Health Insurance in Ohio

Medical care and services in the US are incredibly expensive without health coverage. Therefore, many uninsured individuals delay or forego necessary medical care, which sometimes leads to more serious health issues. But everyone deserves access to quality and affordable healthcare. And for people in the USA – it’s one of the top priority questions. You’re probably familiar with the healthcare system and how it works in general, but for each state, the insurance options and programs can vary. Whether you are a lifetime Ohio resident or recently moved to the state, we want to highlight the main facts and health insurance options available in Ohio.


% of Ohio residents were covered by Medicare in 2023

Facts about the healthcare system and health insurance in Ohio

1. Ohio is among the top 10 states with the lowest health insurance premiums in the country, according to a 2021 research report. This makes it a great state to live in if you’re looking for affordable health insurance.

2. The state law requires insurance companies to provide mental health and substance abuse treatment services coverage. This includes coverage for counseling, therapy, and inpatient treatment, among other services.

3. Ohio is one of the several states that offer a health savings account (HSA) program for its state employees. An HSA is a tax-advantaged savings account that can be used to pay for qualified medical expenses.

4. Ohio law prohibits insurance companies from denying coverage based on pre-existing conditions. This means that if you have a pre-existing condition, you cannot be denied coverage or charged higher premiums because of it.

5. Ohio has a high percentage of residents who smoke, which can lead to higher healthcare costs and increased rates of chronic diseases. To address this issue, Ohio has implemented a statewide tobacco cessation program that offers free resources and support to help residents quit smoking.

6. While you’re experiencing a coverage gap, you can buy short-term health insurance plans and can get policies with initial terms of up to 364 days. At least 11 insurers are offering short-term health insurance in Ohio.

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The enrollment period for individuals/family insurance in Ohio

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Unlike Medicaid and CHIP programs that have a year-round enrollment period for eligible individuals – people, who don’t have employer-sponsored coverage or qualifying life event, have an opportunity to buy health insurance in Ohio only during the special open enrollment window. As the state uses a federally facilitated health insurance exchange, the period falls under the schedule. From 2022 the residents of the state can enroll or switch the current health insurance plan during the new extended enrollment window that lasts from November 1 to January 15.

Similarly to ACA Marketplace – Medicare also has its own enrollment periods: initial and annual. The initial enrollment period for Medicare in Ohio begins three months before the month of your 65th birthday and ends three months after your 65th birthday. The annual Medicare enrollment window that lasts from October 15 to December 7 allows Medicare beneficiaries the chance to switch between Medicare Advantage and Original Medicare (and add, drop, or switch to a different Medicare Part D prescription plan). People who are already enrolled in Medicare Advantage also have the option to switch to a different Advantage plan or Original Medicare during the Medicare Advantage open enrollment period, which runs from January 1 to March 31.

However, if under different circumstances you missed an enrollment period and don’t have any qualifying life events, there is still a realistic alternative to get health coverage, while waiting for a more comprehensive plan to become available. Ohioans are allowed to get short-term health insurance any time of the year and choose a coverage period of up to a year. These plans may include coverage for doctor visits, hospital stays, and some prescription medications, but usually do not cover pre-existing conditions or certain types of treatments.

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What are Ohio’s Medicare options for seniors and people with disabilities?

According to the latest statistics around 20% of Ohio residents are covered by Medicare in 2023. And while Medicare is commonly associated with aged-based eligibility of turning 65, several circumstances also trigger special eligibility for this program.

In Ohio, about 13% of Medicare beneficiaries are under 65. Check if you’re eligible for the Medicare program and learn more about its different parts.

The federal government’s Original Medicare program or a private Medicare Advantage plan are both options available to Medicare enrollees as their health insurance. However, which part to obtain will be closely related to your health condition and particular needs. Currently, Medicare Advantage is more popular in Ohio than in the country in general. And this is because in certain Ohio counties, there are more than 100 Medicare Advantage plans available, offering additional benefits, such as dental, hearing coverage, and vision coverage.

How to find the most affordable health plan in Ohio?

Whether you need help with finding your affordable health plan options in Ohio, you can rely on Baker Consulting. We know how it might be confusing for most people to find the right plan according to their unique health needs. That’s why it’s so important for us to provide unlimited support and guidance for you in the questions regarding your health.

Contact our licensed insurance broker to receive a full picture of your options with 100% unbiased comparisons of benefits and plan costs today.