Medicare Advantage plans in Illinois are offered by private companies and include additional benefits beyond Original Medicare. Here are the top 5 carriers providing these plans:
- UnitedHealthcare: Largest market share (33%) in Illinois with a 4.1 CMS Star Rating. Offers HMO, PPO, MAPD, and SNP plans with benefits like dental, vision, and telehealth.
- Humana: Known for HMO and PPO plans, including options for dual-eligibles. Offers dental, vision, fitness programs, and an annual cap on out-of-pocket costs.
- Aetna: Focuses on MAPD plans with dental, vision, telehealth, and wellness benefits. Includes the SilverSneakers® fitness program and over-the-counter allowances.
- Cigna: Provides MAPD and SNP plans with dental, vision, prescription drug coverage, and care coordination. Also includes transportation services and chronic care support.
- Essence Healthcare: Offers MAPD and SNP plans with dental, vision, telehealth, and wellness programs. Focuses on specific regions within Illinois.
Key Takeaway: Choosing the right plan depends on your healthcare needs, location, and preferred benefits. For personalized guidance, consulting with local experts can simplify the decision-making process.
5 Reasons Seniors are Choosing Medicare Advantage
1. UnitedHealthcare
UnitedHealthcare stands out as the dominant player in Illinois’s Medicare Advantage market, boasting the largest share of enrollees. Here’s a closer look at its influence.
Enrollment Numbers
In Illinois, UnitedHealthcare commands a 33% share of the Medicare Advantage market. On a national scale, the company serves over 9 million Medicare Advantage members. In 2024, it represented 29% of total Medicare Advantage enrollment across the United States.
CMS Star Ratings
UnitedHealthcare’s Illinois Medicare Advantage plans average a 4.1 CMS Star Rating. This rating highlights the company’s focus on delivering quality care and ensuring member satisfaction.
2. Humana
Humana plays an important role in Illinois’s Medicare Advantage market, offering various options tailored to meet the needs of Medicare beneficiaries.
Plan Types Offered
Humana provides both HMO and PPO Medicare Advantage plans. For those eligible for both Medicare and Medicaid, the Humana Gold Plus Integrated Medicare-Medicaid plan combines Medicare, Medicaid, and prescription drug coverage into a single, streamlined option.
In addition to standard coverage, Humana includes extra features that enhance their plans.
Supplemental Benefits
Humana’s Medicare Advantage plans in Illinois go beyond the basics of Original Medicare. These plans include coverage for dental, vision, and hearing care, along with integrated prescription drug benefits. They also offer the security of an annual cap on out-of-pocket expenses, helping members manage healthcare costs more effectively.
CMS Star Ratings
According to 2025 industry data, the average Medicare Advantage Star Rating is 3.92. Notably, 40% of contracts are rated four stars or higher, with 62% of enrollees in these top-rated plans. These figures reflect the competitive environment in which Humana operates and the standards they meet to remain a strong player in the Medicare Advantage space.
3. Aetna
Aetna plays a significant role as a Medicare Advantage provider in Illinois.
Plan Types Offered
Aetna provides Medicare Advantage Prescription Drug (MAPD) plans, which bundle Medicare benefits with prescription drug coverage. These plans simplify healthcare by combining services into one package, eliminating the need for separate Medicare supplement plans or standalone prescription drug coverage.
Supplemental Benefits
Aetna goes beyond basic coverage by including several additional benefits in its Medicare Advantage plans. These plans extend beyond Original Medicare by offering dental, vision, and hearing coverage – services that traditional Medicare typically doesn’t include.
Members also benefit from an over-the-counter (OTC) allowance, which helps cover the cost of everyday health items. The plans feature the SilverSneakers® fitness program, offering access to gyms and fitness classes tailored for seniors.
Another standout feature is Resources For Living®, which provides personalized support to help members navigate healthcare decisions. Aetna also includes telehealth services, making it easier for members to consult healthcare professionals remotely, and offers comprehensive care management for those managing chronic conditions.
For those needing medical equipment, Aetna covers durable medical equipment (DME) such as wheelchairs, oxygen supplies, and hospital beds.
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4. Cigna
Cigna plays a vital role in Illinois Medicare Advantage, offering coverage options that cater to seniors throughout the state.
Plan Types Offered
Cigna primarily provides Medicare Advantage Prescription Drug (MAPD) plans in Illinois. These plans combine Medicare Parts A, B, and D into one streamlined package, making it easier for members to manage their healthcare while ensuring prescription drug coverage is included.
The company takes a coordinated care approach, merging medical and prescription benefits. This setup helps improve medication management and reduces the risk of treatment conflicts. Alongside these core offerings, Cigna includes a variety of extra benefits to enhance the overall value of its plans.
Supplemental Benefits
Cigna’s Medicare Advantage plans go beyond the basics of Original Medicare by offering a range of additional benefits. Members can access dental coverage, which includes cleanings, preventive care, and some restorative services. Vision coverage provides annual eye exams and allowances for eyewear, while hearing benefits include evaluations and discounts on hearing aids.
Members also benefit from an over-the-counter allowance for everyday health items and transportation services to help seniors with mobility challenges get to medical appointments. Telehealth services are available, allowing members to consult with healthcare providers virtually.
Cigna’s plans feature wellness programs, such as fitness benefits and personalized health coaching, to encourage proactive health management. For those managing multiple chronic conditions, Cigna offers care coordination services, ensuring seamless communication between healthcare providers.
Additionally, members who need medical equipment are covered for durable medical equipment, including mobility aids, respiratory devices, and other essential tools prescribed by their doctors.
