There are many low-priced Ohio health insurance plans that have premiums 15%-40% less than the typical standard policy. Coverages are often quite rich and the underwriting criteria is identical to all other contracts. And if you qualify for a full federal tax credit subsidy, your entire premium could be waived. That’s called free healthcare coverage!
Generally, the major differences between the most expensive plans and the “low cost” plans are the out of pocket expenses on major claims and the number of allowed office visits per year. Also, non-generic prescriptions may be limited or not covered under the low cost catastrophic plans. But you no longer have to prove you are in good health to qualify for a policy.
The two categories on the Ohio Health Insurance Marketplace that offer the cheapest prices are “Bronze” and “Catastrophic” policies. Although eliminating all of the premium is nearly impossible (unless you qualify for the maximum subsidy), a large portion of your financial obligation is often paid by the government.
However, “Silver” plan options should always be included in comparisons because of their “cost-sharing” provision that is not available in any other Metal policy. Essentially, it works like this: If you qualify for household income guidelines, immediately, you will receive a reduced deductible and/or copay. A $2,500 deductible can quickly turn into a $1,000 deductible. Sometimes, it reduces to $300 or lower.
Since the subsidy reimbursement is based on your income (along with income of other adult family members), any sudden increase in pay could increase your premium. And of course, if there is a substantial reduction in your wages (or if your spouse stops working), you may be presented with more affordable options during the next Open Enrollment. Or you can take the extra money as a tax refund.
Although each situation is different, some of the cheapest plan options are Medical Mutual’s Market Young Adult Essentials, SummaCare’s Individual Value, Kaiser’s Catastrophic, and Anthem Catastrophic. All of these policies are available to applicants under the age of 30, You may also qualify if you meet non-affordability guidelines based on income.
The lowest-priced policies that are available to everyone include: Kaiser Bronze HSA, Medical Mutual Market HSA, SummaCare Individual, HealthSpan 6000 and Anthem’s DirectAccess cbu. Each of these options is a “Bronze” Metal plan that offsets lower prices with higher deductibles. Lower deductibles are offered through “silver” and “Gold” plans.
Perhaps the most critical requirements of the newer policies are the “Essential Health Benefits” that must be included. There are no exceptions. These extra benefits are mandatory and can not be removed. Mental illness, maternity and drug coverage are three of the most prominent ones. The list of 10 also may increase, depending on Congressional approval for proposed additions.
I don’t believe any rational person will disagree that hospitalization and emergency-room coverage should be a key component of all newly-designed plans. But when pregnancy benefits and child-dental benefits become mandatory, naturally, many consumers will will begin to question the legislation itself.
But to stay on-topic…the new “low-cost” plans are now less expensive than a few years ago. Of course, there is a small catch. You need to qualify for federal subsidy relief. If you do, expect to see savings of up to 50%-100% compared to the price you paid a few years ago. For more prosperous households, higher-deductible HSA plans continue to be the best choice.
UPDATE May 2011- It’s hard to believe that I wrote that article 3 1/2 years ago. Time does fly! Many of the plans mentioned in this article have changed or are no longer available. For example, Anthem’s Value plan is not offered. But there are still many affordable plans that are rich in coverage.
UPDATE December 2013 – Now that Exchanges are fully operational, there are multiple low-priced policies offered in all parts of the state. And the Obamacare subsidies (if you qualify) will eliminate most or all of the premium payments in selected situations. Some of the least-expensive policies are listed below:
KP Bronze 5000 Medical
Mutual Market HSA
SummaCare Individual 6350
Medical Mutual Market Young Essentials
Anthem Catastrophic Direct Access
UPDATE February 2014 Open Enrollment extends to March 31st. After that date, alternative options are available. Also, guaranteed coverage will still be offered in special situations, such as divorce, job termination, children reaching age 26 etc…