Ohio Health Insurance: 2023 Coverage Guide

Ohio Affordable Healthcare Insurance

There are several health insurance providers in Ohio, so residents have a few options when buying health coverage. It’s important to compare different health plans to make sure you’re getting the best value for your health care. If you’re an individual or you’re buying coverage for a family, you can get the coverage you need at the best prices by comparing your options with SmartFinancial. However, you may only enroll in a health plan during open enrollment,  unless you are eligible for the Special Enrollment Period due to a qualifying event.

When Is Open Enrollment in Ohio?

November 1, 2022 – January 15, 2023

How to Get Health Insurance in Ohio

Understanding the different levels of protection you can buy is important. It’s also important to choose a tier based on how often you see a doctor. It’s always a good idea to look at the previous year when making a projection.

Another important thing to do is to compare health insurance companies and health insurance quotes. After you submit the form you’ll get several competing health insurance rates to choose from, and we’ll connect you with an agent in your area so you can buy the coverage or ask questions about the plan you’re considering.

What Types of Health Insurance Are Available in Ohio?

HMOs, EPOs, PPOs and POS plans are the most common health plans available in Ohio. These plans are available in bronze, silver, gold and platinum. Keep in mind that a bronze plan covers about 60% of costs, silver covers about 70%, gold 80% and platinum 90%. So you may pay more per month for a platinum plan but you’ll pay little to nothing when you visit a care provider.

Does Health Insurance Cover Pre-existing Conditions?

The Affordable Care Act made it illegal for marketplace health plans to deny anyone health insurance coverage based on pre-existing conditions.

Compare Health Insurance Plans in Ohio

Do I Qualify for a Special Enrollment Period?

Common reasons people qualify for a special enrollment period:

• If you lost a job, changed jobs or started your own business, you may be able to buy health insurance outside the open enrollment period.
• If you were on your parents’ health insurance plan and turned 26 outside the open enrollment period, you can enroll in an individual health plan.
• If you had a health plan that was only valid in one area but you moved to another, you can sign up for a new health plan.
• If you elected a Cobra extension of your previous employer’s group health benefits and reached the deadline, you can enroll in a new health plan.
• If you shared coverage with your spouse but just divorced, you can enroll in a new health insurance plan.
• If you just got married, the two of you can either buy two new individual health plans or one together.
• Birth or adoption of a child means that you can buy health insurance for your new child.
• If you had health care coverage under your spouse or partner’s plan but that person passed away, you can enroll in an individual health plan outside the open enrollment period.
• If you had health insurance through a partner or spouse but they lost coverage for any qualifying reason, you are eligible to buy an individual plan or buy coverage with that spouse/partner again.

Is Health Insurance Required in Ohio?

No, only California, Massachusetts, New Jersey, Vermont, Rhode Island, and DC still require health insurance. Otherwise, there is a tax penalty. Even though it’s not required in every state, buying health insurance is necessary to avoid medical bankruptcy.

How Much Is Health Insurance in Ohio?

The average cost of health insurance in Ohio for a 40 year old is about $456 a month. Health insurance is less expensive, the younger you are. Tobacco use increases health insurance rates.

How to Save on Health Insurance in Ohio

The best way to save on health insurance in Ohio is to compare rates based on the tier system. Beforehand, you’ll want to estimate your medical costs.

Medicare in Ohio

Medicare is health insurance coverage for Americans ages 65 years and older. The government also allows younger people with disabilities to enroll in the program. Individuals with End-Stage Renal Disease (a permanent kidney failure treated with dialysis or a transplant) can also sign up as can some individuals with severe mental health issues. Others who qualify for Medicare disability coverage are individuals with Amyotrophic Lateral Sclerosis (also called Lou Gehrig’s Disease). Most beneficiaries will receive Original Medicare (Parts A and B). Some people buy Medicare Advantage, which includes Part A and B as well as offering vision, dental and prescription drug coverage.

How Many People Are on Medicare in Ohio?

20% of Ohio residents are on Medicare.

How Much Is Medicare in Ohio?

If you do not qualify for Medicare, you can buy it for $499 a month for Part A in 2022 and a standard monthly premium for Medicare Part B was $170.10, or even higher depending on income. 

Original Medicare vs Medicare Advantage: What’s the Difference?

Medicare is a government subsidized health plan that is available to qualified Americans age 65 and older. Medicare Advantage is sold through private health insurance companies, but these policies are also regulated by the government. Medicare Advantage plans offer the same benefits as Medicare Parts A and B. Medicare Advantage plans also offer more coverage for dental, vision, hearing and prescription drugs. Medicare Advantage plans have a maximum out-of-pocket limit. For 2022, it was $7,550 but many plans set their maximums at a much lower cost. That is why it’s important to compare companies. People who opt for original Medicare can buy Medicare Supplements to help with out-of-pocket costs. You cannot buy both Medicare Advantage and Medicare Supplements. If you enroll in a Medicare Advantage Plan during open enrollment, you will automatically be disenrolled from original Medicare.

How to Get Medicare Coverage in Ohio

If you receive social security payments, you may automatically enroll in Medicare, but you may have to sign up if you do not receive payments. The easiest way to enroll in Medicare is by working with a trusted insurance agent to get the coverages you want. Just enter your zip code and answer a few simple questions.

Types of Medicare Plans Available

Original Medicare, Medicare Advantage, Medicare Cost Plans (only offered in certain areas), Demonstration/Pilot Programs (also called Research Studies; only offered in certain areas) and Programs of All-Inclusive Care for the Elderly (PACE).

How Do I Qualify for Medicare?

To qualify for Medicare you must be a citizen of the U.S. or have been a legal resident for at least five years. If you are age 65 or older and you/your spouse have worked for at least 10 years (40 quarters) or you have a disability, Amyotrophic Lateral Sclerosis (ALS) or end-stage renal disease (ESRD), you most likely qualify for Medicare.

How Can I Save on Medicare in Ohio?

You can save on Medicare by signing up for Part B as soon as you’re eligible. People who enroll late must pay a penalty every year. If you’re interested in buying Medicare Advantage, you can shop and compare Medicare plans for the best value.

Ohio State Health System Ranking

Ever wonder how your state stacks up when it comes to quality healthcare? The Commonwealth Fund published a report in 2020 on State Health System Performance. They took into consideration the access to quality care, health outcomes, and disparities in all 50 states. The scores for the Ohio Health System are listed below:

• Ohio: Overall Ranking: 28 of 51
• Ohio: Overall Performance: Below U.S. Average
• Ohio: Access and Affordability: 18
• Ohio: Prevention and Treatment: 16
• Ohio: Avoidable Hospital Use and Cost: 44
• Ohio: Healthy Lives: 41
• Ohio: Health Care Disparities: 3

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Ohio Health Insurance Coverage

The people of Ohio have different kinds of health insurance while some Ohio residents are not insured at all. See the breakdown below:

• Private coverage: 52%
• Medicaid: 21%
• Medicare: 20%
• Uninsured: 7%

Report: America's Health Insurance Plans

Ohio Health Insurance Companies

• Ambetter from Buckeye Health
• Anthem Blue Cross and Blue Shield
• Aultcare Insurance Company
• Buckeye Community Health Plan
• CareSource
• Medical Health Insuring Corp of Ohio
• Molina Healthcare of Ohio, Inc.
• Oscar Buckeye State Insurance Corp
• Oscar Insurance Corporation of Ohio
• Paramount Insurance Company
• Summa Insurance Company, Inc.
• Medical Mutual
• Molina Health Care
• SummaCare Inc of Ohio
• UnitedHealthcare