Affordable Ohio Health Insurance Plans

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Anthem Ohio health insurance quotes are available on our website at the  lowest direct rates provided by the insurer. Anthem Blue Cross Blue Shield individual, small business and family  policies include catastrophic plans, comprehensive plans and Health Savings Accounts (HSAs). Senior Medicare, dental, and vision plans are also offered. Exchange policies include 10 required essential benefits.

In 2019, ACA-compliant plans (applicants under age 65) are available in 25 counties, and a larger market share in the Buckeye State is possible in 2020. Plans for persons that have reached age 65 are also very popular choices. The Pathway HMO provider network is used.  Anthem files plans through the name "Community Insurance Company." The 25 counties offering under-65 coverage are Athens, Auglaize, Belmont, Butler, Coshocton, Erie, Gallia, Gurnsey, Hamilton, Hocking, Jackson, Jefferson, Lawrence, Mercer, Monroe, Morgan, Muskingum, Noble, Ottawa, Perry, Pike, Putnam, Vinton, Warren, and Wyandot.

 

Senior Anthem Medicare Insurance Plans In Ohio 

 

Medicare Supplement Plans

 

Hamilton, Clermont, Butler, Darke, Warren, and Montgomery Counties

 

Female Monthly Rates Age 65

$105 -Plan A

$130 - Plan Select F

$157 - Plan F

$89 - Plan Select G 

$109 - Plan G 

$81 - Plan Select N 

$99 - Plan N

 

Male Monthly Rates Age 65

$115 -Plan A

$143 - Plan Select F

$172 - Plan F

$98 - Plan Select G 

$120 - Plan G 

$89 - Plan Select N 

$109 - Plan N

 

Franklin, Delaware, Licking, Greene, Fairfield, Richland, Wayne, Miami, Mercer, and Shelby Counties

 

Female Monthly Rates Age 65

$99 -Plan A

$123 - Plan Select F

$148 - Plan F

$84 - Plan Select G 

$103 - Plan G 

$76 - Plan Select N 

$93 - Plan N

 

Male Monthly Rates Age 65

$108 -Plan A

$135 - Plan Select F

$162 - Plan F

$92 - Plan Select G 

$113 - Plan G 

$83 - Plan Select N 

$102 - Plan N

 

Cuyahoga, Summit, Lucas, Stark, Lorain, Mahoning, Lake, Trumbull, Medina, Portage, and Columbiana Counties

 

Female Monthly Rates Age 65

$112 -Plan A

$139 - Plan Select F

$167 - Plan F

$95 - Plan Select G 

$116 - Plan G 

$86 - Plan Select N 

$106 - Plan N

 

Male Monthly Rates Age 65

$112 -Plan A

$139 - Plan Select F

$167 - Plan F

$95 - Plan Select G 

$116 - Plan G 

$86 - Plan Select N 

$106 - Plan N

 

 

Medicare Advantage Plans

 

Anthem MediBlue Preferred (HMO) -  $0 deductible with maximum out-of-pocket expenses of $4,900. Office visit copays are $5 and $40. The inpatient hospital copay is $295 for the first six days. Days 7-90 have a $0 copay. The inpatient mental health care copay is $300 for the first five days. The outpatient mental health care copay is $40 for individual or group therapy visits, and partial hospitalization services. Skilled nursing facility benefits are provided with a $0 copay for the first 20 days, and a $142 copay for days 21-100.

Outpatient hospital visits are subject to a $0-$285 copay. A $40 copay applies to therapy visits (occupational, physical, speech, and language). Ambulance services are covered with a $260 copay. The ER and Urgent Care copays are $90 and $35. Lab services are subject to a $0-$10 copay. Prosthetic devices and durable medical equipment are subject to 20% coinsurance.

