What type of Ohio health insurance should you buy? Catastrophic or comprehensive coverage? Catastrophic plans cost substantially less, but typically place a deductible on most benefits, often have higher out-of-pocket expenses, and limit the number of times times you can visit a physician with just a copay.
Comprehensive plans are less expensive, and feature low copays on primary-care physician and specialist office visits, Urgent-Care, and prescriptions. Also, federal subsidies (if you qualify) can drastically reduce the rate for comprehensive plans. Catastrophic-tier options are not eligible for the instant tax-credit.
So…What’s the answer? Based upon my 35 years of experience in the healthcare business, you would expect an easy explanation. It actually is not so simple. To accurately answer that question, we need to somehow accurately predict your medical expenses for each calendar year. Since there is no psychic in the house, perhaps utilizing actual rates and family scenarios will help determine the most cost-effective choice.
Case Study Comparison
Perhaps comparing specific rates and coverage would help. So we created a hypothetical family to use in our calculations. Both husband and wife are 40 years old and they have two children (ages 10 and 12). There are no pre-existing conditions and they live in the Columbus area (Franklin County). The total household income is $55,000 which provides a federal subsidy of approximately $480 per month. This amount has automatically been deducted from the premium.
Typically, they use their 100% covered preventive benefits, including routine annual physicals and OBGYN visits. But they rarely utilize their policy for other expenses. Although an occasional flu or allergy expense occurs, this family is quite healthy.
Let’s Compare Monthly Rates!
Bronze Plans With Higher Deductibles And/Or Out-Of-Pocket-Expenses
$257 – Aetna Bronze Deductible Only HSA
$309 – UnitedHealthcare Bronze Compass HSA 5500
$313 – Anthem Bronze Pathway X HMO 5000-40
$325 – Aetna Bronze $15 Copay
Gold Plans With Lower Deductibles And/Or Out-Of-Pocket Expenses
$556 – Molina Marketplace Gold Plan
$594 – UnitedHealthcare Gold Compass 0
$703 – Anthem Gold Pathway X HMO 1450 20
$744 – Aetna Gold $10 Copay
Interpreting these premiums shows that savings of approximately $2,500-$6,000 are possible when choosing plans with higher deductibles and/or higher maximum out-of-pocket expenses. Therefore, when enrolling for new coverage, or renewing an existing plan, strongly consider less-expensive options if no significant medical conditions are present. NOTE: If you missed Open Enrollment in Ohio, an alternative plan may have to be selected, or you can retain your current qualified coverage.
Every Household Situation Is Different
Each individual and family is different and that’s why we take the time to review your specific details and make recommendations based on what’s best for you. Please feel free to call us anytime at (888) 513 6446 or contact us by clicking on the “Contact Us” tab at the top of the page.
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