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Ohio State Continuation Of Health Coverage Benefits – COBRA Information

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Ohio COBRA health insurance coverage is available to qualified residents of the state who have lost their medical benefits from their employer. Children and  spouses are also eligible and would receive the same benefits as the primary recipient. However, the business must have at least 20 employees. Under certain conditions, if your employer has less than 20 employees, you may be able to purchase a policy for six months under the state continuation law. But there is no obligation to accept your offer, and often, during Open Enrollment, alternative options are less expensive.

Typically, you’ll receive notification in writing and you’ll have approximately 60 days to secure other benefits or accept COBRA rates, which can be quite costly. This is because you are paying the full premium that your employer was charged for your medical benefits. There may also be a small administrative charge with slightly raises the cost. However, you do not have to “apply” for coverage and no medical questions are asked. Pre-existing conditions will be covered in their entirety, although deductibles, copays, and coinsurance may apply.

It’s A Federal Law!

COBRA (Federal Consolidated Omnibus Reconciliation Act) is a federal law that allows employees that leave their jobs to continue and maintain their former employee’s health insurance coverage for 18 months. Normally, employees are required to pay the entire cost of the coverage, making  benefits unaffordable for most Ohio workers. But sometimes, the rates are very reasonable.

Income restrictions limit coverage to individuals that make less than $145,000 and to  families that make less than $290,000. Also, COBRA is offered with group health plans when employers have more than 20 employees. Voluntary or involuntary termination of employment (other than gross misconduct) or a reduction in the number of hours of employment are “qualifying events” that would allow employees to become eligible. The United States Department Of Labor offers additional information online.

However, it is possible that  premiums (even after the subsidy) will be expensive and possibly unaffordable. If there are no existing major medical conditions, an individual insurance policy is an alternative to COBRA health insurance. Depending on age, zip code and some other factors, rates may be quite affordable. And this type of coverage can be kept indefinitely, without the worry of a major health condition occurring just before coverage expires. There are many  alternatives and we’re happy to review them with you.

We’re the state’s preferred choice for affordable Ohio COBRA health insurance alternatives. Anthem Blue Cross, Aetna, Medical Mutual and UnitedHealthOne are some of the major insurers we consider when researching your options. If you would like to instantly view your options, please click on the “Quote” button at the top of the page. Your personal information will never be shared with any other person or company.

Best Healthcare In Hamilton County, Ohio – Affordable Cincinnati Plans

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Low cost individual Hamilton County (Ohio) health insurance plans can be viewed and purchased online. We help you find the most competitive rates for the most popular policies. Many single and family policies offered by the major Cincinnati area insurers, such as Ambetter (Buckeye Health Plan), Anthem Blue Cross Blue Shield, CareSource, Humana, Medical Mutual, and Molina. Typically, southwestern Ohio prices are among the lowest available in the Buckeye State.

Additional companies provide coverage for Medicare-eligible Seniors. Medicare Supplement, Advantage, and Part D drug prescription plans are offered by many companies that don’t participate in the Under-65 Marketplace. Several of the larger carriers include AARP (UnitedHealthcare), Aetna, MediGold, Gateway, Cigna, Mutual Of Omaha, USAA, United American, and Gerber.

 

When purchasing Ohio health care coverage , it is extremely important to work with an experienced broker located in the area. Many online websites are not familiar with Cincinnati  plans because they are not located in Ohio. Also, it is likely that many of the out-of-state websites will request financial information (we do not). And unless you enjoy irritating phone calls and emails, it may not be a pleasant experience. We are located just North of Kings Island, so we closely watch and monitor rates and specific details that may be changing.


Cincinnati Health Insurance Plans

Area counties  that feature very competitive rates include Hamilton (of course), Warren, Clermont, Clinton, Highland, Brown, Butler, and Adams. Although Montgomery, Miami, Preble, and Greene counties are located closer to the Dayton area, they also feature very attractive prices. Typically, insurers utilize the same network for both metropolitan areas. Northern Kentucky residents much purchase plans approved by their state’s Department of Insurance.

 

Cincinnati individual policies are quite affordable when compared with other parts of the state. Molina and CareSource offer comprehensive plans that are usually very competitively priced, if you feel office visit and prescriptions coverages are important to have. Ambetter’s Balanced Care 2 and Balanced Care 1 individual plans offer comprehensive coverage at extremely attractive rates. But in Hamilton County, Medical Mutual must always be considered. Their HSA and high-deductible options are often the least expensive plans when considering “name” carriers.

