Meta Description: Stressed about losing Medicaid in Illinois? You’re not alone. Learn how to transition from Medicaid to ACA Illinois Marketplace coverage and book a free consultation with Tanya Danilkovich.

If you recently opened a letter telling you that your Medicaid coverage is ending, you probably felt something close to panic. Maybe confusion came first, then frustration — because nothing about your health situation changed. You still need your medications. You still have a doctor you trust. And yet, here is this notice telling you that your coverage is gone.

That feeling is completely valid. And you are far from alone.

Right now, hundreds of thousands of Illinois residents are receiving the exact same type of notice as part of a large, statewide process called the Medicaid unwinding. This is not something you caused. It is a system-wide event that has been unfolding across every state since early 2023, affecting millions of Americans who were enrolled in Medicaid during the COVID-19 pandemic. According to KFF, tens of millions of people nationwide have been subject to Medicaid redeterminations since the federal continuous coverage requirement ended.

By the time you finish reading this guide, you will understand exactly what triggered your coverage loss, what your real options are right now, and what your single most important next step is — starting today.

I want to be transparent with you from the beginning: my name is Tanya Danilkovich, and before I became a licensed independent insurance broker, I spent years working as a Medicaid, SSI, and SNAP eligibility coordinator — on the inside of the exact public benefits system you are trying to navigate right now. I have processed eligibility cases, reviewed redeterminations, and guided families through benefit transitions from the other side of the desk. I know how disorienting this moment feels. And I want to help you move through it with clarity and confidence.

What Is the Medicaid Unwinding — And Why Did This Happen?

Losing Medicaid right now is almost certainly the result of a nationwide policy shift — not something you did wrong.

Here is what happened in plain English. During the COVID-19 pandemic, a federal rule required every state — including Illinois — to keep Medicaid enrollees continuously covered. That meant the state had to pause all of its normal annual eligibility reviews, called redeterminations, for the duration of the federal Public Health Emergency. Millions of people who might otherwise have lost coverage during those years were protected by this rule, even if their income or household situation had changed.

That federal protection ended on March 31, 2023. Once it expired, Illinois was legally required to restart normal annual redeterminations for its entire Medicaid caseload — all at once. Illinois processes approximately one-twelfth of its caseload per month on a rolling schedule, which is why termination notices have been going out steadily since April 2023 and continue today.

Starting with redeterminations due on or after June 1, 2024, Illinois also removed several flexibility measures that had been in place, including a 30-day grace period for late renewal forms and the ability to self-attest residency in certain cases. This change, outlined by Age Options, makes it easier to lose coverage unintentionally if paperwork is delayed, incomplete, or sent to an old address.

The most common reasons people lose Medicaid during this process include:

• Income above the eligibility threshold — for most Illinois adults under 65, the Medicaid income limit is 138% of the Federal Poverty Level (FPL)
• Changes in household composition — a marriage, divorce, a child aging out of coverage, or a change in dependents
• Failure to respond to a renewal notice — often because it went to an outdated address, was mistaken for junk mail, or was never received
• Administrative or data verification errors — the state could not electronically verify a piece of information, and coverage was ended even though the person may still be fully eligible

That last point matters deeply. According to Illinois HFS guidance, coverage can be lost not because a person is ineligible, but because the system could not confirm their information. Having worked on the eligibility side of this process, I can tell you firsthand that incorrect terminations happen more often than most people realize. If something about your termination feels wrong, it is absolutely worth investigating before you assume the decision is final.

The most important thing to understand right now: losing Medicaid does not mean losing access to affordable coverage. It means the pathway has changed — and there are real, accessible options on the other side.

The Clock Is Ticking — Your Illinois Special Enrollment Period Explained

One of the most critical things to know right now is that losing Medicaid or CHIP coverage is classified as a Qualifying Life Event (QLE). That legal designation gives you a protected window — called a Special Enrollment Period (SEP) — to enroll in a health insurance plan on the ACA Marketplace outside of the normal enrollment season.

Here are the essential facts about your SEP:

• You have 60 days from the date your Medicaid coverage ends to enroll in a Marketplace plan. This is confirmed by Illinois HFS.
• You do not have to wait until your Medicaid officially ends to begin the process. In many cases, you can apply in advance once you know the termination date, so that your new coverage starts the month after Medicaid ends — with no gap in between.
• Illinois residents enroll through the federal Marketplace at Healthcare.gov, which is locally supported through a state initiative called Get Covered Illinois.
• If you miss the 60-day SEP window and do not have another qualifying event, you may have to wait until the next Open Enrollment Period — which typically runs from November 1 through January 15 — to get Marketplace coverage. That could mean several months completely uninsured.

