Affordable Ohio Health Insurance Plans

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Get affordable Cincinnati health insurance coverage in minutes. We help you find all of the top companies in the Hamilton County area and the best low-cost Marketplace plans. The quotes that we provide are always the direct rates published by each insurer. You can either purchase coverage “direct” or with help. Queen City Exchange personal plans are often 30%-55% less expensive than Ohio group policies. A full portfolio of Senior Medicare products is also offered.

65+ plans (Supplement, Advantage, and Part D) are provided by many carriers. Applicants that have reached age 65, or who are eligible for Medicare, can view and compare all area plans, and customize benefits to match specific health conditions and a personal budget. Many MA plans include prescription drug benefits and additional ancillary perks. SW Ohio rates are typically very competitive.

Ohio Health Marketplace Plans (Under Age-65)

You can also reduce your premium if you qualify for a federal tax subsidy that is automatically deducted from your rate. Depending on how many persons are to be covered, and your modified adjusted gross income (MAGI), the savings could be substantial. The Obamacare subsidy could potentially pay your entire premium. You can also choose to enroll in a plan that is not subsidized, and there are many low-cost options in Southwestern Ohio.

Also available are policies that are “off” the Marketplace and do not utilize subsidies to change the premium. Often, the number of available physicians and hospitals is higher when enrolling in this type of policy. For example, the Cleveland Clinic and Bethesda North Hospital (pictured below) are sometimes considered “in-network” for many unsubsidized policies, but not available (other than an emergency) for Exchange coverage, unless you are covered through Oscar.

Open Enrollment

During Open Enrollment, the federal subsidy is applied to the price of each Marketplace plan. “Catastrophic” policies, which are available to any applicant under age 30, are the only options that can not receive federal aid. Platinum, Gold, Silver, and Bronze policies are fully-eligible. Companies offering Marketplace benefits will differ, depending upon your county of residence. Northern Kentucky coverage must be purchased separately.

Non-compliant plans (short-term and indemnity) are often less-expensive options, but typically don’t provide unlimited benefits or fully cover pre-existing conditions. Also, depending on the company, network negotiated repricing may not provide as much savings as Exchange contracts. However, these types of policies can be purchased at any time, including after the Open Enrollment period has ended.

NOTE: If you are over age 30 and qualify for “financial hardship,” you may be able to enroll in a catastrophic contract. However, often, a Bronze-tier plan will cost the same (or less), and may be a more suitable choice. The two available “catastrophic” policies offered in Hamilton County are:

Medical Mutual Market Young Adult Essentials – Three pcp and mental health office visits are provided with a $40 copay. Additional visits must meet deductible. Policy deductible is $9,100 and coinsurance is 0%. Urgent Care, ER, and prescription drugs must also meet deductible.

Anthem Catastrophic Pathway X HMO 9100 – Three pcp and mental health office visits are provided with a $40 copay. Additional visits must meet deductible. Policy deductible is $9,100 and coinsurance is 0%. Urgent Care, ER, and prescription drugs must also meet deductible.

Many Exchange policies utilize different provider networks than past traditional plans. Generally, the new networks are thinner, and don’t include as many physicians, specialists or medical facilities. Therefore, it’s important to verify (in advance) that your own doctors will continue to give you their negotiated discounted prices.

You can also purchase policies if you miss Open Enrollment. Many of highly-rated companies (UnitedHealthcare, National General, and others) offer plans that are designed to provide benefits until you are eligible for the next Open Enrollment. Although some features are not available (maternity, for example), the cost is very low and a policy can be issued the same day you apply.

Companies Offering Coverage

Several of the larger Ohio companies offer inexpensive Exchange options in the area. These carriers include Anthem BCBS, Ambetter, CareSource, Medical Mutual, UnitedHealthcare, and Molina. Oscar and SummaCare are very reputable companies but don’t have active networks in the southern part of the state. Aetna, Humana, and Premier no longer offer individual coverage, although Senior Medicare products are available. Cigna also offers Medigap plans, but not under-65 private policies in the Buckeye State.

Kaiser Permanente previously sold its block of business in the northern part of the state to Catholic Health Partners. Regulatory approval was given, and HealthSpan Partners was created to offer private policies. More than 75,000 members made the transition to their new provider with the main service area in the western and southern portion of the state. However, HealthSpan ceased writing private plans, so policyholders renewed their policies with different companies.

Catholic Health Partners (CHP) (now called Mercy Health) maintains a big presence in Hamilton and surrounding counties, and also previously purchased a portion of SummaCare’s block of business. CHP is considered a very consumer-friendly organization and is a very well-respected entity in the medical care business. When HealthSpan stopped writing plans, Medical Mutual acquired the block of business.

