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Ohio State Student Health Insurance Plan Options – Compare OSU Rates

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As a condition for enrollment at Ohio State University (OSU), students are required to be covered under a qualified health insurance plan. This requirement applies to undergraduate students enrolled for six or more eligible credit hours (four or more eligible credit hours for graduate and professional students and three hours for post-candidacy students). You may choose to purchase private on and off-Marketplace coverage or the OSU option.

All international students must also meet these requirements, and are automatically enrolled in the “comprehensive” plan. Also, auto-enrolled are students that study overseas, interns, and persons working on dissertations or a thesis. However, if alternative qualified coverage is in-force, a waiver will be granted. If no selection is made, the comprehensive plan will automatically be selected. Generally, you must select a choice about seven days before August Semester classes begin.

When registering for classes for the first calendar year term, the Buckeye Link will indicate the cost of coverage for the comprehensive plan option. That coverage can be kept, or waived, with proof of another qualified policy. If waived, a supplementary WilceCare policy (discussed in detail later) also becomes available. NOTE: The annual period of coverage is August to August as opposed to using the calendar year.

Qualifying Events

If you miss the Enrollment/Select/Waive period for changes to the comprehensive plan, a 31-day period is granted if you qualify for a “qualifying event,” and submit the appropriate form to SHI. However, any form received after that period will not be considered. Coverage can be requested to be added or terminated. Examples are listed below:

Death of spouse, child, or dependent

Dependent no longer eligible for other coverage because of age restriction

Adding a spouse because of marriage

Deleting a dependent because of divorce

Dependent becomes US citizen

Adding a newborn from legal adoption or delivery

Dependent leaves country to return home

Employment change leads to new healthcare eligibility

Domestic partnership is terminated

 

2016-2017 Rates

OSU student health insurance rates for 2016-2017 are listed below. These rates are “per semester” with the plan offered and underwritten by UnitedHealthcare, one of the nation’s largest healthcare providers. Details of the OSU student health insurance plan can be viewed through the provided link. NOTE: Although UHC has greatly reduced their presence on state and federal Exchanges, it does not impact the specific plans offered at OSU. All of the options below satisfy ACA (Affordable Care Act) requirements and regulations, and include “minimum essential requirements.”

(Paid TWICE per year)

Student –   $1377

Student And Spouse –   $2754

Student And Spouse And  Child –   $4131

Student And Two Or More Children –   $4131

Student And Spouse And Two Or More Children –   $5508

OSU Medical Center Serves Ohio State Students

Ohio State University Hospital Is One Of The Finest In The Midwest

Plan Overview

The policy provides comprehensive healthcare benefits, including coverage for office visits, prescriptions, Urgent Care and ER visits, major medical, mental illness, dental, and vision. If network facilities are utilized, maximum out-of-pocket expenses will be minimized. However, the UnitedHealthcare network is also available for off-campus treatment. Within the Franklin County PPO Network area, there are many available facilities. NOTE: Picture above is property of OSU.

Additional specific network highlights include a low $100 deductible and $2,000 maximum out-of-pocket costs (in-network treatment). Both primary-care physician (PCP) and specialist office visits  are subject to only a $15 copay with no limit on the number of covered visits. Also, no referrals are required. Vision and dental exams also feature the $15 copay. NOTE: The benefit package was recommended by the Student Health Insurance Advisory Committee and approved by the Board of Trustees.  Additional benefits include:

100% qualified preventative benefits with no out-of-pocket costs.

10% coinsurance for diagnostic tests (blood work and x-rays), MRIs, and PET/CT scans.

10% coinsurance for generic drugs, 20% for preferred brand drugs, and 50% for non-preferred brand drugs.

10% coinsurance for physician/surgeon and facility fees.

10% coinsurance and $100 copay for Emergency-Room visits.

10% coinsurance for hospice and rehabilitation services, skilled nursing care, and durable medical equipment.