Key Fact: You have 60 days from your Medicaid termination date to enroll in a Marketplace plan. Don’t wait.

This window, while time-sensitive, is absolutely navigable — especially with the right guidance. In my experience working with clients at TD Integrity Insurance Solutions, the families who reach out earliest in this window consistently end up with the most options and the most time to make a thoughtful, informed choice. The 60-day window sounds generous until it isn’t.

Your Real Options After Losing Medicaid in Illinois

You have more choices available to you than you may realize. Here is a clear breakdown of every meaningful option.

Option 1 — Enroll in an ACA Marketplace Plan (The Most Common Path)

The ACA Health Insurance Marketplace — accessed through Healthcare.gov — is the most common and, for many people, the most financially accessible path forward. Marketplace plans are private health insurance plans that are required by law to cover ten categories of essential health benefits, including doctor visits, hospitalization, maternity care, mental health services, and prescription drugs.

Two forms of financial assistance can significantly reduce what you pay:

• Premium tax credits lower your monthly premium. The amount of assistance is based on your household income and size — generally, the lower your income within the eligible range, the greater the reduction in your monthly cost.
• Cost-sharing reductions (CSR) lower your actual costs when you use healthcare — things like deductibles, copays, and annual out-of-pocket maximums. There is one critical detail here that is commonly missed: CSR assistance is only available on Silver-level plans. If you qualify for CSR and choose a Bronze plan because the premium looks lower, you forfeit this benefit entirely.

One of the most important and often surprising truths about the transition from Medicaid to ACA in Illinois: many people who lose Medicaid qualify for Marketplace plans with very low monthly premiums — sometimes $0 — after subsidies are applied. According to healthinsurance.org, this is a consistent reality for Illinois residents in lower income brackets. The assumption that private insurance is automatically unaffordable deserves to be questioned before any decision is made.

Option 2 — Reapply or Appeal If the Decision Was an Error

Not everyone who loses Medicaid during unwinding was actually ineligible. If you believe your termination was a mistake, you have two important pathways:

• Reinstatement within 90 days: If you complete your redetermination paperwork within 90 days of losing coverage, your Medicaid can be reinstated — potentially without any gap. Healthcare providers can bill Medicaid for services received during that period. Illinois HFS and Age Options both confirm this pathway. If the 90-day window passes, a new application is required.
• Appealing an incorrect termination: If your income was miscalculated, documents were lost, or your disability or medical expenses were not properly considered, you have the right to request reconsideration through Illinois HFS. Practical steps: keep every notice you receive, call the number on the notice to ask about appeal rights and deadlines, log into the Illinois ABE (Application for Benefits Eligibility) portal to check your status and submit documents, and contact a free legal aid organization if you need help interpreting a denial. Guidance is available at hfs.illinois.gov.

Having worked inside this system, I can tell you that incorrect terminations happen more frequently than most people expect — often because a document was missing from a file or an address change never made it into the database. If something feels wrong about the decision you received, it is worth pursuing before you move on.

Option 3 — Enroll in Employer-Sponsored Coverage

Losing Medicaid also qualifies as a QLE for most employer health plans, which typically triggers a 30-day special enrollment window to join a job-based plan outside of the annual open enrollment period. If you or your spouse have access to coverage through an employer, notify HR promptly and ask specifically about this window.

One nuanced point worth knowing: employer coverage is not automatically your best or most affordable option. Depending on your income and household size, a subsidized ACA Marketplace plan can sometimes offer lower total costs than an employer plan — particularly if the employer’s contribution to premiums is limited. This is exactly the kind of side-by-side comparison that an independent broker can help you evaluate without any pressure or bias toward a particular outcome.

Option 4 — Children May Still Qualify for Medicaid / All Kids (CHIP)

This is one of the most commonly missed and most consequential points in this entire guide.

In Illinois, children ages 0–18 can qualify for Medicaid or the All Kids program — Illinois’s combined Medicaid/CHIP program for children — at a much higher income threshold than adults. According to healthinsurance.org, children are eligible up to 318% of the Federal Poverty Level — far above the 138% FPL limit that applies to most adults.

This means a parent can lose their own Medicaid eligibility due to income while their children remain fully eligible for All Kids. These are separate eligibility determinations. Many families mistakenly enroll their children in private Marketplace coverage when the children were never actually ineligible for free or low-cost public coverage — and end up paying significantly more than necessary.

