Best Health Insurance Plans in Ohio

Compare Health Insurance Plans in Ohio

Monday, September 9 2019 By Tess Owen

Residents of The Buckeye State know they have a diverse landscape, but what about diverse health care choices? Ohio is ranked as the 36th best state when it comes to health care. The study takes health care access, quality, and good public health into consideration for the rankings.

Health Care Choices in Ohio

According to the Ohio Department of Insurance, residents can get health insurance through several different routes:

1. Employer-provided
   1. From your employer
   2. Through your spouse's employer
   3. Through COBRA
2. Individual or family plans
   1. Through HealthCare.gov
   2. Directly from a health insurance company
3. Government-assisted
   1. Medicare
   2. Medicaid

Where do most Ohioans get their health insurance coverage?

Ohio Health Insurance Sources

Sources	Percent
Employer-Provided	51%
Individual or family	5%
Medicaid	22%
Medicare	15%
Other Public Care	1%
Uninsured	6%
Source: Kaiser Family Foundation, Health Insurance Coverage of the Total Population

Only six percent of Ohio residents are uninsured, putting the state ahead of the national average. That's good news for policyholders, because the more uninsured people there are, the higher costs can be for insured people.

Ohio Medical Insurance Costs and Rate Factors

Ohio residents spend $8,712 on health care expenditures per year, more than the national average. So what factors determine how much you'll be paying in Ohio? Health care costs vary quite a bit based on the individual, but these are the main factors companies will consider when pricing your policy:

Body Mass Index

According to the CDC, obesity makes you more likely to suffer from numerous health conditions. That's why many insurers will ask for your BMI to price your policy. A higher BMI could mean a higher risk, causing policy prices to jump.

In 2017, Ohio had a 33.8 percent obesity rate, the 11th highest rate in the country. Out of the many Ohio residents who used QuoteWizard to compare health insurance plans, 36 percent have a BMI in the obese range.

Tobacco Use

There are substantial risks that come from smoking. Tobacco users also pay more for health insurance. According to America's Health Rankings, 21.1 percent of Ohio residents are smokers, the eighth highest rate in the country.

Age

Health insurance can increase as your age does. According to HealthCare.gov, older people pay up to three times more for health care than younger people. On average, OH residents who used QuoteWizard to shop for health insurance plans are 40 years old.

Plan Type

If you want more coverage, you're going to have to fork over more funds. Marketplace plans are divided into four different metal categories: bronze, silver, gold, and platinum.

So, how much should you expect to pay for health care in Ohio? Here are the average monthly prices in 2019 for a middle-aged Ohio resident:

2019 Ohio Martketplace Plan Rates

Bronze	Silver	Gold
$296	$370	$456
Source: Kaiser Family Foundation, Change in Average Marketplace Premiums by Metal Tier

Premiums for a gold plan cost about 54 percent more than a bronze plan. This price jump is because gold plans cover 80 percent of health care costs, whereas bronze plans only cover 60 percent.

The lowest level of coverage is the catastrophic plan, which people under 30 or with a hardship or affordability exception are eligible for. This type of plan comes with a $7,150 yearly deductible. With such a high deductible, it may be worth it to purchase a bronze or silver plan that saves you money when you need to use your insurance.

Location

Due to the different laws, regulations, and insurance providers surrounding the health care marketplace, your location is a big factor in how much you'll pay in premiums.

Health insurance rates are also usually community rated. Costs are dependent on claims that everyone in your area files. This means that if a neighbor files a high number of claims, your policy prices could spike. 

Living in a healthier state could keep your costs low. Ohio is ranked as the 39th healthiest state in America.

Ohio Health Insurance Companies

Ohio residents have plenty of options when it comes to finding the right health insurance provider. Here are some of the top insurers in the state:

• AultCare (Phone Number: 1-800-344-8858)
• Ambetter (Phone Number: 1-877-687-1189)
• CareSource (Phone Number: 1-844-539-1733)
• Medical Mutual (Phone Number: 1-866-488-3266)
• Molina Healthcare (Phone Number: 855-542-1973)
• Paramount (Phone Number: 419-887-2525)
• SummaCare (Phone Number: 888-251-7953)

These providers offer both family and individual plans. Check insurer sites to see how coverage varies based on where in the state you live.

Ohio Health Care Insurance Laws

The Affordable Care Act makes it so that insurance companies can't use certain factors when pricing your policy.

• Pre-existing conditions: People with pre-existing conditions used to pay more for health insurance. But according to the Department of Health & Human Services, insurance companies can no longer charge people with pre-existing conditions more.
• Gender: According to a study by Health Services Research, women historically pay more for health care. However, insurance companies cannot charge men and women different premiums for the same plan.
• Insurance and medical history: Thanks to the ACA, insurance companies can no longer analyze your medical history and past insurance coverage.

The health insurance marketplace has out-of-pocket limits. For 2018, the out-of-pocket limits are $7,350 for an individual plan and $14,700 for a family plan.

Ohio law requires that insurance companies provide at least some coverage for these services:

• Infertility treatment
• Coverage for emergency services
• Maternity benefits
• Hospitalization coverage for mental illness
• Mammography
• Cancer clinical trial
• Outpatient coverage for mental and emotional disorders

There are more services that insurers need to provide. Check out the full list here.

Medicare and Medicaid in Ohio

Medicare and Medicaid are government-funded health care programs offered to different groups. Medicare helps those over 65 and Medicaid offers coverage to low income families and children.

Medicare

Those over 65 are eligible for Medicare. There are a number of options within the program, including parts A, B, C, D, and supplemental coverage plans. You may also qualify for a Medicare Savings Program. In Ohio, there are four kinds of Medicare Savings Programs, including:

Qualified Medicare Beneficiary (QMB):

• Single person with a monthly income lower than $1,025.
• Couple with a monthly income lower than $1,374.

Specified Low Income Medicare Beneficiary (SLMB):

• Single person with a monthly income lower than $1,226.
• Couple with a monthly income lower than $1,644.

Qualified Individual (QI):

• Single person with a monthly income lower than $1,377.
• Couple with a monthly income lower than $1,847.

Qualified Disabled and Working Individuals (QDWI):

• Single person with a monthly income lower than $2,030.
• Couple with a monthly income lower than $2,727.

Medicaid

These are the state's Medicaid financial requirements:

Ohio Medicaid Financial Requirements

Household Size	Maximum Yearly Income
1	$16,612
2	$22,491
3	$28,369
4	$34,248
5	$40,127
6	$46,005
7	$51,884
8	$57,762

Ohio Department of Insurance

Website:

Homepage

Insurance Commissioner:

Jillian Froment

Insurance Hotline:

(800) 686– 1526

Office Hours:

Monday - Friday
8:00 am to 5:00 pm

File a Consumer Insurance Complaint

Complaint Page

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