 

Exclusions

Not all medical expenses are covered, regardless if treatment is performed in the Columbus area, or outside of Ohio. A partial listing of exclusions is listed below:

Experimental or unapproved surgery

Bariatric surgery

Cosmetic surgery

Hearing aids

Infertility treatment

Adult dental care

Weight loss programs

Long-term care

Foot care

If you receive treatment at the Wilce Student Health Center, usually there will be very little (or no) out of pocket cost. Otherwise, copays of $15 and $25 apply to many popular office visits. There is a $100 deductible to meet and the  maximum out of pocket amount is $5,000. A 10% coinsurance often applies to services, which is fairly typical.

Ohio State University Student Health Insurance Options

The WilceCare Supplement covers diagnostic lab tests and X-rays.

WilceCare Supplement Plan Option

If you opt out of the “comprehensive” option, and choose to utilize your own private plan, depending on your deductible and network benefits, higher out-of-pocket expenses could result, depending on the number of submitted claims. The WilceCare option is a pre-paid coverage that provides benefits for common ailments (and injuries).  It is not a qualified insurance plan, and covered treatment must be provided at the Wilce Student Health Center during normal operating hours.

The two main components of the contract are prescription drugs and outpatient treatment. In-hospital expenses, or any services provided away from the Wilce Center are not covered.  The Buck ID is the only identification needed for treatment. Major highlights of the rider are listed below:

Annual cost is $225. Spouses and dependents are not eligible for coverage.

$2,000 is the maximum amount of benefits paid for the contract year. Prescription drugs have a separate maximum of $225.

Outpatient services include office visits, physical therapy, allergy injections, diagnostic services, including x-rays, lab tests, and electrocardiograms, and needed supplies.

Prescription drugs for conditions that are covered under the program. Coinsurance is 10% for generic drugs, 20% for brand name drugs (no possible generic substitute offered), and 50% for brand name drugs with generic substitute available. A $10 copay also applies, unless the cost of the prescription is less.

Exclusions

The following conditions and expenses are excluded:

Dental and vision treatment, including glasses, contact lenses, and hearing aids.

Non-prescribed medications (over-the counter) and contraceptives.

Preventative treatment. NOTE: These types of expenses are 100% covered under private and group plans.

Psychotherapy and psychiatry.

OSU Ohio Healthcare Plans

It’s Important To Properly Compare All Ohio Student Health Insurance Plan Options

Comparison Of OSU Student Plan To Available Private Plans

For our comparison, we are assuming the insured is a healthy 20 year-old  who lives in the Columbus area. It should be noted that rates vary, depending on where you live, your smoking status, and age. For this comparison, we did NOT include a federal subsidy, which can substantially lower premiums if you meet eligibility requirements. Listed below are some of the best plans to consider for student health coverage in Ohio. Rates are monthly:

$112 – CareSource Just4Me Bronze – $6,650 deductible with $40 and $80 copays on pcp (Primary-Care Physician) and specialist office visits respectively.

$132 – UnitedHealthcare Compass HSA 5500 – HSA-eligible plan with $5,500 deductible and $6,500 maximum out-of-pocket expenses.

$136 – Molina Marketplace Silver – $2,000 deductible with $20 and $55 office visit copays. The generic drug copay is $10.

$148 – Anthem Bronze Pathway X PPO 5000 30 – $5,000 deductible with pcp office visit of $55.

$173 – Molina Marketplace Gold – $500 deductible with $15 and $35 office visit copays. Maximum out-of-pocket expenses are $6,850.

$179 – UnitedHealthcare Gold Compass 0 – $0 deductible with $30 and $60 office visit copays. $6,850 maximum out-of-pocket expenses.

$185 – Anthem Silver Pathway X PPO 2000 20 – $2,000 deductible with $45 copay on pcp office visits.

$197 – Anthem Gold Pathway X HMO 1450 20 – $1,450 deductible with $30 and $50 office visit copays. )nly $3,100 for maximum out-of-pocket expenses.