Hamilton And Surrounding Counties

Rates in Hamilton County tend to be lower than areas in the Northern portion of the state. Several of the lower-cost counties in the area include Hamilton, Warren, Clermont and Butler. Other surrounding counties also enjoy low rates, including Clinton, Brown, Montgomery and Highland.

A typical medical plan in Southwestern Ohio will cost approximately 10%-20% less than similar policies in the Akron, Toledo and Cleveland areas. However, the cost of a plan in the Columbus area is typically similar to rates in this area. Northern Kentucky residents (including Boone, Kenton, Campbell, Gallatin, Carroll, and Trimble counties), often work in Hamilton County. However, plan availability is based on county and state of residence, so only Kentucky plans are offered.

Recently, Medical Mutual rates have become extremely competitive in Hamilton County. Here you can review their HSA plans which are among their most popular policies. As a non-profit company, MM seems to be able to constantly (almost every year) offering popular policy options to both individuals and small businesses. They no longer include the Cleveland Clinic in their provider network. However, Oscar now offers the CC in their Buckeye State network.

Reasons for more favorable prices in these areas include lower office visit, specialist and diagnostic testing charges, reduced hospital costs and less medical claims in recent years. For example, a family of four in the Cincinnati area can often pay  $2000 less per year than a similar family in a neighboring state (such as Indiana or Kentucky).  Increased credits from the federal government (APTC) have also substantially lowered premiums the last several years.

Insurers in our state can negotiate lower costs and the savings is passed to you. Compared to other large Midwestern cities, such as Chicago, Detroit, Indianapolis and St. Louis, you’ll find local rates to be substantially lower from every company. Although the Affordable Care Act legislation has closed the gap, typically, if you move out of Ohio, expect your premiums to increase.

The Under-65 Exchange

The Exchange (we have discussed this extensively on other pages and in our blog) has offered additional choices for many persons buying their own plans. Please let us guide you through a very complex quoting and application process. We complete online enrollment is 10 minutes, and complete the entire application for you. You can terminate coverage at any time, and billing is always monthly. May $0 premium plans are offered.

Although no applicant can be turned down, there are many changes from past years, including the federal tax subsidies, special taxes on medical devices, and a framework of options called “metal” plans. We help you find the best plan, and also easily enroll for coverage, so you can avoid the confusion of the federal website.

Other factors that influence rates include age, smoking status, household income, and where you live. As an experienced local broker since 1980, We research and compare the most affordable options for you. We also believe it is important to consider only the major “A” rated companies and avoid any type of “medical discount” plan. Christian Health Medical Plans are also available, and can be considered outside of Open Enrollment periods.

The Cheapest Health Insurance In Cincinnati

Rates for most single and family households are typically lower than prices from several years ago. We listed several examples below. Rates shown are monthly.

 

Two adults (ages 40) and one child (age 15) with combined household income of $65,000.

$88Ambetter Clear Bronze

$103Medical Mutual Market HMO 9100

$114 – Medical Mutual HMO Standard Bronze

$115 – Medical Mutual Market HMO 8000

$123Anthem Bronze Pathway X HMO 9100

$125 Anthem Bronze Pathway X HMO 9100/0% Standard

 

30-year-old with household income of $35,000

$60Ambetter Clear Bronze

$65Medical Mutual Market HMO 9100

$69 Medical Mutual HMO Standard Bronze

$70Medical Mutual Market HMO 8000

$72 – Anthem Bronze Pathway X HMO 9100

$73 – Anthem Bronze Pathway X HMO 9100/0% Standard

 

Two adults (age 62) with combined household income of $54,000.

$78 – Ambetter Essential Care 1.

$110 – Ambetter Essential Care 10

$141 – Molina Core Care Bronze 2

$153 – Molina Core Care Bronze 1

$178 – Molina Core Care Bronze 5

$344 – Medical Mutual Market HMO 8500

 

Single adult (age 50) and one child (age 20) with combined household income of $46,000.

$164 – Ambetter Essential Care 1.

$182 – Ambetter Essential Care 10

$194 – Molina Core Care Bronze 2

$200 – Molina Core Care Bronze 1

$212 – Molina Core Care Bronze 5

$292 – CareSource Marketplace Bronze

Your free quote only includes the most reputable companies that offer a wide range of policy options. Although fewer carriers now participate in the Marketplace (Under age-65), additional carriers may be offering private plans in SW Ohio within the next two years.

Unlike many online services, we never charge any fee for our services. The quotes are free, our advice is completely unbiased and always based on current information, and the application process is much quicker than you expect.

