Last Updated on by Ed Harris
Antidote Health Plan Of Ohio provides affordable individual and family medical plans for persons not eligible for Medicare. The carrier uses the most modern and revolutionary techniques to offer convenience and accessibility to Buckeye State residents. $0 copay virtual office visits and ultimate access to physicians and medical providers is available 24/7. $0 medications and the broad Quality Care Partners network have become very popular features.
Antidote Health Plans provide ACA Marketplace coverage in the following Ohio counties: Butler, Champaign, Clark, Clermont, Coshocton, Cuyahoga, Defiance, Delaware, Fairfield, Franklin, Gallia, Geauga, Greene, Guernsey, Hamilton, Hocking, Holmes, Jackson, Lake, Licking, Logan, Lucas, Mahoning, Medina, Monroe, Montgomery, Morgan, Muskingum, Noble, Perry, Pickaway, Portage, Putnam, Seneca, Stark, Summit, Trumbull, Union, Vinton, Warren, Washington, and Wayne. Note: Coverage is also offered in Arizona (Pima and Maricopa Counties).
The insurer was created by a small number of persons seeking to create a quality insurer specializing in virtual AI-assisted coverage. This Health Maintenance Organization (HMO) is in the early stages to tweak and change the current healthcare system. The subscription-based telehealth coverage forms the backbone of the carrier. Expansion into additional states (other than Ohio and Arizona) is likely.
Antidote Catastrophic Tier Plans In Ohio
Catastrophic Standard – $0 copay for first three primary care physician visits. $9,200 deductible and 0% coinsurance with maximum out-of-pocket expenses of $9,200. Applicants must be under the age of 30. Advance Premium Tax Credits (APTC) are not available.
Antidote Bronze Tier Plans In Ohio
Bronze Complete – Office visit copays are $0 and $40/$100 (Tier 1) and $0/$75 and $40/$150 (Tier 2). Antidote virtual providers receive the lowest copay. $8,000 policy deductible with maximum out-of-pocket expenses of $9,200. Diagnostic tests (blood work and x-rays) and imaging (PET/CT scans and MRIs) are subject to 50% coinsurance (Tier 1) and 60% coinsurance (Tier 2). ER visits are are subject to 50% coinsurance (Tier 1) and 60% coinsurance (Tier 2). Urgent Care copays are $0 when treated by a virtual provider. Rehabilitation services, skilled nursing care, and durable medical equipment are subject to 50% and 60% coinsurance (Tiers 1 and 2). Emergency medical transportation subject to 40% and 50% (Tier1 and Tier 2) coiinsurance.
Generic drug copays are $0 when prescribed by a virtual provider. Otherwise, the copay is $35. Preferred brand drug copays are $75 when prescribed by a virtual provider. Deductible does not apply. Otherwise, the copay is $150. Deductible does not apply. Non-preferred brand drugs are subject to 50% coinsurance. Specialty drugs are subject to 50% coinsurance.
Bronze Complete + Dental – Same policy as Bronze Complete but with adult dental benefits added.
Bronze Elite – Office visit copays are $0 and $40/$100 (Tier 1) and $0/$75 and $40/$150 (Tier 2). Antidote virtual providers receive the lowest copay. $6,500 policy deductible with maximum out-of-pocket expenses of $9,200. Diagnostic tests (blood work) are subject to $0 and $75 copays. Diagnostic imaging (PET/CT scans and MRIs) and x-rays are subject to 40% coinsurance (Tier 1) and 50% coinsurance (Tier 2). ER visits are are subject to 40% coinsurance (Tier 1) and 50% coinsurance (Tier 2). Urgent Care copays are $0 when treated by a virtual provider. Rehabilitation services are subject to $75 copay when referred by a virtual provider or a $150 (office visit). Skilled nursing care, and durable medical equipment are subject to 40% and 50% coinsurance (Tiers 1 and 2). Emergency medical transportation subject to 40% and 50% (Tier1 and Tier 2) coinsurance.
Generic drug copays are $0 when prescribed by a virtual provider. Otherwise, the copay is $35. Preferred brand drug copays are $75 when prescribed by a virtual provider. Deductible does not apply. Otherwise, the copay is $150. Non-preferred brand drugs are subject to 40% coinsurance. Specialty drugs are subject to 40% coinsurance.
Bronze Elite + Dental – Same policy as Bronze Elite but with adult dental benefits added.
