Most people in Ohio are enrolled in a health insurance plan through their employer. If you do not have job-based coverage, you have to purchase Ohio health insurance on your own. By 2014, Ohio will have a health insurance exchange where you can shop for your coverage. One Source Benefits helps you understand the various types of Ohio health insurance plans and purchase an affordable option that can meet your unique needs.
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Health Insurance Ohio
– Types of Plans
Health insurance plans in Ohio are classified under two broad heads: managed care plans and indemnity plans.
Managed care includes HICs (health insuring companies), PPOs and POS plans. The health care providers in the plan network contract with the insurance company to perform services for members at pre-negotiated rates and will usually submit the claim to the insurance company for them. Some plans require members to pick a Primary Care Physician (PCP). The PCP can provide references to a specialist in the plan network if necessary.
A HIC plan offers comprehensive coverage for a monthly premium. Out-of-pocket costs are likely to be lower than other plans. Members may have to make a copayment for services from in-network doctors.
With a PPO (Preferred Provider Organization) plan, members will benefit from using the insurance company’s network of preferred doctors and hospitals. These healthcare providers are under contract to provide services to the health insurance plan’s members at a discounted rate. Members typically won’t be required to have a primary care physician and can choose to see any doctor or specialist within the network. Enrollees can go out-of-network but would have to pay a higher percentage of the cost of coverage than for in-network services.
A POS (Point of Service) plan offers flexibility as it blends features of both HICs and PPOs. Members can see doctors in the network or other doctors, with a higher cost to use doctors outside the network.
Indemnity (Fee for Service) policies offer a broader selection of healthcare providers than managed care plans. Under these traditional Ohio health insurance plans, members can use any hospital or doctor and have to pay a monthly premium, an annual deductible and coinsurance for each service. Indemnity policies pay their share of the costs for covered services only after they receive a bill (which means that you may have to pay up front and then obtain reimbursement from your health insurance company).
It can be quite confusing when you are faced with so many choices. That’s where we come in. As an experienced, licensed health insurance broker in Ohio, we can provide you with the guidance necessary to compare different options and choose the right Ohio health insurance plan for you and your family.