Ohio Health Insurance Consumer Guide

To qualify for health coverage through the Marketplace in Ohio, you must:⁵

• Live in Ohio
• Be either a United States citizen or national, or be lawfully present
• Not be incarcerated
• Not be enrolled in Medicare
  

Eligibility for financial assistance (premium subsidies and cost-sharing reductions) depends on your income and how it compares with the cost of the second-lowest-cost Silver plan in your area – which depends on your age and location. In addition, to qualify for financial assistance with your Marketplace plan you must:

• Not have access to affordable health coverage through your employer. If your employer offers coverage but you feel it’s too expensive, you can use our Employer Health Plan Affordability Calculator to see if you might qualify for premium subsidies in the Marketplace.  
• Not be eligible for Medicaid or CHIP.

In Ohio, you can sign up for an ACA-compliant individual or family health insurance between November 1 and January 15 during open enrollment. Your coverage starts on January 1 if you enroll before December 15. But if you apply between December 16 and January 15, your coverage will begin on February 1.⁶ 

Outside of the annual open enrollment window, you may be eligible to enroll if you experience a qualifying life event, such as giving birth or losing other health coverage. (There’s also an extended SEP for people who lose Medicaid or CHIP between March 31, 2023 and July 31, 2024. ⁷) 

Note that some people can enroll year-round even without a specific qualifying life event.⁸

To enroll in a Marketplace plan in Ohio, you can: 

• Visit HealthCare.gov, a platform where you can shop, compare, and buy individual and family health plans. 
• Purchase individual and family health coverage with the help of an insurance agent or broker, a Navigator or certified application counselor, or an approved enhanced direct enrollment entity.⁹
• You can also call HealthCare.gov’s contact center by dialing 1-800-318-2596 (TTY: 1-855-889-4325). The call center is available 24 hours a day, seven days a week, but it’s closed on holidays.

You can find affordable health insurance options in Ohio through HealthCare.gov – the ACA Marketplace. 

Under the Affordable Care Act, you may qualify for income-based subsidies, known as Advance Premium Tax Credits (APTC). These credits can reduce your premium and lower your overall costs. 

During the open enrollment period for coverage in 2023, about 84% of people using Ohio’s exchange qualified for subsidies, and those eligible for saved an average of $479/month. As a result, the average enrollee’s premium was about $117/month after subsidies.¹⁰

If your household income is less than 250% of the federal poverty level, you may also be eligible for cost-sharing reductions (CSR). CSRs help lower your deductibles and out-of-pocket expenses. With APTCs and CSRs, an ACA plan may be a cost-effective health insurance option.

Low-cost health insurance is also available through Medicaid. Use our guide to see if you qualify for Medicaid in Ohio.

Source: CMS.gov¹¹

Ohio’s exchange offers plans from eleven insurance companies, with UnitedHealthcare joining as a new addition in 2023. Below are the insurers offering plans for 2023: ¹²

• AultCare Insurance Company
• Buckeye Community Health Plan
• CareSource
• Community Insurance Company (Anthem BCBS)
• Medical Health Insuring Corp. of Ohio 
• Molina Healthcare of Ohio
• Oscar Buckeye State Insurance Corporation
• Oscar Insurance Corporation of Ohio
• Paramount Insurance Company
• Summa Insurance Company
• UnitedHealthcare 

Each county has at least two insurance providers, and  all but five counties have three or more health plan options available.¹²

Ohio’s individual market insurers have proposed the following average rate increases for 2024:¹³

Source: Ohio Rate Review Submissions¹³

The approved rate changes apply to full-price premiums. Most Ohio exchange enrollees receive premium tax credits, so they don’t pay the full premium. ¹⁴ For those who qualify for subsidies, changes in plan rates and subsidy amounts determine their net rate change.  

In the 2023 open enrollment period, 294,644 people were insured through Ohio’s Marketplace.¹⁵ 

The surge in enrollment during these years happened primarily due to the American Rescue Plan (ARP) making ACA’s premium subsidies more substantial. Under the ARP – now extended by the Inflation Reduction Act – subsidies are more significant and accessible through the end of 2025.¹⁶

Source: 2014,¹⁷ 2015, ¹⁸ 2016,¹⁹ 2017,²⁰ 2018,²¹ 2019,²² 2020,²³ 2021,²⁴ 2022,²⁵ 2023,²⁶ 2024²⁷

Healthcare.gov: This is the federal website where you can enroll in a health insurance plan through the ACA Marketplace. 

Ohio Medicaid: Eligible individuals and families can enroll in Medicaid, which provides low-cost or free health coverage. You can also enroll in Medicaid through Healthcare.gov or call (800) 318-2596.

Ohio Department of Insurance (ODI): To receive assistance with insurance and Medicare, call an ODI representative at (800) 686-1526. 

Ohio Department of Job and Family Services: You can get help if you’re struggling to afford health coverage or want to know more about Medicaid eligibility or benefits.

Ohio Senior Health Insurance Information Program (OSHIP): OSHIP offers free health insurance information to people on Medicare.