Individual Health Insurance in Ohio: What You Need to Know
Maybe you need individual health insurance in Ohio for yourself or your family, or perhaps you’re unsure what individual health insurance (also known as Marketplace coverage) is and if you qualify for it. Either way, we’re here to answer your questions and provide guidance to help you navigate the essential details about individual health insurance.
What is Marketplace health insurance in Ohio?
Plans from the Health Insurance Marketplace, commonly referred to as Affordable Care Act (ACA) plans, provide private health coverage for individuals or families without employer-sponsored coverage. These plans are available in all 50 states and Washington, D.C.
A Marketplace plan may be the right option for you if you need coverage for more than one year (in some cases, these plans may also be a good fit for shorter periods of coverage). These plans provide preventive services at no cost and never ask about previous or current medical conditions. Read more for specific scenarios in which Marketplace coverage may make sense for you.
Do you have to have health insurance in Ohio?
No. The tax penalty fee for not being enrolled in a health insurance plan ended in 2018, however we highly recommend enrolling in health coverage to avoid potentially excessive health care costs.
How do you get Marketplace health insurance in Ohio?
What are the eligibility requirements for Marketplace health insurance in Ohio?
You must meet the following eligibility requirements to enroll in Marketplace health insurance in the 50 states or Washington, D.C.:
- Live in the United States
- Be a U.S. citizen or national (or be lawfully present)
- Not be incarcerated
How do you enroll in Marketplace health insurance in Ohio?
There are multiple ways to enroll in Marketplace coverage:
- Online
- By phone
- With a paper application
- Through an agent/broker, such as RetireMed
- Through certified enrollment partner websites
When can you enroll in Marketplace health insurance in Ohio?
Enrollment periods are the same for all 50 states and Washington, D.C.
Open Enrollment is Nov. 1-Jan. 15
Outside of the annual Open Enrollment, you can get coverage or switch plans in these special cases:
- You have a life change or income that qualifies for a Special Enrollment Period.
- You lose coverage under Medicaid or the Children's Health Insurance Program (CHIP). You can enroll any time of year and coverage can start immediately.
How much does health insurance in Ohio cost per month?
The monthly cost of Marketplace plans is individualized and based on the estimated income of all household members. These plans generally have deductibles, copays, and other out-of-pocket costs that apply to most covered benefits.
Nearly all households qualify for the premium tax credit, which is a subsidy based on household size and income. This tax credit could reduce your monthly insurance premium for a Marketplace plan. There is an income number called Modified Adjusted Gross Income (MAGI) that determines the amount of premium subsidy assistance you will receive from the government. Learn more about tax credits.
What is the best private health insurance?
All Marketplace plans cover 10 essential health benefits (including emergency services, prescription drugs, and hospitalization), preventive health services, and treatment for pre-existing conditions. Some states have laws requiring insurance companies to cover services or procedures in addition to these.
Because plans are standardized, coverage sold by various insurance companies will only have nuanced differences. However, costs and networks can vary greatly, so comparing your plan options is a very important step. Our health plan advisors can help you review the Marketplace plans available in your area to determine which would best fit your needs and budget.
How can I get short-term health insurance in Ohio?
If you need health coverage for up to three months, a short-term plan may be a good fit. This type of plan is intended to be used for unexpected and unanticipated medical needs, not for planned care, and is different from a Marketplace plan. Short-term plans do not cover preventive care services. These plans are medically underwritten, meaning you must qualify to be accepted, and do not cover pre-existing conditions. A short-term plan may be right for you if you're:
- Between jobs and waiting for your new coverage to begin
- Turning 26 and no longer eligible to be on your parent’s insurance
- Graduating college
- Looking for coverage outside of the Marketplace Open Enrollment Period and don't have a qualifying event
- Under 65 and do not need coverage for pre-existing conditions
Ready to find out more about short-term plan options? Schedule a call with us today!
Unsatisfied with your current health plan or agent?
If you’re unhappy with the service you’ve received from your current health insurance agent, it may be time to consider a new agent. We’re here to help.
Our advisors can compare individual health plan options suited to your personal needs and help you choose the right plan for your situation. We work with most major insurance companies to make sure you have access to a wide range of reliable coverage options. Plus, you’ll enjoy year-round support – all at no cost or obligation. We advocate for you by:
- Researching your health plan options
- Enrolling you in the right plan
- Helping you get the most out of your plan and benefits
- Answering questions about your plan
- Helping navigate and resolve claim or billing issues
If you're not getting the level of service you deserve, schedule a free 20-minute assessment with our team.