$201 – Medical Mutual Market 1750 – $1,750 deductible with $30 and $60 office visit copays (with 25% coinsurance).

$245 – Market 1000 – $1,000 deductible with $25 and $50 office visit copays. Maximum out-of-pocket expenses are $6,500.

There are many affordable student health insurance options and it’s very possible one of the plans listed above may be worth considering. Our contact information is listed at the top of the page and we are always available to discuss the best choices.

Summary

We continue to be recognized as the premier resource for all student medical coverage. You can view additional details here and view quotes live online. Often, purchasing your own private coverage is much less expensive and many benefits will be much more comprehensive. However, each situation is different so we’ll be happy to provide our unbiased advice and input.

It is also important to note that we are not affiliated with the OSU student health insurance program. However, optional  coverage from many top-rated companies is very comprehensive, and rates are quite attractive. Specific questions regarding OSU student plan rates, coverage, eligibility requirements and enrollment details should be directed to this website.  However, we also encourage comparing rates from all of the available carriers, not just one. Our quote section at the top of the page will help.

2017 Ohio Health Insurance Plan Rate Projections – Individual/Group

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Ohio health insurance companies are required by the Affordable Care Act legislation to provide rate increase requests of more than 10% to the federal or state government. These price increases will be studied and reviewed, to determine if the changes are fair and warranted. Consumers can voice their opinion regarding the evidence the insurers have provided to justify the premium hikes.

Below, we have provided ACA-compliant plans in Ohio and their requested (from the insurer) rate increases for January 1, 2017 effective dates. It is unlikely that the Department of Insurance will approve all premium increases in their entirety. Information is imported from “Rate Review,” which is managed by the Center for Medicare and Medicaid Services.

 

Aetna

13.19% – HMO Small Group

9.02% – HMO Sam’s Small Group

7.28% – Indemnity Plan Small Group

12.57% – PPO Small Group

12.97% – Managed Choice – PD – Individual

11.37% – Managed Choice Individual

 

AultCare

9.95% – Small Group HMO

10.43% – Small Group

24.09% – Individual

 

Anthem BCBs (Community Insurance)

12.04% – HMO Individual

9.48% – PPO Individual

4.96% – PPO Small Group

2.5% – PPO Off-Exchange

 

Buckeye Community Health Plan (Ambetter)

-0.79% – Ambetter Individual

-1.14% – Ambetter Individual Plus Vision

 

CareSource

13.29% – HMO Enhanced Individual

13.53% – HMO Basic Individual

 

Consumers Life (MedMutual)

1.86% – Off Exchange Individual

1.88% – HMO Individual

 

Federated Mutual

20.61% – Small Group

 

Freedom Life

9.98% – Individual

 

Humana

7.39% – Small Group

12.45% – Cincinnati/No.KY HMOx Small Group

 

Medical Health Insuring Corp. (Medical Mutual)

-17.13% – MedMutual HMO Individual

-17.17% – MedMutual HMO Off-Exchange

18.32% – MedMutual Connect Small Group

 

Medical Mutual

18.36% – MedMutual Small Group

 

Molina

2.36% – Molina Healthcare Individual

 

Paramount

9.88% – Individual Exchange

2.22% – ALLC OOA Small Group

 

Pekin Life

5.11% – Choice Plus Small Group

6.47% – Flex Plus Small Group

5.92% – Classic Choice Small Group

 

Premier Health

39.82% – Premier Individual

39.23% – Premier PD Individual

 

Summa

1.51% – QHP Group Small Group

4.78% – QHP Group Qualified Small Group

6.22% – QHP Individual Qualified

 

Health Plan Of The Upper Ohio Valley

7.92% – Silver HMO Small Group

9.04% – Gold HMO Small Group

7.90% – Platinum HMO Small Group

16.64% – Bronze Individual

13.46% – Bronze HMO Small Group

 

THP Insurance Company

5.40% – Gold PPO Small Group

8.19% – Bronze PPO Small Group

5.64% – Silver PPO Small Group

5.84% – Platinum PPO Small Group

5.92% – Gold HRA Small Group

6.57% – Silver HSA Small Group

18.30% – Bronze HSA Small Group

 

