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Same Person, Same Illinois ZIP, Two Very Different Health Insurance Prices
Here's a real pattern we see every week in Illinois. Same person, same ZIP code, same month — and two quotes that are hundreds of dollars apart. Here's why.
The person
A 50-year-old self-employed consultant in Chicago. Healthy, no medications, earns about $110,000. No subsidy.
Quote one: Get Covered Illinois
Full-price Silver PPO-style plan from one of Blue Cross Blue Shield of Illinois, Ambetter, Aetna CVS Health, and Oscar: around $900 a month in 2026, $5,000 deductible, network concentrated around Chicago. The price has nothing to do with his health — guaranteed-issue plans can't ask.
Quote two: private shared-network
A PPO on the Cigna, Aetna and PHCS PPO network: around $450 a month, $2,500 deductible, national network. The price has everything to do with his health — he answered a questionnaire and qualified.
Why both prices are "right"
They're answering different questions. The marketplace asks "what does it cost to insure everyone?" and spreads it evenly. The private plan asks "what does it cost to insure you?" For a healthy person, the second question has a lower answer. For someone with a serious condition, it wouldn't — and the marketplace would be the better deal.
What it means for you in Illinois
Illinois moved to its own state-run marketplace, Get Covered Illinois, for 2026 coverage, and Chicago-area marketplace plans are heavily HMO — one reason suburban business owners look at national PPOs. If you're healthy and above the subsidy line, you should see both numbers before you renew. Check your options.