5. Essence Healthcare
Essence Healthcare stands as one of the leading Medicare Advantage providers in Illinois, focusing on specific regions within the state. Its plans combine standard Medicare coverage with specialized care options, catering to the unique needs of its members.
Plan Types Offered
Essence Healthcare provides Medicare Advantage Prescription Drug (MAPD) plans that bundle hospital, medical, and prescription drug coverage. It also offers Special Needs Plans (SNPs) designed to deliver coordinated care for individuals managing chronic health conditions.
Supplemental Benefits
Members can access additional perks with Essence Healthcare plans, including dental and vision coverage, telehealth services, and wellness programs – offering benefits that go beyond what Original Medicare typically provides.
Carrier Comparison Table
Selecting the right Medicare Advantage carrier in Illinois involves weighing several factors, including quality ratings, plan options, benefits, and coverage areas. Below is a comparison of the top five Medicare Advantage providers in the state to help guide your decision.
| Carrier | Rating | Plan Types Available | Supplemental Benefits | Geographic Coverage in Illinois |
|---|---|---|---|---|
| UnitedHealthcare | 4.0-4.5 stars | HMO, PPO, MAPD, SNPs | Dental, vision, hearing aids, wellness programs, telehealth, transportation | Statewide, including Chicago, Springfield, Rockford, and Peoria |
| Humana | 3.5-4.0 stars | HMO, PPO, MAPD, SNPs | Dental, vision, prescription drugs, fitness programs, meal delivery | Major metro areas and suburban regions |
| Aetna | 4.0-4.5 stars | HMO, PPO, MAPD | Dental, vision, telehealth services, wellness coaching | Chicago metro area and select counties |
| Cigna | 3.5-4.0 stars | HMO, PPO, MAPD, SNPs | Dental, vision, prescription drugs, chronic care management | Urban centers and nearby suburbs |
| Essence Healthcare | 3.5-4.0 stars | MAPD, SNPs | Dental, vision, telehealth, wellness programs | Regional areas within Illinois |
The CMS star ratings (ranging from 1 to 5 stars) indicate overall performance, factoring in customer satisfaction, care coordination, and health outcomes. In Illinois, most carriers achieve ratings between 3.5 and 4.5 stars, reflecting solid service quality.
When it comes to plan types, HMO plans require staying within a network and working with a primary care physician, while PPO plans allow out-of-network care at a higher cost. MAPD plans combine medical and prescription drug coverage, and SNPs are designed for individuals with chronic conditions or specific healthcare needs.
Coverage varies significantly by carrier. UnitedHealthcare offers statewide access, including major cities like Chicago and Springfield. Aetna focuses on the Chicago metro area, while Essence Healthcare provides services in select regional areas. Your location will largely determine which carriers and plans are available to you.
This table serves as a quick guide to compare carriers based on quality, plan offerings, and regional availability. Supplemental benefits also vary, offering additional value like dental, vision, fitness programs, and more, depending on the provider.
Conclusion
When selecting a Medicare Advantage plan, focus on finding one that aligns with your healthcare needs, location, and the benefits you prioritize. Each carrier brings something different to the table, from broad coverage areas to additional perks that can make a real difference in your care.
This guide has outlined how various carriers cater to different priorities. The right plan for you will depend on factors like your preferred doctors and hospitals, prescription drug coverage, and any extra benefits that matter to you. For tailored advice, it’s always a good idea to consult with experts who can guide you through the decision-making process.
Illinois Health Agents offers personalized assistance in Medicare plan selection. With access to highly-rated insurance carriers, they work to recommend plans that suit both your healthcare needs and your budget.
Take the time to explore your Medicare Advantage options. The plans from these five carriers provide the flexibility to help you maintain a healthy and active lifestyle. By working with local experts, you can feel confident that your chosen plan will meet your coverage and financial goals.
FAQs
What should I consider when selecting a Medicare Advantage plan in Illinois?
When choosing a Medicare Advantage plan in Illinois, there are several factors to weigh to ensure the plan aligns with your health needs and financial situation. Start by looking at costs, including monthly premiums (some plans even offer $0 premiums), deductibles, and out-of-pocket maximums. These numbers can significantly impact your overall expenses.
Next, examine the coverage options. Many plans include extras like dental, vision, hearing, and prescription drug coverage. These additional benefits can make a big difference depending on your specific healthcare requirements.
It’s also essential to verify that your preferred doctors, hospitals, and specialists are in-network, as most plans operate within specific provider networks. Double-check that your current prescriptions are included in the plan’s formulary. Don’t overlook extra features like telehealth services, which can add convenience to your care.
Because plans differ in benefits and network limitations, taking the time to compare options will help you find one that suits both your healthcare needs and your budget.
How do CMS Star Ratings affect my choice of a Medicare Advantage plan?
CMS Star Ratings are an essential tool for assessing the quality and performance of Medicare Advantage plans. These ratings, which range from 1 to 5 stars, reflect key factors such as customer satisfaction, plan effectiveness, and health outcomes.
Plans that achieve 4 or more stars are often recognized for offering better benefits and services, which helps them build strong reputations and attract more enrollees. In contrast, plans with lower ratings may struggle with reduced funding, potentially affecting their ability to compete. Opting for a highly rated plan means choosing one that adheres to strict quality standards and prioritizes the needs of its members.
What extra benefits do Medicare Advantage plans in Illinois offer compared to Original Medicare?
Medicare Advantage plans in Illinois frequently offer extra perks that Original Medicare doesn’t cover. These can include services like dental, vision, and hearing care, along with wellness programs such as fitness memberships. Certain plans may also cover durable medical equipment (DME) and other health-related services.
These added features aim to provide broader support for your health, which is why many people opt for Medicare Advantage plans when looking for more extensive coverage options.
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