Diagnostic tests are subject to a $0-$150 copay, and x-rays are subject to a $50-$110 copay. Diagnostic radiology services are subject to a $130-$150 copay. Dental, vision, and hearing services are subject to $0, $40, and $40 copays respectively, subject to policy limits. LiveHealth Online and Nurse HelpLine services are subject to a $0 copay. The preferred retail cost-sharing for 30 days is $4 (Tier 1), $10 (Tier 2), $42 (Tier 3), $95 (Tier 4), 33% (Tier 5), and $0 (Tier 6). The preferred retail mail-order cost-sharing for 90 days is $12 (Tier 1), $30 (Tier 2), $126 (Tier 3), $285 (Tier 4), NA (Tier 5), and $0 (Tier 6).

 

Anthem MediBlue Access (PPO) -  $50 deductible with maximum out-of-pocket expenses of $6,400. Office visit copays are $10 and $40 ($25 and $60 if not in-network). The inpatient hospital copay is $275 for the first six days. Days 7-90 have a $0 copay. The inpatient mental health care copay is $250 for the first five days. The outpatient mental health care copay is $40 for individual or group therapy visits, and partial hospitalization services. Skilled nursing facility benefits are provided with a $0 copay for the first 20 days, and a $142 copay for days 21-100.

Ambulatory surgical center visits have a $0 copay and 15% coinsurance. Outpatient hospital visits are subject to a $0 copay and 20% coinsurance. A $30 copay applies to therapy visits (occupational, physical, speech, and language). Ambulance services are covered with a $275 copay. A 20% coinsurance applies to air ambulance services. The ER and Urgent Care copays are $90 and $35. Home health care has a $0 copay while lab services are subject to a $0-$15 copay. Prosthetic devices and durable medical equipment are subject to 20% coinsurance.

Diagnostic tests are subject to a $0-$150 copay, and x-rays are subject to a $50-$110 copay. Diagnostic radiology services are subject to a $130-$150 copay. Dental, vision, and hearing services are subject to $0, $40, and $40 copays respectively, subject to policy limits. LiveHealth Online and Nurse HelpLine services are subject to a $0 copay. The preferred retail cost-sharing for 30 days is $4 (Tier 1), $15 (Tier 2), $42 (Tier 3), $95 (Tier 4), 32% (Tier 5), and $0 (Tier 6). The preferred retail mail-order cost-sharing for 90 days is $0 (Tier 1), $30 (Tier 2), $84 (Tier 3), $190 (Tier 4), NA (Tier 5), and $0 (Tier 6).

 

Anthem MediBlue Access Core (Regional PPO) -  $250 deductible with maximum out-of-pocket expenses of $5,400. Office visit copays are $10 and $30 ($25 and $50 if not in-network). The inpatient hospital copay is $255 for the first five days. Days 6-90 have a $0 copay. The inpatient mental health care copay is $250 for the first five days. The outpatient mental health care copay is $25 for individual or group therapy visits, and partial hospitalization services. Skilled nursing facility benefits are provided with a $0 copay for the first 20 days, and a $137.50 copay for days 21-100.

Ambulatory surgical center visits have a $0-$225 copay. Outpatient hospital visits are subject to a $0 copay and 20% coinsurance. A $30 copay applies to therapy visits (occupational, physical, speech, and language). Ambulance services are covered with a $295 copay. A 20% coinsurance applies to air ambulance services. The ER and Urgent Care copays are $80 and $25. Home health care has a $0 copay while lab services are subject to a $0-$15 copay. Prosthetic devices and durable medical equipment are subject to 20% coinsurance.

Diagnostic tests are subject to a $0-$150 copay, and x-rays are subject to a $90-$110 copay. Diagnostic radiology services are subject to a $130-$150 copay. Dental, vision, and hearing services are subject to $0, $30, and $30 copays respectively, subject to policy limits. LiveHealth Online and Nurse HelpLine services are subject to a $0 copay. This plan does not include additional prescription drug benefits.

