Most Affordable Health Insurance Options in Ohio

5.9% of Ohio's population does not have health insurance, reflecting a divide between insured and uninsured individuals in healthcare experiences, as supported by research. It was shown that insured individuals received moderate to high levels of care and had no concerns with provided services. In contrast, uninsured individuals experienced dissatisfaction because of long waiting periods and payment procedures.

Being uninsured has other negative consequences, as even a minor sickness can lead to financial strain. Some individuals may find it challenging to search for health insurance plans due to the wide variety of plans and rates available.

This article explores Ohio's most affordable health insurance options, guiding you through different plans and pricing structures to find coverage that fits the budget.

Low-Cost Health Insurance Plans in Ohio

Among Ohio's low-cost health insurance plans are managed care plans, employer-sponsored health insurance, Medicaid, and Small Business Health Insurance Options or SHOP.

Managed Care

Managed care is a healthcare delivery system in which providers enter into a contract with healthcare providers and medical facilities to manage patient care at reduced costs.

The following coverage is included in managed care plans:

• Preventive care incentives, such as annual check-ups, vaccines, and routine screenings
• Provider networks, such as doctors, specialists, labs, hospitals, and other healthcare facilities
• Primary care provider
• Prior authorization for certain procedures and treatments
• Prescription coverage for generic medications

Managed care includes three (3) different plans: Health Maintenance Organizations (HMOs), Point-of-Service (POS), and Preferred Provider Organization (PPO) plans.

• HMO: HMOs are prepaid health plans where individuals or employers pay monthly premiums. These plans offer comprehensive care, including hospital stays, emergency care, doctor visits, surgery, lab testing, therapy, and x-rays. HMOs often do not cover care from non-network physicians, except in emergencies.
• PPO: PPO plans offer discounted services from independent providers. There will be higher coverage costs for enrollees who go outside the provider network than those who are already within the network.
• POS: A POS plan combines the coverage of HMO and PPO plans. Enrollees may select doctors within the HMO network or outside providers; however, the latter option is more expensive.

Employer-Sponsored Health Insurance

The majority of individuals in Ohio receive their health insurance through employer-sponsored plans. These plans are not mandated by law, so employers usually offer these plans voluntarily. Employers can either limit coverage to employees or extend it to their dependents.

Employers may also provide a Health Savings Account (HSA) and a high-deductible health plan (HDHP), allowing employees to pay healthcare expenses with pre-tax dollars while enjoying lower premiums. However, this setup comes with higher out-of-pocket costs.

Medicaid

Because Ohio extended Medicaid under the Affordable Care Act, low-income adults without dependent children have been eligible for coverage since 2014.

The following individuals can also enroll in Medicaid:

• Adults under the age of 65 having income up to 138% of the federal poverty level (FPL)
• Pregnant women with household income up to 205% of the FPL. The mother’s coverage continues for 12 months after the baby’s birth
• Children with household income up to 211% of FPL

In Ohio, Medicaid offers a wide range of health care services, including the following:

• Private duty nursing
• Preventive health
• Behavioral health
• Early and Periodic Screening, Diagnostic, and Treatment (EPSDT)
• Professional medical services
• Family planning
• Emergency room visits
• Dental services
• Inpatient and outpatient hospital services

Medicaid enrollment is available year-round and does not require waiting for an open enrollment period. Ohio uses a federally administered insurance marketplace, so enrolling can be done through HealthCare.gov or by calling 1-800-318-2596.

You can verify your eligibility for Medicaid on the Ohio Medicaid website, over the phone at 800-324-8680, or in person at the county Department of Job and Family Services office.

Small Business Health Insurance Options (SHOP)

Small businesses, often those with up to 50 employees, may be able to enroll in SHOP plans through an insurance carrier or with the help of a SHOP-registered agent or broker.

Below are the lowest premiums for SHOP health insurance plans based on metal category and age of enrollee:

• Bronze: For Bronze plans, the lowest premium starts at $194.78 for enrollees under 20, increasing to $213.34 at age 21, $242.14 at age 30, and $272.65 at age 40. By age 50, the premium rises to $381.03, reaching $579.01 by age 60.
• Silver: Silver plans follow a similar pattern, starting at $251.36 for those under 20 and rising to $275.32 at age 21. The premium increases to $312.47 by age 30, $351.84 at age 40, $491.70 by age 50, and $747.18 for those aged 60.
• Gold: Gold plans are higher across all age groups, with premiums starting at $316.54 for those under 20, then increasing to $346.70 at age 21, $393.51 at age 30, $443.09 at age 40, $619.21 by age 50, and $940.95 by age 60.
• Platinum: Platinum plans have the highest premiums, beginning at $380.60 for enrollees under 20. The premium rises to $416.87 at age 21, $473.15 at age 30, $532.76 at age 40, $744.53 at age 50, and a significant $1131.38 by age 60.

Most Affordable Private Health Insurance Providers in Ohio

Private health insurance options in Ohio are created for those who may not qualify for government programs but still need coverage. Companies like SummaCare, Molina Healthcare, AultCare, and Oscar Health provide a range of options.

SummaCare - Cheapest Health Insurance Provider in Akron County

SummaCare is based in Akron and was established in the early 1990s. This health insurance provider caters to those looking for low-cost health insurance and benefit administration services.

For residents in Akron, SummaCare is the most affordable option, offering Silver plans starting at $414 per month.

Molina Healthcare - Cheapest Health Insurance Provider in Ohio

Molina Healthcare offers Ohio's lowest-priced health insurance options, with Silver plans beginning at $398 per month, although rates vary depending on the county.

Known for its partnership with state governments, Molina delivers services through government-sponsored programs, including Medicaid and the Children's Health Insurance Program (CHIP). Molina also provides Medicare Advantage plans, which offer comprehensive care with minimal out-of-pocket costs.

AultCare

AultCare was established in 1985 to preserve healthcare and health insurance locally in Ohio and avoid insurance company subsidies. This health insurance provider offers affordable options for health insurance, starting at $429 per month for its Silver plans.

Oscar Health

For gold-tier health plans, Oscar Health, a healthcare technology company established in 2012, offers the most affordable option, starting at $481 monthly. Availing their Gold plan is advisable for those needing surgeries, medical treatments, or prescriptions.

Wrap Up

Government programs like Medicaid for low-income individuals and SHOP for small business owners exist. There are also managed care plans, which aim to provide healthcare at reduced costs through HMOs and POS and PPO plans. Employers may also provide sponsored health insurance plans to employees and their dependents.

As for private health insurance providers in Ohio, their costs of health plans range from $398 to $481 monthly, depending on the metal tier and coverage; for those looking for Silver plans, Molina Healthcare, Aultcare, and Summacare in Akron County offer low-cost options. Oscar Health has the most affordable option for Gold plans, which starts at $481 a month.

Available health insurance does not need to be expensive. With these affordable health insurance options, you can make sure that you and your family can access quality healthcare services and treatment.

FAQs on Most Affordable Health Insurance Options in Ohio

Are health discount cards considered health insurance?

No, health discount cards are not considered health insurance. Using health discount cards reduces the cost of medical services but does not provide the protection and coverage that health insurance offers.

Are there any penalties for not having health insurance in Ohio?

There are no penalties for not having health insurance in Ohio, as the tax penalty was eliminated in 2018.

How does age affect my health insurance premium?

Age influences health insurance premiums since people's healthcare needs often increase as they get older. As a result, premiums tend to climb with age to cover the increasing risk of medical consultations, chronic diseases, and specialized care.