What is Ohio Health Insurance?

When you think of tuberculosis (TB), your mind may immediately envision 19th century America. Suffering from few limited care options, rudimentary treatment plans and unsanitary living and working conditions, many people living during the 1800's were infected by and died from TB. Though not seen frequently, tuberculosis is still an aggressive respiratory infection and the incidents of diagnosed tuberculosis in Ohio have been increasing since 2006. While the number of overall incidents is still relatively low, risk of contagion is high and is just one small reason why health insurance is so important for Ohio residents.

With health insurance, you allow yourself some financial control over any expenses incurred by an accident or illness. With faithful payment of your annual premium, you can rest in the knowledge that your health insurance company will absorb the majority of your health care expenses and you will benefit from advanced treatment options. You may be expected to pay a small copayment or deductible, but these amount to a very small percentage of total health care costs.

Health insurance companies are able to guarantee your coverage by pooling your health insurance premiums with the premiums of other policyholders. In doing so, the insurance company develops a pool of funds called a reserve. They use these funds to pay the thousands of dollars in expenses that you won't have to. Since many policyholders use very little of the benefits promised to them, health insurance companies are generally able to carry over unused funds from their reserves to help them cover unexpected costs the following year.

Terminology used in this section:

Premium: A premium is the annual fee that a policyholders are expected to pay in order to retain an effective policy and prevent a lapse in coverage.

Copayment: A copayment is the amount of money that policyholders must pay out of pocket for treatment, doctor visits and/or medications. Copayments are paid when treatment or medication is given and can range in amount from $25 to $100.

Deductible: A deductible is the minimum amount that a policyholder is required to pay for medical treatment upfront. Once the deductible has been met, their policy will begin to cover treatment costs. If you choose to carry a deductible in your policy, you'll pay all expenses put of pocket until you reach the deductible, at which time you'll only be expected to pay copayment amounts.

How Residents Benefit from Ohio Health Insurance

Luckily tuberculosis is no longer a fatal infection and can be treated, but the six to eight month treatment plan and daily regimen of medications is costly. Without health insurance the financial burden of treatment for TB or any illness, accident disease of infection could bring devastation to your budget and plans for the future. With health insurance, illness, accident and disease become affordable and predictable.

Take a common accident such as a broken leg. Without health insurance, treatment for a broken leg could devastate your budget. When you factor in all the costs, including the trip to the emergency room, ex-rays, bone resetting, plaster cast and pain medications, you could be facing a bill totaling thousands of dollars. If you have health insurance, you will have paid your annual premium and a small copayment (usually between $25 and $100) reducing your out of pocket expenses and saving you a substantial amount of money. If you have a chronic illness, such as asthma or diabetes, the amount of money you can save just on your monthly prescriptions is staggering. With a medication copayment of $10 to $50, your health insurance policy can save you $600 per year in medications alone.

The Many Options for Health Insurance in Ohio

There are many options available to consumers searching for the right health care policy. For those who don't want preventative care or routine doctor visits and simply want to feel safe in the event of a catastrophic illness, there is major medical coverage. With major medical coverage, you have a plan that covers expenses arising from catastrophic illness and accidents. With such a policy, there is a lower likelihood that you will actually use the coverage and this low risk allows the insurance companies to charge a very low premium.

If you'd prefer a policy that allows you to visit your primary care physician for routine visits and has prescription drug coverage, individual insurance coverage is a great choice. Allowing you to choose between high, low and no deductibles and varying copayment schedules, individual insurance gives you the freedom to create an affordable policy that contains the coverage you need. Individual coverage is best for relatively healthy individuals since it is underwritten based on your individual health history.

For those with chronic illnesses or other health problems, group health insurance is often a better option. Group coverage can be obtained through your association with a fraternal group or union or through your employer. Since group health insurance is underwritten based on the experience of similar groups, the risks are considered lower and your individual health history is not taken into consideration. Many students of Ohio colleges will have access to group coverage through their school. Should you need to leave the group, you'll have access to COBRA coverage for up to 18 months.

State subsidized programs for uninsurable individuals (called High Risk Pools) can be options for those who have preexisting conditions and do not have access to group health coverage. In June 2005, the state of Ohio completed a high risk pool feasibility study. The study provided the state with projected enrollment, cost and funding scenarios. While the plans to develop the high risk pool are still active, the pool itself may not come to fruition until 2011 or later.