 

Anthem MediBlue Essential (HMO) -  $0 deductible with maximum out-of-pocket expenses of $4,900. Office visit copays are $5 and $40. The inpatient hospital copay is $350 for the first five days. Days 6-90 have a $0 copay. The inpatient mental health care copay is $300 for the first five days. The outpatient mental health care copay is $40 for individual or group therapy visits, and partial hospitalization services. Skilled nursing facility benefits are provided with a $0 copay for the first 20 days, and a $137.50 copay for days 21-100.

Ambulatory surgical center visits have a $0-$245 copay. Outpatient hospital visits are subject to a $0-$295 copay. A $40 copay applies to therapy visits (occupational, physical, speech, and language). Ambulance services are covered with a $265 copay. A 20% coinsurance applies to air ambulance services. The ER and Urgent Care copays are $80 and $35. Home health care has a $0 copay while lab services are subject to a $0-$10 copay. Prosthetic devices and durable medical equipment are subject to 20% coinsurance.

Diagnostic tests are subject to a $0-$150 copay, and x-rays are subject to a $90-$110 copay. Diagnostic radiology services are subject to a $130-$150 copay. Dental, vision, and hearing services are subject to $0, $40, and $40 copays respectively, subject to policy limits. LiveHealth Online and Nurse HelpLine services are subject to a $0 copay. The preferred retail cost-sharing for 30 days is $4 (Tier 1), $15 (Tier 2), $42 (Tier 3), $95 (Tier 4), 31% (Tier 5), and $0 (Tier 6). The preferred retail mail-order cost-sharing for 90 days is $12 (Tier 1), $45 (Tier 2), $126 (Tier 3), $285 (Tier 4), NA (Tier 5), and $0 (Tier 6).

 

Anthem MediBlue Plus (HMO) -  $0 deductible with maximum out-of-pocket expenses of $4,100. Office visit copays are $5 and $35.  The inpatient hospital copay is $290 for the first five days. Days 6-90 have a $0 copay. The inpatient mental health care copay is $250 for the first five days. The outpatient mental health care copay is $40 for individual or group therapy visits, and partial hospitalization services. Skilled nursing facility benefits are provided with a $0 copay for the first 20 days, and a $137.50 copay for days 21-100.

Ambulatory surgical center visits have a $0-$175 copay. Outpatient hospital visits are subject to a $200 copay. A $30 copay applies to therapy visits (occupational, physical, speech, and language). Ambulance services are covered with a $265 copay. A 20% coinsurance applies to air ambulance services. The ER and Urgent Care copays are $80 and $30. Home health care has a $0 copay while lab services are subject to a $0-$10 copay. Prosthetic devices and durable medical equipment are subject to 20% coinsurance.

Diagnostic tests are subject to a $0-$140 copay, and x-rays are subject to a $80-$100 copay. Diagnostic radiology services are subject to a $120-$140 copay. Dental, vision, and hearing services are subject to $0, $35, and $35 copays respectively, subject to policy limits. LiveHealth Online and Nurse HelpLine services are subject to a $0 copay. The preferred retail cost-sharing for 30 days is $4 (Tier 1), $15 (Tier 2), $42 (Tier 3), $95 (Tier 4), 31% (Tier 5), and $0 (Tier 6). The preferred retail mail-order cost-sharing for 90 days is $12 (Tier 1), $45 (Tier 2), $126 (Tier 3), $285 (Tier 4), NA (Tier 5), and $0 (Tier 6).

 

Anthem MediBlue Access Basic (Regional PPO) -  $1,000 deductible with maximum out-of-pocket expenses of $6,000. Office visit copays are $10 and $40 ($40 and $60 if not in-network). The inpatient hospital copay is $295 for the first five days. Days 6-90 have a $0 copay. The inpatient mental health care copay is $250 for the first five days. The outpatient mental health care copay is $40 for individual or group therapy visits, and partial hospitalization services. Skilled nursing facility benefits are provided with a $0 copay for the first 20 days, and a $137.50 copay for days 21-100.