Bronze Standard – Office visit copays are $50 and $100. $7,500 policy deductible with maximum out-of-pocket expenses of $9,200. Diagnostic imaging (PET/CT scans and MRIs) and x-rays are subject to 50% coinsurance. Diagnostic tests (blood work) are subject to $0 and $75 copays. ER visits are are subject to 50% coinsurance. Urgent Care copay is $75. Rehabilitation services are subject to $50 copay. Skilled nursing care, and durable medical equipment are subject to 50% coinsurance. Emergency medical transportation subject to 50% coinsurance.
Generic drug copays are $25 and the deductible does not apply. Preferred brand drug copays are $50. Non-preferred brand drugs are subject to a $100 copay. Specialty drugs are subject to a $500 copay.
Silver Complete – Office visit copays are $0 and $15/$30 (Tier 1) and $0/$45 and $15/$60 (Tier 2). Antidote virtual providers receive the lowest copay. $6,500 deductible with maximum out-of-pocket expenses of $9,200. Diagnostic tests (x-rays and blood work) are subject to 30% coinsurance (Tier 1) and 40% coinsurance (Tier 2). Diagnostic imaging (PET/CT scans and MRIs) are subject to 30% coinsurance (Tier 1) and 40% coinsurance (Tier 2). ER visits are are subject to 30% coinsurance (Tier 1) and 40% coinsurance (Tier 2). Urgent Care copays are $0 when treated by a virtual provider. Otherwise, 30% and 40% coinsurance applies. Rehabilitation services are subject to 30% and 40% coinsurance (Tiers 1 and 2) with a maximum of 60 visits per benefit period. Skilled nursing care, and durable medical equipment are subject to 30% and 40% coinsurance (Tiers 1 and 2) with a maximum of 90 visits per benefit period. Emergency medical transportation subject to 30% and 40% (Tier1 and Tier 2) coinsurance.
Generic drug copays are $0 when prescribed by a virtual provider. Otherwise, the copay is $15. Preferred brand drug copays are $25 when prescribed by a virtual provider. Otherwise, the copay is $50. Deductible does not apply. Non-preferred brand drugs are subject to 30% coinsurance. Specialty drugs are subject to 30% coinsurance.
Silver Complete + Dental – Same policy as Bronze Elite but with adult dental benefits added.
Silver Elite – Office visit copays are $0 and $15/$30 (Tier 1) and $0/$30 and $15/$60 (Tier 2). Antidote virtual providers receive the lowest copay. $5,000 policy deductible with maximum out-of-pocket expenses of $9,200. Lab tests have a $0 copay (Antidote virtual provider) or otherwise a $45 copay. X-rays are subject to 30% coinsurance (Tier 1) and 40% coinsurance (Tier 2). Diagnostic imaging (PET/CT scans and MRIs) are subject to 30% coinsurance (Tier 1) and 40% coinsurance (Tier 2). ER visits are are subject to 30% coinsurance (Tier 1) and 40% coinsurance (Tier 2). Urgent Care copays are $0 when treated by a virtual provider. Otherwise, 30% and 40% coinsurance applies. Rehabilitation services are subject to a $30 copay (Antidote virtual provider) or otherwise a $60 copay.(Tiers 1 and 2) with a maximum of eight copay visits per benefit period. Skilled nursing care, and durable medical equipment are subject to 30% and 40% coinsurance (Tiers 1 and 2) with a maximum of 90 visits per benefit period. Emergency medical transportation subject to 30% and 40% (Tier1 and Tier 2) coinsurance.
Generic drug copays are $0 when prescribed by a virtual provider. Otherwise, the copay is $15. Preferred brand drug copays are $25 when prescribed by a virtual provider. Otherwise, the copay is $50. Deductible does not apply. Non-preferred brand drugs are subject to 30% coinsurance. Specialty drugs are subject to 30% coinsurance.
Silver Elite + Dental – Same policy as Bronze Elite but with adult dental benefits added.
Silver Standard – Office visit copays are $40 and $80. $5,00 policy deductible with maximum out-of-pocket expenses of $8,000. Diagnostic imaging (PET/CT scans and MRIs) and x-rays are subject to 40% coinsurance. Diagnostic tests (blood work) are subject to 40% coinsurance. ER visits are are subject to 40% coinsurance. Urgent Care copay is $60. Rehabilitation services are subject to $40 copay. Skilled nursing care, and durable medical equipment are subject to 40% coinsurance. Emergency medical transportation subject to 40% coinsurance.
Generic drug copays are $20 and the deductible does not apply. Preferred brand drug copays are $40. Non-preferred brand drugs are subject to a $80 copay. Specialty drugs are subject to a $350 copay.
