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Ambetter

Health insurance plans for individuals and families in Illinois.

Ambetter Health Insurance
Ambetter

Find Your 2026 ACA Health Plan

Compare Ambetter ACA plans available in your area. Enter your ZIP code to see plans and pricing - no contact info required.

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Ambetter – Illinois Health Plans

 

What’s new in 2026

  • Start Smart for Your Baby – Every pregnancy is different. And each person is unique. What doesn’t change is  Ambetter’s commitment to your health and the health of your family. Ambetter’s program was created to support you when you need it. From pregnancy to delivery and after your baby is born. Find useful information about topics that are important to you. Plus, download and save helpful checklists and appointment info!

About Ambetter

Ambetter is a good choice for anyone who qualifies for Cost Sharing reductions, as well as for people who are more concerned about their prescription drug coverage (more copays then similar Blue Cross plans) vs gaining access to a wide provider & hospital network. They also offer medical plans bundled with optional vision & dental plans.

About Premier:

Premier is Ambetter Health’s broadest provider network and is available in all Ambetter Health counties. Members can visit any in-network provider, no referrals needed! When searching the Ambetter Guide, choose “Premier” to locate in-network providers. Adult vision and adult dental buy-ups are available on many plans.

Checking whether your doctor is covered? See our Ambetter provider search guide for how to search the network correctly, which hospital systems are included (Advocate and RUSH), and the 25 Illinois counties where Ambetter is sold.

Ambetter plans are grouped by metal tier. Descriptions for each tier is as follows:

Bronze Plans Are No Longer Being Offered For Plan Year 2026

    Silver plans – Compare Plans Here

    Recommended if you:

    • See your primary care physician for preventive care every year
    • Don’t anticipate any major ongoing medical needs
    • Would like a premium that fits most budgets
    • Would like out-of-pocket expenses that fit most budgets

    Gold plans – Compare Plans Here

    Recommended if you:

    • Will use your coverage often
    • Have an ongoing medical condition that needs treatment
    • Want additional security and peace of mind
    • Are okay with higher monthly premiums
    • Prefer lower out-of-pocket costs

     

    Ambetter Programs: 

    MyHealthPays – The My Health Pays® program helps you focus on your total health. When you complete healthy activities, such as eating right, moving more, saving smart and living well, you can earn up to $500 in rewards! Use reward points to shop for special items at the online My Health Pays Rewards Store or convert them into dollars to spend on healthcare-related items. It’s your choice! Use your rewards to help pay for: 

    • Monthly premium payments
    • Doctor Copays
    • Deductibles/Coinsurance
    • Utilities
    • Telecommunications
    • Transporation, Education, Rent, Childcare
    Restrictions may apply

    Ambetter Coverage Map

    • Bond
    • Calhoun
    • Clinton
    • Cook
    • DuPage
    • Greene
    • Grundy
    • Henderson 
    • Henry
    • Jersey
    • Kane
    • Kankakee
    • Kendall
    • Lake
    • Macoupin
    • Madison
    • Mercer
    • Monroe
    • Montgomery
    • Randolph
    • Rock Island
    • St. Clair
    • Washington
    • Whiteside
    • Will

    Provider Network Highlights

    Cook County

    • Advocate Health Care
      – Advocate Childrens Hospital
      – Advocate Christ Medical Centers
      – Advocate Good Samaritan Hospital
      – Advocate Good Shepard Hospital
      – Advocate Lutheran General Hospitals
      – Advocate South Suburban Hospitals
      – Advocate Trinity Hospital
    • Endeavor Health:
      – Evanston Hospital
      – Northwest Community Hospital
      – Northshore
      – Swedish Hospital
    •  Rush University Medical Center
    • Sinai Health Systems
    • Prime Healthcare
    • Ascension Health

    DuPage County

    • Endeavor Health
      – Edward-Elmhurst Health
      – Northshore-Highland Park
    • Advocate Aurora Health
      – Advocate Condell
      – Advocate Good Samaritan
      – Advocate Good Shepard

    Madison, St Clair, Monroe Counties (East St. Louis)

    • Hospital Sisters Health System (HSHS)
    • SSM Hospital System
    • Saint Luke’s Hospital – St Louis, MO

    Rock Island, Henry, Mercer Counties (Quad Cities)

    Genesis Medical Center Silvis
    UnityPoint Health Trinity – Rock Island

    Will, Kane, Kankakee Counties

    • Rush Copley Medical Center

     

    2026 Plan Comparison – Our Top 3 Recommended Ambetter Plans

    Plan Highlights Focused Silver (Base) Complete Silver (Base) Everyday Gold
    Plan Info Lowest cost Silver plan that includes copays for PCP, Specialist, Lab, Urgent Care & Generic Rx. $0 deductible at 87% and 94%. Lowest cost Gold plan premium on the Core portfolio.
    DEDUCTIBLE $6,300 $6,000 $750
    MAX OUT OF POCKET $8,000 $8,500 $7,500
    COINSURANCE 50% 40% 35%
    PCP VISIT $45 $30 $35
    TELEHEALTH/VIRTUAL NO CHARGE NO CHARGE NO CHARGE
    SPECIALIST VISIT $100 $60 $55
    LAB $50 $40 $35
    PREFERRED GENERIC / GENERIC RX $3 / $25 $3 / $20 $3 / $15
    PREFERRED RX $75 $55 $60
    URGENT CARE / VIRTUAL URGENT CARE $60 / $0 $60 / $0 $35 / $0

     