Terminology used in this section:

Underwriting: The process of determining a proposed insured's health risk to the insurance company based on his or her previous health history. The determinations made during this process will decide whether or not the insurance company should issue coverage and whether any additional charges should be charged to the policyholder in order to hedge against increased risk.

Preexisting Conditions: Any illness or injury that is chronic or has long lasting consequences that was diagnosed in a proposed insured prior to consideration for their policy. Most insurance companies exclude preexisting conditions from coverage benefits for a certain time period.

COBRA: A national program which guarantees the continuation of health coverage once employment or union association is terminated with the provider of the group health insurance as long as a payment is made. COBRA allows the continuance of existing coverage for up to 18 months. It will end sooner if a new policy is issued to the policyholder. Those who elect COBRA coverage will be subject to administration fees and full cost of insurance.

Choosing the Perfect Health Insurance Coverage for Ohio Residents

Shopping for health insurance coverage does not need to be overwhelming and stressful. By putting a little time into researching your options and understanding their impact, you can be armed with information that makes your choice easier and more educated. The following circumstances and options should all be considered when you shop for health insurance:

PPO or HMO: When choosing a policy, you will be asked if you want an HMO or a PPO. Health Maintenance Organizations (HMO's) are insurance plans that use a predetermined network of physicians to care for policyholders. Under an HMO, only visits to the insurance company's network of physicians will be covered under your insurance policy. Visits to facilities and doctors not considered in-network will be paid for by the policy holder purely out of pocket.

Preferred Provider Organizations (PPO's) use a preferred network of physicians that you are encouraged to see, but you won't be required to restrict your health care visits only to physicians that are in-network. Should you decide to go outside the network, your PPO policy will pay a limited benefit to your out of network chosen provider.

Your age: Insurance policies become more expensive as you age. Luckily, when you are over the age of 65, Medicare coverage will relieve you of much of your health insurance needs. There are some expenses that Medicare won't cover, so you do still need to consider Medigap coverage. Many expenses can be covered with Medigap, including: alternative therapies, travel for medical treatment and massage therapy. Medigap policies can also help you pay for copayments.

Your health: Until the state of Ohio finalizes their high risk pool, group coverage will continue to be the best (and sometimes only) option for those with preexisting conditions. It is important to explore any opportunity you may have to get group coverage. Explore groups and unions that you can join that offer this coverage and check with your human resources department to find out if group health insurance is offered by your employer.

Deductibles: High deductibles can be useful to individuals that don't visit their primary care physicians frequently. Combined with a health savings account, policyholders can utilize a hefty tax benefit while still enjoying low premium expenses.

Premium payment frequency: there are many ways to pay your insurance premiums. You can pay them frequently by paying monthly or quarterly, or, you can pay them in larger sums by paying them semi-annually or annually. Because the loss of your policy can have extremely negative consequences, it is important to choose the frequency that will help you avoid lapse.

Terminology used in this section:

Health Savings Account (HSA): Health Savings accounts become your own personal pool of funds for medical treatment in that they hold deposited funds which can only be used to pay out of pocket medical expenses. Some of these expenses include co-pays and deductibles. Funds deposited into an HSA are tax deductible. There are many permitted uses for HSA funds, generally including: acupuncture, dental work, massage therapy, and illness related travel expenses.

Lapse: A lapse is the cessation of insurance benefits due to nonpayment of premium.

Major Ohio Health Insurance Providers

With all the health insurance providers licensed to provide policies in Ohio, it can be overwhelming to narrow down your choices. The following insurance companies have done a particularly good job tailoring plans to fit the specific needs of Ohio residents.

Blue Cross Blue Shield of Ohio: The Blue Cross Blue Shield of Ohio website is comprehensive and offers quotes, physician searches and informative webinars. They are also one of the top 100 employers in the state of Ohio, making a significant employment impact in Akron, Canton, Cincinnati, Cleveland, Columbus, Dayton, Toledo and Youngstown. With over 6,400 insurance agents in Ohio, you'll have no problem finding answers to any questions you may have.

Humana One: Humana One's website has a friendly user interface with a, "Plan Pointer" to help you find the right plan for you. Their 3 major options- "Portrait," "Monogram" and "Autograph" provide individualized plan options for every circumstance. With networked physicians statewide, including in Lorain and Parma, you'll be sure to find a physician you trust.

Golden Rule Health Insurance of Ohio: Golden Rule Health Insurance of Ohio Has both health and dental insurance plans available to Ohio residents. Some of their plans offer preventative care with no deductible and competitive copayments. They also offer health saving accounts. Golden Rule has agents and networked physicians nationwide.