UnitedHealthcare

6.55% – Heritage Plus Small Group

5.91% – Choice Plus Small Group

6.68% – Navigate Small Group

 

US Health And Life

6.61% – PPO Small Group

6.65% – HSA Small Group

Paramount Health Insurance Plans And Rates In Ohio

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Low-cost health insurance in Ohio is offered by Paramount. Plans are available to individuals and groups, both on and off the Marketplace Exchange. Northwest Oh residents can choose affordable HMO, Elite, and Advantage options that provide quality coverage at a competitive price. The rates you view on our website from your free quote request, are the lowest offered prices since the Department of Insurance regulates rates.

Paramount has offered policies for more than 25 years, and offers popular consumer-driven products to applicants under the age of 65, along with Seniors that are eligible for Medicare. A National Committee for Quality Assurance (NCQA) accreditation was originally awarded in 1995. A “Quality Improvement Program” has been implemented, and is designed to improve patient treatment and service, and review the effectiveness and efficiency of their providers.

Policies are offered in 4o counties in Northeastern Ohio and Southern Michigan. Partial benefits are provided in Delaware, Hardin, Knox, Allen, and Paulding counties. If additional areas are added to their network coverage area, we will update the map below.

Paramount Health Insurance Ohio Network

Paramount Ohio Service Area

Available Individual And Family Plans – Under Age 65

Exchange (and off-Exchange) coverage is offered during Open Enrollment, and after the OE period has ended (with a special exemption). A large Paramount Ohio Insurance Provider Network (doctors, specialists, hospitals, and medical facilities) gives state residents many local options for treatment. Shown below are single and family policies that are not medically underwritten.

Catastrophic – Must be under age 30 to qualify. Cheapest available plan with $6,850 deductible. A $35 copay is provided for the first three primary-care physician office visits. No coinsurance, so maximum out-of-pocket expense is also $6,850. Also, federal subsidies are not available, regardless of your household income. All other plans are subsidy-eligible.

Bronze 1 HSA – HSA-eligible plan with $6,500 deductible and 0% coinsurance. You may choose a financial institution to administer your tax-free deposits that can pay for qualified medical, dental and vision expenses. Generally, this option is most cost-effective if there are no major medical conditions, and you do not anticipate that any family member is likely to meet the deductible.

Bronze 2 – $45 primary care physician (pcp) office visit copay with no limit on the number of allowed visits. Specialist visits are subject to the policy deductible of $6,000. There is a 40% coinsurance after the deductible is met. Prescriptions, including inexpensive generic drugs, must meet the coinsurance and deductible.

Silver 1 – Much lower deductible ($2,250) with office visits copays for both pcp and specialists ($35 and $75). Generic drug copay of $15 may help with selected prescriptions. Brand and Non-Preferred drugs have copays of $50 and $100. Maximum out-of-pocket cost is $6,800, although since “cost-sharing” is applicable, copays and deductibles could reduce, depending upon household income level. A 40% coinsurance also applies until deductible is reached.

Silver 2 – Similar to prior plan with some minor differences. Deductible is higher ($3,000), although maximum out-of-pocket costs are $800 lower. Specialist visits are also $10 lower and coinsurance is 30%.

Silver 3 – Same rate as Silver 2 plan but with a $500 higher deductible ($3,500), but also a higher specialist copay ($75 vs. $65).

Gold 1 – Low $1,000 deductible with $20 and $30 office visit copays. Generic drug copay is only $7, and Brand drugs do not have to meet a deductible.

Gold 2 – Slightly more expensive than previous plan. $1,500 deductible with $10 and $20 office visit copays. $6 generic drug copay with $5,000 maximum out-of-pocket expenses. Specialty prescriptions are subject to a 20% copay.

