Time flies when you’re getting a deal on your health insurance. The first year of “Obamacare” is pretty much in the books and that means you get to do the whole thing over again.
Alright, hold on, maybe not the whole thing.
NOTE: You're probably going to want to check out our updated list for 2016.
If you’re happy with the way everything went last year, if your plan got the job done and you can manage the new rate then you just need to reconfirm your subsidy for 2015 and you’re good to go.
Much like last year this list is going to be pretty short. Very little has changed in terms of what plans and companies remain a good option for you.
Most companies are still offering restricted networks of doctors and hospitals. HMO’s are making a comeback with companies like Caresource and UnitedHealthCare.
If you’re wondering what the difference between HMO’s and PPO’s are, HMO’s are what you buy when you can’t afford a PPO. At least that’s what my dad always taught me.
If you want a more detailed explanation, our “Complete Guide to Buying Health Insurance” ebook has a pretty good answer.
Yes, there are a few new faces also playing in Ohio’s marketplace this year.
But at the end of the day, there is still only one company I can firmly recomend this year and it’s the same one as last year. Medical Mutual.
I will include a couple honorable mentions this year as there are a few very slim (see specific) alternatives.
But let’s get on with the list.
MedMutual Market HSA 3000 Silver
Deductible: $3,000 (Single) $6,000 (Family)
Coinsurance: 0 Percent after deductible
Out-of-Pocket Max: $3,000 (Single) $6,000 (Family)
First, don’t let the deductible and out-of-pocket max fool you. Plans that have zero percent coinsurance mean that you aren’t responsible for any money beyond the deductible. So the most money you will pay in a calendar year for covered medical services is $3,000 for a single person or $6,000 for a family (two or more people).
This is the plan I wish was around last year. HSA’s and $3,000 deductibles go together like peanut butter and jelly.
In a lot of cases this is the happy medium between all things health insurance.
Also, since this is a silver plan, if your income is low enough and you qualify for the extra cost sharing subsidies you could be looking at a plan with a $500 deductible (single person) and out-of-pocket max.
That is crazy.
NOTE: The plan will technically not be a HSA at the two lowest cost sharing levels because the deductible does not meet the minimum requirements.
MedMutual Market HSA 6000 BronzeDeductible: $6,000 (Single) $12,000 (Family)
Coinsurance: 0 Percent after deductible
Out-of-Pocket Max: $6,000 (Single) $12,000 (Family)
It’s hard to fall in love with this plan without doing some serious math or unless it’s the only one you can afford.
Before you make any crazy health insurance statements that you can’t take back, you will want to see how much this plan will cost you and figure out how much money it will save you in comparison to a lower deductible.
I actually break all off that down for you in my free 5-part video course on “How to Get Health Insurance After Obamacare” in the fourth video.
Yes paying $12,000 up front before the plan “kicks in” is a pretty scary proposition, but the question you need to ask yourself is how much did you pay toward your deductible last year?
If your answer is $500, $1,000, $2,000 or even $3,000 than you have probably have been wasting your money on too low of a deductible.
The worst thing you can do is just meet your deductible or barely go over it. If you do, than your health insurance company wins big time.
You want to make sure you have guaranteed medical expenses that exceed whatever your deductible you're buying by a couple thousand dollars.
That is of course if you want to get the most out of the policy.
MedMutual Market Classic 1000 GoldDeductible: $1,000 (Single) $2,000 (Family)
Coinsurance: 20 Percent after deductible
Out-of-Pocket Max: $5,000 (Single) $10,000 (Family)
This plan made the list last year and I’m going to reluctantly include it again this year.
If we are being honest with each other, it’s very rare for this plan to actually make sense for you.
BUT, because there are a few people/scenarios where it might be your best option, It is on here for you to know about.
You are going to pay a lot of money for it and still have to pay a decent amount of money in the big picture if you have to use it.
The Market Classic 1000 Gold’s strength is in its unlimited copays for doctor office visits and prescription medication.
You are going to want to be absolutely sure you need those copays before you take this plunge.
AssurantThey deserve an honorable mention for offering a network that is on par, if not better than Medical Mutual’s. However they are only an honorable mention because they will make you pay dearly for that network compared to Medical Mutual.
InHealth MutualThey are the new kids on the block, but might be worth a look for anyone willing to roll the dice on a brand new health insurance company in its first year. Upon first glance the network is decent and the plan offerings standard.
Cost Sharing Subsidy WorthyAgain, if your income falls between 200-138 percent on the federal poverty scale (FPL) in addition to Medical Mutual’s Market HSA 3000 silver, their Market Classic 2000 Silver will offer you two of the greatest deal in the history of health insurance.
Where Is Everyone Else… Still?I was really hoping this year would be a little different. The independent insurance agent in me hates being a one trick pony.
If I squint really hard and maybe close one eye another plan from another company might make sense. Medical Mutual did make a few changes that weren’t for everyone, but they still made 99 percent of the people I dealt with happy.
You goal is to pick a plan and a company that provides the greatest choice of doctors and hospitals at the most affordable rate and has a plan structure that works for you.
If Medical Mutual has had one consistent downfall it’s that it has a pretty big gap between their silver and bronze plans. Other companies might have more options for you to choose from, however of the three items to choose a health insurance company on, plan structure is the one I would comprise on first.
The Bottom Line
Much like what I said last year, yes I want to be able to offer you more choice. Yes I wish Medical Mutual had more plan options.
But it is what it is. I’m not going to offer those things just to offer them. They have to make sense for you.
It is my job however to make sure you make the best of whatever situation is thrown at you.
Again, this list of plans was assembled with the intention of make sure you knew which plans were a slam dunk to consider.
Are there a few other (see rare) options that might appeal to you more?
If you think or want to know if they will be of interest to you, just let me know.
Joey is the third generation to join the family business. He's the agency’s primary content creator and all around web guy. When Joey isn’t talking about insurance on the internet, or helping clients he’s probably spending time with his family. In other rare spare moments he could be found obsessing over one of the local Cleveland sports teams, struggling to stay awake late enough to play video games or trying to remember how to play the bass guitar.