The Ohio Health Insurance Exchange is the new way to buy healthcare in the Buckeye state. Although our website makes it easy for you to compare Marketplace plans and apply for coverage, we understand there are many questions that consumers have. Whether its regarding Open Enrollment, Obamacare subsidies or finding the cheapest options, we have the answers for you.
What Is The Ohio Health Exchange?
It’s the new “Marketplace” that was created by the passage of “The Affordable Care Act.” Different plans are offered from various companies (not all of them) and policies are quite different since there are mandatory coverages that must be included. Single, family and small business plans are offered.
I Have Coverage At Work Already. Am I Eligible?
More than likely, you can buy a policy since you probably meet all of the eligibility requirements. However, you may not be able to qualify for the federal subsidy. So unless your company coverage is VERY expensive and/or you are in a higher household income bracket, you may be better off with your employer-sponsored plan.
What Is The Tax Penalty If I Don’t Buy Coverage?
Currently it is $95 per year (adults) or 1% of your income, whichever is higher. However, next year it increases to $325 and 2% respectively. And the tax increase again in 2016.
What Companies Can I Buy A Policy From?
In addition to Anthem (mentioned above), other carriers offering Open Enrollment include Medical Mutual, CareSource, Molina, Kaiser Permanante, HealthSpan and SummaCare. Kaiser has recently been purchased by HealthSpan, so names of approved plans may be changing. Catholic Health Partners, which is headquartered in Cincinnati, is the parent company of HealthSpan. Confusing isn’t it?
What If I Miss Open Enrollment?
“Qualifying Life Events” allow you to purchase a policy outside of the conventional period. Some of the special circumstances include divorce, ending of COBRA, loss of eligibility for Medicaid or CHIP, dependent reaching age 26, moving out-of-state and birth of a child.
You may be able to buy an Ohio health insurance policy that is considered “outside” of the Exchange. However, you will still owe any applicable tax penalties.
Can I Buy A Children’s Only Policy?
Now you can. For the last few years, unless it was a limited short-term plan, other than Assurant, no other carrier wanted the business. But that has changed.
Who Can Buy The Cheap Catastrophic Health Plans?
If you are under age 30, then you are eligible for this low-cost plan. But for anyone else, if no available Marketplace options cost less than 8% of their household income, then they also are eligible to purchase this type of policy.
A catastrophic policy covers all 10 “Essential Health Benefits,” but also features a high $6,350 deductible for individuals and a whopping $13,700 deductible for families. There is no coinsurance so the out-of-pocket expense is $0 after the deductible is met.
What Are The Best Ohio Anthem Blue Cross Plans?
Anthem offers several options in every county. The Gold DirectAccess is perhaps the most comprehensive policy. The Silver and Bronze DirectAccess plans have similar benefits, but with higher out-of-pocket expenses. A children’s dental benefit is also available in conjunction with some of the contracts.
Are Dental Benefits Included?
If you are under age 18, it is a mandatory requirement (One of the 10 Essential Benefits) that you have access to coverage as part of your healthcare policy or separately. Adults can purchase separately a wide range of dental options. Monthly rates usually range from about $7-$10 (Bare bones ) to about $20-$32) (comprehensive).
What Are The Different Billing Options?
That’s one change that will help many customers. Previously, it was acceptable for a company to require you to pay electronically if you selected the monthly method. However, that practice has changed. Now, electronic fund transfers, hard-copy checks, money orders and debit cards must be accepted. These new billing options will apply to both new premiums and ongoing bills.
Is It True That Only Certain Insurers Have The Cleveland Clinic In Their Provider Network?
If you purchase an Ohio Exchange plan, Medical Mutual’s provider network includes the Cleveland Clinic. However, they are the only listed carrier. If you buy a policy that is non-Obamacare, many companies and managed-care contracts are listed, including Aetna, Anthem BCBS, Boeing, CareSource, Cigna, HealthAmerica, Humana, Kaiser, Kohl’s, Lowe’s, MultiPlan, SummaCare, and UnitedHealthcare.
Why Is Medical Mutual Cheaper On The Exchange?
It is possible that 2014 Exchange rates for Medical Mutual will be less than expensive than the cost you are paying now. One reason is the federal subsidy that is applied. Another contributing factor is that the longer you keep an existing plan (that you have previously purchased), the more rate hikes you will have experienced. And if there were pre-existing conditions present at the time of application, you may be paying a higher premium.
If I Decide NOT to Buy A Policy, Am I Breaking The Law?
Yes, although you aren’t going to go to jail or get arrested. The “individual responsibility requirement” is the portion of the new legislation that requires you to buy qualified benefits. If you don’t, you must pay the higher of $95 per adult ($47.50 per child) or 1% of your income. The federal tax filing threshold ($10,000/ single fling or $20,000/ joint filing). This tax continues to increase each year.
Are Short-Term Policies Still Available In Ohio?
These types of policies are typically used when you only need temporary benefits. The period of benefits is less than 12 months and often only a few months. Sometimes…just one month. Since they don’t comply with the minimum essential health benefits requirement, they can not be purchased through Exchanges.
However, plans can be purchased (UnitedHealthcare usually has the lowest prices) through our website. They are not guaranteed renewable and pre-existing conditions are usually excluded.
Can I Drop COBRA During Open Enrollment And Enroll In A Different Plan?
You can apply for a different policy, even if you are presently covered under COBRA. However, it’s important to properly compare the differences in benefits, since it’s likely there are existing medical conditions that are being treated. Also, if you initiate the termination of benefits, you will have to wait until Open Enrollment the following year to change plans. The exceptions would be special approved situations, such as birth of a child or termination of a group contract.
What Is The Average Smoking Penalty For Marketplace Policies?
The law allows companies to charge up to 50% extra for nicotine users. However, here in our beloved Buckeye state, typical increases will vary from about 5%-30%, depending on which carrier that is writing the policy. Since it can often change the amount you pay by hundreds (or thousands) of dollars per year, please contact us for a comparison of the cheapest plans.