Ambulatory surgical center visits have a $0 copay - 15% coinsurance. Outpatient hospital visits are subject to a $0 copay - 20% coinsurance. A $35 copay applies to therapy visits (occupational, physical, speech, and language). Ambulance services are covered with a $295 copay. A 20% coinsurance applies to air ambulance services. The ER and Urgent Care copays are $80 and $35. Home health care has a $0 copay while lab services are subject to a $0-$10 copay. Prosthetic devices and durable medical equipment are subject to 20% coinsurance.

Diagnostic tests are subject to a $0-$130 copay, and x-rays are subject to a $90-$110 copay. Diagnostic radiology services are subject to a $130-$150 copay. Dental, vision, and hearing services are subject to $0, $40, and $40 copays respectively, subject to policy limits. LiveHealth Online and Nurse HelpLine services are subject to a $0 copay. The preferred retail cost-sharing for 30 days is $6 (Tier 1), $15 (Tier 2), $42 (Tier 3), $41% (Tier 4), 29% (Tier 5), and $0 (Tier 6). The preferred retail mail-order cost-sharing for 90 days is $18 (Tier 1), $45 (Tier 2), $126 (Tier 3), 41% (Tier 4), NA (Tier 5), and $0 (Tier 6).

 

Anthem MediBlue Dual Advantage (HMO SNP) -  $0 deductible with maximum out-of-pocket expenses of $6,700. Office visit copays are $0 and $0. The inpatient hospital copay is $0 per stay. The inpatient mental health care copay is $0 per stay. The outpatient mental health care copay is $0 for individual or group therapy visits, and partial hospitalization services. Skilled nursing facility benefits are provided with a $0 copay per stay.

Outpatient hospital visits are subject to a $0 copay. A $0 copay applies to therapy visits (occupational, physical, speech, and language). Ambulance services are covered with a $0 copay. No coinsurance applies to air ambulance services. The ER and Urgent Care copays are $0. Home health care has a $0 copay while lab services are subject to a $0 copay. Prosthetic devices and durable medical equipment are subject to no coinsurance.

Diagnostic tests and x-rays are subject to a $0-$150 copay. Diagnostic radiology services are subject to a $130-$150 copay. Dental, vision, and hearing services are subject to $0-$40 copays subject to policy limits. LiveHealth Online and Nurse HelpLine services are subject to a $0 copay. The preferred retail cost-sharing for 30 days is $2 (Tier 1), $12 (Tier 2), $42 (Tier 3), $95 (Tier 4), and 33% (Tier 5).

 

Anthem MediBlue Prime Select (HMO) -  $0 deductible with maximum out-of-pocket expenses of $4,900. Office visit copays are $5 and $40. The inpatient hospital copay is $295 for the first 6 days. The inpatient mental health care copay is $240 for the first 6 days. The outpatient mental health care copay is $40 for individual or group therapy visits, and partial hospitalization services. Skilled nursing facility benefits are provided with a $167.50 copay for days 21-100.

Outpatient hospital visits are subject to a $275 copay. A $40 copay applies to therapy visits (occupational, physical, speech, and language). Ambulance services are covered with a $295 copay. The ER and Urgent Care copays are $80 and $35. Home health care has a $0 copay while lab services are subject to a $0-$10 copay. Prosthetic devices and durable medical equipment are subject to no coinsurance.

Diagnostic tests and x-rays are subject to a 0 copay. Diagnostic radiology services are subject to a $0 copay. Dental, vision, and hearing services are subject to $0 copays subject to policy limits. LiveHealth Online and Nurse HelpLine services are subject to a $0 copay. The preferred retail cost-sharing for 30 days is $0 (Tier 1), $0-$3.35 (Tier 2), $0-$8.35 (Tier 3), $0-$8.35 (Tier 4), and $0-$8.35 (Tier 5).