 

Prices substantially reduce when you consider plans that limit the number of covered office visits, and/or place deductibles on specialist visits and non-generic prescriptions. Although out-of-pocket costs are higher, the lower premium helps offset some of the extra expenses. Several available plans are: Molina Marketplace Bronze, CareSource Federal Simple Choice Bronze, MedMutual HMO 7150, Anthem Bronze Pathway X HMO 7150, and Anthem Bronze Pathway X HMO 5000.

 

Low cost individual Health Savings Accounts (HSAs) have also grown in popularity in recent years. An HSA provides the opportunity to tax-deduct a portion of your medical expenses, and also provide 100% coverage after a deductible has been met. If all deposits are not used when you reach age 65 and are eligible for Medicare, funds can be utilized for other qualified expenses. Several available HSAs include MedMutual Market HMO 6400 HSA, MedMutual Market HMO 4000 HSA, and Anthem  Bronze Pathway X HMO 0 For HSA.

 

Private individual  health insurance is available in Hamilton County and most parts of the state. We provides unbiased advice and information for consumers. The quotes you view on our website are free and our responsibility is to find the policies that best meet your specific needs. We take our job seriously and have more than 37 years of experience in the Cincinnati market.

Anthem Ohio Health Insurance Rates Could Double

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Anthem Ohio health insurance rates could double…or even quadruple if  overhaul legislation is passed, according to a recent Wall Street Journal article. Wellpoint Inc., the nation’s largest health insurer and parent company of Anthem ( View details here) published a report that said Buckeye State  rates would more than double for average individuals and nearly QUADRUPLE for younger healthier people. Wellpoint also said  that 70% of small businesses would also pay higher prices if the new proposed legislation is enacted.

Wellpoint derived its data from 14 states (including Ohio) that have Blue Cross plans and studied the impact of the main changes under consideration. They said rates  (view here) would increase for individuals of average age and health, with younger customers seeing the largest increases. The study did consider Senior Medicare products for persons that have reached age 65.

Currently, Ohio prices are among the lowest in the country. The Cincinnati, Dayton and Columbus areas enjoy some of the lowest rates in the state. But current  reform proposals threaten to substantially increase rates, and possibly force  residents to purchase coverage they don’t want (if the “public option” is included in legislation). For example, maternity benefits are generally not needed for persons that have reached age 50. However, maternity and several other benefits may be required on future policies, which will undoubtedly raise premiums.

You can view the entire Wall Street Journal article online.

UPDATES:

January 2012 –   So far,  rates haven’t doubled, but we may find out within the next six months. The Supreme Court will be ruling on the legality of many portions of the new health care legislation. Stay tuned!

September 2012  The Supreme Court did rule in favor of the mandate which taxes Americans if they do not purchase coverage in 2014.

May 2017 – Is Obamacare about to be repealed and replaced? The House has approved the new TrumpCare plan, but the Senate is not quite ready yet.

Most Expensive Ohio Health Insurance Plans – Highest Available Rates

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The MOST expensive Ohio health insurance plans? Now wait a minute! Buckeye State residents don’t care about expensive plans. You want me to do what I do best…find the most affordable coverage. Right? Of course!

Well…today I’m going to deviate a bit. I spend 20 hours per day (OK…it seems that long) quoting, preaching, researching and writing about the cheapest available plans ( see here ) Almost all of this blog’s content deals with saving you, the consumer, money. Whether it’s short term coverage, a policy you keep quite a while, comprehensive benefits, or a cheap catastrophic option, we know all of the details.

Today is different. I have researched hundreds of plans from the major companies in an effort to find the ten most expensive Ohio individual policies. These plans are terrific policies, with rich coverage, and low out-of-pocket expenses. But…they are very expensive. OK. Here they are:

1. Humana Portrait Share 80 Plus RX Unlimited $1,000 Deductible

2.Celtic Preferred Managed Indemnity Plan $1,000 Deductible

3. UnitedHealthOne Copay Select 0% Coinsurance $500 Deductible

4. Med Mutual SuperMed One Standard 500 with Office visit and RX $500 deductible

5.Anthem Premier 80% BuyUp RX $250 Deductible

6.Anthem Premier 80% BuyUp RX $500 Deductible

7.Aetna First Dollar PPO 30 No Deductible

8.Celtic Preferred Managed Indemnity Plan $500 Deductible

9.Humana Portrait Share 80 Plus RX Unlimited (ded) $1,000 Deductible

10. Anthem Premier 80% BuyUp RX $1,000 Deductible

And there they are! The 10 most costly individual medical plans. Although many available riders are available (maternity, accidental benefits, extra liability etc…), none were included. Each plan is quite comprehensive, with office visit, prescription, and major medical coverage.


