Ohio Health Insurance F.A.Q.

Tax credits may be available to you to from the Federal Government to purchase individual health insurance coverage.   In order to qualify for a tax credit you generally speaking cannot have group coverage available to you, or have other insurance coverage such as VA, Medicare or Medicaid.   Tax credits vary based upon a variety of factors such as Household Size, County you reside in, the age of people applying for income, and your modified adjusted gross income.   If you are married you must file a joint tax return to get a tax credit.  To see if you qualify for a tax credit and how much you may be eligible for you would need to fill out an application and get your Eligibility Results from the Health Insurance Marketplace.  

In order to find health insurance plans available to you can shop for plans through healthcare.gov or go to agent websites to pull up plans. I always recommend using a website that will show you all plans available to you that are available to you so you can see all your plan choices and make the best decision as to which company and plan meets your needs. If you would like to see quotes for plans and pricing and see if you may be eligible for a tax credit you can go to our agency’s quoting tool by clicking the link below.

HMO Stands for Health Maintenance Organization. What this means to you as an insured is that in order for you to be covered with the exception of an emergency you have to use health insurance providers that are in the plan network in order to have coverage.

PPO Stands for Preferred Provider Organization. Being insured in a PPO you have more freedom of choice of providers you may use. You will generally save money and have lower deductibles, copayments, coinsurance, and out of pocket maximums by using providers that are contracted with your plan. This type of plan does allow you to use providers that are not contracted with the plan as well however you will typically pay much more money out of your pocket to use out of network providers. Anything that sounds good about have more freedom of choice to providers in these plans can quickly end when you evaluate how much more you may have to pay out of pocket for medical services by using an out of network provider. Always check to see what out of pocket costs you may incur before deciding to use and out of network provider.

This can be done in a variety of ways but the best way to do this is going directly to the insurance carrier website and that is where you will find the most up to date information. You can find these links by using our health insurance quoting tools and find the link to the provider networks for plans in your area. Many insurance carriers that offer coverage in the Health Insurance Marketplace have much more limited networks with fewer provider choices than they may offer in the group health insurance market. If you are insured in a group insurance plan and losing your benefits do not automatically assume if you enroll in the individual marketplace with the same company that you can use the same providers. Click the link below for more information on plans available in your county and links to their provider networks.

The Affordable Care Act mandates what services are covered in plans offered in the individual marketplace and these services are covered at no cost to the insured. Examples of services that may be covered under your plans preventative services can include PapSmear, Mammograms, PSA Testing, Colonoscopy’s and other colorectal screenings and many others. The rules pertaining to qualifying for these tests to be covered as a preventative benefit are set by the Federal Government as part of The Affordable Care Act not the insurance company. To see more information on Preventative Services visit www.healthcare.gov and type Preventative Services in the search bar.