Ohio Health Insurance

Last updated July 30th, 2020

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Ohio offers many low-cost health insurance options. Premiums for Marketplace plans have been consistently lower than the U.S. average.

The Buckeye State has one of the lowest uninsured rates in the country. Millions of Ohioans get insurance through Medicaid and Medicare. Meanwhile, hundreds of thousands choose coverage through private Obamacare plans in Ohio’s Health Insurance Marketplace.

With this summary on buying health insurance in Ohio, you should have no trouble finding affordable coverage for you and your family.

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Ohio and the Affordable Care Act (ACA) 

Ohio’s uninsured rate fell by half since the Affordable Care Act (ACA) took effect in 2010. Six percent of the total population are uninsured as of 2018, down from 12 percent in 2010. This amounts to 735,400 uninsured individuals out of a population of roughly 11.3 million.1

Ohio’s Medicaid expansion to single adults earning up to 138 percent of the federal poverty level (FPL) largely drove the drop in uninsured rates. Ohio adopted Medicaid expansion under ACA rule in 2014. The uninsured population fell to eight percent in that year and has remained in the single digits ever since.1

As of October 2019, 717,100 adults gained coverage under Ohio’s Medicaid expansion.2 In total, about 2.4 million Ohioans enrolled in Medicaid.3

However, recent changes to Ohio’s Medicaid work requirements may cause as many as 36,000 residents to lose coverage. In March 2019, the Buckeye State got federal approval that changed eligibility restrictions for able-bodied adults ages 50 and younger. These individuals must work at least 80 hours a month, attend classes, or participate in job training to qualify for benefits. Ohio Medicaid officials plan to implement these new rules in January 2021.

Ohio Health Insurance Marketplace and Enrollment

Ohioans use the federal Marketplace (or exchange) to enroll in individual/family health insurance under the Affordable Care Act, known as Obamacare. This also applies if you’re a self-employed entrepreneur with no employees.

Enrollment for Ohio health insurance generally takes place from November 1 to December 15 each year. You also have the opportunity to enroll year-round for certain qualifying life events, such as losing coverage or starting a new job.

Nearly 207,000 residents enrolled in Marketplace coverage in 2019, down from about 230,000 in 2018. Enrollment in the Buckeye State peaked in 2016 at almost 244,000; it has declined every year since.4 Overall, enrollments have declined nationwide. Some of the reasons include shorter enrollment deadlines and less federal funding.

Ohio Health Insurance Companies for 2020

There are 10 Ohio insurance companies that offer individual and family plans on the exchange for 2020. According to Ohio’s Department of Insurance, all 88 counties have plans from at least one of these insurance carriers:

  1. AultCare Insurance Company
  2. Buckeye Community Health Plan
  3. CareSource
  4. Community Insurance Company
  5. Medical Health Insuring Corp. of Ohio
  6. Molina Healthcare of Ohio, Inc.
  7. Oscar Buckeye State Insurance Corporation
  8. Oscar Insurance Corporation of Ohio
  9. Paramount Insurance Company
  10. Summa Insurance Company

Can You Get Cheap Health Insurance in Ohio?

Ohio has had lower Marketplace premiums than the U.S. average since the exchanges began in 2014. In 2020, a 40 year old would pay $375 a month for a silver plan in Ohio. Nationally, the average sits at $462 a month.

You could get cheaper Ohio health insurance if your income qualifies you for low-cost coverage. Options include an Obamacare plan, Medicaid, or the Children’s Health Insurance Program (CHIP).

Completing an application for Marketplace health insurance will reveal if you qualify for Obamacare subsidies or low-cost coverage through Medicaid/CHIP.

Obamacare for Low-Income Ohio Residents

An Obamacare plan may be the cheapest option for you and your family if you qualify for subsidies based on your income and household size. For the 2019 plan year, 78 percent of Ohio Marketplace enrollees received premium tax credits (subsidies) to lower their monthly costs.

You generally need to earn between 100 percent and 400 percent of the federal poverty level (FPL) to qualify.

If you have a family of three, for instance, your income in 2019 must be between $20,780 and $83,120 to qualify. This would drop to between $12,140 and $48,560 if you’re single.

Subsidies only apply to metal plans (bronze, silver, gold, or platinum) sold through the Marketplace.