UPDATES:

January 2012 –   Thankfully, many of these plans are no longer available. There are still a lot of expensive health care plans, so we’ll do our best to steer you away from them. Of course there are many more low cost policies offered by every company, so those are the options we’ll focus on.

September 2012 –   See! We really do update our content on the website. It appears that just about all of the plans from that list have either been withdrawn or have undergone major design changes. Was it because of our blog post? I doubt it, but we know the major insurers always watch what we write about because of our large readership.

May 2017 – All of the above-mentioned plans are no longer offered. New Marketplace plans have replaced them, and it’s possible that “TrumpCare” plans will replace Marketplace plans in 2019!

Anthem Ohio BCBS Health Savings Accounts – High-Deductible Plans

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The Anthem Blue Cross Blue Shield Health Savings Account (HSA) is an affordable Ohio medical insurance plan that can reduce your costs and provide comprehensive benefits for yourself and your family. The current available policies are  innovative options that help you manage your expenses, reduce your taxes, take advantage of network repricing, and take control of your health care.

When compared with other comprehensive plans, it offers flexibility, competitive rates and lower out-of-pocket costs that make it an Ohio policy that should always be considered. The  “high deductible health plan” (HDHP) is the insurance portion of the policy, while the savings account allows you to pay for current expenses, and deposit funds for future qualified medical expenses on a tax-free basis. 

You may also leave funds in the account to be used at a later date.  Many approved financial institutions (Banks are the most popular) can set up the “savings account” portion. Interest is typically paid on the “fixed” portion of the money. Additional equity options are sometimes offered, although additional financial risk is taken. Additional HSA information can be found here. Note: Any person that qualifies as a dependent on a federal tax return, is not eligible.

An Ohio Anthem HSA Will Save You Money

Policies that are considered HDHP, and meet all necessary requirements are: Bronze Pathway PPO 0%, Bronze Pathway HMO 0%, Silver Pathway PPO 10%, and Silver Pathway HMO 10%.  Once the deductible is met, 90% or 100% of all covered medical expenses are paid with 0% or 10% co-insurance. The lifetime maximum has been eliminated so you will never run out of coverage.

Most individuals and families can set up this type of plan, although you can not be eligible for Medicare or listed as a dependent on another policy. We help you understand the benefits, apply for coverage and set up the “savings” portion (although that is optional). If you have an existing working relationship with a local bank that is authorized to set up the HSA account, they should be strongly considered.

100% Preventative Benefits

Also covered is adult and child preventive care coverage that is not subject to the deductible or waiting period. Routine office visits (subject to the deductible) receive “Network Repricing” which reduces out-of-pocket expenses by approximately 10%-25%. Lab test and X-ray costs are often discounted by as much as 50%-80%.  MRIs also receive discounts that are often more than $1,000.  Staying inside the network is important since you’ll pay much less you might expect.

Additional included coverages, that are sometimes not found in other plans, include home health care, skilled nursing and physical, occupational and speech therapy. A 24/7 NurseLine and members-only discounts on healthy lifestyle services are also provided for all Ohio Anthem policyholders. An additional benefit is that the network extends to other states so you can continue to utilize coverage. We can provide specific information regarding availability of physicians, specialists and hospitals. Or, you can request a list of providers, which we will forward to you.

We proudly represent Anthem and provide the lowest published rates they offer. Please keep in mind that rates from each company (such as Medical Mutual and UnitedHealthcare) are different in all areas of the state. So it is possible that we may recommend additional companies that have more competitive offers in your area. We’ll always give you a fair an unbiased opinion that is best suited for your circumstances.

New 2018 Plans Not Offered

Anthem will continue to offer Group and Senior products with 2018 effective dates in all 88 Ohio counties. However, private individual coverage (including HSAs) will not be available, unless you live in Pike County. And actually, only a single catastrophic policy is offered “off-Exchange.” Thus, 18 counties may not have any carriers offering coverage. More than 10,000 existing Anthem policyholders will have to obtain benefits through a different company.