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). Short-term, Senior, dental, and vision plans are also offered. Exchange policies include 10 required essential benefits.
In 2018, ACA-compliant plans are not offered, although a return to the Buckeye State is possible in 2019 or 2020. Senior Medicare, Group, dental, and vision plans continue to be offered. Grandfathered and grandmothered plans (Non-ACA contracts) are not impacted. Important: The healthcare content of this page references plans that are not available. We will update policy information when Anthem re-introduces private coverage.
You can enroll for plans that are both on and off the Marketplace. In most parts of the state, prices are quite competitive when compared to the other large companies. We assist you in finding the right coverage that stays within your budget. You can quickly apply online during Open Enrollment, and also after the deadline has expired (with an SEP exception). Senior Medigap plans are also offered to Medicare-eligible applicants. Advantage and Supplement contracts allow you to cover many expenses not paid by Original Medicare.
Applying For 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, since it is 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
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.
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.
Catastrophic Pathway X PPO 7150 - Cheapest BCBS policy in the state features a $7,150 deductible with no additional coinsurance. Since it is a Catastrophic-tier plan, you must be under age 30 to enroll, unless you can prove "financial hardship." The network used is the Pathway X Tiered Hospital. The BlueCard allows you to cover Urgent care and ER expenses as "in-network" if treated in a BCBS plan area.
The first three primary care physician (pcp) visits are included with a $40 copay. However, each subsequent visit is subject to the deductible, although a negotiated discount may reduce your cost. Prescription benefits are included but like most major medical expenses, must first meet the deductible.
Specialist visits, diagnostic tests and x-rays, ER and Urgent care visits, inpatient and outpatient hospital expenses, are included benefits that are fully-covered once the deductible has been met. Of course, preventative expenses (routine annual physicals, OBGYN visits, etc...) are 100% covered without meeting the deductible.
Bronze Pathway HMO 7150 - Least expensive plan that is eligible for subsidies. Deductible is $7,150 with 0% coinsurance. Utilizes the Pathway HMO Network. Once deductible is met, covered benefits paid at 100%. This plan is ideal for single persons and families that rarely meet a deductible, want the lowest premium, and are most interested in covering preventative and major medical expenses.
Bronze Pathway PPO 5150 -$5,150 deductible with maximum out-of-pocket expenses of $7,150. Two pcp office visits with a $50 copay are included (per person). Coinsurance, after the deductible, is 25% for most expenses. Tier 1 and Tier 2 drugs are also subject to a 25% coinsurance. Tiers 3 and 4 are subject to a 40% coinsurance.
Bronze Pathway PPO 5850 - $5,850 deductible with 35% coinsurance and maximum out-of-pocket expenses of $7,150. All non-preventative office visits subject to the deductible (no copays). Urgent Care and in-hospital admission out-of-pocket expenses are also higher than previous plan.
Bronze Pathway PPO 0% For HSA - Cheapest Health Savings Account available. $6,550 deductible with 0% coinsurance means once the deductible has been met, there are no out-of-pocket expenses. Dental, vision, and medical expenses can be paid from a separate "savings" account that you establish and manage.
Bronze Pathway HMO 0% For HSA - Similar to previous plan, but without out-of-network coverage. Also utilizes HMO network instead of PPO network.
Bronze Pathway PPO 6800 - $60 copay for the first two pcp office visits. $6,800 deductible with maximum out-of-pocket expenses of $7,150. Coinsurance is 25%. Tier 1 and Tier 2 drugs are subject to $25 and $80 copays, but no deductible.
Bronze Pathway HMO 5000 - $5,000 deductible with $7,150 maximum out-of-pocket expenses and 40% coinsurance. $50 copay for first two pcp office visits with deductible and coinsurance applicable to most other expenses.
Bronze Pathway HMO 5200 - $5,200 deductible with $7,150 maximum out-of-pocket expenses and 20% coinsurance. Pcp and specialist copays are $35 and $70 for the first two visits. NOTE: Most other Anthem plans place a deductible on specialist visits. Tier 1 drugs are subject to 20% coinsurance and Tier 2 drugs are subject to 40% coinsurance.
Silver Pathway PPO 2000 - $2,000 deductible with maximum out-of-pocket expenses of $7,150. $45 copay for first two pcp office visits. Thereafter, the deductible and 20% coinsurance applies. Tier 1 and Tier 2 prescriptions only have to meet $15 and $45 copays respectively.
