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Why Do Some Prescriptions Cost More Than Others?

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Ohio health insurance companies divide all drugs into categories (tiers) based on cost and use. “Generic” drugs are the least expensive type of prescription. They typically cost between $3 and $10 and are available from most pharmacies in the state, including Walmart, Target, major grocery chains, Walgreens and CVS.

Preferred drugs don’t have a generic equivalent, but they still tend to be fairly inexpensive. They may cost between $10 and $40, depending on the condition that is being treated. Tier Three options are more expensive and are not very common. But they are more expensive than generic and preferred alternatives.

Best RX Coverage in Ohio Health Insurance

Most Health Insurance Plans In Ohio Have RX Benefits

Specialty drugs are the most expensive. Usually they are used with very serious medical conditions that involve a very specialized (and sometimes radical) type of treatment. A few examples are treatment for cancer rejection or rheumatoid arthritis. Your copay and/or coinsurance will tend to be fairly high for this type of prescription.

By purchasing medicines directly through the mail (mail order), often your out of pocket costs will reduce. Most major insurers offer this feature and the savings can be substantial, especially if it is an ongoing purchase. Home delivery is convenient and usually the drugs are delivered every 90 days.

 

Prescription Drug Information Video

Most Ohio health insurance plans (either current or through the Exchange after 2014) provide mandated prescription benefits. Although the copays may differ, there is no annual or lifetime cap, which is extremely important if you are taking an expensive medication.”Platinum” policies will have the best benefits.

Please call or email us if you have concerns or questions regarding RX benefits on an existing policy or new health insurance coverage in Ohio that you intent to buy. We can explain which plans will offer the most coverage for your prescriptions but at the lowest cost.

Delphi, Retirees Reach Agreement On Health Care And Benefits

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Ohio white-collar retirees from  Delphi Corp. could be getting some help with their health care costs after a tentative agreement was reached between the bankrupt company and a committee representing those retirees. The settlement must be approved by Delphi’s creditors and the bankruptcy court.

The company will contribute $8.75 million into a separate fund that will be established to subsidize medical costs for salaried retirees.

The fund also covers the cost of creating a Voluntary Employees’ Benefit Association (VERA), a system that covers health care insurance costs with tax-free funds. A national health care program will be selected to manage the fund.

Delphi estimates that it will cost the typical retiree between $300 and $660 per month to maintain coverage, while family coverage could cost as much as $1,800 per month. Dental coverage would cost between $45 and $125 extra, depending on whether individual or family coverage is requested.

Earlier this year, a U.S. Bankruptcy judge allowed Delphi to abruptly terminate health care and life insurance benefits for its current and future salaried employees.

We offer professional local advice to Delphi employees. All major companies are researched to find high quality Ohio health care at the guaranteed lowest available cost.

How Safe Is Your Ohio Insurance Policy?

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Are you concerned about the safety of your insurance here in Ohio? Should you be concerned? Probably. You pay (and sometimes invest) a lot of money throughout your lifetime on insurance coverage so you deserve to know where the money is going.

A $170 billion federal bailout is the only thing keeping insurance heavyweight AIG afloat. And many other companies are losing millions of dollars every quarter. Insurance companies invest heavily in the stock market and real-estate market…which have generated massive losses in the last 12 months.

But…don’t worry. Your policy is quite safe! The Ohio Life and Health Insurance Guaranty Association was created to protect policyholders, up to specific limits, against financial failure of an insurance company licensed to sell those types of policies in the state.

You can read more about this Association here.

A few additional points to consider:

·        Health Maintenance Organizations (HMOs) are not included

·        Policies sold by insurers not licensed to do business in Ohio are not included.

·        The Guarantee Association can provide this coverage because it collects money, through assessments from insurance carriers here in the Buckeye state.

·        The Ohio Department of Insurance regulates the Association.

Many consumers are worried about the impact of “The Affordable Care Act” on their personal and business health insurance policies. Although rates are expected to rise when the Ohio Healthcare Exchange is fully functioning in 2014, you can help protect yourself by staying informed and applying for the right plan.