Medigap Coverage For Seniors In The Cincinnati Area

 

Ohio Medicare Supplement Plans (Hamilton County)

Shown below are current monthly prices for a non-smoking 65-year-old male. Although we update prices weekly, occasionally, actual rates may slightly differ. Also, female rates are generally lower than male rates.

Plan C

$138 – Paramount

$146 – New Era Life

$154 – AARP-UnitedHealthcare

$166 – Medical Mutual

$176 – Heartland National Life

$232 – Oxford Life

$256 – United American

$267 – GPM Health

$384 – Assured Life

 

Plan F (High Deductible)

$34 – United American

$37 – New Era Life

$45 – Great Southern Life

$50 – Medico

$50 – Cigna

$53 – National Health

 

Plan F

$133 – Central States

$136 – Manhattan Life

$138 – Accendo

$138 – Mutual Of Omaha

$139 – Lumico Life

$139 – Capitol Life

$145 – United States Fire

$145 – Continental Life

$145 – Humana

$149 – AARP-UnitedHealthcare

$155 – New Era Life

$157 – Great Southern Life

$169 – National Health

$178 – Anthem BCBS

$186 – Cigna

$220 – Medico

$280 – United American

 

Plan G (High Deductible)

$34 – United American

$34 – New Era Life

$44 – United States Fire

$45 – Mutual Of Omaha

$46 – Humana

$50 – Continental Life

 

Plan G

$113 – New Era Life

$114 – Mutual Of Omaha

$115 – AARP-UnitedHealthcare

$115 – Continental Life

$116 – Manhattan Life

$118 – Lumico Life

$118 – Anthem BCBS

$119 – Oxford Life

$119 – Capitol Life

$120 – Heartland National

$120 – Accendo

$123 – Humana

$124 – Paramont

$125 – Medical Mutual

$134 – Union Security

$136 – Sentinel Security

$138 – Great Southern Life

$138 – National Health

$145 – Medico

 

Plan N

$90 – Manhattan Life

$91 – Accendo

$91 – Mutual Of Omaha

$91 – Capitol Life

$92 – New Era Life

$92 – Continental Life

$93 – Union Security

$94 – United States Fire

$94 – Central States

$96 – Bankers Fidelity

$96 – Heartland National Life

$96 – Humana

$104 – Great Southern Life

$104 – AARP-UnitedHealthcare

$104 – Assured LIfe

$108 – GPM Health

$114 – Paramount

$118 – Cigna

$120 – Medical Mutual

$121 – Medico

$124 – Anthem BCBS

$192 – United American

$203 – Oxford Life

 

Medicare Advantage Plans With Prescription Benefits In Hamilton County

AARP Medicare Advantage Plan 6 – $0 monthly premium with $195 deductible and maximum out-of-pocket expenses of $4,900. Office visit copays (pcp and specialist) copays are $5 and $45, and the Urgent Care and ER copays are $30-$40 and $90. Lab services and outpatient x-rays are subject to $0 and $14 copays. Outpatient mental health group and individual visits are subject to $30 and $40 copays. Routine dental, eye, and hearing exams are covered with $0 copays. 30-day preferred pharmacy copays are $3 (Tier 1), $12 (Tier 2), and $47 (Tier 3). 90-day preferred pharmacy copays are $9 (Tier 1), $36 (Tier 2), and $141 (Tier 3).

AARP Medicare Advantage Plan 2 – $20 monthly premium with $150 deductible and maximum out-of-pocket expenses of $4,200. Office visit copays (pcp and specialist) copays are $0 and $35, and the Urgent Care and ER copays are $30-$40 and $90. Lab services and outpatient x-rays are subject to $0 and $14 copays. Outpatient mental health group and individual visits are subject to $30 and $40 copays. Routine dental, eye, and hearing exams are covered with $0 copays. 30-day preferred pharmacy copays are $2 (Tier 1), $8 (Tier 2), and $45 (Tier 3). 90-day preferred pharmacy copays are $4 (Tier 1), $16 (Tier 2), and $135 (Tier 3).

Aetna Medicare Value Plan – $0 monthly premium with $150 deductible and maximum out-of-pocket expenses of $5,000. Office visit copays (pcp and specialist) copays are $10 and $45, and the Urgent Care and ER copays are $10-$65 and $90. Lab services and outpatient x-rays are subject to $0-$30 and $10-$100 copays. Outpatient mental health group and individual visits are subject to $40 copays. Routine eye and hearing exams are covered with $0-$45 copays. 30-day preferred pharmacy copays are $0 (Tier 1), $5 (Tier 2), and $47 (Tier 3). 90-day preferred pharmacy copays are $0 (Tier 1), $10 (Tier 2), and $141 (Tier 3).  