Sample Rates (Under Age 65)

Since the cost of coverage varies, depending on several factors, we have illustrated below monthly rates for specific household situations. If a federal subsidy is available, it has automatically been applied to reduce the premium. However, any applicant can choose to decline the Obamcare subsidy. This federal aid is only offered during Open Enrollment and SEP situations. If you missed Ohio Open Enrollment, many options are available, including inexpensive (but non-compliant) short-term plans.

 

25 Year-Old Male Living In Zip Code 43617 – $15,000 Income (Sylvania – Lucas County)

$78 – Bronze 2

$107 – Silver 1

$153 – Gold 1

 

40 Year-Old Couple Living In Zip Code 43608 – $27,000 Income (Toledo – Lucas County)

$176 – Bronze 2

$250 – Silver 1

$366 – Gold 1

 

50 Year-Old Couple Living In Zip Code 45840 – $45,000 Income (Findlay – Hancock County )

$219 – Bronze 2

$326 – Silver 1

$492 – Gold 1

 

45 Year-Old Couple With Two Children Living In Zip Code 44870 – $55,000 Income (Sandusky – Erie County )

$195 – Bronze 2

$318 – Silver 1

$508 – Gold 1

 Medigap Plans In Northern Ohio

Affordable Senior Ohio Health Plans Are Available

Senior Medicare Plans And Medigap Supplements

Medigap coverage can help policyholders pay deductibles, and reduce out-of-pocket expenses. Typically, you can choose and physician, specialist, or hospital that accepts Medicare patients. Four plans are available to eligible applicants residing in the service area. The monthly rates shown below are for selected ages that do not use tobacco products.

Age 65

$102 – Plan A

$119 – Plan N

$147 – Plan C

$155 – Plan F

Age 70

$122 – Plan A

$142 – Plan N

$175 – Plan C

$185 – Plan F

Age 75

$148 – Plan A

$172 – Plan N

$213 – Plan C

$224 – Plan F

 

Advantage Plans

Three Ohio  options are shown below. “Advantage” contracts are issued by private carriers who have contracted with Medicare to provide Parts A and B coverage. Depending on the company, HMO, PPO, Fee-For-Service, and Medicare Savings Accounts are available. If you have End-Stage Renal Disease (ESRD), unfortunately, you are not eligible. The official enrollment period begins on October 7th and ends on December 15th.

All three “Elite” plan options include an annual routine vision exam, 100% preventative benefits, health and wellness programs, and a Silver Sneakers membership. The negotiated network discounts should always be used for any expenses that are subject to a deductible and/or out-of-pocket expenses. The Elite contracts also received a 4-Star rating from Medicare for 2016. An overall and summary star rating is assigned.

Dental Benefits

An optional Delta Dental rider is available for $18.50 per month. Two exams and cleanings are covered each year. The annual maximum benefit is $500 and Full-Mouth x-rays are covered every three years. Emergency palliative benefits and a brush biopsy (for oral cancer detection)are also included. NOTE: Delta dental plans are not offered outside of the Open Enrollment period.

DentaQuest and EyeQuest Networks are used with Advantage contracts. Elite plans are available in the following counties: Allen, Cuyahoga, Defiance, Erie, Fulton, Henry, Lake, Lorain, Lucas, Medina, Ottawa, Sandusky, Williams, and Wood.

Elite Standard Medical And Drug – $36 per month.  Office visit copays are only $5 and $40 with maximum policy out-of-pocket expenses of $3,400. ER copay is $75. Enhanced vision hardware benefit included. $5 and $20 copays on preferred generic and generic drugs. Preferred brand copay is $45. Outpatient physical, occupational, speech/language copay is $40.

Elite Enhanced Medical Only – $0 per month. Yes, that premium is correct. Office visit copays are $20 and $45 with maximum out-of-pocket expenses of $6,100. There is no deductible to meet and most lab tests, diagnostic tests and x-rays must only meet a small copay of $0-$10. The hospital outpatient copay is $200 and the Urgent Care copay is $45.

