Affordable Ohio Health Insurance Plans

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Ohio family health insurance coverage provides comprehensive office visit, prescription, wellness, and catastrophic benefits in one policy. Depending on the deductible, medical insurance rates for Ohio adults and children are very inexpensive with the help of available federal tax subsidies. Plans also cover qualified preventive expenses at 100% with no out-of-pocket cost. Guaranteed acceptance is provided for Marketplace plans. Short-term plans are medically-underwritten, but are available at any time, and have no Open Enrollment deadlines.

The average cost of Marketplace plans will vary, depending upon the number of covered persons, their ages, county of residence, and smoking status. Deductibles, copays, and out-of-pocket prescription drug expenses will also impact the cost of coverage. The number of available carriers will also vary, since major companies including Anthem and Medical Mutual do not offer coverage in all counties. Oscar, Paramount, and SummaCare also only market plans in specific counties.

Humana, Cigna, and UnitedHealthcare offer Senior and ancillary products, but not private medical plans. Dental and vision coverage can often be purchased with a medical plan or bought separately outside of the Marketplace. Underwriting is generally not required and coverage can go into effect the next day. Federal and state subsidies do not apply to ancillary or short-term medical plans. Marketplace plans, however, are offered to applicants that do not qualify for a subsidy.

Molina plans are not available throughout the entire state, although rates are very competitive. Paramount offers policies in the following northwest counties: Defiance, Erie, Henry, Huron, Lucas, Ottawa, Sandusky, Seneca, Williams, Wood, and Wyandot. Available Paramount plans include Silver 6 ($25 and $75 office visit copays, $6,500 policy deductible, and $15 and $25 preferred and non-preferred generic drug copays), Silver 5 ($20 and $75 office visit copays, $4,000 policy deductible, and $15 and $25 preferred and non-preferred generic drug copays), and Gold 3 ($15 and $55 office visit copays, $2,500 policy deductible, and $10 and $20 preferred and non-preferred generic drug copays)

When more than one person is covered, we understand that your needs are different than a single plan. Finding policies with lower copays for primary-care physician (pcp) and specialist office visits, and other routine lab tests and x-rays, is generally considered a priority. Urgent Care visits should always be covered with a copay, and subject to a deductible. We review and customize the options that work best for yourself and all persons covered on your policy.

If you only need coverage for a few months (but less than 12 months), a short-term medical policy in Ohio should be considered. Although a temporary contract lacks comprehensive benefits and is not eligible for a federal subsidy, it may be the best option if an Open enrollment deadline is missed. Many plans provide a copay for Urgent Care and Teledoc visits. However, preventative benefits, unlike Marketplace plans, are not covered at 100%. The UnitedHealthcare and Aetna PPO networks are used with two of the most popular temporary policies.

Anthem introduced a new temporary plan last year and prices are competitive in most areas. Six different plans are offered with deductibles ranging from $1,000 to $10,000. The extensive Anthem network can be utilized and unlike most temporary plans, pre-existing conditions may be covered. Medical underwriting is required, so it is possible that coverage will be denied.

Recent Changes And Enhancements

Annual upgrades and improvements generally improve policy benefits, and often add important features that may have been previously omitted. For example, mental illness, non-generic drugs, maternity, and contraception are four mandated coverage benefits that have been added within the last seven years. COVID-19 testing and preventative treatment was also provided by all carriers with little or no out-of-pocket costs.

Online primary-care physician appointments are offered by most companies with small or $0 copays. Telemedicine visits have become increasingly popular and in may situations, eliminate the need to physically drive to a doctor’s office. Medical issues, symptoms, and prescription drug options can be easily discussed. A diagnosis can be provided with specific treatment instructions. Remote medical equipment can also monitor conditions. Note: Aetna now offers remote pcp office visit benefits to group plan members.

Each year, additional preventative benefits are added that are not subject to a copay, coinsurance, or deductible. The tax/penalty for not complying with the law (enrolling in “qualified” coverage) has also been eliminated. Previously, if your household income increased, the penalty became larger. Not enrolling in a qualified plan during the Open Enrollment period may require applying for coverage that lacks specific mandated benefits.

 

Center For Disease Control And Prevention Family Health Portrait Tool

A free government service from the Surgeon General is the Family Health Portrait tool. The application is online and allows you to record your family medical history that can be shared with your personal physicians or other relatives. Each family member can learn about conditions that may be more prevalent than anticipated, and preventative action can be taken. Results can be updated and also printed or emailed. Your information is private and secure, since the federal government does not utilize the data.

Conditions that are at a higher risk for family members can be documented and the information can be shared. Several of these conditions include colorectal cancer, ovarian cancer, breast cancer, heart disease, diabetes, and osteoporosis. Although family health history can not be altered, unhealthy habits, including tobacco usage, excess alcohol consumption, and lack of exercise, can be changed. And the positive results are often immediate.

