ObamaCare in Ohio
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About Obamacare in Ohio
Most individuals, except for select groups, are now required to have health insurance coverage with the minimum essential benefits. This is established in the “Individual Mandate” of the Affordable Care Act (Obamacare), which is a federal law intended to change the way insurances worked. The law went into effect on January 1st, 2014 and those who do not have coverage will have to pay a tax penalty. Currently, the penalty is $95 per adult and $47.50 per child or one percent of the total family income, whichever is higher. These amounts will increase the next two years. If you need to find out if you apply for an exemption, go to: https://www.healthcare.gov/exemptions/.
Take into account that if you have Medicare, Medicaid, COBRA, a job-covered insurance or any other insurance that covers the minimum essential benefits, you are good to go. The Health Insurance Marketplace is the website you should visit if you want to purchase subsidized health insurance coverage. In Ohio, the marketplace is facilitated by the federal government and you will find it at: https://www.healthcare.gov/. All the plans offered at the Marketplace are certified as Qualified Health Plans (QHP).
Individual & Family Coverage
The Ohio Health Insurance Marketplace offers four levels of coverage and a Catastrophic plan for people under 30, or who are unable to afford a plan due to their income level. The coverage levels are called metal tiers and the cost will vary among them. Bronze plans must cover 60 percent of the costs, Silver must cover 70 percent, Gold must cover 80 percent and Platinum must cover 90 percent. The plans with lower premiums will have higher copayments and deductibles and the plans with high premiums will have lower out-of-pocket expenses. Regardless of which level you choose, all the plans must cover the minimum essential benefits including emergency care, prescription drugs, doctor visits, hospitalizations, and maternity care, among others.
Open enrollment period in OH ended on March 31st, 2014. The next open enrollment period starts on November 15th, 2014 and ends on February 15th, 2015. If you have experienced a qualifying life event such as marriage, birth of a child or loss of job coverage, you may apply for Special Enrollment Period. In that case, you will have 30 days after your qualifying life event to apply.
The Health Insurance Marketplace in OH has a separate Small Business Health Options Program (SHOP) Marketplace for small businesses with less than 50 full-time employees. Through SHOP, employers will be able to review, compare, ask questions and choose the plan than best suits their needs. If you own a small business and want to provide coverage to your employees, you will have advantages such as controlling how much you will pay in premiums and choose the level of coverage you want to offer to your employees.
Small businesses with less than 50 employees are not required by law to provide health insurance coverage. Using SHOP gives you the advantage of choosing the level of coverage that you want to provide to your employees, control how much you will pay for premiums and obtain information or answers to your questions. Even if small businesses with less than 50 full-time employees are not required by law to offer health insurance benefits, if you purchase a group plan for your employees, your business will be more competitive and you will keep your employees satisfied.
If you want to purchase a SHOP plan, visit https://www.healthcare.gov/small-businesses/, review the plans and compare premiums. If you decide to purchase one, contact an agent, broker or the insurance company directly. The enrollment is throughout the year, before the 15th of any month.
With the approval of the Affordable Care Act in Ohio, individuals with pre-existing conditions cannot be discriminated against. Starting in 2014, insurers will no longer be authorized to refuse coverage due to pre-existing conditions. Regardless of your health status, you will enjoy the same privileges as a healthy person. If you were denied insurance in the past because you have cancer, diabetes, a chronic illness or any other medical condition, you will never experience this again, even with the same company that previously turned you down.
In addition, insurance providers are not allowed to modify your plan, change more or drop you if you get sick. Men and women will now pay the same amount and have the same benefits.