 

Part D Prescription Drug Plans And Rates

 

Medicare Rx Standard -  $97.20 per month. $380 deductible does not apply to Tier 1 and Tier 6 drugs. Coinsurance or copay applies until total annual cost of drug reaches $3,820. Preferred 1-month copays are $1 (Tier 1), $5 (Tier 2), $30 (Tier 3), 40% (Tier 4), 25% (Tier 5), and $0 (Tier 6). Preferred 3-month copays are $3 (Tier 1), $15 (Tier 2), $90 (Tier 3), 40% (Tier 4), NA (Tier 5), and $0 (Tier 6). 2,795 formulary drugs are available.

 

Medicare Rx Plus - $90.80 per month.  $0 deductible. Coinsurance or copay applies until total annual cost of drug reaches $3,820. Preferred 1-month copays are $1 (Tier 1), $3 (Tier 2), $40 (Tier 3), 39% (Tier 4), 33% (Tier 5), and $0 (Tier 6). Preferred 3-month copays are $3 (Tier 1), $9 (Tier 2), $120 (Tier 3), 39% (Tier 4), NA (Tier 5), and $0 (Tier 6). 3,017 formulary drugs are available.

 

Applying For Under Age-65 Coverage

Applications are not underwritten (short-term plans are an exception), so medical questions are not required to be answered. A physical is not needed, and no fees are charged. Usually, the underwriting process is very quick and a notification of the offer is provided in writing by Anthem BC. Typically, we can complete a phone or online enrollment in less than 15 minutes.

You do NOT have to accept the offer. And with most submitted applications, you don't have to pay any money upfront. Typically, the final price matches the original quoted premium. The main reasons for any variance are  that a birthday occurred after the application date, or the federal subsidy was changed by the Department of Health and Human Services (HHS).

You can also use our website to purchase an "Exchange" policy, and replace a plan that you may already have. Or, if you are not insured, (it is  not required by federal law), you can buy an inexpensive option that will keep your costs down. Pre-existing conditions will not be treated any differently than any other new illness or injury, and you will have full access to all network providers.

Anthem Blue Cross Plans In Ohio (Under Age-65)

There are several affordable single/family policies offered with or without a federal subsidy. Each policy covers the mandatory required 10 "Essential Health Benefits" and will satisfy the mandatory coverage requirements of the Obamacare legislation. Maternity, mental illness, office visits, prescription drugs, and hospitalization are several of the most common benefits. Note: You can view the drug list selection, which will help you determine the appropriate Tier, and approximate cost. More than 70,000 pharmacies are available along with home-delivery options.

Once your policy is active, many additional benefits are provided, including "LiveHealth Online," which provides access to physicians at any time, including weekends. Allergies, flu, fever, rashes, and viruses are popular reasons to utilize this service.  Advice, treatment, and/or prescription drugs can be also provided along with visits with a psychologist or licensed therapist.


24/7 Nurselines (registered nurses) offer immediate assistance with a wide range of concerns and topics. Discounted prices also help you save money on many products, including Jenny Craig, LASIK eye surgery, hearing aids, smoking cessation, and vitamins.

LiveHealth Online allows customers to speak live to a physician 24/7 from a computer or smartphone. The live video session can often eliminate the need for an Urgent Care or ER visit. An Online Psychology option also offers mental health and substance use/therapy counseling. This benefits is offered to plans with the "LiveHealth Online" designation. The copay is only $5.

 

Bronze Plans

 

Bronze Pathway HMO 4600 Online Plus - $50 primary care physician copay. Specialist visits are subject to deductible and copay. $4,600 deductible with $7,900 maximum out-of-pocket expenses and 30% coinsurance. Urgent Care visits subject to deductible, $50 copay and coinsurance. ER visits subject to deductible, $500 copay, and coinsurance. Tier 1 prescription drug copays are $20 and $30, and Tier 2 prescription drug copays are $80 and $90.

