Shopping for health insurance in the state of Ohio might seem like a daunting task. Thankfully, there are many options open to Ohioans who are uninsured or underinsured. Whether you're healthy or not, this page will provide you with valuable information for obtaining health coverage. Read on to learn about COBRA, short-term insurance, and the difference between group and individual coverage. If you're healthy enough to obtain coverage on the individual market, need a short-term plan, or if you have a small business and qualify for small group, Health Plan One can help. If not, review the information on this page about Ohio Medicaid, Healthy Start, and Healthy Families. All of these government programs can help those who are medically uninsurable or who cannot afford private coverage obtain health coverage.
What Every Ohio Resident Should Know About Health Insurance
The type of health insurance familiar to most consumers is group coverage offered by an employer. With group health insurance through your employer, the policy is partially paid for by the company on behalf of their employees. The company will contribute a large percentage toward the monthly premium and you (the employee) will be responsible for paying the difference, about 16-27%. With group plans you have little choice in the specific benefits of the plan (these are determined by negotiations between the company and the insurance carrier) but you also cannot be denied coverage under the group plan no matter what prescriptions you may take or preexisting conditions you may have. By insuring a large group of employees together under one plan of the company's choosing, individual employees are not subject to medical underwriting, rather the entire group is underwritten as a whole to determine the premium level everyone will pay. Therefore, the amount you pay in premiums as well as the quality of the coverage you receive are dependent not on how healthy you are or what benefits you would like to have, but how healthy your group is as a whole and what benefits the company has chosen for you.
Unfortunately, companies frequently have a waiting period before new employees can qualify to receive health insurance benefits. If this is the case with your new job, consider getting a short-term policy from the point where your previous coverage ends to the time when your new company's insurance kicks in. Such options are available through Health Plan One. Simply visit our Short-Term information page for your free quotes. It is important not to have a lapse in coverage of more than 63 days. If you do, your new insurance carrier may refuse to cover treatment for pre-existing conditions you may have such as asthma or acne for up to a year after your policy goes into effect. For this reason, having continuous health insurance coverage is particularly important.
What If I'm Between Jobs?
As previously mentioned, it is important not to have a break in coverage of more than 63 days. As a result, if you've recently lost your job, look into extending the coverage you had with your employer through COBRA. With the COBRA program through the federal government, you can extend your plan for up to 18 months after losing your job. You will however have to pick up the entire premium cost which your employer had previously been paying. For this reason, it is frequently more economical for people who've lost their jobs to invest in an individual/family insurance policy through Health Plan One.
With individual coverage, you choose the health insurance carrier and benefits you want with the help of Health Plan One. We will quote plans for you and your family from all the different carriers available in Ohio so that you can choose from a wide price range and spectrum of options to tailor a plan that fits your needs. Even if you are not between jobs, a plan on the individual market through Health Plan One could still be the best option for your family. Many companies do not offer benefits to their employees, and often those companies that do offer benefits do so at an exorbitant cost for low quality plans. It is important to note that with individual coverage in Ohio each person who applies is medically underwritten and may be approved, denied, or rated-up by the carrier depending on their health history in recent months.
If you're healthy and are unhappy with the health insurance offered by your employer, are between jobs, or are not offered benefits by your company, enter your zip code into the Health Plan One quoting engine at the top of this page to view the most competitively priced plans in your area with benefits tailored to your needs. Quotes are absolutely free, and you're under no obligation to buy. Our licensed insurance specialists are also available via LiveChat (see the button to the right) or toll-free at (877) 567-5267 to answer any questions.
If you're not healthy, there are still many programs available to you. See below for details on the options which best fit your medical and financial situation.
Small Group Plans
If you are self-employed you could qualify for a small group plan in Ohio. If you own a small business and have at least 2 eligible employees, you can apply for a small group plan at any point during the year. Eligible employees work at least 25 hours per week. Small groups which meet these requirements may apply, but know that groups are subject to medical underwriting. This means that though no one in the group can be denied coverage, the carrier can increase the rates based on the health history of employees enrolling.
Health Plan One can help you by quoting plans for small groups. Simply call our toll-free number at (877) 567-5267.
Ohio Medicaid and Medicare
Ohio Medicaid is a state-federal government cooperative program meant to provide basic health coverage to residents in need. The program provides coverage to the following groups:
- Children under age 19
- Pregnant women
- Families with children under age 19
- People with disabilities
- Adults 65 and over
- Certain women screened for breast and/or cervical cancer
To qualify from one of these groups for Medicaid, an individual must be a US citizen, be a resident of Ohio, have a social security number, and meet certain financial requirements. These income ceiling levels are available here:http://medicaid.ohio.gov/forohioans/FinancialRequirements.aspx Details on the citizenship requirements are available here:http://medicaid.ohio.gov/forohioans/GetCoverage/WhoQualifies.aspx Covered services include family planning services and supplies, inpatient hospital care, home health services, lab & X-ray, physician services, and much more. For a full outline of covered services, click here: http://jfs.ohio.gov/OHP/consumers/benefits.stm
Medicaid also sponsors other types of assistance, including Medicare premiums, Disability Medical, Refugee Medical, and Alien Emergency Medical.
Click here to view information about Ohio Medicare Advantage plans.
Healthy Start & Healthy Families
Healthy Start is Ohio's version of the federally-mandated SCHIP program. Healthy Start is a Medicaid program available to children under 19 and in families with income up to 200% of the federal poverty level, and pregnant women in families whose income is up to 200% of the federal poverty level.
Healthy Families is a related Medicaid program available to families including a child under 19 with incomes up to 90% of the federal poverty level.
Further details on the basic requirements of these programs are available here:http://jfs.ohio.gov/OHP/consumers/familychild.stm
Individuals who are eligible for Medicaid and these programs will also have access to the Healthchek services, Ohio's Early and Periodic Screening, Diagnosis and Treatment Program. In order to discover health problems at an early age and prevent them from turning into major health crises, Healthchek covers 8 check-ups in a child's first 2 years, and annual check-ups each year thereafter that they are still eligible for Medicaid. If a potential problem is found, further diagnosis and treatment are covered. For more information on Healthcheck, click here:http://jfs.ohio.gov/OHP/consumers/Healthchek.stm
For more information on the Primary Care and Rural Health Programs, click here:http://www.odh.ohio.gov/odhPrograms/chss/PCRH_Programs/pcrh1.aspx
For more information on programs to assist HIV positive individuals in Ohio, click here:http://www.odh.ohio.gov/odhPrograms/chss/aids/aids1.aspx
For information on the Child & Family Health Services Program, click here:http://www.odh.ohio.gov/odhPrograms/cfhs/cf_hlth/cfhs1.aspx
HIPAA Plans - Ohio's High Risk Pool Alternative
For information on HIPAA plans available in Ohio to those residents who are for medical reasons uninsurable on the private market, check out our HIPAA Insurance page.