Low-cost Ohio health insurance plans are offered through the Marketplace. Medical Mutual, Anthem, Ambetter, Oscar, Molina, SummaCare, and CareSource feature budget-friendly policies that are extremely affordable and inexpensive. Premiums for individuals, families, the self-employed or the unemployed will be much cheaper than you realize after viewing some of the plans, and including a federal instant tax credit (subsidy).
We help you apply and enroll for both on and off-Exchange policies. Medical questions and physicals are not required,and meeting specific underwriting guidelines are not needed. Quality benefits are no longer impossible to obtain, and the ACA subsidy could pay most or all of your premium payments for Ohio Marketplace plans. The instant tax credit is based on your household income, and ages of all applicants.
You can obtain benefits with many companies, regardless if you have previous coverage, or if a prior policy has lapsed. During the official Open Enrollment election periods, there are no pre-existing condition exclusions, and previously unavailable benefits, such as mental illness and maternity, are included on all Exchange plans. Out-of-pocket costs will vary, and can be quite substantial, unless an upper-tier plan is selected.
The best health insurance often contains coverage found in more expensive policies. While catastrophic expenses are covered, additional benefits such as office visits, prescriptions, preventative exams and lab/X-ray costs are also included. Preventive benefits are covered at 100% with no waiting period. Thus, if your policy effective date is January 1, a routine annual physical scheduled for January 2 is completely covered. Complications that result from the annual physical may be subject to a deductible.
Student medical plans are offered by most carriers. Since most students are under age 25, prices are less expensive than the typical adult plan. Preventative benefits are also provided without a copay, coinsurance, or deductible. Since University-provided policies will always cost more than $25 per month, continuing coverage through a parent’s subsidized contract (or employer-provided group plan) is often the only option to keep premiums low.
Affordable Care Act Plans
Healthcare reform changes mandated the preventive benefits coverage along with many additional items including the elimination of lifetime caps on benefits paid. These extra benefits also apply to high-deductible policies and most other contracts. Only short-term, critical illness, limited-benefit, and other unapproved policies do not contain these requirements.
Additional “essential benefits” automatically began to be included on all policies five years ago as part of legislation issued by the Department of Health And Human Services. Maternity and mental illness are two provisions that are covered along with many others. Previously, comprehensive contracts excluded many of these services or placed a waiting period and/or extra deductible on benefits. Policies are also not medically-underwritten, so no medical questions are asked, and a physical is not required for any applicant.
Our “Get Free Quotes” box at the top of this page, allows you to view and compare all available Ohio health insurance plans at the lowest available rates. Also, listed below are some budget-oriented choices with surprisingly comprehensive benefits. Depending on the plan, a copay (only) may apply to primary care physician and,or specialty office visits. “Virtual” office visits often have a $0 or low copay. Urgent Care copays are higher, and sometimes not subject to the policy deductible.
Market HMO Young Adult Essentials (Medical Mutual) – Since this policy is offered in the “catastrophic” Metal tier, unless you’re under 30 or can qualify for a financial hardship exception, it is not available. The plan is ideal for students, professionals or young persons that seek the lowest available premium, and are willing to accept a larger ($8,550) deductible.
A $40 copay for office visits (first three) bypasses the deductible and large negotiated provider discounts help offset the cost of additional non-preventive visits. An optional dental and vision rider is also offered. A children’s eye exam and dental checkup is also included at no charge. The plan is available in many parts of the state.
HMO Value (SummaCare) – If you live in Northeastern Ohio, this policy is another cheap catastrophic option. The deductible of $8,550 is high, although once it has been met, 100% of your expenses are covered without additional coinsurance.
Core Care Bronze 1 (Molina) – $6,100 deductible with 50% coinsurance. Office visit copays are $35 and $75 with an Urgent Care copay of $35 (all after the deductible). The generic drug copay is $27, although most generic drugs can be purchased for a lower amount.