Bronze Pathway HMO 5000 - $50 primary care physician copay for the first two visits only. Specialist visits are subject to deductible and copay. $5,000 deductible with $7,900 maximum out-of-pocket expenses and 40% coinsurance. Urgent Care visits subject to deductible and coinsurance. ER visits subject to deductible, $500 copay, and coinsurance. All prescription drugs are subject to deductible and coinsurance. 

Bronze Pathway HMO 6000 - $50 primary care physician copay for the first two visits only. Specialist visits are subject to deductible and copay. $6,000 deductible with $7,900 maximum out-of-pocket expenses and 35% coinsurance. Urgent Care visits subject to deductible and coinsurance. ER visits subject to deductible, $500 copay, and coinsurance. All prescription drugs are subject to deductible and coinsurance.  

Bronze Pathway HMO 7900 - $7,900 deductible with 0% coinsurance. All non-preventative expenses must meet deductible.

Bronze Pathway HMO 5500/0 For HSA - HSA-eligible plan with $5,500 deductible and 0% coinsurance. All non-preventative expenses must meet deductible. Tax-deductible deposits into the HSA are permitted for qualified medical, dental, and vision expenses.

Bronze Pathway HMO 6500/0 For HSA - HSA-eligible plan with $6,500 deductible and 0% coinsurance. All non-preventative expenses must meet deductible. Tax-deductible deposits into the HSA are permitted for qualified medical, dental, and vision expenses.

 

 

 

What are best Ohio Anthem plans? Find affordable individual healthcare coverage and enroll.

 

Silver

 

Silver Pathway HMO 2100 - $2,100 deductible with maximum out-of-pocket expenses of $7,900 and 20% coinsurance. Pcp office visit copay is $30. Urgent Care visits subject to deductible, $50 copay, and coinsurance. ER visits subject to deductible, $500 copay, and coinsurance. Tier 1 and Tier 2 drug copays are $20 and $50.

Silver Pathway HMO 3000 - $3,000 deductible with maximum out-of-pocket expenses of $6,000 and 10% coinsurance. Pcp office visit copay is $40 for the first three visits. Urgent Care visits subject to deductible, $50 copay, and coinsurance. ER visits subject to deductible, $200 copay, and coinsurance. All prescriptions subject to deductible and coinsurance.

Silver Pathway PPO 10% For HSA - HSA-eligible  plan with $3,200 deductible and $5,000 maximum out-of-pocket expenses. Coinsurance is 10%.  Similar to Bronze HSA options, but with a lower deductible and higher coinsurance.

Silver Pathway HMO 3500 - $3,500 deductible with  maximum out-of-pocket expenses of $5,700 and 25% coinsurance. No limit on pcp and specialist visits subject to a copay ($20 and $60). Urgent Care visits also have a copay ($90). For families with many office visits, this plan is a popular option. Tier 1 and Tier 2 drugs also receive fairly low copays ($10 and $40).

Silver Pathway HMO 0 For HSA - HSA-eligible  plan with $4,000 deductible and $4,000 maximum out-of-pocket expenses. Coinsurance is 0%. 

Silver Pathway HMO 4000 Online Plus - $4,000 deductible with  maximum out-of-pocket expenses of $5,250 and 30% coinsurance. No limit on pcp and specialist visits subject to a copay ($25 and $60). Urgent Care visits also have a copay ($90). For families with many office visits, this plan is also a popular option. Tier 1 and Tier 2 drugs also receive fairly low copays ($10 and $40).

Silver Pathway HMO HMO 4500 - $4,500 deductible with  maximum out-of-pocket expenses of $6,500 and 25% coinsurance. No limit on pcp and specialist visits subject to a copay ($25 and $60). Urgent Care visits also have a copay ($90). Tier 1 and Tier 2 drugs also receive fairly low copays ($10 and $40). Similar to previous plan, but with higher maximum out-of-pocket limits.