Gold Complete – Office visit copays are $0 and $10/$25 (Tier 1) and $0/$25 and $10/$45 (Tier 2). Antidote virtual providers receive the lowest copay. $2,000 deductible with maximum out-of-pocket expenses of $8,000. Diagnostic tests (x-rays and blood work) are subject to 30% coinsurance (Tier 1) and 40% coinsurance (Tier 2). Diagnostic imaging (PET/CT scans and MRIs) are subject to 30% coinsurance (Tier 1) and 40% coinsurance (Tier 2). ER visits are are subject to 30% coinsurance (Tier 1) and 40% coinsurance (Tier 2). Urgent Care copays are $0 when treated by a virtual provider. Otherwise, 30% and 40% coinsurance applies. Rehabilitation services are subject to 30% and 40% coinsurance (Tiers 1 and 2) with a maximum of 60 visits per benefit period. Skilled nursing care, and durable medical equipment are subject to 30% and 40% coinsurance (Tiers 1 and 2) with a maximum of 90 visits per benefit period. Emergency medical transportation subject to 30% and 40% (Tier1 and Tier 2) coinsurance.
Generic drug copays are $0 when prescribed by a virtual provider. Otherwise, the copay is $5. Preferred brand drug copays are $15 when prescribed by a virtual provider. Otherwise, the copay is $30. Deductible does not apply. Non-preferred brand drugs are subject to 30% coinsurance. Specialty drugs are subject to 30% coinsurance.
Gold Complete + Dental – Same policy as Bronze Elite but with adult dental benefits added.
Gold Elite – Office visit copays are $0 and $10/$25 (Tier 1) and $0/$15 and $10/$45 (Tier 2). Antidote virtual providers receive the lowest copay. $1,500 policy deductible with maximum out-of-pocket expenses of $7,000. Lab tests have a $0 copay (Antidote virtual provider) or otherwise a $25 copay. X-rays are subject to 20% coinsurance (Tier 1) and 30% coinsurance (Tier 2). Diagnostic imaging (PET/CT scans and MRIs) are subject to 20% coinsurance (Tier 1) and 30% coinsurance (Tier 2). ER visits are are subject to 20% coinsurance (Tier 1) and 30% coinsurance (Tier 2). Urgent Care copays are $0 when treated by a virtual provider. Otherwise, 20% and 30% coinsurance applies. Rehabilitation services are subject to a $25 copay (Antidote virtual provider) or otherwise a $50 copay.(Tiers 1 and 2) with a maximum of eight copay visits per benefit period. Skilled nursing care, and durable medical equipment are subject to 20% and 30% coinsurance (Tiers 1 and 2) with a maximum of 90 visits per benefit period. Emergency medical transportation subject to 20% and 30% (Tier1 and Tier 2) coinsurance.
Generic drug copays are $0 when prescribed by a virtual provider. Otherwise, the copay is $5. Preferred brand drug copays are $15 when prescribed by a virtual provider. Otherwise, the copay is $30. Deductible does not apply. Non-preferred brand drugs are subject to 20% coinsurance. Specialty drugs are subject to 20% coinsurance.
Gold Elite + Dental – Same policy as Bronze Elite but with adult dental benefits added.
Gold Standard – Office visit copays are $30 and $60. $1,500 policy deductible with maximum out-of-pocket expenses of $7,800. Diagnostic imaging (PET/CT scans and MRIs) and x-rays are subject to 25% coinsurance. Diagnostic tests (blood work) are subject to 25% coinsurance. ER visits are are subject to 25% coinsurance. Urgent Care copay is $45. Rehabilitation services are subject to $30 copay. Skilled nursing care, and durable medical equipment are subject to 25% coinsurance. Emergency medical transportation subject to 25% coinsurance.
Generic drug copays are $15 and the deductible does not apply. Preferred brand drug copays are $30. Non-preferred brand drugs are subject to a $60 copay. Specialty drugs are subject to a $250 copay.
Note: Finding a provider in your area is easy. This link allows you to view doctors, dentists, vision specialists and pharmacies in your area. Seniors that are Medicate-eligible can view their Part D prescription drug plans in Ohio and select the plan that best meets their needs.