Aetna Medicare Premier – $0 monthly premium with $0 deductible and maximum out-of-pocket expenses of $4,900. Office visit copays (pcp and specialist) copays are $0 and $35, and the Urgent Care and ER copays are $10-$65 and $90. Lab services and outpatient x-rays are subject to $0-$10 and $0-$50 copays. Outpatient mental health group and individual visits are subject to $40 copays. Routine eye and hearing exams are covered with $0-$35 copays. 30-day preferred pharmacy copays are $0 (Tier 1), $0 (Tier 2), and $47 (Tier 3). 90-day preferred pharmacy copays are $0 (Tier 1), $0 (Tier 2), and $141 (Tier 3).  

Allwell Medicare – $0 monthly premium with $125 deductible and maximum out-of-pocket expenses of $4,900. Office visit copays (pcp and specialist) copays are $0 and $45, and the Urgent Care and ER copays are $45 and $90. Lab services and outpatient x-rays are subject to $0 and $45 copays. Outpatient mental health group and individual visits are subject to $40 copays. Routine eye, dental, and hearing exams are covered with $0-$45 copays. 30-day preferred pharmacy copays are $0 (Tier 1), $9 (Tier 2), and $37 (Tier 3). 90-day preferred pharmacy copays are $0 (Tier 1), $27 (Tier 2), and $111 (Tier 3).   

Anthem MediBlue Essential – $0 monthly premium with $60 deductible and maximum out-of-pocket expenses of $4,900. Office visit copays (pcp and specialist) copays are $5 and $40, and the Urgent Care and ER copays are $35 and $90. Lab services and outpatient x-rays are subject to $0-$10 and $50-$110 copays. Outpatient mental health group and individual visits are subject to $40 copays. Routine eye, dental, and hearing exams are covered with $0-$40 copays. 30-day preferred pharmacy copays are $4 (Tier 1), $15 (Tier 2), and $42 (Tier 3). 90-day preferred pharmacy copays are $12 (Tier 1), $45 (Tier 2), and $126 (Tier 3).

CareSource Advantage Zero Premium – $0 monthly premium with $250 deductible and maximum out-of-pocket expenses of $6,700. Office visit copays (pcp and specialist) copays are $9 and $50, and the Urgent Care and ER copays are $45 and $90. Lab services and outpatient x-rays are subject to $30 and $50 copays. Outpatient mental health group and individual visits are subject to $40 copays. Routine eye, dental, and hearing exams are covered with $0-$50 copays. 30-day preferred pharmacy copays are $6 (Tier 1), $15 (Tier 2), and $47 (Tier 3). 90-day preferred pharmacy copays are $18 (Tier 1), $45 (Tier 2), and $141 (Tier 3).       

MediGold Southwest OH Essential Care– $0 monthly premium with $250 deductible and maximum out-of-pocket expenses of $4,500. Office visit copays (pcp and specialist) copays are $10 and $50, and the Urgent Care and ER copays are $40 and $80. Lab services and outpatient x-rays are subject to $10 and $50 copays. Outpatient mental health group and individual visits are subject to $40 copays. Routine eye, dental, and hearing exams are covered with $0-$50 copays. 30-day preferred pharmacy copays are $2 (Tier 1), $18 (Tier 2), and $45 (Tier 3). 90-day preferred pharmacy copays are $6 (Tier 1), $54 (Tier 2), and $135 (Tier 3).    

MeridianCare Essential– $0 monthly premium with $0 deductible and maximum out-of-pocket expenses of $4,800. Office visit copays (pcp and specialist) copays are $0 and $35, and the Urgent Care and ER copays are $0 and $80. Lab services and outpatient x-rays are subject to $0 copays. Outpatient mental health group and individual visits are subject to $35 copays. Routine eye, dental, and hearing exams are covered with $0-$35 copays. 30-day preferred pharmacy copays are $0 (Tier 1), $10 (Tier 2), and $45 (Tier 3). 90-day preferred pharmacy copays are $0 (Tier 1), $20 (Tier 2), and $90 (Tier 3).    

Mutual Of Omaha CareAdvantage Complete– $0 monthly premium with $0 deductible and maximum out-of-pocket expenses of $4,500. Office visit copays (pcp and specialist) copays are $5 and $40, and the Urgent Care and ER copays are $35 and $90. Lab services and outpatient x-rays are subject to $0 copays. Outpatient mental health group and individual visits are subject to $35 and $40 copays. Routine eye, dental, and hearing exams are covered with $0-$45 copays. 30-day preferred pharmacy copays are $2 (Tier 1), $7 (Tier 2), and $42 (Tier 3). 90-day preferred pharmacy copays are $6 (Tier 1), $21 (Tier 2), and $126 (Tier 3).     

And…for your entertainment…we made a YouTube video about medical insurance in the Cincinnati area.