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Humana Ohio Individual Health Insurance - Senior And Under 65 Rates

Affordable Ohio Health Insurance Plans

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Humana individual health insurance plans in Ohio are available at attractive prices. Both on and off-Marketplace coverage may return in 2019 although Medicare and Group plans are offered. Once the OE period ends, coverage can be purchased from other carriers by qualifying for one of several SEP (Special Enrollment Period) exemptions. You can view free quotes on our website, compare multiple plans and apply for benefits in less than 15 minutes.

Senior Medigap (Supplement and Advantage) contracts are offered to persons that have reached age 65 and are Medicare-eligible. Since MedSup plans are standardized (no difference in benefits from one carrier to another), the specific plan will have to be available in the County where you reside.

 

On And Off-Exchange Plans Available

All on and off-Exchange policies cover qualified preventive benefits at 100%. There are no copays or deductibles to meet. Another cost-saving feature is the network-negotiated price reductions you receive when utilizing in-network facilities. Whether it's a small or large claim, savings can be as much as 80%. Although inpatient and outpatient hospital expenses are heavily discounted, smaller items also receive reductions, including x-rays, blood tests, and Urgent Care visits.

A total of 10 plans were previously offered. Several HMO plans were available both on and off the Marketplace. Additional PPO options were offered only off the Exchange. Coverage is transferable to other states if you move and are eligible for a "Special Enrollment" exclusion. Prices, however, will vary, depending on the area of service.

 

 

Compare Ohio Humana health insurance quotes for comprehensive medical coverage. Office visits, prescriptions, Urgent Care, and maternity.

 

Previously-Available Plans For Individuals And Families Under Age 65

HMO

Humana HMO plans are offered as Exchange contracts and are therefore available for federal subsidies. A local network of physicians, specialists and hospitals is available and should be used to secure the lowest costs. Drugs are administered through the "Select RX" network, which includes Walmart, CVS, Sams Club and RightSourceRX.com. During Open Enrollment in Ohio, many low-cost options are offered. The subsidy is offered in the form of an instant tax-credit and automatically reduces your premium. Comprehensive Gold-tier plans will provide lower out-of-pocket costs.

A Primary Care Physician (PCP) helps coordinate your treatment and recommends specific specialists that can provide the best medical care. Staying "in-network" reduces your healthcare expenses, since other than emergencies, out-of-network expenses are typically paid by the subscriber.

The three available networks for Ohio are:

Dayton HMOx - Anchored by Premier Health Partners. Covers Butler and Warren counties.

Dayton HMOx - Anchored by Premier Health Partners. Covers Greene, Montgomery, Preble and Miami counties.

Cincinnati/ Northern KY HMOx -Includes TriHealth and St. Elizabeth Healthcare (Children's, Good Samaritan, and  Bethesda North Hospitals).

The prescription and provider lookup link, will easily find doctors, hospitals, and other facilities in your area.

 

Available HMO Plans

Catastrophic

Basic 7150 is the "catastrophic" tier contract. Thus, you must be under age 30 to apply for coverage unless you qualify for a "financial hardship" exemption. The deducible is $7,150 with no coinsurance. Therefore, once the deductible has been met, all covered expenses are paid without any additional out-of-pocket costs. Three office visits are allowed each year (primary care physician) with only a $15 copay applicable. And yes, the person pictured below will only pay $15 when she visits her physician! NOTE: Behavioral, mental, and substance abuse outpatient service visits also receive the $15 copay.

Non-emergency ER visits are not covered. Examples would be seeking treatment for a common cold or flu, when a pcp or urgent-care visit would be more suitable. All covered drugs are paid at 100% after the deductible has been met. Children 19 and younger can receive one vision exam and a pair of glasses each year, after the deductible has been met.

 

 Affordable PPO health insurance in Ohio is offered by Humana. Suprisingly, rates are very low and you may get a federal subsidy to help pay the premium.

Bronze

Bronze 6550  is the cheapest non-catastrophic plan offered and is thus available to all ages. The deductible is $6,550 with 0% coinsurance. Thus, once the deductible is met, all covered claims are paid at 100% with no out-of-pocket expenses.  Negotiated discounts will help reduce out-of-pocket expenses for many common procedures.

