Independent Medicare Broker in Chicago, Illinois

Medicare guidance for Chicago, Illinois

Cook County and the collar counties are treated as separate service areas by many plans, so a plan available in Chicago proper may not be offered in Naperville or Kankakee, and the provider network can differ even where the plan name is the same.

O’Neal Insurance Group works with people across Chicago and the surrounding suburbs, including Aurora, Naperville, Joliet, Elgin, Waukegan and Kankakee. Guidance is free, there is no obligation, and you can meet by phone or online screen sharing rather than travelling to an office. Call (312) 348-7209 to start.

Your county decides what is available

Medicare Advantage and Part D plans are approved county by county, not statewide. For this area that usually means Cook County, with neighbouring DuPage, Will, Lake, Kane and Kankakee counties. Your permanent address determines which plans you may enroll in, so that is the first thing to confirm — not the premium.

Check your hospitals and doctors first

Around Chicago, care is concentrated in a handful of systems, including Northwestern Medicine, Rush, UChicago Medicine, Advocate Health Care and Cook County Health. Participation changes from year to year and differs between plans from the same insurer, so verify your own doctors and preferred hospital directly with the plan and with the provider office before enrolling. A plan can be excellent on paper and still be the wrong plan if your cardiologist is out of network.

What to have ready

• Your Medicare number and your Part A and Part B start dates.
• Your permanent ZIP code and county.
• Every doctor and specialist you want to keep.
• Every prescription, with exact dosage and how often you take it.
• Any Medicaid, Extra Help, VA or employer coverage you already have.

Enrollment periods that apply

Most people can make changes during the Annual Enrollment Period each autumn, with changes effective 1 January. People already in a Medicare Advantage plan have a further window early in the year to switch or return to Original Medicare. Separate Special Enrollment Periods may apply if you move, lose other coverage, or gain or lose Medicaid. Moving to or from Chicago is itself a qualifying event worth asking about.

Costs beyond the premium

A zero-dollar premium does not mean zero cost. Compare the annual out-of-pocket maximum, specialist and hospital copays, and how each of your prescriptions is tiered on that plan’s formulary. For many people the drug tiers, not the premium, are what separates a good plan from an expensive one.

Help that does not cost anything

If you moved between city and suburb, or are planning to, confirm the plan still serves your new county before you assume coverage carries over.

You can also get free, unbiased counselling from your State Health Insurance Assistance Program (SHIP), or compare every plan yourself at Medicare.gov or by calling 1-800-MEDICARE. We do not offer every plan available in your area, and you are always free to review all of your options.