Elite Enhanced Medical And Drug – $78 per month. Office visit copays are $5 and $40 with maximum out-of-pocket expenses of $3,400. ER copay is $75. Enhanced vision hardware benefit included. $2 and $15 copays on preferred generic and generic drugs. Preferred brand copay is $45. Outpatient physical, occupational, speech/language copay is $40.

2016 Healthcare Changes In Ohio – What To Expect

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2016 Ohio health insurance plans will look different in 2016. The rates will change. Some plans will be added, while others will be eliminated. New carriers may enter the Marketplace, while others, such as Assurant, will exit the Exchanges. Federal tax subsidies will be different, depending on your projected household income.

Who knows what Ohio healthcare will look like in 2016. Well, We think we do! Our tongue and cheek predictions below may not come true, but we had a lot of fun writing them!

 

January – In an unprecedented move, all major Ohio health insurance companies offer to slash their 2016 rates by 60%. However, there is a big caveat. The stipulation is that the Cleveland Browns must win the Super Bowl on February 7th if prices are to decrease.

The problem is that the Browns finished the season with a  7-9 record, missed the playoffs, and aren’t even playing in the Super Bowl! When asked to comment, a Humana spokesman stated that  they will extend the offer to 2017 since the risk would still be “incredibly low.” Thankfully, the Bengals were not included in this offer.

February – Open Enrollment ends on January 31st, and millions of Americans, including many households in the Buckeye State, are still without coverage. However, on February 1, the Department of Health and Human Services announces that OE will be extended until December 31st.

To ease the burden on Department employees, consumers must apply for coverage only during designated times. These times are between 3:00 am and 4:00 am Tuesdays and Fridays, and only on odd-numbered days. General maintenance is expected to be performed between 3:10 and 3:50 am on these designated days.

March – Of course, that means March Madness, so during the NCAA Basketball Tournament, no new applications will be taken, no claims will be paid, no payments will be processed, and phone calls and emails will not be returned from any health insurance company in Ohio.

Funny Health Insurance Websites

Ohio March Madness!

However, there’s some good news! If any Ohio University (Ohio State, Miami, Xavier, Toledo, Kent State etc…) makes it to the “Final Four,” a $250 rebate will be given to all customers. If they win the National Championship, a $1,000 rebate will be given.

April – Is it an April Fool’s joke? Nobody seems to know. Apparently, Ohio grocers are offering to pay 50% of your health insurance bill on the first day of April. Your only requirement is to bring in your statement, and 16 forms of identification and the bill is instantly paid.

Ah. OK. It’s quite clear now. 16 forms of identification. Well…if you have plenty of aliases, multiple personalities or you tend to keep old college ID cards and driver’s licenses, you may catch a break. Otherwise, it appears to be an April Fool’s joke gone bad.

May – April showers bring….You know…May flowers.  So, to commemorate the upcoming warmer weather, each insurer has assigned itself to a specific flower, and all corporate and local offices must reflect that motif.

Some of the selections made by the carriers are listed below:

Aetna – Carnation

Humana – Snapdragon

Medical Mutual – Rose

Premier – Marigold

Anthem Blue Cross – Daffodil

Ambetter – Geranium

UnitedHealthcare – Hydrangea

SummaCare – Daffodil

NOTE: Anthem and SummaCare both selected the same flower and subsequently sued each other to determine who has the exclusive flower rights.

June – Ohio’s newest health insurance company is under investigation for allegedly not paying a single claim during the first five months of the year. “No Pain No Claim” is the name of the carrier that started to offer policies in 2016. Approved by regulators, they offer coverage in 12 Counties located near the Indiana border.

When asked to provide claim records and payout information, an official of the company said, “We don’t have any documentation regarding claims. Our operational expenses were too high this year although by 2020 we hope to start reimbursing a few policyholders.”

July – An enormous data breach hits the Midwestern states as a rogue hacker believed to be living in Cincinnati infiltrates many large financial institutions. Oddly, no personal or sensitive information is taken. But every policyholder receives new ID cards with their first-grade teacher’s name on it. Very strange.