Silver

Silver 4150 features a $4,150 deductible with office visit copays of $20 and $40. The maximum out-of-pocket expenses are $7,150 with 20% coinsurance. Since Silver-tier plans are eligible for "cost-sharing," if you qualify for a subsidy, this option must be strongly considered. Generic and brand drugs are subject to $18 and $50 copays. Non-preferred brand and specialty drugs are subject to 50% coinsurance. ER visits must meet a $600 copay along with the deductible. Out-of-network treatment does not count towards your deductible.

Gold

Gold 1400 - $1,400 deductible with $20 and $40 office visit copays. Maximum out-of-pocket expenses are $6,000 with 20% coinsurance. Tier 1, 2, and 3 drugs receive $5, $10, and $20 copays respectively. Tier 4 and 5 drugs are subject to 35% coinsurance.

Platinum

There are no Platinum-tier plans offered by Humana in Ohio.

 

PPO

PPO plans utilize the ChoiceCare network, which is the largest collection of providers that Humana offers. With more than 600,000 doctors and practitioners, almost 4,000 hospitals and 60,000 pharmacies, you won't have trouble finding treatment anywhere in the state. Out-of-network benefits are provided, but you will incur a much higher cost.

However, PPO contracts are only available "Off The Marketplace," so federal subsidies can not be used with these plans.

 

Humana Senior Health Insurance Plans In Ohio

Annual enrollment (AEP) occurs between October 15th and December 7th each year. Your effective date of changes or new policies you purchase is January 1st. You can change from one Medicare Advantage or dug prescription plan to another, and also return to conventional Medicare coverage and purchase a Supplement (Medigap) policy. NOTE: From January 1 to February 15th, you can return to original benefits provided by the Federal Government (MA Disenrollment Period).

Typically, about 15 or 16 plans are available in areas of the Buckeye State. Medicare Supplement (Medigap), Medicare Advantage, and Drug Prescription policies are offered to eligible applicants. Generally, you must be age 65 or over, unless you have a qualified exception.

 

Medicare Supplement  - Available plans include Plan A, Plan B, Plan C, Plan F, Plan F (High Deductible), Plan K, Plan L, and Plan N. Plans K and L pay the Part A deductible, but because of higher-out-of-pocket costs, premiums are often the lowest of all available options. However, there is a maximum cap on your total expenses for the year. Plan N also features lower rates. Plan F features a $2,200 deductible and significantly lower premiums. Current monthly rates are shown below for 65 year-old males. Female rates are lower.

Montgomery (Dayton area), Greene, Champaign, Darke, Miami, Pickaway, Preble, Clark, Shelby, Ross, Pike, and Warren Counties

$55 - Plan F (HD)

$80 - Plan K

$111 - Plan N

$113 - Plan L

$140 - Plan A

$147 - Plan B

$170 - Plan C

$174 - Plan F

 

Cuyahoga and Lake Counties (Cleveland Area) and Portage County

$60- Plan F (HD)

$88 - Plan K

$118 - Plan N

$124 - Plan L

$154- Plan A

$161 - Plan B

$187 - Plan C

 

Franklin, Licking, and Delaware Counties (Columbus Area)

$55 - Plan F (HD)

$80 - Plan K

$106 - Plan N

$113 - Plan L

$140 - Plan A

$147 - Plan B

$170 - Plan C

$174 - Plan F

 

Mercer, Logan, Fairfield, Wayne, and Marion Counties

$52 - Plan F (HD)

$76 - Plan K

$101 - Plan N

$107 - Plan L

$133 - Plan A

$139 - Plan B

$161 - Plan C

$165 - Plan F

 

Hamilton and Clermont Counties (Cincinnati Area), and Madison County

$55 - Plan F (HD)

$80 - Plan K

$106 - Plan N

$113 - Plan L

$140 - Plan A

$147 - Plan B

$170 - Plan C

$174 - Plan F

 

Summit County (Akron Area)

$55 - Plan F (HD)

$80 - Plan K

$106 - Plan N

$113 - Plan L

$140 - Plan A

$147 - Plan B

$170 - Plan C

$174 - Plan F

 

Medicare Advantage - Available plans include Gold Plus HMO, HumanaChoice PPO (with or without prescriptions), and Gold Choice PFFS. The Gold Choice option allows you to use any provider that accepts the terms and conditions of reimbursement. Advantage plans are very popular Senior options because of their low cost (sometimes the premium is $0) and extra benefits, such as dental, vision, and hearing.

