How Much Is Health Insurance in Ohio?

Health insurance is a type of coverage that pays for medical expenses incurred by the insured. Health insurance can help protect you from high medical costs and provide access to quality health care services. However, the cost of health insurance can vary depending on many factors, such as your age, income, location, health status, plan type, and provider network. In this blog post, we will explore how much health insurance costs in Ohio per month and what factors affect the price.

Key Takeaways:

The average monthly premium for a benchmark silver plan in Ohio was $462 in 2020, but most people paid less due to financial assistance from the federal government or the state.
The cost of health insurance in Ohio can vary depending on several factors, such as your age, income, location, health status, plan type, and provider network.
There are several ways to find affordable health insurance in Ohio, such as the Health Insurance Marketplace, Medicaid, CHIP, employer-sponsored health insurance, and short-term health insurance.

The Average Cost of Health Insurance in Ohio

According to the latest data from the U.S. Department of Health and Human Services (HHS), the average monthly premium for a benchmark silver plan in Ohio was $462 in 2020. This was slightly lower than the national average of $462. A benchmark silver plan is a plan that covers about 70% of the average person’s medical costs and is used to determine the amount of premium tax credits that eligible individuals can receive to lower their health insurance costs.

However, the average premium does not reflect the actual cost that most people pay for health insurance in Ohio. This is because many people qualify for financial assistance from the federal government or the state to reduce their premiums and out-of-pocket expenses. For example, in 2020, 86% of Ohioans who enrolled in a plan through the Health Insurance Marketplace received a premium tax credit that lowered their monthly premium to an average of $113. Additionally, 46% of Ohioans who enrolled in a plan through the Marketplace received a cost-sharing reduction that lowered their deductibles, copayments, and coinsurance.

The Factors That Affect the Cost of Health Insurance in Ohio

The cost of health insurance in Ohio can vary significantly depending on several factors, such as:

Your Age

The older you are, the more you will pay for health insurance in Ohio. This is because older people tend to have higher health risks and use more health care services than younger people. Under the Affordable Care Act (ACA), health insurance companies can charge older adults up to three times more than younger adults for the same plan. For example, according to eHealth, a 60-year-old in Ohio would pay an average of $1,038 per month for an individual plan in 2020, while a 30-year-old would pay an average of $456 per month for the same plan.

Your Income

The lower your income, the less you will pay for health insurance in Ohio. This is because you may qualify for financial assistance from the federal government or the state to lower your health insurance costs. For example, if your household income is between 100% and 400% of the federal poverty level (FPL), you may be eligible for a premium tax credit that reduces your monthly premium for a plan purchased through the Marketplace. In 2020, the FPL was $12,760 for an individual and $26,200 for a family of four. If your household income is below 138% of the FPL, you may be eligible for Medicaid, which is a public health insurance program that provides free or low-cost coverage to low-income individuals and families. In 2020, Medicaid covered about 3 million Ohioans, or 26% of the state’s population.

Your Location

The cost of health insurance in Ohio can vary depending on where you live in the state. This is because different areas have different levels of competition among health insurance companies, providers, and hospitals, which can affect the price and quality of health care services. For example, according to ValuePenguin, the cheapest silver plan in Ohio in 2020 was Ambetter Balanced Care 29 (2020), which had a monthly premium of $312 for a 40-year-old non-smoker. However, this plan was only available in six counties: Adams, Brown, Highland, Pike, Scioto, and Vinton. In contrast, the most expensive silver plan in Ohio in 2020 was CareSource Marketplace Low Premium Silver Dental Pediatric Vision (2020), which had a monthly premium of $1,029 for a 40-year-old non-smoker. This plan was only available in one county: Cuyahoga.

Your Health Status

The cost of health insurance in Ohio can vary depending on your health status and medical history. This is because some health insurance plans may have different benefits and costs for different types of services and conditions. For example, some plans may have lower copayments or coinsurance for preventive care services such as annual check-ups, immunizations, and screenings, while others may have higher copayments or coinsurance for specialty care services such as surgery, hospitalization, and prescription drugs. Additionally, some plans may have exclusions or limitations for pre-existing conditions, which are health problems that you had before you enrolled in the plan. Under the ACA, health insurance companies cannot deny you coverage or charge you more based on your pre-existing conditions. However, some plans may require you to wait a certain period of time before they cover your pre-existing conditions or may not cover them at all.