2025 Ohio Antedote Health Insurance Rates (Monthly)
Franklin County
30 Year Old With $30,000 Household Income
$0 – Bronze Complete
$6 – Bronze Elite
$11 – Bronze Complete + Dental
$16 – Bronze Elite + Dental
$18 – Bronze Standard
$77 – Silver Complete
$87 – Silver Complete + Dental
$109 – Silver Elite
$119 – Silver Elite + Dental
$131 – Silver Standard
$182 – Gold Complete
$193 – Gold Complete + Dental
$238 – Gold Elite
$248 – Gold Standard
$249 – Gold Elite + Dental
40 Year Old Couple With $50,000 Household Income
$9 – Bronze Complete
$33 – Bronze Elite
$59 – Bronze Complete + Dental
$83 – Bronze Elite + Dental
$86 – Bronze Standard
$219 – Silver Complete
$243 – Silver Complete + Dental
$291 – Silver Elite
$315 – Silver Elite + Dental
$340 – Silver Standard
$455 – Gold Complete
$480 – Gold Complete + Dental
$583 – Gold Elite
$605 – Gold Standard
$607 – Gold Elite + Dental
50 Year Old Couple And One Child With $65,000 Household Income
$0 – Bronze Complete
$38 – Bronze Elite
$41 – Bronze Complete + Dental
$79 – Bronze Elite + Dental
$84 – Bronze Standard
$315 – Silver Complete
$356 – Silver Complete + Dental
$439 – Silver Elite
$481 – Silver Elite + Dental
$525 – Silver Standard
$725 – Gold Complete
$767 – Gold Complete + Dental
$945 – Gold Elite
$983 – Gold Standard
$987 – Gold Elite + Dental
Cuyahoga County
25 Year Old With $25,000 Household Income
$10 – Bronze Complete
$19 – Bronze Complete + Dental
$30 – Bronze Elite
$40 – Bronze Elite + Dental
$41 – Bronze Standard
$94 – Silver Complete
$104 – Silver Complete + Dental
$123 – Silver Elite
$132 – Silver Elite + Dental
$143 – Silver Standard
$189 – Gold Complete
$198 – Gold Complete + Dental
$239 – Gold Elite
$248 – Gold Standard
$249 – Gold Elite + Dental
30 Year Old And One Child With $45,000 Household Income
$87 – Bronze Complete
$105 – Bronze Complete + Dental
$125 – Bronze Elite
$143 – Bronze Elite + Dental
$145 – Bronze Standard
$246 – Silver Complete
$264 – Silver Complete + Dental
$300 – Silver Elite
$318 – Silver Elite + Dental
$338 – Silver Standard
$425 – Gold Complete
$443 – Gold Complete + Dental
$521 – Gold Elite
$537 – Gold Standard
$539 – Gold Elite + Dental
55 Year Old Married Couple With $40,000 Household Income
$53 – Bronze Complete
$91 – Bronze Complete + Dental
$140 – Bronze Elite
$182 – Bronze Elite + Dental
$187 – Bronze Standard
$424 – Silver Complete
$466 – Silver Complete + Dental
$551 – Silver Elite
$594 – Silver Elite + Dental
$639 – Silver Standard
$843 – Gold Complete
$886 – Gold Complete + Dental
$1,069 – Gold Elite
$1,108 – Gold Standard
$1,112 – Gold Elite + Dental
Hamilton County
35 Year Old With $25,000 Household Income
$0 – Bronze Complete
$0 – Bronze Elite
$11 – Bronze Complete + Dental
$11 – Bronze Elite + Dental
$12 – Bronze Standard
$72 – Silver Complete
$83 – Silver Complete + Dental
$109 – Silver Elite
$119 – Silver Elite + Dental
$131 – Silver Standard
$182 – Gold Complete
$193 – Gold Complete + Dental
$238 – Gold Elite
$248 – Gold Standard
$249 – Gold Elite + Dental
50 Year Old With $50,000 Household Income
$0 – Bronze Complete
$16 – Bronze Complete + Dental
$30 – Bronze Elite
$46 – Bronze Elite + Dental
$48 – Bronze Standard
$135 – Silver Complete
$151 – Silver Complete + Dental
$183 – Silver Elite
$199 – Silver Elite + Dental
$215 – Silver Standard
$291 – Gold Complete
$307 – Gold Complete + Dental
$395 – Gold Elite
$389 – Gold Standard
$391 – Gold Elite + Dental
60 Year Old Married Couple With $60,000 Household Income
$170 – Bronze Complete
$178 – Bronze Complete + Dental
$231 – Bronze Elite
$278 – Bronze Elite + Dental
$284 – Bronze Standard
$551 – Silver Complete
$599 – Silver Complete + Dental
$695 – Silver Elite
$743 – Silver Elite + Dental
$794 – Silver Standard
$1,024 – Gold Complete
$1,073 – Gold Complete + Dental
$1,279 – Gold Elite
$1,322 – Gold Standard
$1,327 – Gold Elite + Dental
Hamilton County
35 Year Old With $25,000 Household Income
$0 – Bronze Complete
$0 – Bronze Elite
$11 – Bronze Complete + Dental
$11 – Bronze Elite + Dental
$12 – Bronze Standard
$72 – Silver Complete
$83 – Silver Complete + Dental
$109 – Silver Elite
$119 – Silver Elite + Dental
$131 – Silver Standard
