As a resident of Ohio, the law makes it possible for you to buy a short-term health plan for as little as 30 days or up to 364 days. Unlike other states where you can extend coverage for multiple years during enrollment when you first apply for temporary coverage in the Buckeye State, you’re limited to a maximum of 364 days of coverage.
If you want to reapply for a new policy later, you’ll need to complete another application, again with a maximum limit of 364 days. You’re also allowed to apply for short-term medical coverage in Ohio in increments: You can enroll for 180 days and then reapply for a second 180-day coverage period during the same year.
What You Need to Know
- Ohio doesn’t allow short-term plans to last past 364 days.
- The Buckeye State has dozens of short-term options available.
- Temporary health insurance makes sense in a number of situations, including when you’ve lost a job, don’t qualify for subsidies for an ACA plan or are waiting for new employer-based coverage.
Is Short-Term Health Insurance Right For Me?
A short-term health plan (also called temporary health insurance) could be a good option if you need immediate coverage that’s more affordable than an Affordable Care Act (ACA) plan purchased through the federal Health Insurance Marketplace. Enrollment for temporary insurance can be completed online in just a few minutes.
Since short-term medical plans don’t cover preexisting conditions, they’re typically best for people who are relatively healthy and don’t plan to use their coverage a lot. But if you’re looking to temporarily fill a gap in coverage, a short-term health plan can be an easy and quick alternative to permanent plans that are more expensive.
Temporary coverage may also make sense if you’re waiting for permanent coverage and/or find yourself uninsured for various reasons, such as:
- You’ve lost your job.
- You’re in a 90-day waiting period for coverage with a new employer.
- You’re getting married or divorced.
- You’re turning 26 and aging off your parent’s health plan.
- You missed the ACA Open Enrollment Period.
- You can’t afford the monthly premiums on an ACA plan and don’t qualify for a subsidy.
- You’re retiring early and aren’t yet eligible for Medicare.
- You’re not eligible for Medicaid or other programs to help you get or pay for insurance.
While Ohio doesn’t allow residents to enroll in short-term medical insurance for more than 364 days, any plan you choose can be tailored to your needs. You can choose your deductible (which will influence your coinsurance options) and then decide if you want to add a doctor’s office copay and/or prescription copay benefits. (You’ll find more information on these costs below.)
With short-term policies, you can apply for coverage any time of year. This can be a big help if you’ve missed the Open Enrollment Period to sign up for coverage through an Affordable Care Act plan and you don’t qualify for a Special Enrollment Period.
Most short-term insurance plans have other benefits as well, like the option for telehealth care for a low fee. This allows you to see a doctor through a video visit for less than what you would pay for an in-person consultation.
When Would Short-Term Health Insurance Not Be Right for Me?
If you have a preexisting condition or a chronic medical condition that requires multiple office visits each year, take prescription drugs and/or have been told by a doctor to seek further treatment, temporary coverage is unlikely to be the best option for you. In these cases, a federal Marketplace health plan could serve you better.
In Ohio, as in many other states, short-term policies aren’t required to cover previously diagnosed conditions or illnesses. If you do submit a claim for a doctor’s visit or hospital stay related to a preexisting condition, the policy administrator at the insurance company has the right to investigate your health history to ensure your condition doesn’t relate to a previous problem.
Any plan sold through the Marketplace must include 10 essential health benefits as mandated by the Affordable Care Act. These benefits include cancer screenings, oral and vision care for children, hospitalization, lab tests, and birth control. These services can often be worth the cost of the monthly insurance premium, especially if you see a doctor frequently or anticipate needing surgery or ongoing treatment while you’re covered.
What Does a Short-Term Plan Cost in Ohio?
As with other types of insurance, when you buy a short-term health plan you pay what’s known as an insurance premium. This monthly payment is calculated based on your age, gender and where you live. A 35-year-old woman in Columbus would pay between $64 to $280 per month in premiums, depending on the plan, according to the Pivot Health cost calculator.
There are more than 50 short-term health insurance plans in Ohio to choose from. As you shop for health insurance, keep these costs top of mind so you can make the best selection for your budget and medical needs:
The deductible is the amount you pay out-of-pocket for medical services before the insurance carrier is responsible for contributing to your costs. Annual deductibles range from $1,000 to $20,000, depending on the plan you choose. The lower the deductible, the higher your monthly premiums will be (and vice versa).
Once you’ve paid your deductible for the year, any additional medical expenses are typically shared by you and your insurance company. Known as coinsurance, this is the percentage you pay for those additional costs. For example, you may choose a plan with 20% coinsurance. This means you pay 20% of any additional costs after you’ve paid your deductible and your insurance company pays the rest (80%). Some insurers will pay 100% of your coinsurance, so if you can’t afford any additional medical charges after paying the deductible, look for a plan with 100% coinsurance.
Some short-term medical plans have copayments (or copays), which is a fixed amount you pay for covered services, like doctor’s office visits or prescription drug coverage. These copays can help save you money by capping the cost of a consultation or generic medications to one flat price. For example, in Ohio, you can get temporary insurance with a $60 copay for urgent care visits. Without the copayment, a visit can run up to $200, which you would have to pay in full if your deductible hasn’t been met.1
Total Coverage Maximum
The cost of your monthly premium is also determined by how much coverage you want during the duration of the policy. A policy, for example, may cover you up to $100,000 of medical expenses, which may make sense if you’re buying coverage for a shorter amount of time. Or perhaps you want to have up to $1 million in insurance protection if you’re buying a 364-day plan.
How Do I Buy a Short-Term Insurance Plan in Ohio?
You can purchase a short-term plan online from multiple insurance carriers authorized to sell policies in Ohio. Or you can work with a health insurance agent in person or over the phone to choose a policy and complete your application.
You can enroll online at a private marketplace like Pivot Health, sign up with a licensed agent or buy a policy directly from a health insurance company.
Getting Extra Insurance Coverage in Ohio
If you’re concerned about your ability to pay for a short-term plan, you can buy additional insurance coverage to supplement your coverage.
Limited-benefit health insurance is a no-deductible plan that pays cash benefits for doctor’s office visits, hospital stays, lab work and more. Depending on the plan selected, benefits include lump-sum payouts to the person who is insured. As an example, a 35-year-old woman living in Ohio could receive between $54 and $193 a month in payouts.
Limited medical benefits pay specific cash payments for both sickness and accidental injuries regardless of other coverage. No specialist referrals are required and benefits do not vary; the fixed dollar amount covers both in- and out-of-network providers, giving you the freedom to see anyone you like.
Additional benefits include emergency room visits, surgeries, ground and air ambulance, and some plans include an accidental death benefit for your beneficiaries. Benefits do vary by plan so be sure to read the plan disclosures carefully.
With dozens of short-term health insurance plans to choose from in Ohio, you can feel assured there’s one that’s right for you, either on its own or coupled with a limited-benefit plan that gives you extra financial protection.
No matter which plan you’re interested in, you can get quotes at no cost online or through a licensed health insurance agent.
If you do decide to purchase temporary medical coverage, be sure to keep these questions in mind as you evaluate a policy:
- Premium: How much can you afford to pay each month for coverage?
- Deductible: How much can you afford to pay out-of-pocket annually beyond the cost of your monthly premium?
- Coinsurance: Do you need the insurance company to pay 100% of expenses after you meet your deductible, or can you shoulder more expenses to keep your monthly premium lower?
- Total coverage: What is the maximum amount of coverage you’ll need based on your current health?
Armed with this knowledge, you’ll be well-equipped to make the choice that’s right for you.