Several of the most popular and highest-rated (US News & World Report) Medicare Advantage plans in the state are the Humana Gold Plus plans that also include drug prescription benefits. $0 premium contracts are available in many counties, including Butler, Carrol, Clark, Clermont, Delaware, Fairfield, Franklin, Hamilton, Licking, Mahoning, Portage, Stark, Summit, Trumbull, Warren, and Wayne.

The deductible ranges from $100 to $360 (depending where you live), and the maximum out-of-pocket expenses range from $3,900 to $6,700. in-hospital expenses range from $295-$350 for 1-6 days. Generally, the office visit copays are $10 and $45. RX benefits will vary, but typically, Tier 1 and Tier 2 drugs (Preferred Generic and Generic) are 100% covered when 90-day mail-order cost sharing is used.

The Choice PPO and Gold Plus HMO plans include the following additional benefits:

Routine hearing coverage

Over-the-counter drugs and related supplies

Fitness program with helpful supervision

Dental services

Hearing Services

 

HumanaChoice PPO (R5495-001) - $0 monthly premium with $1,000 deductible and maximum out-of-pocket expenses of $6,700. Office visit copays are $20 and $45 with inpatient hospital copay of $295 for the first six days. The ER and Urgent Care copays are $80 and $35 respectively. Estimated copays of additional services are $0-$105 for lab services, $20-$95 for outpatient x-rays, $45 for radiation therapy, $0-$105 for diagnostic tests and procedures, $265-$295 for diagnostic radiology, and $45-$70 for diagnostic mammography.

The skilled nursing facility copay is $0 for the first 20 days, and $167.50 for days 21-100. Occupational, speech, and physical therapy copays are $20-$40. The pulmonary and cardiac rehabilitation copay is $20. The inpatient mental health services copay is $295 for the first five days, and $0 for days 6-90. Outpatient group and individual (mental health) copays are $40-$105. Ground ambulance services are covered with a $265 copay. Part D prescription drugs are not covered.

 

HumanaChoice PPO (H5216-109) - $25 monthly premium with $0 deductible and maximum out-of-pocket expenses of $6,700. Office visit copays are $15 and $45 with inpatient hospital copay of $415 for the first four days. The ER and Urgent Care copays are $80 and $35 respectively. Estimated copays of additional services are $0-$105 for lab services, $15-$95 for outpatient x-rays, $45 for radiation therapy, $0-$105 for diagnostic tests and procedures, $385-$415 for diagnostic radiology, and $45-$70 for diagnostic mammography.

The skilled nursing facility copay is $0 for the first 20 days, and $167.50 for days 21-100. Occupational, speech, and physical therapy copays are $15-$40. The pulmonary and cardiac rehabilitation copay is $15. The inpatient mental health services copay is $415 for the first three days, and $0 for days 4-90. Outpatient group and individual (mental health) copays are $40-$85. Ground ambulance services are covered with a $265 copay.

The 30-day preferred retail pharmacy copays are $2 (Tier 1), $8 (Tier 2), $47 (Tier 3), $100 (Tier 4), and 29% (Tier 5). The 90-day preferred mail-order copays are $0 (Tier 1), $0 (Tier 2), $131 (Tier 3), and $290 (Tier 4). A $195 pharmacy Part D deductible applies to Tiers 3, 4, and 5. 

 

HumanaChoice PPO (H5225-030) - $163 monthly premium with $250 deductible and maximum out-of-pocket expenses of $3,400. Office visit copays are $5 and $30 with inpatient hospital copay of $250 for the first seven days. The ER and Urgent Care copays are $80 and $25 respectively. Estimated copays of additional services are $0-$35 for lab services, $5-$90 for outpatient x-rays, $30 for radiation therapy, $0-$90 for diagnostic tests and procedures, $220-$250 for diagnostic radiology, and $30-$70 for diagnostic mammography.