This is an area where my background in Medicaid eligibility coordination is particularly valuable. Household-level coverage situations — where different family members may be eligible for different programs — are exactly what I help families identify and plan for at TD Integrity Insurance Solutions.

How the ACA Marketplace Actually Works — A Plain-English Guide for First-Time Enrollees

For many people coming off Medicaid, the Marketplace is completely unfamiliar territory. That is entirely normal. The goal of this section is to give you enough foundational knowledge to feel confident — not overwhelmed — going into a conversation about your options.

Metal tier levels — it’s about cost-sharing, not quality:

Marketplace plans are grouped into four tiers: Bronze, Silver, Gold, and Platinum. The tiers reflect how costs are split between you and the insurer — they do not reflect the quality of care you receive.

• Bronze: Lower monthly premium, but higher deductible and out-of-pocket costs when you actually use care.
• Silver: Moderate premium and moderate cost-sharing. Critically — cost-sharing reductions are only available on Silver plans. For income-eligible enrollees, a CSR-eligible Silver plan can actually have lower total out-of-pocket costs than a Bronze plan, despite the higher premium. This is one of the most misunderstood and financially consequential aspects of the Marketplace.
• Gold/Platinum: Higher monthly premiums, but lower costs when care is used. These tiers may make financial sense for people with frequent, predictable medical needs.

The bottom line: choosing a plan based solely on the lowest monthly premium can be a costly mistake. Total cost means premium plus out-of-pocket expenses. The right tier depends entirely on how much healthcare you realistically expect to use.

Plan network types — HMO vs. PPO:

• HMO (Health Maintenance Organization): Usually requires a primary care physician and referrals to see specialists. Coverage is generally limited to in-network providers except in emergencies.
• PPO (Preferred Provider Organization): More flexibility to see specialists without referrals, and some coverage for out-of-network providers — at a higher cost.

Before enrolling in any plan, verify that your current doctors, hospitals, and specialists are in that plan’s network. If they are not, you may face significantly higher costs or need to change providers.

Prescription drug formularies:

Each plan has a formulary — a list of covered medications organized into cost tiers. A prescription covered affordably under one plan may fall into a more expensive tier under another. Always confirm your current medications are covered and at what cost level before you select a plan.

This is exactly the kind of detail that is easy to overlook when enrolling alone — and exactly where working with an experienced, independent broker delivers real, tangible value.

Common Mistakes Illinois Residents Make During This Transition — And How to Avoid Them

After years of working with clients navigating this exact situation, here are the mistakes I see most often — and what to do instead.

• Waiting too long and missing the 60-day SEP window. This is the single most consequential error. Once the window closes, you may face months of uninsured exposure before the next Open Enrollment Period. The time to act is now, even if you feel uncertain. Illinois HFS guidance confirms this deadline clearly.
• Assuming they won’t qualify for financial help on the Marketplace. Many people who lose Medicaid significantly overestimate what they will owe for private coverage. After premium tax credits are applied, many Illinois residents in this income range qualify for very low-cost or $0-premium plans. Healthinsurance.org reinforces this consistently. Verify before you assume.
• Not checking whether children still qualify for All Kids/CHIP separately. Children are eligible for All Kids up to 318% FPL. Enrolling children in private Marketplace plans when they were never disqualified from public coverage is a costly and entirely avoidable error.
• Choosing the cheapest premium without understanding total out-of-pocket costs. A Bronze plan with a very low premium can become financially devastating for someone with ongoing prescriptions or chronic health needs. The premium is only part of the picture.
• Going directly to a single insurance company instead of comparing the full market. Visiting one carrier’s website or call center shows you only that company’s plans. There is no comparison, no advocacy, and no one looking out for your interests. An independent broker compares the entire market — at no cost to you whatsoever.
• Skipping network and prescription verification before enrolling. Enrolling without confirming that your doctors and medications are covered in-network can result in unexpected bills or forced provider changes. This step takes minutes with proper guidance and prevents significant financial harm.

The TD Integrity Approach: Why Working With an Independent Broker Makes This Easier — and Costs You Nothing

Let’s address the biggest misconception directly: working with a licensed health insurance broker does not cost you anything extra. Brokers are compensated directly by insurance carriers. Your monthly premium is identical whether you enroll through a broker or alone through Healthcare.gov. There is no hidden fee, no markup, and no obligation.

What you gain, however, is significant.

As an independent broker, Tanya Danilkovich is not employed by or contracted exclusively with any single insurance carrier. She compares plans across multiple top carriers to find what genuinely fits your health needs, budget, and provider preferences — not what generates the best outcome for any one insurance company. That independence is fundamental to the way TD Integrity Insurance Solutions operates.