Examples of Ohio Health Insurance Costs After Obamacare Subsidies5

Individual

  • A 30-year-old in Cleveland, OH who earns half of the maximum for an individual ($24,280) could buy a 2020 silver plan for $126 per month after subsidies ($291 without subsidies). 
  • The same Cleveland resident earning the minimum salary ($12,140) would likely qualify for Medicaid.

Family 

  • A family of three in Columbus, OH earning the maximum income of $83,120 could get a 2020 silver plan for $677 a month after subsidies ($873 without subsidies).
  • If the same family earned half as much ($41,560), they could save $657 with subsidies—bringing their monthly cost for a silver plan to $216 per month. 
  • If this family made the bare minimum of $25,100, they would likely qualify for Medicaid.

Medicaid and CHIP for Low-Income Adults and Children 

Twenty-one percent of Ohioans receive health insurance through Medicaid and CHIP.2 Children and able-bodied adults under 65 make up the majority of Medicaid and CHIP enrollees (79 percent). Elderly and individuals with disabilities compose the rest.2

Medicaid and CHIP are generally provided for free or at a low monthly cost. You may qualify for Medicaid if you earn no more than $16,612 a year. Ohio’s Medicaid income limits typically increase by $5,878 for each additional household member.

CHIP is available to children under 19 from households that earn too much to get Medicaid. The government caps eligible incomes at $24,980 for an individual. You can add $8,840 for each additional person in your household to get the maximum limit.

Ohio Medicare Coverage For Seniors and Disabled Adults

Roughly 2.3 million Ohio residents enrolled in Medicare in 2018. More than half (about 1.5 million) receive benefits through the federal government’s Original Medicare program. Just under two out of five enrolled in private Medicare Advantage plans.6  Among Ohio beneficiaries, almost four out of five were 65 and older and about one out of five were younger than 65.

You may get Original Medicare automatically upon turning 65 or during your 25th month of receiving Social Security Disability Insurance (SSDI) benefits. You can also enroll in Medicare Advantage instead, which offers an alternative way to get Part A hospital and Part B medical insurance. Most Medicare Advantage plans also include Medicare Part D prescription drug coverage. Original Medicare, on the other hand, doesn’t cover most prescription medicines.

Unlike Original Medicare, Medicare Advantage plans have a cap on out-of-pocket costs. But Original Medicare enrollees can add a Medicare Supplement plan (also called Medigap) to help pay some or all of their out-of-pocket expenses. Many of these enrollees (little over 1 million) also add a separate Part D drug plan to help pay for medications.8

About Short Term Health Insurance in Ohio

Ohio allows the sale of short term health insurance with coverage for up to 364 days. Some states allow plan renewals for up to 36 months; Ohio does not.

Short-term coverage is designed to fill a temporary coverage gap. For example, it may make sense when you’re waiting for coverage to begin at a new job or you missed the open enrollment period to sign up for major medical insurance.

Short-term plans are not ACA-compliant. But they usually cost less than ACA plans. Insurers could deny you coverage based on your health status or a pre-existing condition. But if approved, you could get coverage as soon as the next day. 

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Article Sources
  1. Kaiser Family Foundation (KFF). Health Coverage of the Total Population.

  2. Kaiser Family Foundation (KFF). Medicaid in Ohio, October 2019.

  3. Medicaid.gov. September 2019 Medicaid & CHIP Enrollment Data Highlights.

  4. Kaiser Family Foundation (KFF). Marketplace Enrollment, 2014-2019.

  5. Kaiser Family Foundation (KFF). Health Insurance Marketplace Calculator. Individual silver plan subsidy for income $24,280 and Medicaid eligibility for income $12,100 is based on a non-tobacco smoking, 21-year-old in Cleveland, OH. Family silver plan subsidies (incomes of $83,120 and $41,560) and Medicaid eligibility income $20,780 is based on a family of three in Columbus, OH consisting of two non-smoking 25-year-old adults and a 5-year-old.

  6. Kaiser Family Foundation (KFF). Total Number of Medicare Beneficiaries.

  7. Kaiser Family Foundation (KFF). Distribution of Medicare Beneficiaries by Eligibility Category.

  8. Kaiser Family Foundation (KFF). Medicare Prescription Drug Plans: Stand Alone PDP Enrollment.