Health Insurance in Ohio & the Health Insurance Exchange

Today, people can get private health insurance from any insurance provider. They can also get Obamacare health insurance through Healthcare.gov. The deadline for enrollment is January 31, 2017.  If you don’t have an insurance policy, you may be required to pay a huge penalty. You’re also putting your life and the state of your finances at risk.

What should you do if you haven’t yet taken out an insurance policy? What are your options for health insurance in Ohio? We can help answer these questions. All you need to do is call 1-888-418-8795. This will help you get in touch with a licensed health insurance agent who can guide you through the rules of the Affordable Care Act.

About Healthcare.gov

Healthcare.gov hosts the Ohio health insurance marketplace under the ACA. This is an exchange that is facilitated by the federal government however, it is not administered by the Ohio Department of Insurance. Instead, it is operated by the US Department of Health and Human Services (HHS).

The state of Ohio still keeps oversight of the insurance plans. It is also active in the certification of qualified health plans (QHPs).

Another problem with Healthcare.gov is that it does not offer easily accessible information regarding your options. There are very few details available concerning your co-payments, deductibles, and healthcare provider networks.

Obamacare in Ohio

Before the Affordable Care Act, many residents in Ohio faced increasingly high premiums especially those with serious medical conditions. Some breast cancer patients had to pay insurance premiums of up to $1,500 per month.

But with the implementation of Obamacare, the marketplace for health insurance offered affordable health care plans to nearly everyone, regardless of any pre-existing medical conditions. Breast cancer patients who faced $1,500 premiums were now able to get insurance that lowered their premiums to just $130 a month.

The benefits of the ACA for Ohio are immense. Almost 1 million people in the state are covered by health insurance. About 300,000 were able to get insurance from the exchange. Some 700,000 residents gained insurance because of the Medicaid expansion of the ACA in Ohio.

On average, the premiums will rise at about 12% for Ohio residents this year. However, most of these health insurance cost-increases for low and middle income Ohio residents can be covered by government subsidies.

Health Insurance Carriers in the State Marketplace

You can find different insurance providers in the Ohio marketplace. Compared to other states, you have more options as to which health insurance provider you can sign on with.

Ohio has a total of 10 carriers that are offering insurance through the marketplace. In contrast, its neighbour state West Virginia has a grand total of just 2 carriers.

However, the availability of options depends greatly on where you live in the state. Out of the 88 counties in Ohio, there are 20 counties that have only a single carrier offering insurance plans through the state marketplace. Another 27 other counties have only 2 carriers. That’s a far cry from 2016, when every county in the state had at least 4 carriers.

Health Insurance Plans

Regardless of which carrier you choose, your health insurance plan will belong to any of the 4 basic categories.

  1. Bronze plans. These offer the cheapest premiums but on average they only cover 60% of the costs.
  2. Silver plans. The premiums are a bit higher for these plans, but the coverage increases to 70% of the total expenses.
  3. Gold plans. Now the coverage extends to 80% of the medical bills, but the premiums are even more expensive.
  4. Platinum plans. These come with the most expensive monthly premiums. However, the insurance carrier can cover about 90% of the total medical expenses.

There is a stopgap measure known as a catastrophic plan, but this is only available for those who are younger than 30 and who have a valid (and provable) excuse as to why they can’t afford regular “metallic” plans. These exemptions include bankruptcy, a death in the family, or homelessness.

All the metallic and catastrophic plans cover at least 3 visits to the doctor per year. It also pays for various preventive health services, including screening for disease, supplementary support for pregnant women, support for mental health issues (including depression) and counseling for drug and alcohol abusers.

More than 69,000 people in Ohio have insurance through Obamacare to help pay for treatment for mental health conditions and substance abuse issues. Another 151,000 with these conditions have insurance because if the Medicaid expansion in Ohio.

What Happens When You Don’t Get Insurance?

If you’re unable to get insurance within the time guideline, you may be assessed a heavy fine through tax penalties.

This fine can be 2.5% of the annual income of your household, less the amount of the federal tax filing threshold. It can also be $695 per adult and $347.50 per child, although the total amount for the whole family cannot go over $2,085. The option that yields the greater penalty will take effect.

However, you may have a valid reason why you do not have coverage. It can be because you’re in prison, you’ve gone through a financial hardship, your income is below the minimum tax filing threshold, or you are part of a religious organization that is opposed to insurance benefits. If you qualify for any of these exemptions, then you do not need to pay a penalty.

Why Do You Need Health Insurance in Ohio?

The truth is that no one knows for sure what kind of medical situation they or their loved ones will find themselves in. Without insurance, you may not have the finances to pay for your medical treatments.

Besides, with a good health insurance plan, you’re more likely to make use of preventive health services that can help save your life.

If you don’t have insurance yet, you can still get one now. Give us a call and we’ll gladly show you some of the most affordable health insurance options in Ohio.