Ohio Health Insurance Information

→ Visit the Ohio Department of Insurance online

Guaranteed Health Insurance Plan

As a HIPPA eligible enrollee, you can buy either a Basic or Standard Plan individual health insurance policy any time without waiting for an open enrollment period. All individual insurers must offer either the basic or standard plan; are guaranteed the right to purchase either plan; and are not subject to any pre-existing condition exclusion periods or elimination riders.

HIPAA Eligibility

To be HIPAA eligible in Ohio, you must:

1. Have 18 months of continuous creditable coverage, with at least the last day under the Brethren Ministers Group; and
2. Not be eligible for Medicare, Medicaid or a group plan; and
3. Apply for health insurance for which you are HIPAA eligible within 63 days of losing your prior coverage; and
4. Not have health insurance.

Note: If you know your group coverage is about to end, you can apply for coverage for which you will be HIPAA eligible.

How much will health insurance coverage cost?

As HIPAA eligible applicants, the most you can be charged is two times the amount that an insurance company would charge a healthy individual buying that same plan.

Insurance Availability

Traditional individual health carriers must guarantee issue two standardized products to individuals exercising their group-to-individual HIPAA portability rights.

• HMOs must guarantee issue coverage one month each year to HIPAA eligible individuals
• For a link to all Ohio health insurers, including HMOs, click on Ohio Insurers

Coverage Highlights

Basic Plan Highlights

• Covers hospital and physician services
• Limited prescription drug benefits
• Pays 50% of covered services after a $1000 deductible
• Special limits apply to coverage for mental health care, preventative services, and organ transplants
• Routine maternity not covered
• $50,000 maximum per calendar year for all coverage

Standard Plan Highlights

• Covers hospital and physician services
• Limited prescription drug benefits and other health services
• Annual deductible of $750
• 80/20 or 60/40 co-insurance, depending on which plan chosen
• Lifetime maximum of $1 million

How can I be insured in Ohio?

For enrollment information, visit the Ohio Department of Insurance online at www.ohioinsurance.gov, or call (800) 686-1526.

Special insurance for children: Healthy Start

A family of four making up to $36,800 a year may be eligible for Healthy Start.

• Do you qualify? Visit Eligibility
• Questions? View their FAQs, or call (800) 324-8680