medigap, is offered by private insurance companies. There are up to 10 standardized policy options in most states, each one marked with a letter. Plans of the same letter offer the same benefits no matter which insurance company offers the plan, but prices may vary.

Local resources for Medicare in Illinois

  • Medicare Savings Programs in Illinois: Illinois has programs to help beneficiaries who are unable to pay their out-of-pocket Medicare costs. Anyone can apply for these savings programs, but they are generally for Medicare beneficiaries whose income is below a government-set limit.
  • Illinois State Health Insurance Counseling and Assistance Program (SHIP): The Senior Health Insurance Program (SHIP) offers complimentary Medicare counseling for Illinois Medicare beneficiaries.

How to apply for Medicare in Illinois

To qualify for Medicare, you must be either a United States citizen or a legal permanent resident of at least five continuous years.

The Medicare enrollment process is the same in all states. Illinois residents can be enrolled automatically when they turn 65, provided they are receiving retirement benefits through either the Social Security Administration or the Railroad Retirement Board. Some Illinois residents may actually be enrolled sooner than age 65 if they receive Social Security disability benefits (or certain Railroad Retirement Board benefits) for 24 consecutive months.

You may also qualify for automatic enrollment if you have amyotrophic lateral sclerosis (or Lou Gehrig’s disease); in this case, you’ll be automatically enrolled in Medicare starting the first month of disability benefits.

In these cases, Illinois residents will receive their Medicare card in the mail a few months prior to their Medicare start date.

If you aren’t receiving retirement benefits when you turn 65 or if you qualify for Medicare because you have end-stage renal disease, you won’t be automatically enrolled. If you have to enroll manually, you may visit your local Social Security office or register online or by phone.

  • Visit the Social Security website.
  • Call Social Security at 1-800-772-1213 (TTY users should call 1-800-325-0778), Monday through Friday, 7AM to 7PM.
  • Apply in person at a Social Security office.
  • If you worked for a railroad, call the Railroad Retirement Board at 1-877-772-5772 (TTY users call 312-751-4701), Monday through Friday, 9AM to 3:30PM.

I can help you sort through the Medicare options available in Illinois, based on your needs and plan choices. To learn more about my background and why I enjoy helping people with their Medicare questions, see my profile using the “View profile” link below. When you feel ready, reach out to me for a phone appointment or an email showing plans that could work for you; the links for those are below also. To take a look at plans right now, use the Compare Plans button on the right side of this page.

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