Low-cost health insurance in Northwest Ohio is offered by Paramount. Plans are available to individuals and groups, both on and off the Marketplace Exchange. 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 pricing.
Paramount has offered policies for more than 25 years, and features 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. Affiliated with ProMedica, plans are also offered to small and large companies that are providing group benefits to their employees.
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 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.
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. One annual eye exam and a pair of glasses each year are provided at no cost.
Bronze Standard – $45 primary care physician (pcp) office visit copay with no limit on the number of allowed visits. Specialist and Urgent Care visits are subject to 50% coinsurance. Deductible is $6,650 with maximum out0of-pocket expenses of $7,150 and 50% coinsurance. Preferred and non-preferred generic drugs are subject to a $35 copay. Other drugs are subject to 35%-45% coinsurance.
Silver 1 – $30 and $75 office visit copays (no deductible or coinsurance) with $75 copay also for Urgent Care Visits. $3,250 deductible with maximum out-of-pocket expenses of $7,150 and 40% coinsurance. $10, $20, $50, and $100 copays on preferred generic, non-preferred generic, preferred brand, and non-preferred brand drugs. Oral chemotherapy, specialty drugs, and injectables are subject to 40% coinsurance.
Silver Standard – $30 and $65 office visit copays (no deductible or coinsurance) with $75 copay also for Urgent Care Visits. $3,500 deductible with maximum out-of-pocket expenses of $7,150 and 20% coinsurance. $15, $15, $50, and $100 copays on preferred generic, non-preferred generic, preferred brand, and non-preferred brand drugs. Oral chemotherapy, specialty drugs, and injectables are subject to 40% coinsurance. Very similar to previous plan, but slightly more expensive.
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
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.
$102 – Plan A
$119 – Plan N
$147 – Plan C
$155 – Plan F
$122 – Plan A
$142 – Plan N
$175 – Plan C
$185 – Plan F
$148 – Plan A
$172 – Plan N
$213 – Plan C
$224 – Plan F
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.
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.