The skilled nursing facility copay is $20 for the first 20 days, and $167.50 for days 21-100. Occupational, speech, and physical therapy copays are $30-$90. The pulmonary and cardiac rehabilitation copay is $10. The inpatient mental health services copay is $250 for the first six days, and $0 for days 7-90. Outpatient group and individual (mental health) copays are $30-$90. Ground ambulance services are covered with a $265 copay.

The 30-day preferred retail pharmacy copays are $2 (Tier 1), $8 (Tier 2), $47 (Tier 3), $100 (Tier 4), and 29% (Tier 5). The 90-day preferred mail-order copays are $0 (Tier 1), $0 (Tier 2), $131 (Tier 3), and $290 (Tier 4). A $195 pharmacy Part D deductible applies to Tiers 3, 4, and 5. 

 

Humana Gold Plus HMO (H6622-012) - $0 deductible and maximum out-of-pocket expenses of $6,700. Office visit copays are $7-$10 and $45 with inpatient hospital copay of $395 for the four days. The ER and Urgent Care copays are $80 and $35 respectively. Estimated copays of additional services are $0-$35 for lab services, $10-$95 for outpatient x-rays, $50 for radiation therapy, $0-$110 for diagnostic tests and procedures, $365-$395 for diagnostic radiology, and $50-$70 for diagnostic mammography.

The skilled nursing facility copay is $0 for the first 20 days, and $167.50 for days 21-100. Occupational, speech, and physical therapy copays are $10-$40. The pulmonary and cardiac rehabilitation copay is $10. The inpatient mental health services copay is $395 for the first three days, and $0 for days 4-90. Outpatient group and individual (mental health) copays are $40-$110. Ground ambulance services are covered with a $265 copay.

The 30-day preferred retail pharmacy copays are $1 (Tier 1), $4 (Tier 2), $47 (Tier 3), $97 (Tier 4), and 31% (Tier 5). The 90-day preferred mail-order copays are $3 (Tier 1), $12 (Tier 2), $141 (Tier 3), and $291 (Tier 4). A $100 pharmacy Part D deductible applies to Tiers 3, 4, and 5.

 

Prescription Drug Plans

WalMart RX Plan - For WalMart and Sam's Club - $1 copay for preferred generic drugs and $4 copay for generic drugs. Tier 3, Tier 4, and Tier 5 drugs have 20%, 35%, and 25% coinsurance respectively.  For other network pharmacies - $10 copay for preferred generic drugs and $15-$20 copay for generic drugs. Tier 3, Tier 4, and Tier 5 drugs have 25%, 44%-50%, and 25% coinsurance respectively.

Preferred Rx Plan - For WalMart and Sam's Club - $0 copay for preferred generic drugs and $1 copay for generic drugs. Tier 3, Tier 4, and Tier 5 drugs have 20%, 35%, and 25% coinsurance respectively.  For other network pharmacies - $0 copay for preferred generic drugs and $1 copay for generic drugs. Tier 3, Tier 4, and Tier 5 drugs have 20%, 35%, and 20% coinsurance respectively.

Enhanced Rx Plan - For WalMart and Sam's Club - $3 copay for preferred generic drugs and $7 copay for generic drugs. Tier 3, Tier 4, and Tier 5 drugs have $42 copay, 44%, and 33% coinsurance respectively.  For other network pharmacies - $3 copay for preferred generic drugs and $7 copay for generic drugs. Tier 3, Tier 4, and Tier 5 drugs have $42 copay, 44%, and 33% coinsurance respectively.

 

Areas Of Ohio That Feature Lowest Rates

 

Humana offers affordable medical coverage in Cincinnati and all of Hamilton County. Get a free quote now.

Each individual and family scenario is different, especially considering that subsidy amounts will greatly differ. But typically, the areas in the state that feature the lowest rates for PPO policies are listed below. NOTE: One reason that Cincinnati is high on the list is the presence of the College of Medicine and Academic Health Center (pictured above) and its contribution to the community. The combination of education, research and patient care contributes to keeping treatment prices down.

Cincinnati

Middletown

Dayton

East Canton

Mansfield

Steubenville

Athens

North Columbus

Chillicothe

 

Six Available Dental Plans (Monthly Premiums Shown Per Individual)

$15 Value -  HMO plan with no deductible or policy maximum. $10-$15 office visit copay. Small discount for orthodontia if you utilize specific providers.