$182 – Gold Complete
$193 – Gold Complete + Dental
$238 – Gold Elite
$248 – Gold Standard
$249 – Gold Elite + Dental
40 Year Old Married Couple With Two Children With $75,000 Household Income
$27 – Bronze Complete
$63 – Bronze Elite
$103 – Bronze Complete + Dental
$139 – Bronze Elite + Dental
$143 – Bronze Standard
$344 – Silver Complete
$380 – Silver Complete + Dental
$452 – Silver Elite
$488 – Silver Elite + Dental
$527 – Silver Standard
$700 – Gold Complete
$737 – Gold Complete + Dental
$892 – Gold Elite
$925 – Gold Standard
$928 – Gold Elite + Dental
50 Year Old Married Couple With One Child With $65,000 Household Income
$82 – Bronze Complete
$120 – Bronze Elite
$162 – Bronze Complete + Dental
$200 – Bronze Elite + Dental
$205 – Bronze Standard
$418 – Silver Complete
$456 – Silver Complete + Dental
$533 – Silver Elite
$571 – Silver Elite + Dental
$612 – Silver Standard
$796 – Gold Complete
$835 – Gold Complete + Dental
$1,0 – Gold Elite
$1,034- Gold Standard
$1,038 – Gold Elite + Dental
Antidote Telehealth Services are available 24/7 and allow consumers to access quality medical care at their convenience. Diabetes care, hypertension care, mental health, and primary care can be effectively managed. Coverage is available in the Buckeye State and also Georgia, Arizona, Florida, New York, and Texas. Monthly cost and benefits are listed below:
Primary Care – $49 per visit. Designed to cover primary care, urgent care, and medical notes by clinicians. Access is available at any location using any type of device.
Complete Care – $49 per month ($75 for a family). Designed to cover primary care, diabetes care, and hypertension care. Access is available at any location using any type of device. Also included: customized treatment plans for chronic conditions and primary care, personalized medication management, motivation, support, and encouragement, 12 yearly visits, medical records access, and cancellation of coverage at any time without a penalty.
Mental Health – $99 per month. Complete diagnosis and evaluation, retain personal board-certifies physician, three-week follow-up visitation, evidenced-based management of medications, plus customized treatment plans for chronic conditions and primary care, personalized medication management, motivation, support, and encouragement, 12 yearly visits, medical records access, and cancellation of coverage at any time without a penalty.
2025 Plan Documents
The following documents are available upon request:
Evidence of Coverage – The EOC document indicates the policy is not a Medicare Supplement plan. It also reminds consumers that if there are both a primary and secondary plan, benefits may not be paid from both plans.
Evidence Of Coverage Amendment – Changes and additions include the definitions of “related services,” hearing aids, and an otalaryngologist. Covered expenses also do not include assistive listening device cords and assistive listening device batteries.
Change In Chiropractic Care Coverage – To conform with the State Of Ohio legislative changes, benefits have been updated for chiropractic services, physical therapy, and occupational therapy. Cost-sharing parity is now required.
Member Rights And Responsibilities – Several examples include: To be treated with respect and recognition of dignity, to receive information in a different format in compliance with the Americans with Disabilities Act, To be kept informed of uncovered benefits, and to be able to use an interpreter if needed.
Prior Authorization Guidelines – Category of service categories include behavioral health, diagnostic imaging, durable medical equipment, inpatient admissions, and outpatient services and procedures.
24/7 Virtual Care Riders – Additional benefits and coverage for elite and complete plans.
Dental Rider – Services must be “covered.” Examples include periodic and limited oral examinations, bitewings, tropical fluoride, anterior root canal, and extractions.
Dental Benefit Summaries – Prior authorization is often needed for specific services. 100% coverage is available for x-rays, teeth cleaning, and limited and comprehensive periodic examinations.