Funny LeBron Stories

LeBron’s Marketplace!

August – In an effort to increase market share, surprisingly, Medical Mutual and Humana decide to change their corporate names and logos. The move is effective on October 1, and all stationery and business cards will also be changed.

Medical Mutual will become “LeBron’s Marketplace” and Humana will become “Buckeye Nuts And Guts.” Both companies are obviously attempting to capitalize on  the Ohio theme. Of course, it may not be so popular in other states.

September – A special Open Enrollment period has been approved for the entire month by the Department of Health and Human Services (HHS). To qualify, you must file your 2016 and 2017 federal tax returns before the end of 2015 and agree to pay applicable back-taxes of all immediate family members. Although it is not anticipated that any person will take advantage of this newly-created SEP, many Department employees are praising this idea as an “act of kindness.”

October – Halloween tricks and treats from the healthcare industry. In an effort to promote responsible eating, employees are encouraged to give out raspberries, beet juice, or broccoli spears to children, and forgo the traditional candy items. However, the city of Cleveland quickly responds to the idea, by extending Beggars Night to the entire month of October and requiring all treats consist of a minimum of one pound of chocolate, and two dozen Rice Krispies treats..

November – Open Enrollment officially begins with a massive advertising campaign designed to increase the number of Americans that sign up by 40%. As a special inducement, if you enroll in a plan during the first 15 days of November, a frozen turkey will be sent in time to enjoy before next July 4th.

However, for individuals or families that enroll AND refer a friend, a small mobile home that is completely furnished, will be sent. The value of this inducement is $11,500 and is unfortunately, taxable.

December – Keeping with the “Holiday Spirit,” during this month, insurers are offering potato latkes and pumpkin pie to all policyholders that schedule a preventative colonoscopy. Of course, the food is served after the procedure has completed. The evening before the colonoscopy, a tasty concoction of bowel-cleansing Miralax is provided.

If You Missed Ohio Open Enrollment – 10 Things You Need To Know

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Open Enrollment to purchase subsidized health insurance in Ohio typically occurs between November and February each year. During that time, no medical questions are asked, and single and family plan rates are  reduced by the federal government by using a subsidy in the form of an instant tax-credit. On and off Marketplace coverage is available, so if your income is high, you can still enroll in an affordable plan.

However, if you didn’t watch the news or read a newspaper, procrastinated too long, or simply didn’t have money set aside to buy a policy, you probably missed the OE period. But you can still obtain affordable healthcare benefits. Here are 10 items that will help you secure coverage now, and ensure you won’t miss Open Enrollment next year!

1. Don’t miss Open Enrollment this year! There’s always plenty of advertising in both the print and online media. Generally, if you want your policy to be effective January 1, the deadline is December 15th, so don’t wait after the Holidays to do your healthcare shopping. November 1st is the first day, and it runs through January 31st. If you miss the cutoff, you will probably need an “SEP” (discussed later) to receive favorable treatment.

2. Consider purchasing a temporary Ohio health insurance plan. No, it won’t match the office visit and prescription copays that an Exchange policy offers, but it will provide a very inexpensive stopgap option that is easy on your pocketbook and can be placed in-force within 24-36 hours. UnitedHealthcare is one of many companies that offers low rates. Medical Mutual also offers competitive pricing.

Although temporary policies are ineligible for Obamacare subsidies, for most individuals and families, prices are still less than most Marketplace contracts. And, up to $1 million of coverage can be purchased  “per claim” or per “policy period.” You can terminate your benefits with a phone call and utilize a nationwide provider network.

Ohio Open Enrollment Missed

Having A Baby Qualifies For A Special Enrollment Period

3. Determine if you qualify for a “Special Enrollment Period.” Commonly referred to as an SEP, specific life events that cause a change in family status, allow you to take advantage of this special period of 60 days to secure either subsidized or unsubsidized Exchange coverage. It doesn’t matter if it occurs in January, July, September, or any other month.