$21 Preventive Plus -  $50 and $150 deductibles per person/family. $1,000 annual maximum coverage per year. However, benefits offered in and out of network. 100% coverage for preventive services.

$22 Smart Choice -  $100 deductible and $1,000 maximum per year benefits. 100% preventive coverage with outside network coverage.

$31 Smart Choice Pediatric -  $35 annual deductible with no maximum benefit.

$34 Loyalty Plus -  $150 per person deductible (maximum $450 per family). Annual maximum increases from $1,000 to $1,500 after two years. Both basic and major service coverage also increase after the first two years.

$37 Traditional Plus -  $50 deductible and $1,000 annual benefit maximum. Preventive services covered at 100% (in-network), non-network coverage is included.

 

Humana Vision Plan In Ohio

Coverage is available "off-Marketplace" in most parts of the state. Dilation-needed exams are covered with only a $10 copay. Single vision, bifocal and trifocal lenses are covered with only a $25 copay. Contact lenses are allocated $115 per year (both conventional and disposable).

An examination, and purchase of lenses or contact lenses (and a frame) are covered once per year. Possible discounts may lower the price for scratch-resistant and anti-reflective coatings. Lasik procedures done at LasikPlus, TLC and QualSight Lasik will receive discounted prices.

The HumanaOne Vision Care plan is also accepted at many major participating providers including LensCrafters, Sears, JCPenney, Target and Pearle Vision. Also, more than 30,000 ophthalmologists and optometrists accept Humana vision insurance. 

 

Group Benefits Through Employer

Large and small group coverage is offered to Ohio groups. Unlike private healthcare plans, options are available in most areas of the state, with a wide variety of deductible and out-of-pocket expense options. Flexible billing arrangements can be made and broad nationwide networks allow customers to choose among many facilities. Listed below are the most popular employer-sponsored benefits:

Health - Humana Simplicity shows costs upfront and makes budgeting much easier. "Total Health" provides options for companies with 100 or more employees. Level funded premiums (10 or more employees) is designed for catastrophic coverage. Coinsurance, copay, and high-deductible (HDHP) options are also offered.

Dental -  100% preventative benefits are included with optional orthodontic coverage. Advantage Plus, Prepaid/DHMO, Dental PPO, Preventative Plus, and Traditional Preferred plans are offered.

Vision - Rates are typically inexpensive, and not as costly as dental coverage. Vision Exam Plus (annual eye exam included) and Materials Only (lenses, frames, and contact lenses) plans are available.

Disability - Conventional and alternative treatment is available. 

Life - Group term life insurance provides small and large face amounts of tax-free benefits to beneficiaries of employees. Term contracts are the least expensive policy and are ideal if you need large amounts of coverage for the least cost. Basic coverage is provided as a multiple of your annual compensation, with up to $10,000 of additional benefits available for your spouse. Supplemental coverage is offered in addition to the Basic amount, and is generally paid by the employee.

Group Medicare - Retired employees may be able to consider a Medicare Advantage plan, which often provides more comprehensive benefits than original Medicare. The insurer administers the plan instead of the federal government. Prescription plans are also offered with mail-delivery pharmacy available (see below).

Pharmacy - Plans can be set up to provide separate coverage or work with existing in-force prescription drug benefits. Both small and large companies are eligible, and specialty medications can also be ordered. Printable drug lists are regularly updated. Thousands of pharmacies are available, including several mail-order options. Printable drug lists are provided to help consumers understand choices, and coordinate prescriptions with the primary-care physician.

Wellness - Healthy employees are more productive, and several programs are offered to improve workplace culture and satisfy needs of workers. Personal health coaching (smoking cessation and weight loss) and employee assistance programs (EAP) can provide a positive rate-of-return for both employee and worker. "Go365" is designed to reduce medical claims and has been very effective. Additional programs include holistic well-being, Goal-Guru, Kurbo, Weight Watchers, flu vaccinations, and Biometrics screenings.

Additional online services are provided to all customers. These free services include access to claim information, online bill-paying, prescription search, and help with enrollment.

 

Get Quotes Now

You're just moments away from comparing Humana individual health insurance plans with all of the other major companies. Get your free online quote now, and within minutes you can enroll for 2018 benefits at a surprisingly affordable price.