Silver Pathway HMO 5000 - $5,000 deductible with  maximum out-of-pocket expenses of $6,500 and 35% coinsurance. No limit on pcp visits subject to a copay of $35. Urgent Care visits subject to deductible, $50 copay, and coinsurance. Tier 1 and Tier 2 drugs also receive fairly low copays ($10 and $40).

Silver Pathway HMO 6000/25% - $6,000 deductible with  maximum out-of-pocket expenses of $7,900 and 35% coinsurance. No limit on pcp visits subject to a copay of $45. Urgent Care visits subject to deductible and $50 copay. Tier 1 and Tier 2 drugs also receive fairly low copays ($15 and $45).

 

 

Gold

 

Gold Pathway HMO 2000 - $2,000 deductible with maximum out-of-pocket expenses of $6,750 and 20% coinsurance. Office visit copays are $25 and $45 (unlimited usage) with $90 Urgent Care copay. Level 1 and Level 2 drug copays are $20 and $45.

 

Sample Under Age-65 Monthly Rates 

 

Hamilton, Butler, and Warren Counties Age 35 With Household Income Of $25,000

$125 - Bronze Pathway X HMO 7900

$141 - Bronze Pathway X HMO 6000

$145 - Bronze Pathway X HMO 5000

$149 - Bronze Pathway X HMO 6500 0 For HSA

$174 - Bronze Pathway X HMO 5500 0 For HSA

 

Provider Networks

Finding a doctor, specialist, hospital, Urgent-Care, dentist, pharmacy, hospital, or other medical facility is easy. Also, there are thousands of providers across Ohio that are "in network," and will provide a negotiated discount that can save thousands of dollars. You can view options in your area here, or simply contact us, and we will verify that your own provider is on the list. The two types of networks are described below:

HMO (Health Maintenance Organization) - Unlike most HMOs, you are not required to pre-select a  primary-care physician (pcp). Another popular feature is that referrals are not needed if an appointment with a specialist (chiropractor, allergist, cardiologist, internist, urologist, neurologist, etc...) is needed. Out-of-network services are typically not covered, unless the situation is a medical emergency.

PPO Both in-network and out-of-network coverage is available, and referrals are not needed. The negotiated savings can be significant on both low-deductible and high-deductible plans. Ohio hospitals are designated as either Tier 1 (lower cost) or Tier 2. In several areas, you have the "Tiered" network option.

 

Anthem Dental Options

 

 Cheap dental insurance plans in Ohio. Comprehensive and preventive benefits at an affordable rate.

 

A dental policy can also be added for a moderate price. Checkups and X-rays are usually covered with little out of pocket cost. Larger expenses such as root canal or extractions will have a waiting period and higher out of pocket cost. Generally, prices compare favorably to other popular dental plans from Humana, Aetna, UnitedHealthcare, and Delta Dental.

Three stand-alone plans are available. They are: Dental Family Value, Dental Family, and Dental Family Enhanced. You can view additional Ohio dental information here.

Dental Family Value - $50 deductible (per person) and no annual in-network maximum benefit for children. For adults, the maximum benefit is $750. The out-of-pocket limit is $350 ($700 per family) and there is no waiting period for preventative and diagnostic coverage. Cleanings, exams, and x-rays are covered at 100%. Basic services have no waiting period for persons under age 19. Adults have a six-month waiting period. Complex and major services, crowns, dentures, bridges, and orthodontia are not covered for adults.

Dental Family - $50 deductible (per person) and no annual in-network maximum benefit for children. For adults, the maximum benefit is $750. The out-of-pocket limit is $350 ($700 per family) and there is no waiting period for preventative and diagnostic coverage. Cleanings, exams, and x-rays are covered at 100%. Basic services have no waiting period for persons under age 19. Adults have a six-month waiting period. Complex and major services, crowns, dentures, and bridges have a 12-month waiting period. Orthodontia is not covered for adults.