    Reasons to Choose Ambetter

    • My Health Pays: Members can earn up to $500 in rewards annually, which can reduce monthly premiums by up to $41 per month.
    • Teladoc Program with a $0 copay: At home, in the office or even on vacation. Get medical advice, a diagnosis or a prescription for non-emergency health issues when you need it
    • Affordable Health Plans: Ambetter is projected to have one of the lowest cost Silver plans available on the Marketplace for 2023 Open Enrollment.
    • Start Smart for your Baby: A program created to provide advice and resources for pregnant members and new parents
    • Health Management Programs
    • 24/7 Nurse Advice Line
    • Care Management
    Bronze Plans

    Bronze Plans

    Recommended if you:

    • Rarely use your coverage or see the doctor
    • Want a “just in case” plan
    • Prefer very low monthly premiums
    • Are okay with higher out-of-pocket costs

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    Top 2026 Ambetter of Illinois plans - details and ratings

    Ambetter of Illinois (Celtic) sells in about 25 counties for 2026 with an HMO network that includes a RUSH health system partnership across Chicagoland. Pricing is typically competitive; its service reputation is the trade-off - BBB reviews skew strongly negative on reachability and billing. Representative 2026 plans below; cost sharing varies by county - confirm at quote.

    Star ratings are seeded from public ratings and complaint data and adjust as visitors rate each plan.

    Ambetter Everyday Bronze

    The budget lane of the 2026 lineup.

    Metal level
    Bronze
    Network
    Ambetter HMO (incl. RUSH partnership)
    Plan type
    HMO
    Deductible (single)
    Confirm at quote
    Out-of-pocket max (single)
    Confirm at quote
    HSA-eligible
    No

    Rate this plan

    Rate all four categories - Cost, Plan Value, Customer Service, and Network Size - to unlock the submit button. Comment optional. If you add a first name or county they are shown with your review - leave them blank to stay anonymous.

    Baseline: 3.3 / 5 - seeded from public ratings and complaint data; updates as visitor ratings come in.

    Cost4.0 baseline
    Plan Value3.5 baseline
    Customer Service2.5 baseline
    Network Size3.0 baseline
    Thanks - your review has been submitted.

    Ambetter Focused Silver

    Narrow-design silver aimed at low premiums.

    Metal level
    Silver
    Network
    Ambetter HMO
    Plan type
    HMO
    Deductible (single)
    Confirm at quote
    Out-of-pocket max (single)
    Confirm at quote
    HSA-eligible
    No

    Rate this plan

    Rate all four categories - Cost, Plan Value, Customer Service, and Network Size - to unlock the submit button. Comment optional. If you add a first name or county they are shown with your review - leave them blank to stay anonymous.

    Baseline: 3.3 / 5 - seeded from public ratings and complaint data; updates as visitor ratings come in.

    Cost4.0 baseline
    Plan Value3.5 baseline
    Customer Service2.5 baseline
    Network Size3.0 baseline
    Thanks - your review has been submitted.

    Ambetter Premier Silver

    The silver to check first if you qualify for cost-sharing reductions.

    Metal level
    Silver
    Network
    Ambetter HMO
    Plan type
    HMO
    Deductible (single)
    Confirm at quote
    Out-of-pocket max (single)
    Confirm at quote
    HSA-eligible
    No

    Rate this plan

    Rate all four categories - Cost, Plan Value, Customer Service, and Network Size - to unlock the submit button. Comment optional. If you add a first name or county they are shown with your review - leave them blank to stay anonymous.

    Baseline: 3.3 / 5 - seeded from public ratings and complaint data; updates as visitor ratings come in.

    Cost4.0 baseline
    Plan Value3.5 baseline
    Customer Service2.5 baseline
    Network Size3.0 baseline
    Thanks - your review has been submitted.

    Ambetter Premier Gold

    Top of the 2026 Illinois lineup.

    Metal level
    Gold
    Network
    Ambetter HMO
    Plan type
    HMO
    Deductible (single)
    Confirm at quote
    Out-of-pocket max (single)
    Confirm at quote
    HSA-eligible
    No

    Rate this plan

    Rate all four categories - Cost, Plan Value, Customer Service, and Network Size - to unlock the submit button. Comment optional. If you add a first name or county they are shown with your review - leave them blank to stay anonymous.

    Baseline: 3.3 / 5 - seeded from public ratings and complaint data; updates as visitor ratings come in.

    Cost4.0 baseline
    Plan Value3.5 baseline
    Customer Service2.5 baseline
    Network Size3.0 baseline
    Thanks - your review has been submitted.

    Public sentiment on Ambetter service is citable: its Illinois BBB reviews are strongly negative, centered on unreachable customer service. Weigh that against consistently competitive premiums - and add your own rating above.

    Ambetter of Illinois rate filing history

    Illinois redacts most carrier-level actuarial detail, so a complete requested-vs-approved table per carrier is not publicly available. Here is what the Illinois Department of Insurance and public filings do show - statewide averages plus this carrier’s known figures:

    Plan yearRequestedApprovedNote
    2026 (Ambetter)+18.7% → +38.6% revisedwithin statewide finalLargest revised 2026 request
    2027 (Ambetter)+9.2%pendingLowest 2027 request in IL
    2018 (statewide)~+30%~+30%CSR-defunding silver load year
    2020 (statewide)-0.3%-0.3%
    2024 (statewide)+4.9-5.7%Semi-weighted final
    2025 (statewide)+4.6%Filings partially redacted
    2026 (statewide)+23.4-29.4%+28.8%Final IDOI weighted avg; driven by enhanced-subsidy expiration
    2027 (statewide)+14.0%pendingRequested average

    Sources: Illinois DOI rate filing publications and final-rate releases, ratereview.healthcare.gov, and ACA Signups Illinois tables. Figures are market averages, not your personal premium; subsidies through Get Covered Illinois can absorb much of an increase.