Ohio healthcare plans provide guaranteed benefits at a price you can afford. There are several policies that are extremely budget-friendly, very popular, and offered by reputable insurance providers. But there is one particular option that is very simple, low cost, and issued by a non-profit company.
Meet the MedMutual Market HMO 6400 HSA Bronze plan from Medical Mutual. It’s an inexpensive policy that is HSA-eligible and should be considered by all individuals and families that would like to reduce their costs, but also limit their potential out-of-pocket expenses for large medical claims. The HSA portion of the plan is optional and does not increase the premium. The plan is offered both “on” and “off” the Exchange.
However, it is not available in all areas of the state. To enroll in the plan, applicants must reside in one of the following counties: Allen, Ashland, Ashtabula, Athens, Auglaize, Brown, Butler, Clermont, Champaign, Clark, Columbiana, Crawford, Cuyahoga, Defiance, Delaware, Fairfield, Franklin, Fulton, Geauga, Hamilton, Hancock, Hardin, Henry, Hocking, Huron, Knox, Lake, Licking, Lorain, Lucas, Mahoning, Marion, Medina, Mercer, Morrow, Pickaway, Portage, Putnam, Richland, Seneca, Summit, Trumbull, Union, and Wood.
Subsidy And Pre-Existing Conditions
It is an ACA (Affordable Care Act) compliant policy that can be purchased regardless if you qualify for an Obamacare subsidy. It’s also available for both single persons and families (both large and small). Since there is no medical underwriting, applicants can not be declined. Any medical conditions you are treated for (presently or the past) will be covered and will not impact the premium. Spouses and dependents can be included on the policy without having to create additional applications.
Thanks to the previously-mentioned legislation, your pre-existing conditions (if you have any), will be fully covered. You may purchase this policy on or of the Exchange and directly through our website. Of course, you always view the lowest offered rates without paying any fees, and you will be credited with a government subsidy if you qualify. You do not have to utilize any government aid, although it would be offered throughout the year. Future Trump Administration changes could impact the subsidy, Open Enrollment periods, and the mandate requiring citizens to purchase healthcare coverage.
Listed below are a few examples of the subsidy you could receive towards the purchase of coverage if you reside in Franklin County. The amount of subsidies can vary, depending on your zip code, age, and household income. Dollar amounts are annualized. NOTE: This is the amount of financial help the federal government provides to pay your premium.
It is NOT the rate you pay. Those figures are provided later in the article. Also, future changes in tax credits from President Trump’s new options, may impact the amount of subsidy received. Medical Mutual quotes for other plans are available. Several plan options offer copays for office visits and prescription drugs. Urgent Care and ER visits may be subject to a deductible.
Subsidy Based On Household Income
35 year-old with $25,000 income – $2,952
45 year-old with $25,000 income – $3,792
45 year-old with $35,000 income – $2,196
45 year-old married couple with $45,000 income – $6,888
45 year-old married couple with $55,000 income – $5,628
45 year-old married couple and two children with $55,000 income – $12,708
45 year-old married couple and two children with $70,000 income – $10,272
55 year-old married couple and two children with $85,000 income – $14,448
60 year-old with $40,000 income – $5,928
Applications are easily submitted. Typically, we provide an online link, although applying by phone is also an option. The process takes approximately 10 minutes and you do not have to submit a payment when you apply for coverage. If you meet the guidelines for federal subsidy assistance, we show you how much your premium will be reduced.
How The Market HMO 6400 HSA Works
Here’s how it works. The deductible is $6,400. Once your non-preventative expenses have exceeded this amount, the policy covers all medical expenses with no out-of-pocket costs. However, prior to the deductible, qualified preventative expenses are covered at 100%. This includes routine annual physicals, mammograms, pap smears, and OBGYN visits. Depending on your age, many additional services are fully covered, including the following screenings: blood pressure, cholesterol, colorectal cancer, depression, diabetes, HIV, lung cancer, obesity, STI, and tobacco use.
Some additional features include allowing qualified dependents to stay on the policy until age 26, large network-negotiated discounts, and pediatric vision hardware and lens coverage up to age 19. The plan is also HSA-eligible, and therefore, qualified medical, dental, and vision expenses can be paid with tax-deductible dollars. An HSA side-account must be set up to take advantage of several of the plan features.
That’s pretty simple, isn’t it? Lifetime benefits are unlimited. Therefore, regardless if you incur $100,000 of medical bills or $10 million, all covered expenses will be paid. That’s quite a difference from the $1 million caps from earlier years. And if you have multiple large claims in the same year, you only have to satisfy one deductible. On family plans, regardless of the number of members, only two deductibles must be satisfied.
If you’re reasonably healthy, you will probably never (or rarely) meet your yearly deductible. However, all recognized preventive expenses (such as routine annual physical examinations and wellness) are paid by Medical Mutual. Your cost is nothing. This feature can potentially save you a substantial amount of money compared to other plans. And the list of approved preventive expenses is extensive and constantly growing.
What if you’re not so healthy? You still will qualify for a policy. As previously mentioned, you can no longer be denied because of medical conditions. However, a lower-deductible policy may be a better choice if you have a chronic condition or expect to have single or multiple surgeries in the following year.
By utilizing the vast Medical Mutual network, you’ll also be able to pay discount prices on healthcare that is subject to the deductible. That’s because the insurance company negotiates on your behalf, and lowers the fees charged by physicians, hospitals, laboratories and other providers. Sometimes you’ll only save a few dollars, but other times it may be a few hundred dollars. Or perhaps thousands of dollars on a hospital claim. And yes…even tens of thousands on very large claims.
So…How affordable is this plan? Consider these examples. The only assumptions are that the applicants are non-smokers living in Delaware County. Prices shown are monthly and include subsidies.
Family of four (Ages 50, 50, 15 & 18). $72,000 household income – $163
Family of four (Ages 50, 50, 15 & 18). $85,000 household income – $279
Family of three (Ages 30, 30, 5). $55,000 household income – $170
Family of three (Ages 40, 40, 10). $55,000 household income – $149
Single person (Age 35) $35,000 household income – $179
Single person (Age 45) $40,000 household income – $211
Single parent with one child (Age 35) $35,000 household income – $52
Single parent with one child (Age 28) $38,000 household income – $126