What an independent broker provides that Healthcare.gov alone cannot:

• Accurately reporting household income and composition — a common source of errors that can affect your subsidy amount and create tax reconciliation problems at year-end
• Explaining plan differences in plain English, including the critical CSR/Silver plan nuance, network structures, and formulary details
• Verifying that your current doctors, hospitals, and prescriptions are covered before you commit to a plan
• Being available year-round for questions, plan changes, and renewals — not just during open enrollment season

What sets the TD Integrity approach apart is a perspective that very few brokers anywhere can offer: years spent working as a Medicaid, SSI, and SNAP eligibility coordinator — on the inside of the exact system you are navigating right now. That means understanding how redeterminations are actually processed, where administrative errors occur, how household-level eligibility is evaluated, and what options are frequently overlooked by families in transition. That institutional knowledge is the lens through which every client situation at TD Integrity Insurance Solutions is examined.

One important clarification: Tanya provides education, plan comparison, and genuine advocacy. Final eligibility determinations for Medicaid are always made by government agencies — HFS and IDHS. Marketplace eligibility and subsidies are determined through Healthcare.gov. What TD Integrity provides is clarity, thorough comparison, and someone firmly in your corner.

Why Tanya Danilkovich Is Uniquely Qualified to Guide You Through This

When you lose Medicaid coverage in Illinois, you don’t need a call center reading from a script. You need someone who has been inside the system, understands every pathway available to you, and genuinely cares about finding the right fit for your family — not just getting you enrolled.

Tanya Danilkovich brings a specific and rare combination of credentials to this exact situation:

• 15+ years of experience as a licensed independent insurance broker, helping individuals, families, and small business owners understand and navigate their coverage options
• Former Medicaid, SSI, and SNAP eligibility coordinator — she has worked directly inside the Illinois public benefits system, processed eligibility cases, reviewed redeterminations, and guided families through benefit transitions from the inside out
• Truly independent broker status — not affiliated with any single insurance carrier; works for the client’s best interest, not any company’s enrollment quota
• Licensed in Illinois, Florida, and Ohio — with deep, specific familiarity with Illinois Medicaid policy, the Illinois ACA Marketplace, and the local provider landscape
• Founder of TD Integrity Insurance Solutions — built on the philosophy of ‘Personalized guidance you can trust’ and a genuine commitment to simplifying complex systems for real families facing real decisions

If you are currently navigating the transition from Medicaid to ACA coverage in Illinois, that combination of insider knowledge and independent advocacy is exactly what the situation calls for.

Illinois Resources for Medicaid Renewal, Appeals, and Marketplace Enrollment

Here are the official resources you need — organized and explained in plain English.

• Illinois ABE (Application for Benefits Eligibility) Portal — hfs.illinois.gov: Log in to check your Medicaid renewal date, submit renewal documents, update your address, and monitor your application status.
• Illinois Department of Healthcare and Family Services (HFS): The primary agency for Medicaid renewal questions, redetermination guidance, appeals, and coverage reinstatement requests.
• Illinois Department of Human Services (IDHS): For benefit-related questions, application support, and assistance navigating public benefits in Illinois.
• Healthcare.gov — Get Covered Illinois: To explore ACA Marketplace plans, apply using your Special Enrollment Period, compare subsidies, and enroll in coverage.
• KFF Medicaid Unwinding Resource: For broader context on the national Medicaid unwinding process and what to expect.

Not sure which resource applies to your specific situation? That is exactly what a free call with Tanya is for.

Ready to take the next step?

Navigating the transition from Medicaid to ACA coverage in Illinois does not have to be confusing or overwhelming. Whether you need help understanding your options, comparing plans, checking whether your children still qualify for All Kids, or simply making sense of a notice you received — Tanya Danilkovich is here to provide clear, honest, no-pressure guidance.

Book your free, no-obligation consultation with Tanya Danilkovich at TD Integrity Insurance Solutions today. There is no cost to you, no obligation to enroll in anything, and no pressure — just personalized guidance you can trust.

This article is intended for general educational purposes only and does not constitute individualized medical, legal, tax, or financial advice. Medicaid eligibility determinations are made by the Illinois Department of Healthcare and Family Services and the Illinois Department of Human Services. ACA Marketplace eligibility and subsidy determinations are made through Healthcare.gov. Please consult a licensed insurance professional and the appropriate government agencies for guidance specific to your household situation.