How to find health coverage for you and your family
Most people get health insurance from their employer, yet
many Ohioans have no coverage. This number includes workers
who choose not to participate in a health plan sponsored
by their employer, employers who cannot afford the cost of
providing employee health insurance, individuals who leave
a job and exhaust their continuation rights and those who
are unemployed and without health insurance.
Here are current options if you are seeking health
insurance.
Employer-provided
This is generally the most affordable coverage. Secure it
if offered. Employers typically require you to pay a portion
of the monthly premium.
COBRA coverage
Ask if you are eligible for your employer’s Consolidated
Omnibus Budget Reconciliation Act (COBRA) plan.
HIPAA coverage
If you are not eligible for COBRA or when COBRA expires,
but you have had 18 months of continuous group health coverage
where the most recent coverage was under an employer group
health plan, you are considered “Federally Eligible” for
a Health Insurance Portability and Accountability Act (HIPAA)
plan. The 18 months could be a combination of any creditable
health coverage, including Medicare. You need to apply
for either the “Ohio basic” or “Ohio
standard” health plan within 63 days of losing your
previous coverage.
High-deductible major medical policy
When it comes to insurance, no matter the type, higher deductibles
usually mean lower premiums. That is because you are taking
more responsibility for your own care. You may be able
to combine a Major Medical plan with a Health Savings Account,
which basically allows you to spend pre-tax money on your
smaller health bills and use the Major Medical plan for
the catastrophic expenses.
Short-term insurance
While this won’t cover pre-existing conditions, it
is better than no coverage at all. You can generally take
these out either on a month-to-month basis or on a term of
six to 12 months.
Individual coverage
Individual means the insurance is not connected to an employer
plan. Individual plans are medically underwritten. Companies
can decline you based on your health or attach exclusions
to your policy. Individual plans take into account your
past and present health and then factor it into your premium.
Cost varies, so shop around.
Open enrollment
If you are unable to secure coverage through the normal enrollment
process, you may be able to get coverage through open enrollment,
which is conducted on a first-come, first-served basis.
Applicants are accepted until each Health Maintenance Organization
(HMO) and traditional insurer reaches a statutory quota.
Coverage secured during open enrollment can be expensive
and it must take effect within 90 days after the company
accepts your application. However, the policy may require
you to wait one year before preexisting conditions are
covered.
Professional organizations and association plans
Sometimes local associations such as chambers of commerce
and professional groups offer health insurance. Coverage
may also be available through a religious or fraternal
organization.
Discount health plans
These plans are not insurance products; instead, they discount
services provided by certain physicians,
hospitals and pharmacies. If insurance is unaffordable to
you, a discount health plan may serve as an option to lower
your costs in certain situations. Be certain to read the
membership agreement. The Department has limited authority
over these plans.
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