Ohio is nicknamed as the ‘Buckeye State’, because of the many buckeye trees which once covered the hills and plains of the state. It was partitioned from the Northwest Territory and included into the Union as the 17th state in 1803, and the state has lot to do to improve its health rankings. Thus, there is room for improvement for the residents of this Buckeye state to improve their health and get on track of their health by wisely investing into health insurance plan exactly as per their needs that will help them stay healthy and provide financial protection in case of medical emergency. With a federally facilitated exchange residents of the state can enroll in health insurance plans through the Ohio exchange, HealthCare.gov. Open enrollment for the 2020 coverage has started from November 1 and will end on December 15, 2019. For offering health coverage in 2020, ten insurers are offering health plans in Ohio’s exchange, thereby giving residents of every county with the choice of at least two insurers in the exchange. Residents of 42 counties of Ohio has only one insurer in 2018 that dropped to 16 counties in 2019 and due to expansion of the coverage area, Logan County is the only county in 2020 where only 1 insurer will be offering plans through exchange.
Highlights and Updates of Ohio Health Insurance
- Ohio has a federally run health insurance marketplace so residents can enroll in health plans through HealthCare.gov.
- In Ohio Open enrollment for 2020 coverage has started from November 1 and will end on December 15, 2019. To buy regular medical coverage outside that window, residents of Ohio will need a qualifying event.
- Ten insurance carriers are offering health plans in the Ohio exchange for the 2020 coverage.
- In Ohio short term health plans are available for an initial plan term of up to 364 days.
- Since 2013, the uninsured rate in Ohio has dropped by more than 40%.
- For 2019 coverage around 207,000 people enrolled in Ohio exchange.
Individuals & Family Health Insurance in Ohio
Ohio residents can choose from a variety of individuals and family health plan offered by participating private insurance companies through federal exchange, HealthCare.gov. Keeping in mind the budget and healthcare needs of every individual and their family, insurance companies of Ohio has design health plans with different coverage options and price range. Whether one requires lots of doctor’s appointment or one just wishes to be covered for emergencies, Ohio has a plan to match everyone’s need and budget. Individual and family plans come with lot of options in Ohio, as right from preventive care to maternity and new-born care, residents will have the health insurance coverage for all the standardized essential benefits.
In Ohio following individual and family health insurance plans are available:
PPO – Preferred Provider Organization is a managed care health plan having a network of preferred healthcare providers to whom the members are supposed to visit in case of medical emergency. In this plan members are neither required to choose a primary care physician nor they need to obtain referral from primary care physician to visit any specialist. PPO plan requires members to pay an annual deductible to pay in order to receive coverage of their medical bills from the insurance company. Members may have a certain co-payment for certain services or need to cover a certain percentage of the total charges of their medical bills. Members of this plan have the freedom to choose any medical facility or provider for their healthcare needs and irrespective which healthcare provide one choose, the in-network healthcare services cover greater benefits than out-of-network services.
HMO – Health Maintenance Organization plans cover a wide range of healthcare services through a network of healthcare providers who agree to supply medical services to members at discounted rates. HMO plans likely offer coverage for a broader range of preventive healthcare services compared to any other type of plan. Members of HMO plans need to choose a primary care physician, who take care of most of their healthcare needs and also provide a referral to members for seeing a specialist. With HMO plans members usually have lower out-of-pocket healthcare expenses. The members are not required to pay a deductible before the start of the coverage starts and their co-payments are also likely to be minimal. Members will likely have no coverage for medical services received by out-of-network providers or for services obtained without a proper referral from primary care provider.
High Deductible Health Plans with Health Savings Accounts – A Health Savings Account is a tax-free saving account, in which individuals can save money to pay for current and future health expenses. It is used in conjunction with a High Deductible Health Plan to make healthcare more affordable. A high-deductible HSA-compatible health insurance plan generally has a lower premium compared to a plan with a lower deductible, so the money saved can be deposited in the Health Savings Account. The members of this plan has complete control on the money in the account and are free to make decisions on how the money can be spend without relying on a health insurer. Members also have the freedom to decide upon the investment types to make the money in the account grow.
Flexible Spending Accounts – FSA is a special account in which people save their money to pay for certain out-of-pocket health care costs. The best thing about this account is that people do not have to pay taxes on the saved amount and it can be used only for sudden medical expenses. In order to use the money saved in the Flexible Spending Account, people need to submit a claim to the FSA along with a proof of the medical expenses and a statement that the healthcare services, which they have received are not covered under their plan. Thus, people will receive reimbursement for the cost incurred on their medical treatment.
Dental Insurance Plans in Ohio
Dental plans in Ohio are cost-effective and flexible way to obtain best oral healthcare benefits by having access to thousands of dentists who have agreed to provide dental services at substantially reduced rates. Dental insurance in Ohio is available through most recognized insurance carriers like Anthem, Blue Cross, UnitedHealthcare, Medical Mutual and Humana along with some small carriers offering discount dental plans. In Ohio two following types of dental plans are available:
Managed Care – Managed care dental plans have network of dentists, specialists and oral surgeons, who agree to offer dental care at discounted rates to the members of the plan. The dental care services are priced in advance at a pre-arranged rate and for major dental care like root canals and crowns, larger discounts are offered. With managed care plans insured has less paper work and lower out-of-pocket costs.
Indemnity Plans – In Indemnity dental plans, members are required to pay upfront for their dental service and later on submit their claim to obtain reimbursement for their dental treatment. Though, people enrolled in this plan have a wider selection of dentists and facilities to obtain dental care. In indemnity dental plans, insurance companies pay for the dental services only after they receive bill for the availed dental care services.
Vision Insurance in Ohio
Residents of Ohio looking for eye care coverage for the services rendered by ophthalmologists and optometrists may purchase vision insurance offered by private insurance carriers. There are some major private insurance carriers offering yearly coverage for eye examinations along with partial or full coverage for eyeglasses, sunglasses, and contact lenses, and these plans are available with or without copays depending on the vision plan chosen.
Short-term Health Plans in Ohio
Short-term health plans are primarily preferred by many due to its affordability factor and these plans usually work best for those who do not require regular medical care like frequent visits to the doctor or expensive prescriptions. Though short-term plans do not come with many benefits like major medical health plans but still they offer some coverage that is affordable for many people. Purchasing short-term plans in Ohio also make people ineligible for any guaranteed issue health plans like HIPAA or COBRA plan. People looking to buy short term plan should keep in mind that these plans do not cover pre-existing medical conditions or several other benefits that are generally covered by the more comprehensive plans. In Ohio short-term plans are available for terms of up to 364 days and these plans are non-renewable. Until October, 2018, the short term plans were not available for more than three months in duration and prohibited renewals but Trump Administration allowed this plan to be of longer terms. In Ohio even non-renewable short-term plans has to comply with the following state requirements such as:
- Certain care such as newborn care, mammograms, autism spectrum disorder treatment must be covered.
- Details of network-providers should be disclosed to the members of the plan.
- Internal as well as External reviews.
Insurance Carriers in Ohio
The ten insurance companies offering plans in Ohio’s exchange for 2020 include:
- Community Insurance Company (Anthem BCBS)
- Medical Health Insuring Corp. of Ohio
- Oscar Buckeye State Insurance Corporation
- Oscar Insurance Corporation of Ohio