Ohio Health Insurance Marketplace Plans
The Ohio Health Exchange offers individuals, business owners and families the opportunity to purchase affordable coverage with the help of a federal tax subsidy and guaranteed-approval of submitted applications. Easily, you can shop for quality Ohio medical coverage at the cheapest available rates. There are no exclusions for pre-existing conditions.
In less than a minute, you can compare the companies that will offer the lowest prices for Open Enrollment Exchange. Pre-existing conditions will no longer be excluded and we will help you with the enrollment process. You don't have to worry about the constant glitches and delays many persons have experienced on the .gov website.
Which Companies Are Available?
Anthem Blue Cross and Medical Mutual will offer coverage to consumers in the individual and family marketplace. Other carriers will include Aultcare, Coventry, SummaCare, Buckeye Community, Humana, Kaiser, Molina, Paramount, Time, and Coordinated Health Mutual. UnitedHealthcare (Golden Rule) will not offer policies and will take a "wait and see" approach. Aetna has also announced that they will not offer "on-Exchange" coverage.
However, both companies are expected to offer options "off-Exchange" in 2014. These types of policies may NOT include "essential health benefits" and would therefore not be considered qualified options. That means you may have to pay an Obamacare tax because you did not purchase the type of medical coverage that is required. Assurant is another carrier that will offer specialized options.
In some situations (certainly not all), there will be affordable policies that can be purchased outside of the Marketplace that do meet the "essential health benefits" requirement. Since subsidies will not be payed on these contracts, they will be viable choices for families with household income above $95,000. If you lack physicians or specialists in your area, these policies should be considered.
Which Plans Will Be The Cheapest?
Policies will be available in four actuarial "medal" categories. They are Platinum, Gold, Silver and Bronze. The cheapest policy will be the Bronze option since it pays the least out-of-pocket expenses (expected). Unlike the Platinum option that covers 90% of expected expenses, the Bronze plan will only cover 60%. The State Department Of Insurance will regulate the policies although the Federal Government will run the Exchange (for now).
A catastrophic plan will be offered to consumers that may not be able to afford more expensive policies with the required mandated benefits. If you are under age 30, you can automatically qualify. If you are older than age 30, if there are no "affordable" plans available in your area, you will be able to buy this type of coverage. Although the deductible is high ($6,350), the rates are typically cheap.
Bronze Deductibles will be higher and if you utilize the prescription benefits, you'll pay more. However, you will pay a lower premium, and that extra savings can be used to offset some of your higher expenses. This option is closely comparable to HDHP plans that have been "grandfathered" for many consumers. Silver plans will be the second-least expensive policy and will be ideal for Ohioans willing to pay a slightly higher premium to reduce deductibles and copays.
The Society of Actuaries has predicted that prices will increase by an average of 88%. They based this prediction by comparing the current average monthly premium of $223 to the projected premium of $420. The new federal tax credit will help many consumers pay some of the projected increase. There will be more than 200 plans offered, so broker assistance will be recommended. We have found that the increases have been much smaller. However, for married persons 55 and over with no children in the household, price increases may be the highest.
Is The Government Paying Part Of My Premium?
Ohio health insurance rates, like other states, will be reduced, if you qualify for the new immediate tax credit (subsidy). Here's how it works: Individuals and families that have incomes between 100% and 400% of the Federal Poverty Level (FDL), and who buy an "Exchange" policy are eligible for assistance. Medicaid and Medicaid recipients are not eligible.
The tax subsidies will immediately reduce your premium. Unlike a normal credit, you don't have to wait for a refund to use the money. Based on current FDL levels, a 30-year-old (male or female) that makes %$50,000 per year, will not receive a subsidy. However, if their income is only $25,000, they will receive approximately $1,700. You will also find that some plans will be free!
For a family of four (husband and wife age 40 and two children) with a household income of $75,000, the subsidy will be $4,422, or about $370 per month. For this example, we assumed the family was applying for a "Silver" plan. Of course, a "Bronze" plan would cost less, but would involve more risk. Once the family income reaches about $95,000, you are no longer eligible for financial assistance.
When And How Do You Apply For A Policy?
