Find affordable health insurance for children in Ohio with the help of CHIP, The Affordable Care Act legislation, or Medicaid.Many low-cost plans are available that provide complete preventative benefits with no deductible, copay, or out-of-pocket expenses. We research and compare all major companies to find the best low-cost options that provide the most comprehensive coverage.
There are many reasons why you may need to purchase or enroll for benefits for a baby, teenager or young adult. Often, an employer-sponsored medical plan will cover the employee at little or no cost. But sometimes, dependent coverage is quite expensive, and a "child only" plan will provide richer benefits at a fraction of the cost of group policies.
Also, with many group employer-sponsored plans, the child of the employee may no longer be covered if he/she is not a full-time student. There also may be other reasons, such as the status (full-time or part-time) of the employee. Many companies, in an effort to reduce healthcare costs, have slashed the number of working hours of their employees.
How Obamacare Affects Children's Health Insurance In Ohio
The Affordable Care Act (ACA) legislation was designed to provide quality healthcare benefits to children and adults, without having to medically qualify or pass a physical. For lower-income families that don't qualify for Medicaid, substantial financial relief helps pay most of the premium on all plans (Platinum, Gold, Silver, and Bronze-tiers). Catastrophic plans should not be considered since subsidies are not offered.
In most of the state, a policy will cost between $40 and $100 per month. With some plans, there is a slight discount when more than one child is insured. Coverage can vary with each plan, so it is important to understand the features that are important to you, so we can select the perfect fit.
No-Prior Coverage Penalty Eliminated
The rate for uninsured children is no longer higher than those that have prior coverage. Previously, if the applicant was not listed on another policy, a surcharge or reduction in benefits could apply. Also, a waiting period for specific benefits was sometimes imposed. However, during Open Enrollment periods, prior coverage is now no longer a requirement for obtaining a policy. If you miss the OE deadline (which can change each year), you need a special SEP exception to change companies.
Medical Mutual, Anthem BC, Premier (in selected counties), Aetna, Humana, and UnitedHealthcare are very good carriers to consider. Office visit copays are available for primary care physician (pcp) visits, and specialists, although specific amounts will vary. For instance, specialist copays will be much lower on Silver-tier and Gold-tier plans than Bronze-tier options.
Required Coverage For Infants And Children
"Essential Health Benefits" must be included in all policies. This requirement was one of the principal mandates from the original Affordable Care Act legislation. It provides features such as newborn care, mental health, many pediatric services, some dental and vision coverage and prescriptions. Many of these items, including preventive services, often have no copay or deductible to meet.
It is customary for a copay to apply for office visits and drugs, without having to meet a deductible. Preventive and well child benefits are always included with no deductible. Immunization and vaccine coverage is generally provided on most policies. If a physical is required for playing sports, typically, you will not have to pay for services, since it is covered at 100%.
Although most child prescriptions are generic, and cost less than $10, non-generic prescription coverage will be included on the policy. Comprehensive policies no longer place a cap on the amount of prescription dollars paid by the plan. Thus, if your child has a chronic illness that requires many brand-name prescriptions, they will be covered.
However, the distinction between "formulary" and "non-formulary" prescriptions must be understood, so you are using the drugs that work best, but are also covered under your policy. Each carrier offers a specific comprehensive guide that explains how they classify drugs. Typically there are four "tiers."
This is important in case a major health condition develops and the only treatment is an ultra-expensive non-formulary medication. However, a temporary policy will place specific restrictions on RX benefits since pre-existing conditions are not covered.
We research all of your options, and present you with the most affordable comprehensive Ohio child health insurance plan at the guaranteed lowest allowable rate. For a quick quote and comparison, you can easily compare different plans on our website. Whether you have a young adult in college or an infant, we can help.
Healthy Start is Ohio's federally-mandated SCHIP program. Healthy Start is part of Medicaid and is available to children under 19 whose families meet Federal poverty level guidelines.
Healthchek is Ohio's early and periodic screening, diagnosis and treatment (EPSDT) program. It provides many services to children and teens.
Child & Family Health Services is the community effort to improve birth outcomes, eliminate health disparities, and improve the health status of infants, children and women in Ohio.