 

Anthem Vision Options

"Blue View Vision" coverage can be added to any policy. More than 26,000 locations are network-approved, including Sears Optical, Pearle Vision, Target Optical, and LensCrafters. Online merchants are also available, including Glasses.com, 1-800 CONTACTS, and ContactsDirect. Policy benefits include an annual eye exam, and standard single vision, bifocal, or trifocal plastic lenses every two years. A $20 copay applies to lenses, and the exam. Allowances of $80 and $130 are provided for contact lenses and frames.

 

Anthem Small Group Plan Options (2-50 Employees)

The Pathway Group HMO network provides a large selection of providers along with a "care and cost finder." This tool helps employees compare quality ratings and costs of physicians and other providers. Many procedures are included and additional pharmacy information can also be viewed. Dental, vision, life, and disability coverage can also be added to plans.

The LiveHealth Online feature offers workers the option of visiting with a physician from their pc, labtop, or mobile phone. Headaches, allergies, colds,the flu, and many other topics can be discussed via video with certified physicians and therapists. The cost per session is approximately $49. Workplace wellness is also provided, including multiple campaigns, motivation webinars, and health education. Available plans and a brief description are listed below.

 

Gold Blue Access PPO 500/20%/4000 - $500 deductible with $25 and $50 office visit copays (pcp and specialist). $100 Urgent Care copay. Level 1 prescription copays are $15, $50, and $90.

Gold Blue Access PPO 1000/20%/3750 - $1,000 deductible with $30 and $60 office visit copays (pcp and specialist). $100 Urgent Care copay. Level 1 prescription copays are $15, $50, and $90.

Gold Blue Access PPO 1500/20%/4000 - $1,500 deductible with $25 and $50 office visit copays (pcp and specialist). $100 Urgent Care copay. Level 1 prescription copays are $15, $50, and $90.

 

Review

As an independent trusted broker, we review all of the major Ohio health plans, and only recommend the policies(s) that provide you with maximum coverage at a premium that meets your own budget. Anthem rates are not the same in all areas of the state so we'll do all of the research for you to help find your best options.

The advantage of using our services vs. "going direct," is that we compare all of the carriers, not just one. Therefore, if another company has a more affordable option with better benefits, you'll be able to choose, instead of being forced to select from a single provider.  Business owners and self-employed persons can also view many low-cost options that were not previously available.

 

UPDATES FROM THE PAST:

Anthem Ohio Exchange plans are available through our website. Catastrophic, Platinum, Gold and Silver options can be purchased at extremely low prices with a full Obamacare federal tax subsidy, which can be calculated by contacting us or directly here.

The DirectAccess policies replace the old 2013 portfolio. They are "guarantee-approval" with no required medical questions or physicals needed for enrollment. The availability of doctors and other medical facilities is smaller compared to previous options.

A 24-hour extension has been granted for persons needing coverage by January 1st. The deadline now extends to midnight Christmas eve (December 24th). We anticipate more extensions will be utilized in 2014.

Also, Akron Children's Hospital will remain in the Anthem network, after completing negotiations. This, of course, is great news to residents of the Northeastern portion of the state that utilize the facility.

When enrolling for a new policy, verify with your doctor or specialist that they are included in Anthem's "X" network. This new provider list was created for Marketplace policies and is narrower than previous networks. It is possible that your physician may be considered "in-network" for one plan but "out of network" in another plan.

A major external cyber attack was reported by Anthem this week. Access to the IT system gave hackers access to names, dates of birth, social security numbers and other personal information. Financial data appears not to be included in the stolen information.

The FBI is now involved along with Mandiant Corporation, a highly-respected cyber security company. This breach also impacted many of the company's own employees. Credit monitoring and identity protection help will be provided free to anyone that was affected.

Since Aetna, UnitedHealthcare, InHealth, and HealthSpan have exited the Buckeye State (Marketplace plans), Anthem will be increasing their market share.

Anthem's  individual Ohio business market share will be non-existant, since the Buckeye State's largest carrier is exiting the state. Although Group and Senior business won't be impacted, private single and family coverage will no longer be available.

 

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