Additional topics covered by the service include infectious diseases, rare diseases, genomics, advanced molecular detection weekly clips, CDC publications, and state public health genomics programs map. An Exchange Overview is also available through the state DOI. Resources include information on a health benefit mandate study and state innovation waver. A mental health and substance use disorder benefit toolkit helps providers, consumers, and advocates maximize available benefits.

Family Health Insurance Rates In Ohio

Coverage in the Buckeye state typically costs less than comparable policies from other states. Although premiums are higher than a catastrophic (only) plan, they still may be less costly than coverage you purchase through an employer. Federal subsidies (if you qualify) will further reduce premiums.

Most group plans provided by employers are also comprehensive contracts, although other types of benefits may be offered. However, many employers (especially with under 50 employees) are either reducing full-time positions to part-time, or eliminating healthcare benefits. These changes are often needed since paying an “Obamacare tax” is often much less costly than providing benefits.

NOTE: Ohio Works First (OWF) helps needy families with limited assistance. “hardship” and “good cause” situations may qualify a household with cash benefits for up to 36 months. After 36 months, additional funds are not offered unless the County Department of Job and Family Services provides an extension. Good cause extensions are only offered after a two-year waiting period. Each County Department of Job and Family Services creates its own guidelines and deadlines.

OWF promotes taking personal responsibility and finding employment as quickly as possible. The program is offered to legal residents of the state that have a dependent under age 19, are pregnant, and meet specific income and job requirements. Also, applicants must be a legal US citizen, national, legal alien, or permanent resident.

Below, we examine rates for a “typical” family in different parts of Ohio and use the Cincinnati, Dayton, Columbus and Cleveland areas. Our “sample” is a husband and wife (both age 35) with two children, ages 8 and 6. Policy details are never the same, so we have selected high-quality plans from multiple companies, including Anthem Blue Cross, CareSource, Medical Mutual, Ambetter, and other carriers.

The following rates are monthly and assume a household monthly income of $60,000. The federal instant tax-credit has already been included.

Cincinnati Area Rates

  • $0 – Anthem Bronze Pathway X HMO 8700
  • $18 – Ambetter Essential Care 1
  • $26 – Anthem Bronze Pathway X 6000
  • $34 – CareSource Marketplace Bronze
  • $47 – Anthem Bronze Pathway X 5000
  • $63 – Anthem Bronze Pathway X HMO 6000 20 for HSA
  • $104 – Molina Constant Care Silver 7 200

Dayton Area Rates

  • $0 – Anthem Bronze Pathway X HMO 8700
  • $0 – Anthem Bronze Pathway X HMO 6850 0 for HSA
  • $0 – Anthem Bronze Pathway X 5500
  • $0 – Anthem Bronze Pathway X 5000
  • $0 – Anthem Bronze Pathway X HMO 6000 20 for HSA
  • $0 – Anthem Bronze Pathway X 6000
  • $151 – Anthem Silver Pathway X HMO 6100 0 for HSA

Columbus Area Rates

  • $0 – Anthem Bronze Pathway X HMO 8700
  • $0 – Anthem Bronze Pathway X 5000
  • $0 – Anthem Bronze Pathway X HMO 6000 20 for HSA
  • $0 – Oscar Bronze Simple
  • $0 – Oscar Silver Classic
  • $0 – Anthem Bronze Pathway X 6000
  • $140 – Oscar Silver Simple – PCP Saver

Cleveland Area Rates

  • $0 – CareSource Marketplace Bronze
  • $28 – CareSource Marketplace Bronze First
  • $105 – Ambetter Essential Care 1
  • $107 – Molina Constant Care Silver 7 200
  • $125 – Molina Constant Care Silver 4 200
  • $131 – Molina Constant Care Silver 2 200
  • $133 – Molina Constant Care Silver 7 200

 

Additional plans are available that place a copay on primary-care physician (pcp) visits, but not specialist visits. Instead, a deductible must be met. Several of these policy options include: Anthem Bronze Pathway X HMO 5500,Anthem Silver Pathway X HMO 6900 25, Anthem Silver Pathway X HMO 5000, Anthem Silver Pathway X HMO 2600, Oscar Bronze Classic – PCP Saver, Oscar Bronze Classic Choice, Oscar Silver Simple, Scar Silver Simple Select, SummaCare Bronze 8700, SummaCare Silver 6000, and SummaCare Silver 5000.

 

Note: Managed Care coverage in Ohio is provided by the following five carriers: Buckeye Health Plan, CareSource, Molina, Paramount, and UnitedHealthcare.