Ohio Marketplace Insurance: Everything You Need to Know

Ohio consumers have many health insurance options available to them through the state’s Marketplace Insurance program. This program offers a variety of plans from private insurance companies, as well as financial assistance for those who qualify. Here’s everything you need to know about Ohio Marketplace insurance.

What is Ohio Marketplace Insurance?

Ohio Marketplace Insurance is Ohio’s state-run health insurance exchange. Through this program, Ohio residents can shop for and purchase health insurance plans offered by private insurance companies. Plans are categorized by metallic tiers: bronze, silver, gold, and platinum. Bronze plans have the lowest premiums but the highest out-of-pocket costs, while platinum plans have the highest premiums but the lowest out-of-pocket costs.

The Ohio Marketplace Insurance program also offers financial assistance to those who qualify. This assistance can come in the form of tax credits that lower monthly premiums, as well as cost-sharing reductions that lower out-of-pocket costs like deductibles and copayments.

How Do I Qualify for Financial Assistance?

To qualify for financial assistance through the Ohio Marketplace Insurance program, you must meet certain income requirements. In general, you must have an income between 100% and 400% of the federal poverty level (FPL). This equates to an income between $12,880 and $51,520 for an individual and between $26,500 and $106,000 for a family of four in 2021.

You may also be eligible for financial assistance if you are a member of a federally recognized tribe, if you are an Alaska Native shareholder, or if you are a Native Hawaiian.

What Are My Plan Options?

Ohio residents have a variety of plan options to choose from on the Marketplace. These plans are offered by private insurance companies and are categorized by metallic tiers:

Bronze plans have the lowest premiums but the highest out-of-pocket costs, while platinum plans have the highest premiums but the lowest out-of-pocket costs. You should choose a plan based on your individual health care needs and financial situation.

How Do I Enroll in Ohio Marketplace Insurance?

To enroll in an Ohio Marketplace Insurance plan, you must first create an account on the Healthcare.gov website. From there, you can browse and compare plans offered in your area. You can also calculate your eligibility for financial assistance and apply for it. Once you have chosen a plan, you can enroll online or over the phone.

Frequently Asked Questions

What is the Open Enrollment period for Ohio Marketplace Insurance?

The Open Enrollment period for Ohio Marketplace Insurance typically runs from November 1 to December 15 each year. During this time, Ohio residents can enroll in a new plan, switch plans, or renew their existing plan. Outside of this period, you may only enroll in a new plan if you have a qualifying life event such as losing your job, getting married, or having a baby.

Can I change my Ohio Marketplace Insurance plan mid-year?

Generally, you can only change your Ohio Marketplace Insurance plan mid-year if you have a qualifying life event such as moving to a new state or losing your job. However, some people may be eligible to change their plan during the year if there are issues with their current plan such as a drastic change in premiums or benefits.

What happens if I don’t have health insurance in Ohio?

If you don’t have health insurance in Ohio, you may be subject to a penalty on your federal income taxes. The penalty for not having insurance went away starting in 2019, but some states may have their own individual mandate penalties. Additionally, not having health insurance means that you will be responsible for paying for all of your medical expenses out of pocket.

What should I consider when choosing an Ohio Marketplace Insurance plan?

When choosing an Ohio Marketplace Insurance plan, you should consider factors such as your health care needs, your budget, and the plan’s network of providers. You should also calculate your eligibility for financial assistance, as this can greatly affect the affordability of a plan.

Can I use my Ohio Marketplace Insurance plan outside of Ohio?

Depending on the plan you choose, you may be able to use your Ohio Marketplace Insurance plan outside of Ohio. However, you may face higher out-of-pocket costs or limited coverage if you receive care out of state. Be sure to check your plan’s network of providers and coverage areas before traveling outside of Ohio.