Several of the most common “Life Events” include getting married or divorced, reaching age 26, losing existing employer-provided benefits, moving to a different residence, and becoming pregnant. However, in pregnancy situations, the newborn may enroll in a policy, but not either parent. Therefore, prenatal and delivery expenses will not be covered.

4. Be aware of changing OE dates. For example, for 2014 effective dates, the starting date was October 1 2013, and the ending date was March 31 2014. That was six full months for consumers to take about 25 minutes and purchase their coverage. For 2015 effective dates, the starting point was November 15th and it ended on February 15th. The application time plummeted to about 90 days from about 180 days.

And as previously mentioned, the OE period for 2016 is once again, only three months. Although extensions are possible because of occasional glitches and delays, January 31st is the expected last day to enroll. If you already have a policy, you can either keep your plan, or consider switching to a different option.

5. Don’t go without coverage. Just because you didn’t sign up in time doesn’t mean you have to remain uninsured. Although you won’t be able to duplicate Marketplace plan benefits and prices, you can still obtain a medical plan. Major medical expenses are the most important item to cover, and many available contracts will reduce your potential risk against these types of claims.

Short-term contracts won’t eliminate the special non-compliance tax. However, if you develop a serious illness, or have an accident that results in thousands (or hundreds of thousands) of medical bills, you’ll be able to easily cover the vast majority of expenses. And the cost of temporary plans is extremely cheap.

6. Find out in advance which companies accept your physicians and specialists. The most time-consuming and frustrating part of the process is finding a plan that meets your coverage and budget objectives, but doesn’t include your providers.

By contacting doctors and medical facilities in advance, you can ensure that the plan you purchase (even after the OE period) will provide in-network” benefits for routine and scheduled treatment. Since network provider lists change, it’s important to verify your doctor is not dropping the carrier you are using.

Health exchange Enrollment

If You Miss Open Enrollment, Eat Your Vegetables!

7. Stay healthy, and eat your vegetables, especially if you don’t plan to purchase any major medical or catastrophic coverage throughout the year. Don’t go outdoors, don’t answer the door, don’t eat raw meat, and don’t travel in any vehicle with the possible exception of a golf cart.

Of course, we’re being a bit satirical, but any major disease or accident could have a dramatic impact on your financial health. Postponing your medical coverage to January 1st may be too late to treat a serious ailment.

8. Negotiate lower medical bills with your physician, specialist, hospital, and any other facilities you receive treatment. Often, by paying directly in cash, you can reduce your expenses by as much as 50%. And why not? There’s no claim form, insurance company, or approval process that the healthcare provider has to pay for. So everyone is a winner.

Unless, of course, you incur a huge hospital bill you can’t pay. In those situations, you may be able to negotiate a favorable billing alternative that works within your budget. A $10,000 obligation could result in only monthly payments of $100 or less.

9. Do NOT buy a “Limited Benefit” plan. Generally, these are the policies that are underwritten by a company you may not be familiar with. Obtaining specific benefit details are almost impossible, and a mysterious “application” or “enrollment” fee  is included. Often, it can be as much as $150-$200. Preventative benefits are not covered at 100%, and a large claim could easily result in tens of thousands of dollars of out-of-pocket expenses.

These contracts are often peddled from boiler rooms that are located outside of Ohio. Your payment information (credit card or check) will be requested on the first contact. Obtaining a refund will be practically impossible, and speaking to a live person becomes much more difficult after they have processed your initial payment.

10. Watch for changes to the ACA legislation from the latest Supreme Court challenge such to Obamacare, such as King Vs. Burwell.The government sided with the original legislation in this decision, although future challenges may also reach the Supreme Court.

The King Vs. Burwell verdict ruled in favor of the legality of federal subsidies offered to residents of states that have not set up their own Exchange.  Ohio (and most other states) were at risk of losing these subsidies, which would have effectively doomed the future of Obamacare, unless drastic changes were made.