Your Plan Type and Provider Network

The cost of health insurance in Ohio can vary depending on the type of plan and provider network that you choose. The type of plan refers to the level of coverage and cost-sharing that the plan offers. The provider network refers to the group of doctors, hospitals, and other health care providers that the plan contracts with to provide services at discounted rates. For example, some common types of plans and provider networks are:

HMO (Health Maintenance Organization): A type of plan that requires you to get all your care from providers within the plan’s network, except for emergencies. You also need a referral from your primary care provider (PCP) to see a specialist. HMO plans usually have lower premiums and out-of-pocket costs than other types of plans, but they also have less flexibility and choice of providers.
PPO (Preferred Provider Organization): A type of plan that allows you to get care from providers both inside and outside the plan’s network, but you pay more for out-of-network services. You do not need a referral from your PCP to see a specialist. PPO plans usually have higher premiums and out-of-pocket costs than HMO plans, but they also have more flexibility and choice of providers.
EPO (Exclusive Provider Organization): A type of plan that only covers services from providers within the plan’s network, except for emergencies. You do not need a referral from your PCP to see a specialist. EPO plans usually have lower premiums than PPO plans, but they also have less choice of providers.
POS (Point of Service): A type of plan that combines features of HMO and PPO plans. You can get care from providers both inside and outside the plan’s network, but you pay less for in-network services. You need a referral from your PCP to see a specialist. POS plans usually have higher premiums than HMO plans, but they also have more choice of providers.
HDHP (High Deductible Health Plan): A type of plan that has a higher deductible than other types of plans, which means you pay more out-of-pocket before the plan starts to pay for covered services. However, HDHPs also have lower premiums than other types of plans. HDHPs can be paired with a health savings account (HSA) or a health reimbursement arrangement (HRA), which are tax-advantaged accounts that allow you to save money for future medical expenses.

The type of plan and provider network that you choose can affect the cost and quality of health care services that you receive. Therefore, it is important to compare different options and consider your health needs and preferences before choosing a plan.

How to Find Affordable Health Insurance in Ohio

If you are looking for affordable health insurance in Ohio, there are several ways to find a plan that suits your budget and needs. Some of the options are:

The Health Insurance Marketplace: The Marketplace is an online platform where you can shop for and enroll in health insurance plans that meet the standards and requirements of the ACA. You can compare different plans based on their benefits, costs, quality ratings, and provider networks. You can also apply for financial assistance such as premium tax credits and cost-sharing reductions if you qualify based on your income and household size. You can access the Marketplace through HealthCare.gov or by calling 1-800-318-2596.
Medicaid: Medicaid is a public health insurance program that provides free or low-cost coverage to low-income individuals and families who meet certain eligibility criteria. Some of the groups that may qualify for Medicaid in Ohio include children, pregnant women, parents, seniors, people with disabilities, and people who need long-term care services. You can apply for Medicaid through Benefits.Ohio.gov or by calling 1-844-640-6446.
CHIP (Children’s Health Insurance Program): CHIP is a public health insurance program that provides low-cost coverage to children under 19 who do not qualify for Medicaid and whose family income is too high for Medicaid. CHIP covers services such as doctor visits, hospital care, prescriptions, dental care, vision care, and mental health services. You can apply for CHIP through Benefits.Ohio.gov or by calling 1-844-640-6446.
Employer-sponsored health insurance: Employer-sponsored health insurance is a type of coverage that is offered by your employer or your spouse’s or parent’s employer. Employer-sponsored health insurance plans usually have lower premiums and better benefits than individual plans, because employers pay a portion of the cost and negotiate with health insurance companies for better rates and terms. However, employer-sponsored health insurance plans may not be available to all employees or dependents, and they may have limited provider networks or plan options. You can enroll in employer-sponsored health insurance during the open enrollment period or when you have a qualifying life event such as getting married, having a baby, or losing other coverage.
Short-term health insurance: Short-term health insurance is a type of coverage that provides temporary protection for a limited period of time, usually from 30 days to 12 months. Short-term health insurance plans are typically cheaper than standard health insurance plans, because they have less benefits and more exclusions and limitations. Short-term health insurance plans do not have to comply with the ACA rules and regulations, which means they can deny you coverage or charge you more based on your health status or pre-existing conditions. Short-term health insurance plans are not considered minimum essential coverage, which means you may have to pay a penalty for not having adequate health insurance under the ACA. You can buy short-term health insurance plans from private insurers or brokers.

Finding affordable health insurance in Ohio can be challenging, but not impossible. By comparing different options and considering your personal needs and preferences, you can find a plan that works for you and your budget.