Now that you have had a little time to warm up to this new health insurance marketplace, it's about time we find out what plans you should give the time of day.
With every major health insurance company in Ohio rolling out a completely new lineup of plans to meet the mandates and regulations under the Affordable Care Act, such drastic changes can be overwhelming.
Don't worry, this list is going to be pretty short.
All of those mandates and regulations have left most health insurance companies putting forth a half-hearted effort in offering you coverage that's worth your hard earned money (subsidy or not).
Because of that, you will notice this list is very lopsided (exclusive) to one health insurance company.
NOTE: You're probably going to want to take a look at our updated list for 2016.
The Best of Obamacare in Ohio
If you're looking for an individual or family health insurance policy in the state of Ohio for 2014, that company should be named Medical Mutual. They are the only company to make the list. I'll explain why others didn't make the cut in bit.
Before you get any crazy ideas, no I'm not on the take from Medical Mutual, they simply happen to be the only company putting forth a decent effort in offering health insurance plans worth the paper they are printed on.
Let's get into the list and talk more about that after the break.
1. Medical Mutual: Market HSA (Health Savings Account) 2000 - Gold
I've had my eye on this plan since I first received a leaked document outlining the companies proposed filing with the department of insurance.
The Market HSA 2000 simply provides you with the most protection of any plan available, period.
It comes standard with a $2,000 individual ($4,000 family) deductible and 0% coinsurance. That means your total out-of-pocket maximum is $2,000 or $4,000. Which is the most important number you should be concerned with.
Of course, like all HSA plans there will be no copay for your doctors office visits or your prescription medication. That shouldn't be a problem for most people as the out-of-pocket max is low enough.
The only disappointing thing about the Market HSA 2000 is it's price. There isn't as much separation between it and the next plan on the list the Market Classic 1000 - Gold.
2. Medical Mutual Market Classic 1000 - Gold
The Market Classic 1000 is the “Cadillac” health insurance plan of Ohio's marketplace.
It features a $1,000 individual ($2,000 family) deductible with 20% coinsurance and a out-of-pocket max of $5,000 ($10,000 family). It also is the only plan from Medical Mutual to include unlimited office visit copay's ($25). The plans prescription medication copay's are as follows:
- Retail: $15 copay; Mail Order: $45 copay
- Retail: $30 copay; Mail Order: $90 copay
- Retail: $50 copay; Mail Order: $150 copay
Other benefits include a $50 specialist copay and a $250 emergency room copay
The biggest difference, outside of the copay's between the Classic and HSA plans is the deductibles are embedded vs. aggregate. ‘
Of course, a Cadillac plan is going to come with a Cadillac price and will be the most expensive choice available to you.
3. Medical Mutual: Market HSA 6000 - Bronze
The final plan to make this list is again from Medical Mutual and their Market HSA 6000, which will be your go to plan for affordability and decent coverage.
I would have really liked to see a $4,000 or $5,000 deductible HSA with 0% coinsurance from them, however this is the best we got.
While a $6,000 individual or $12,000 family deductible is a decent amount of money to expect you to come up with throughout the course of the year. This still falls under my rule of “any deductible is better than no deductible.”
That means, if you think $6,000 is a lot of money, which it is, you have never stared a bill for a serious medical procedure in the face.
The Subsidy Game
Of course, if you're buying a plan inside of Ohio's Marketplace, it should mean you qualify for a tax subsidy to lower the monthly price of your health insurance policy. If not, you have no business buying from the marketplace.
These subsidies make it a little challenging to give broad, general recommendations of which plans provide you the most value. However, from the initial evaluations I have provided people with, it looks like those plans will be hard to beat.
Unless...
The only exception is if your income lands you between 200% - 100% of the federal poverty line (FPL) then Medical Mutual's Market Classic 2000 - Silver plan might become a strong contender.
Where's Everyone Else?
You might be wondering why an independent insurance broker, like myself, who prides himself on being able to offer you the best health insurance options (regardless of the company) would put a list together of just ONE company's plans?
Simple answer, they're the best. Period.
Companies like Anthem Blue Cross and Blue Shield and SummaCare will be troubled with severe network limitations in 2014. Meaning you will have to go on a Louis and Clarke like expedition to find in-network or preferred doctors and hospital to receive treatment from.
Other's like Caresource and Molina are long time Medicaid providers and this will be their first go around trying offer health insurance directly to individuals who weren't assigned to them.
NOTE: This is only in reference to individual and/or family health insurance plans sold in the Health Insurance Marketplace with a January 1, 2014 effective date or later.
The Bottom Line
Sure, I would have liked to see more health insurance companies offer plans worthy of being on the list and of course I would have LOVED to see a few more plan choices/deductible options from Medical Mutual. But this is what we were left with.
It's my job to help you make the best of it.
Remember when dealing with health insurance so much of the decision is based on your specific (unique) situation that a one-size-fits-all approach might not work.
This list of plans was put together to help you identify the “without a doubt” options that have a decent chance of working out for you regardless of your situation.
If you are looking for or need something more, don't be shy - just let me know.
