If you live near Columbus, Ohio and need health insurance, we can help. We are licensed with all providers both on and off the exchange. We’ll help you understand your best options depending on your situation.
Enrolling in the coverage that best suits you can be difficult without proper guidance. There are application timelines, networks, tax-credits and costs to consider. If it seems confusing, then contact us. There is no cost to use our services.
Enrolling In Coverage On The Exchange
For many, the government run Marketplace is the best place to buy an individual or family plan. In and around Columbus, there are five (soon to be six) insurance companies offering plans on the Federal Exchange. Those companies are Anthem BCBS, CareSource, Medical Mutual of Ohio, Molina, and Oscar. Ambetter will be offering plans starting with 2021 effective dates.
When you’re enrolling on the Exchange, it’s important to pay attention to networks. All plans sold are HMO policies which means you must receive care in their network. There are no PPO policies available at this time. (HMOs do cover emergencies out of network, however.)
Let’s take a look at the networks for each company in Central Ohio:
Anthem Blue Cross and Blue Shield: Currently offering plans around Central, Ohio in Knox, Licking, Morrow, Muskinghum Coshocton, Perry, Hocking, Ross and Fayette counties
Ambetter: Will cover Ohio State University and other smaller facilities
CareSource: Covers Ohio State University hospital system, Nationwide Children’s, OhioHealth Berger, Madison County Hospital, Fairfield Medical, Memorial Of Union County
Medical Mutual of Ohio: Uses Ohio Health Network which includes Riverside, Grant, and Dublin Methodist in Columbus. In neighboring counties, there’s Fairfield, Hocking Valley, Knox, and memorial Hospitals. They have one of the largest networks in Central, OH.
Molina: Services OSU, James Cancer, SSH Columbus, Regency, Hospital, Berger Hospital in Circleville, Madison County Hospital and Fairfield Medical Center
Oscar: Cover Mt. Carmel hospitals and facilities, St. Ann’s and Nationwide Children’s Hospital
As you can see, there are no plans with crossover between the major medical systems in Columbus. You have to pick and choose which can be difficult if you use both Ohio Health and OSU for instance. It’s unlikely this will change anytime soon. Most of our clients can find a plan with their primary doctors in network, but some changes might be necessary.
Can I Buy Insurance OFF The Exchange?
There aren’t many insurance companies offering Affordable Care Act type coverage off the exchange. One reason is you would not be eligible for tax-credits if you buy off the exchange. The only way to receive those discounts (that are based on your income) is to buy on the exchange.
One company that will is Medical Mutual of Ohio. They will offer more plans off the Exchange in 2021. This doesn’t change their network providers, but the premiums can be less when compared to the same plan on-exchange. This assumes you don’t qualify for tax-credits, however.
The primary issue with on-exchange marketplace plans are the network limitations. All insurance companies now only offer HMO policies. These do not allow for broad access to doctors and hospitals across different healthcare systems. Unfortunately, there are no ACA policies sold off the Exchange that offer PPO coverage. We hope this changes, but nothing is imminent.
Longer Duration Short Term PPO Plans
Currently, only short term health insurance plans offer larger PPO networks in and around Columbus, Ohio. There are a few major companies offering short term coverage – and some plans allow the insured to buy coverage for up to two years.
There are items to be aware of with short term insurance:
- Medical underwriting is required. Not all who apply will be accepted
- Preexisting conditions aren’t often covered. These plans are not appropriate for those with ongoing health issues – or those with procedures that were recommended or pending
- Maternity, expensive prescriptions & frequent doctor’s visits may not be covered
Our clients who most benefit from short term coverage tend by younger and healthier. They may not be worried about maternity coverage, take few prescriptions and have no ongoing health issues. They also don’t qualify for tax-credits on the Federal Marketplace.
With that in mind, our clients can usually lower their monthly premiums significantly when compared to Marketplace plans while also carrying comprehensive coverage. Anthem BCBS, Aetna (thru National General), Medical Mutual of Ohio and United Healthcare all offer short term plans. We can help you find your best options in this category as well.
Helping You Find Suitable & Affordable Health Insurance
Hyers and Associates is an independent insurance brokerage here in Columbus offering coverage both on and off the exchange. We assist with ACA, short term and ancillary plans (like dental & vision insurance) from all carriers direct.
We can help you find the plan(s) that best suit your needs and budget. There is no cost to use our services whatsoever. Contact us to learn more.