Silver Pathway PPO 2500 - $2,500 deductible with $7,150 maximum out-of-pocket expenses and only 10% coinsurance. Office-visit copay (pcp) is $45 with no limit on the number of times used. Specialist visits still must meet deductible and coinsurance. Prescriptions subject to medical deductible and coinsurance.
Silver Pathway PPO 10% For HSA - HSA-eligible plan with $2,700 deductible and $6,550 maximum out-of-pocket expenses. Coinsurance is 10% (40% out-of-network). Similar to Bronze HSA option, but with a lower deductible.
Silver Pathway PPO 3000 - $3,000 deductible with maximum out-of-pocket expenses of $6,000 and 10% coinsurance. First three pcp office visits are subject to only a $40 copay. 10% coinsurance applies to Tier 1 and 2 drugs while a 40% coinsurance applies to Tier 3 and Tier 4 drugs.
Silver Pathway PPO 3500 - $3,500 deductible with maximum out-of-pocket expenses of $5,700 and 20% 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 PPO 4050 - $4,050 deductible with maximum out-of-pocket expenses of $6,500 and 0% coinsurance. Pcp office visit copay is $50, and Tier 1 and Tier 2 drug copays are $15 and $40. Urgent Care visits must meet a $50 copay and the deductible.
Silver Pathway HMO 2850 - $2,850 deductible with maximum out-of-pocket expenses of $7,150 and 15% coinsurance. Pcp office visit copay is $30, and Tier 1 and Tier 2 drug copays are $20 and $50. Like previous plan, Urgent Care visits must meet the deductible. NOTE: This plan is an HMO, so the Pathway HMO network is utilized instead of the Pathway Tiered Hospital network.
Silver Pathway HMO 10% For HSA - HSA-eligible plan with $3,200 deductible, 10% coinsurance, and maximum out-of-pocket expenses of $5,000. 10% coinsurance applies to Tier 1 and Tier 2 drugs, and 40% to Tiers 3 and 4.
Silver Pathway HMO 3500 - $3,500 deductible with $5,700 maximum out-of-pocket expenses and 25% coinsurance. Attractive copays on BOTH pcp and specialist visits ($20 and $60). Urgent Care copay is $90 with $10 and $40 copays on Tier 1 and Tier 2 drugs respectively. Because of the specialist copay, this plan should be strongly considered if multiple applicants frequently visit specialists.
Silver Pathway HMO 4250 - $4,250 deductible with $5,250 maximum out-of-pocket expenses and 30% coinsurance. $25 and $50 copays on pcp and specialist office visits, and a $90 Urgent Care copay. $15 and $40 copays for Tier 1 and Tier 2 drugs.
Silver Core Pathway HMO 5300 - $5,300 deductible with $6,750 maximum out-of-pocket expenses and 25% coinsurance. $35 copay on pcp office visits with deductible applying to most other items. $10 and $40 copays on Tier 1 and Tier 2 drugs.
Gold Pathway HMO 1450 - $1,450 deductible with maximum out-of-pocket expenses of $4,200 and 20% coinsurance. Office visit copays are $30 and $50 (unlimited usage) with $90 Urgent Care copay. Level 1 and Level 2 drug copays are $10 and $35.
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 Ohio Dental Options
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.
Four stand-alone plans are available. They are: Dental Family Value, Dental Family, Dental Family Enhanced, and Dental Smart Access. You can view additional Ohio dental information here.
The most comprehensive plan option is the "Dental Family Enhanced" plan. Separate options are available for dependents (age 18 and under) and adults (19 and over). Small deductibles ($25 and $50) with no waiting period for diagnostic and preventative benefits, make this policy one of the most popular contracts in the state. Cleanings, exams, and x-rays have no coinsurance, and international emergency coverage is included.
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.
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.
UPDATES FROM THE PAST:
November 2013 - 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.
December 2013 - 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.
January 2015 - 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.
February 2015 - 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.
October 2016 - Since Aetna, UnitedHealthcare, InHealth, and HealthSpan have exited the Buckeye State (Marketplace plans), Anthem will be increasing their market share.
July 2017 - Anthem's 2018 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.