In Ohio, the Affordable Care Act (ACA) provides several insurance options for individuals and families. The ACA created a health insurance marketplace where eligible individuals can compare and purchase insurance plans.

No matter if you are searching for the perfect ACA healthcare plan for yourself or a business AUI can help you understand your options. Using online tools, by yourself, can feel overwhelming. You are going to have questions, and honestly, it is always nice to be able to talk to a human rather than trying to find the answer on Google. Here are some of the basics you need to know, but as always, our team is here to help you navigate all your options.

The Health Insurance Marketplace:

The State of Ohio uses the Federally facilitated marketplace, which means residents can access the healthcare.gov website to explore and enroll in ACA-compliant plans.

To explore your insurance options in Ohio, you can visit the healthcare.gov website or call the marketplace call center at 1-800-318-2596. Additionally, local insurance brokers or certified enrollment counselors can assist in selecting a plan that best suits your needs and budget.  The Cost of using a broker, like AUI is built into the rate.  It doesn’t cost anything additional to use us.

What is the ACA Enrollment Period:

The annual open enrollment period typically runs from November 1 to December 15. During this time, individuals can enroll in or update their health insurance coverage for the upcoming year. However, certain qualifying life events, such as marriage, the birth of a child, or loss of other coverage, may qualify you for a Special Enrollment Period, allowing you to sign up outside the open enrollment period.

However, AUI can help you review your plan options prior to open enrollment. We can collaborate with you to see how your current plan compares to others in the marketplace. We can also give you our experience with different options you may not have considered.

How do I know if I qualify for Financial Assistance?

The ACA provides financial assistance to help lower-income individuals and families afford insurance coverage. AUI can help you determine if you or your business would qualify for financial assistance. Today, Ohioans may be eligible for healthcare insurance premium assistance through a Cobra Subsidy or Marketplace Subsidy. Read about options for Ohioans HERE.

2023 Federal Poverty Level (FPL) requirements:

Through the Department of Health and Human Services, Federal poverty levels are used to assess if individuals qualify for healthcare benefit programs such as Marketplace health insurance, Medicaid, and CHIP coverage.  The Affordable Care Act (ACA) affordability requirement for 2023 is 9.12% of an employee’s household income. This is down from 9.61% in 2022. If you think you might be eligible you can check the current requirements HERE.

Two types of Assistance Available:

  • Premium Tax Credits: These tax credits can help reduce the monthly premium cost for eligible individuals and families. The amount of the credit is based on income and household size.
  • Cost-Sharing Reductions: This assistance helps lower out-of-pocket costs, such as deductibles, copayments, and coinsurance, for eligible individuals and families with low to moderate incomes.

To explore your individual options with both programs you can check your eligibility HERE.

Where Do I find Qualified ACA Health Plans:

ACA Health Insurance plans are offered through the marketplace of Qualified Health Plans (QHPs). These plans must meet certain requirements outlined by the ACA, including providing essential health benefits and coverage for pre-existing conditions.

Ohio has expanded Medicaid under the ACA, providing coverage to more low-income individuals and families. If you meet the income requirements, you may be eligible for Medicaid instead of purchasing insurance through the marketplace. Medicaid enrollment is open year-round. For questions regarding eligibility in Ohio please visit the Ohio Department of Medicaid HERE

How can AUI help with ACA healthcare benefits for Individuals and Businesses?

person holding a pink paper heart with AUI logo on it.

We hope that when you are ready to look at ACA healthcare plans available in Ohio, you will reach out to the AUI team. Remember using a broker like AUI doesn’t have an additional cost and you gain access to our health insurance experts year-round.  You get to talk to a dedicated member of our team not matter what comes up throughout the year.

We are here to help you answer the questions that come up often like “What if my provider doesn’t accept the plan” or “How will I know if my medication is covered?”  Our team collaborates with individuals and business owners on a one-on-one basis. We love helping people. We want you to be able to call us and speak to your broker directly with your questions and concerns. That is what we do best. Do not Google it.