Essential Care 1 (Ambetter) – Once the $8,300 deductible is met, benefits are paid at 100% with no out-of-pocket expenses. Virtual online office visits are covered with no out-of-pocket expense. The generic drug copay is $25 (retail) and $67.50 (mail order). Buckeye Community Health is the parent company and offers many inexpensive options in this tier. Vision and dental for adults can be added to all Ambetter contracts
Essential Care 10 (Ambetter) – Slightly more expensive than the Essential Care 1 plan. Deductible is $7,200. Pcp office visits are subject to 50% coinsurance although the deductible does not apply. Virtual online office visits are covered with no out-of-pocket expense. The generic drug copay is $25 (retail) and $67.50 (mail order).
Market HMO 8500 (Medical Mutual) – $8,500 deductible with 0% coinsurance. This policy is ideal if your physicians and hospitals are in the Medical Mutual provider network, and very few non-preventative claims are submitted.
Marketplace Bronze (CareSource) – Since this is a “Bronze” tier plan, all applicants are eligible. So, who is CareSource? Headquartered in Dayton, like Medical Mutual, they’re a non-profit managed-care company that has provided medical coverage for more than 25 years. This plan has a high $7,700 deductible and prices are very attractive in Montgomery County and other areas. Primary care physician visits are covered with a $40 copay. The specialist copay is $80. X-rays have a $125 copay although the deductible must be met. The low-cost drug copay is $30 ($75 mail order).
(Note: Silver tier plans are the only options that allow you to drastically reduce the deductible through “cost-sharing.” If your household income qualifies, you can easily save thousands of dollars on a major claim, and hundreds of dollars on office visits. Yes…It’s a bit like getting money handed to you through your TV!)
Constant Care Silver 4 (Molina) – $7,450 deductible but 0% coinsurance. $30 pcp office visit copay and $65 specialist office visit copay. Provider network is not as large as many other carriers.
Constant Care Silver 2 (Molina) – $5,200 deductible with 40% coinsurance. $30 pcp office visit copay and $65 specialist office visit copay.
Marketplace Low Premium Silver (CareSource) – $6,000 deductible with 25% coinsurance. $35 pcp office visit copay and $75 specialist office visit copay. Low cost and preferred brand drug copays are $20 and $50. The Urgent Care copay is $75.
Silver Saver 2 (Oscar) – $6,200 deductible with $40 copays on BOTH pcp and specialist office visits.Telemedicine visits to specific providers are covered with no out-of-pocket cost. Low $3 copay for Tier 1A generic drugs.
Confident Care Gold 1 (Molina) – $2,925 deductible and 20% coinsurance. The lowest-cost Gold-tier plan in many counties. $10 and $50 office visit copays with $10 Urgent Care copay. Copay for blood work is $15. Generic and preferred brand drug copays are $10 and $50.
Gold Pathway X HMO 2500 (Anthem) – $2,500 deductible with 20% coinsurance. $25 pcp office visit copay and $45 specialist office visit copay. Tier 1 and Tier 2 drug copays are $10 and $35 (Preferred network). The Urgent Care copay is $90.
Secure Care 5 (Ambetter) – $1,450 deductible and 20% coinsurance. $15 and $35 office visit copays with $35 Urgent Care copay. Copay for lab (outpatient) and professional services is $15. Generic and preferred brand drug copays are $15 and $30.
Senior Medicare Options
To find Medigap plans that cost less than $25 per month, Medicare Advantage plans would need to be considered. Although not all contracts cost less than $25, many policies are offered with $0 premiums. Often, dental, vision, and hearing benefits are provided, along with additional perk, such as SilverSneakers or YMCA memberships. Although Supplement plans are more expensive, the network of providers is much more inclusive.
Although many of these low cost policies should always be considered when evaluating affordable options, there are hundreds of additional policies offered by the major carriers, and some may be the best choice for you. That’s where we can help. We’ll research all available plans…not just a few. And if your need is temporary, we’ll consider a “short-term” contract, which allows you to get coverage the next day, and keep for a month, or sometimes as long as 12 months.
Please don’t hesitate to call or contact us with questions. We know Ohio plans better than anybody since we are located here and have 38 years of experience providing help to thousands of clients. And of course, you never pay any fees.