Safest Insurance Companies Ohio

We Research Ohio Insurers

An experienced and reliable website (like ours) will guide you through the process of evaluating, comparing and purchasing a plan, so you can be certain your coverage is with a safe carrier. There are plenty of questionable policies that have low ratings or are simply not rated at all.

When purchasing a policy, make certain the carrier is an “A” rated company and licensed to do business in Ohio. We can always research and verify the background of any company. If you have any questions regarding the safety of any company, please contact us.

United HealthCare of Ohio…Affordable High-Quality Health Insurance

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United HealthCare of Ohio (UHC) offers more than 100 different health insurance policy variations. For a single person, monthly rates can range from $30 to $500 per month. Both catastrophic and comprehensive policies are offered along with HSA, student and small-business options. UHC markets their contracts under the “Golden Rule” name.

To help you decide which  policy is the best fit for you, we have briefly reviewed (below) some of the most popular options.

High Deductible (Catastrophic) Plans

It is your responsibility to pay for any routine health care expenses until your deductible is met. Once you meet your deductible, covered costs are paid by the policy. Generally, your deductible is higher than most other plans. But premiums on this type of  policy are usually fairly low. The most commonly selected deductibles are $5,000 and $7,500.

Plans To Consider: “Saver 80,”  and “Plan 80”

Traditional Copay Plans

Golden Rule Ohio Family Coverage

Ohio Family Health Insurance Through UHC

Copay plans offer similar features and benefits as traditional employer-sponsored plans. Golden Rule offers many plans that feature a set fee for office visits and 100% coverage for preventative visits. Normally, 100% of your exam and history costs are covered after the copay. Drug prescription card benefits are often included. There are many available riders so we can customize benefits to match your needs.

Plans To Consider: “Copay Select” and “Copay Saver”

Health Savings Accounts (HSAs)

United HealthCare offers HSAs with many deductible and coverage options. HSAs combine a high-deductible, lower-cost health insurance plan with an optional tax-favored side account. They will continue to be available when the State Exchange is up and running.

With an HSA Plan in Ohio, you may deposit money that you have saved on premiums into your tax-sheltered account. These savings can subsequently be used to pay your qualified medical, vision and dental expenses. Money that you deposit can be tax-deducted that year, even if it has not been spent yet. Of course

Plans To Consider: “HSA 100” and “HSA 70”

Short-Term Medical Plans

If your health insurance need is six months or less, than a short-term policy might be appropriate. Periods of coverage range from one to six months (and sometimes longer) and policies are usually approved within 48 hours. If you are unemployed or between jobs, this type of coverage is often your best option.

Plans To Consider: “Short Term Medical”

Of course, there are many excellent-rated companies here in the Buckeye state. When we review the policies that will provide the best benefits at the lowest cost, UnitedHealthCare may not always be the perfect fit. As an independent Agency, we will ultimately recommend the highest-rated carrier with the best pricing.

Ohio Health Care Doesn’t Need More Government Expansion

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Expanding government health care programs must be stylish. Everybody is getting into the act. First President Obama.  And now, Ohio Governor Ted Strickland wants to give health insurance to every child in the state. A nice gesture, but the method is quite cost-ineffective.

Marc Kilmer of “The Times-Gazette” in Hillsboro, says it best:

 

Much of the problem of uninsured children could be solved by simply getting those eligible signed up for coverage.
Instead, politicians like Governor Strickland want to expand coverage to those with higher incomes.

Children in families with higher incomes not only have a lower uninsured rate than children who are already eligible for the program, their parents are more likely to be able to afford private coverage.

 

 

 September 2009 Update: It appears that the “public option” is off the table. That’s good news for everyone.

May 2013 Update: Wow! That 3 1/2 years went fast!  The public option has not been discussed for a few years and is not likely to be mentioned again, especially now, with three government scandals rocking the political world. We will start taking Ohio State Marketplace applications in October. It should be a very busy time.