health insurance ohio
Hey there! Blake from Blake Insurance Group here. After helping hundreds of Ohio families find the right health coverage, I wanted to share some straight talk about health insurance in our state.
Let’s face it – health insurance can feel overwhelming. There’s a lot to consider between marketplace plans, Medicare options, and everything in between. But don’t worry – I’m here to break it down into simple terms that actually make sense.
As an independent agent right here in Ohio, I’ve seen firsthand what works (and what doesn’t) for folks like you. Whether you’re looking to save money on premiums, keep your current doctors, or ensure your family has solid coverage, I’ve got you covered.
In this guide, I’ll walk you through everything you need to know about health insurance in Ohio – no fancy jargon, just honest advice from someone who deals with these plans every day. Think of it as having a friend in the insurance business who’s looking out for your best interests.
Ready to dive in? Let’s explore your options and find a plan that fits your needs and budget.
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Customer Reviews
Marketplace Plans
Let me share the specifics about Ohio’s Health Insurance Marketplace plans for 2025.
Insurance Carriers
Ohio’s Marketplace will feature 13 insurance providers, including one new entrant, Antidote Health Plan. The returning insurers include well-known names like:
– Aetna Health
– AultCare Insurance Company
– Buckeye Community Health Plan
– CareSource Ohio
– Anthem BCBS
– Medical Health Insuring Corp. (MedMutual)
– Molina Healthcare
– Oscar Insurance
– Paramount Insurance Company
– Summa Insurance Company
– UnitedHealthcare
Rate Changes for 2025
Most insurers have announced rate adjustments for 2025:
– Buckeye Community Health Plan and Paramount are decreasing rates (-4.4% and -2.59% respectively)
– Molina Healthcare has the smallest increase at 0.48%
– Aetna Health has the largest increase at 17.43%
Enrollment Information
The 2024 enrollment period saw record-breaking numbers, with 477,793 Ohioans enrolling in Marketplace plans. This significant increase was mainly due to enhanced premium subsidies through the American Rescue Plan, extended through 2025.
Important Dates
For 2025 coverage:
– Open enrollment runs from November 1 to January 15
– Enroll by December 15 for coverage starting January 1, 2025
– Enrollments after December 15 will start February 1, 2025
Premium Tax Credits (PTC)
In 2024-2025, premium assistance has been significantly expanded. Now, 92% of marketplace enrollees receive premium tax credits. Key features include:
– Households above 400% of the Federal Poverty Level can now qualify for assistance
– The average consumer saves 48% on monthly premiums
– Nearly 9.4 million people selected plans for $10 or less per month
To qualify, you must:
– Purchase insurance through the Health Insurance Marketplace
– File taxes jointly if married (with some exceptions)
– Not be claimed as a dependent
– Meet income requirements
Cost-Sharing Reductions (CSR)
CSRs provide additional savings on medical expenses for eligible enrollees. For 2024:
| Income Level | Out-of-Pocket Maximum |
|---|---|
| 100-150% FPL | $3,050 |
| 150-200% FPL | $3,050 |
| 200-250% FPL | $7,350 |
Important CSR details:
– Only available with Silver plans
– 50% of marketplace consumers receive these reductions
– Can reduce deductibles from $5,000 to as low as $90 for lowest income brackets
– Must earn less than $36,450 as an individual or $75,000 for a family of four to qualify
Income Guidelines for 2025
For a single person:
– Minimum income for credits: $15,060
– Maximum CSR eligibility: $37,650
For a family of four:
– Minimum income for credits: $31,200
– Maximum CSR eligibility: $75,000
Short-Term Health Insurance
Let me expand on short-term health insurance options in Ohio with the latest updates for 2024-2025.
Current Coverage Duration
Until September 2024, Ohio residents can purchase short-term plans lasting up to 364 days. However, starting September 2024, new federal regulations will limit these plans to a maximum of three months, with the possibility of a one-month renewal, for a total duration of up to four months.
Key Features
Short-term plans in Ohio offer:
– Coverage starting as soon as the next day after enrollment
– Monthly premiums ranging from $79 to $371
– Deductible options from $1,000 to $10,000
– Access to large provider networks
– Ability to cancel anytime without penalty
Who Should Consider Short-Term Coverage
These plans are particularly suitable for people who are:
– Between jobs or waiting for employer coverage to begin
– Transitioning off parent’s insurance
– Graduating from college
– Waiting for Medicare eligibility
– Missing open enrollment for ACA coverage
Important Limitations
Short-term plans have specific restrictions:
– No coverage for pre-existing conditions
– Limited prescription drug coverage
– Must pass medical underwriting to qualify
– Not considered minimum essential coverage under ACA guidelines
Cost Structure
The total cost includes:
– Monthly premiums based on age, gender, and location
– Coinsurance ranging from 0% to 30%
– Various copayment options
– Choice of coverage maximums from $100,000 to $1 million
Remember that while these plans offer quick, flexible coverage, they’re designed as temporary solutions rather than long-term health insurance options.
Medicare in Ohio offers a range of options for eligible residents
To be eligible for Medicare in Ohio, you must:
– Be 65 years or older
– Be a U.S. citizen or permanent resident
– Have worked and paid Medicare taxes for at least 10 years
The Initial Enrollment Period (IEP) begins 3 months before your 65th birthday, includes your birthday month, and extends 3 months after. If you miss this window, you can enroll during the General Enrollment Period from January 1 to March 31 each year.
Coverage Options
Original Medicare
This includes:
– Part A (Hospital Insurance)
– Part B (Medical Insurance)
Medicare Advantage (Part C)
In 2025, Ohio will have 224 Medicare Advantage plans available. These plans offer:
– All Part A and B coverage
– Often include prescription drug coverage
– May provide additional benefits like dental, vision, and hearing care
The average monthly premium for Medicare Advantage plans in Ohio is $16.63 for 2024.
Prescription Drug Coverage (Part D)
Ohio has 24 stand-alone Part D plans available, with premiums starting at $5.10 per month.
Medicare Supplement (Medigap)
These plans help cover out-of-pocket costs associated with Original Medicare. Up to 48 insurers offer Medigap plans in Ohio.
Enrollment Periods
– Annual Enrollment Period: October 15 to December 7 each year
– Medicare Advantage Open Enrollment: January 1 to March 31
Top-Rated Plans
For 2024, some highly-rated Medicare Advantage plans in Ohio include:
– 5-star plans: Medigold, PrimeTime Health Plan
– 4.5-star plans: Health Alliance Medicare, Medical Mutual of Ohio, Paramount Elite Medicare Plans, SummaCare Medicare Advantage Plans
Additional Resources
Contact the Ohio Senior Health Insurance Information Program (OSHIIP) at 800-686-1578 for personalized assistance.
Remember to review your coverage options annually to ensure you have the best plan for your needs and budget.
Blake Insurance Group
Phone: (888) 387-3687
Email: [email protected]
Hours: Mon-Fri 9:00 am to 5:00 pm
Sat-Sun: Closed
Blake Nwosu
Owner & Principal Agent