Our website will have direct links that will make it easy for you to apply for coverage. Tax subsidies will automatically be calculated so you know how much (if any) of the premium will be paid by the federal government. Open Enrollment began in October for 2014 effective dates. For the first year only, it extends through March so some of the glitches can (hopefully) be fixed. But starting in 2015, the Open Enrollment period will be much shorter.
Although the standard application has various questions, none are related to any medical condition you had in the past or are currently being treated for. The vast majority of questions refer to members of the household and other administrative topics. We're always available to help you fill out and complete the application. Choosing the most cost-effective plan may also require some assistance.
Can You Buy A Policy That Is Not Through The Exchange?
Yes. It is feared that the provider list for Exchange plans will be limited. If this is true, an alternative may be to purchase a plan outside of the Marketplace. They will be offered by many of the large companies and the number of participating doctors and specialists should be quite robust. However, some of the options will not contain all required benefits (such as maternity or mental illness). So although prices will be lower, benefits will be less and there may be a special penalty charged by the Dept. of Health and Human Services.
Prices for these options have yet to be determined, but will be released shortly (check our website for quotes). Mandated essential benefits will have to be included, so coverage will not be an issue. But it's possible rates will be lower than Exchange plans if you don't qualify for a subsidy. The difference is likely to be in the 5%-20% range.
Will Rates Be The Same In All Areas Of The State?
The cost of healthcare in Ohio will be different, depending upon which county you reside in. For example, prices in and around Columbus are going to be less expensive than prices in Cleveland. Cincinnati pricing will be different than Athens. It may not necessarily be a substantial difference (as it once was), but there will be a variance. Typically, cities in the Northern counties may be the most expensive.
Naturally, older persons will pay higher premiums and smokers will pay more, unless they quit for at least 12 months. But, as previously discussed, your pre-existing conditions (if applicable) will not impact what you pay. And you can not be denied for a medical issue. Whether you had cancer 10 years ago, or you were just diagnosed with cancer, it will not affect the premium.
Will HSA Plans Be Available?
They will be available under "Bronze" plans, the least expensive policy that will be offered. These types of plans must meet a "60%" requirement (this means they are expected to pay 60% of the average anticipated medical expenses for an applicant) with a possible deductible of $6,000. "Catastrophic" plans may also feature HDHP plans.
HSA plans have historically helped consumers become more cost-conscious with their spending, so their out-of-pocket costs reduce, and a tax-break is included. Coupled with the negotiated pricing that saves money, this type of option will once again, be very popular.
Are There Special Plans For Self-Employed Persons?
Although there are not "special" options available, there are many policies that would work well if you work for yourself. For example, an HSA (previously mentioned) is designed to keep rates low, reduce your taxes, and allow you to accumulate money in a side-account. Additional HSA information online can be found on another page. You can also use these funds to pay for medical, dental, vision or long-term care benefits. Funds not used are never lost. You can allow them to continue to accumulate.
Certainly, many other plans can be purchased since health insurance rates in Ohio are cheaper than most other states. We're experts on finding the best Marketplace policies for single, family or business situations. Quote, email or call. We'll try to help.
Update: 2-14-14 -- About 60,000 applicants from here in Ohio have enrolled in the Marketplace through the end of January. These numbers are a bit lower than originally predicted, and match the lower than expected enrollments of young persons under age 35.
Update: 3-13-14 -- About 18 days remain in this year's Open Enrollment period. However, once the date expires (April 1), Buckeye residents will not necessarily have to wait until November to purchase a policy. There are several plans that can be purchased at any time throughout the year.
Temporary policies cost about 35%-75% less than conventional plans (without the subsidy), and can be kept for as long as one year. There are limitations, including a maternity exclusion, but it will provide up to $1 million of major medical coverage until you can enroll through the Marketplace again.
Update: 6-24-14 -- Ohio Open Enrollment for 2015 is less than five months away! It begins on November 15th and there will be numerous changes. Additional carriers will be offering policies (possibly Aetna and/or UnitedHealthcare) and rates are expected to only slightly increase. In specific areas, prices may actually reduce from 2014 levels. Tax subsidies will continue to reduce premiums and the noncompliance penalty for not enrolling is still in effect.
Anthem, Medical Mutual, Humana and HealthSpan are early favorites to have the most competitive pricing. As soon as the 2015 prices are posted, we'll discuss them with you.