Due to changes brought about by the Affordable Care Act (ACA), also known as ObamaCare, Ohio residents have new options for purchasing health insurance. Ohio did not choose to move forward with a state-based marketplace; as a result, citizens of the state who want to buy Marketplace health insurance can go to the federal Healthcare.gov.
Ohio did decide to implement the expansion in Medicaid eligibility rules, so many lower-income Ohioans will have the option to enroll in Medicaid if they do not qualify for subsidies in the federal Marketplace.
Purchasing Marketplace Health Insurance in Ohio
The Marketplace allows Americans to enter information about their income and household size, and then receive information about what health insurance plans are available in the state and what tax credits they may qualify for. Americans who make between 100% and 400% of the federal poverty level will be eligible for some kind of assistance with health insurance premiums. Those who make between 100% and 250% of the federal poverty level will qualify for assistance with cost-sharing, such as copayments and deductibles. The federal poverty level in 2013 was $23,550 for a family of four.
In addition, all applications for plans purchased in the Marketplace are automatically reviewed for eligibility for Medicaid or Children’s Health Insurance Program (CHIP) coverage. If coverage applies, the application will be forwarded to the appropriate state agency.
The Marketplace lists insurance plans based on metal tiers. Bronze plans have the lowest monthly premiums but highest cost-sharing. Platinum plans have the highest monthly premiums but the lowest cost sharing. Ohioans should choose the best plan for them and their household based on their health needs, their health providers, and their prescription drug needs. Dental care for children is included in all health plans, and adult dental plans are available separately in the Marketplace.
Individuals and families who already have health insurance through their employers do not have to purchase coverage through the Marketplace. If they do, they will not qualify for tax subsidies unless the employer health plan is considered unaffordable by the ACA or it doesn’t meet the minimum coverage requirements.
After open enrollment ends on March 31st, 2014, individuals without current coverage will not be able to obtain health coverage through the Marketplace until the next annual enrollment period, unless they have a qualifying life event. Households without current coverage will need to obtain coverage by March 31st, 2014, or they will face a tax penalty. The tax penalty the first year is the higher of $95 per adult and $47.50 per child or 1% of income. Every following year it increases. If health insurance is unaffordable or special circumstances apply, an exemption can be obtained.
Obtaining Medicaid and CHIP in Ohio
Ohio is one of the states that, after a lengthy political fight, chose to expand Medicaid eligibility requirements. This means that Ohio residents who expect to make less than $32,499 for a family of four in 2014 would qualify for Medicaid coverage in Ohio. Applications in the federal Marketplace are automatically reviewed for Medicaid eligibility. In addition, citizens of Ohio can apply directly with the appropriate state office.
CHIP provides health insurance coverage for children; this coverage remains separate from their parents’ health insurance coverage. This program is for families who make too much to qualify for Medicaid, but still need low-cost coverage for their children. CHIP works closely with state Medicaid programs. Ohio citizens can find out if their children qualify for CHIP through a Marketplace application, calling 1-877-543-7669, or by visiting InsureKidsNow. More information can also be found at Ohio’s Medicaid site.
The ACA has brought additional health insurance options to the citizens of Ohio. It’s important to obtain coverage by March 31st, 2014 or file an exemption to avoid tax penalties. Choosing the right plan for your family based on your medical network and health needs is the first step to a happier, healthier future.