Do you need a new health care plan?
Of course, the answer is not simple, and is not a “one glove fits all” solution. Based upon our 37 years of experience as an unbiased broker, if you have been with the same company for more than three years AND your rates have been steadily increasing more than expected, it may be time to consider a change and to compare Ohio health insurance premiums.
If you get married, your most suitable options may now be different. If you moved from one area of the state to another, prices and plan availability will change. The local network will also be different and you may have to change physicians.
There are many other factors to consider such as what (if any) medical conditions you have (temporary plans only), alternative options, your current carrier offers, and how long you plan on keeping your coverage. Of course there is never a fee to compare rates from different companies and if you apply, you are never under an obligation to accept an offer. And usually, you have ample time to consider multiple plans.
What About The Marketplace Plans?
These plans (available on our website) may provide higher coverage, lower out of pocket costs on major claims, and give you hundreds of dollars in savings each month. In that particular situation, the offer should be strongly considered. If you qualify for a government subsidy, your premiums will reduce. The closer you are to the “Medicaid-Eligibility” line, the greater the chance most or all of your premiums will be paid by the government.
It’s also important to consider the network of facilities and physicians of the new company, although most of the larger carriers have extremely large provider networks. Most plans allow you to seek treatment in other states. However, there are exceptions. For example, the widely renowned Cleveland Clinic can only be utilized by Oscar on Marketplace policies. Previously, Medical Mutual included the Cleveland Clinic in their Exchange network.
It’s usually the smaller carriers you should be concerned with. They may be just starting out in the area (No, don’t be their guinea pig!), and may have a very small number of participating physicians. We assume you would not want to drive 90 minutes away if you one of your children has the flu.
For example, Healthspan (a very reputable company who purchased Kaiser’s Ohio business) initially had a limited number of physicians in many parts of the Buckeye state. Three years ago, HealthSpan began offering private medical plans with very competitive rates. However, by January of 2017, the company ceased operations, closed many facilities, and transferred their block of business to Medical Mutual. Although pending claims were processed, many customers would have preferred earlier notification of the carrier’s financial problems.
How We Find The Best Offers
Our experienced staff finds the Ohio medical coverage that offers you the benefits that you expect to have, and does not charge you for benefits you will never use. Through a combination of ultra-modern software and decades of hands-on experience, we will provide you with the lowest prices from the premier health insurers. Senior Medicare and lower-income Medicaid options are available.
And we’ll help you understand why certain plans are better for you than others, and how you can easily apply for coverage. Whether you’re inside or outside of Open Enrollment, we find the options that will provide the most cost-effective coverage, considering federal tax subsidies and any conditions that are being treated.
After you have provided some basic information, you’ll be able to compare similar plans to what you have, and easily decide if it’s worthwhile to apply for a different policy. Of course, we’ll help provide specific details and differences of the plans you are evaluating, to make the decision process much easier. And if you prefer emails instead of phone calls, that’s fine.
When Should You Not Change Your Health Insurance Policy?
If you are being treated for a serious medical condition, such as cancer, heart disease, AIDS, rheumatoid arthritis, diabetes, or cerebral palsy, you should keep your current coverage until you are eligible for the next “Open Enrollment.” Typically, they begin in November. There are also other serious ailments that also fall into this category.
If you apply for a new underwritten individual policy (temporary), the application will be declined and any payment will be refunded. If COBRA is an option, you can consider that although you also may qualify for a “special enrollment” that may be much less expensive. There used to be HIPAA options, although prices were very high. Now, with passage of recent legislation, HIPAA special plan coverage is not needed.
Also, if you have just had a surgery and are still receiving treatment, you may want to wait until you are no longer under your physician’s care. Once you have that release, your chances drastically improve of getting approved for new coverage. However, if you are receiving ongoing maintenance medication (such as blood pressure, thyroid etc.) it should not (by itself) cause your application to be declined.
I Thought I Can Not Be Declined
This is true. An “Exchange” set up and administered by the federal government determines healthcare rates and plan availability. You should still use our website and links to apply, but there are differences in plan features, and underwriting guidelines. Non-qualified plans, however, may be subject to medical underwriting.
Since policies are classified as “Metal” designations (Platinum, Gold, Silver and Bronze), it is imperative to comprehend the distinctions between each policy, and how “cost-sharing” may save you tens of thousands of dollars. Since you can not be turned down (for medical reasons) on a Marketplace application, we can carefully review the most affordable offers and quickly enroll.
Prices are higher for some applicants, but substantially lower for others. Paying for all of the existing extremely serious conditions is costly, and the average consumer, along with the government, has to pay for it. However, depending on household income, the previously-discussed subsidy can make a huge difference.
If you’re still a bit unclear about what you should do, either contact us (see contact information in upper right-hand side of page). We’ll use more than 35 years of unbiased experience to advise you which plan best matches your current budget and heathcare needs. And of course, there are never any fees. Just a few bad jokes every now and then.
