The Affordable Care Act, which has provided free Medicaid coverage to millions of working age adults and savings on premium and out-of-pocket costs for millions more, is still in effect. Open enrollment for 2021 coverage began Nov. 1. You must enroll by Dec. 15 to get coverage for 2021. Click on “Preview Health Plans and Prices on the home page at HealthCare.gov, using the website’s tools to find out which plans include your preferred healthcare providers and cover the prescriptions you use.
The same 10 insurance companies that sold ACA plans in 2020 have been approved by the State to sell plans for 2021. All Ohio counties will have at least two companies and all but 10 counties have three or more companies offering plans on the ACA Marketplace. https://insurance.ohio.gov/wps/portal/gov/odi/consumers/news-and-events/companies-approved-ohio-exchange-2021
If you expect to need a significant amount of health care, look closely at silver plan options, because people making between 100-250% of the federal poverty level could get financial help to reduce their deductible and co-pays if they choose a silver plan. The financial aid is on a sliding scale.
Special Enrollment periods for people losing jobs, etc.: If you lose coverage or have a major life event (moving, losing a job, marriage, having a baby, etc.) during the year, you can also qualify for a Special Enrollment Period to shop for plans within 60 days following the event. Please check your options before enrolling in expensive COBRA plans. You and your family may qualify for free coverage under Medicaid.
Unfortunately, if your employer offers health insurance, you can’t get subsidies through the ACA if you decline the plan you’re offered at work. But people eligible for expanded Medicaid can switch to Medicaid if their income falls within the limits, and then drop the job-based coverage. Non-citizens who are legally present in the United States can also apply for ACA coverage with subsidies if they have first been determined ineligible for Medicaid.
You can apply for Ohio Medicaid at any time during the year online at benefits.ohio.gov. Medicaid is free, and in Ohio includes dental and vision coverage. Read more about Medicaid below.
Don’t be confused: There are many commercial websites with similar names, so be sure to use the federal website HealthCare.gov for unbiased apples-to-apples comparisons of all your options, and to submit your application for coverage. Once you complete the application, you will get an immediate answer on whether you qualify for lower premiums, deductibles, and co-pays. You can then compare plans with the savings built in to the prices. If HealthCare.gov says your income falls within the Medicaid range, apply directly to Ohio Medicaid via benefits.ohio.gov. You only need to answer the questions with red asterixis.
One of the purposes of the Affordable Care Act is to make the complexities of insurance less confusing by providing transparency. Free local assistance in understanding your options is still available: click on “find local help.” Many federally qualified health centers have staff certified to give you unbiased help in finding a plan that best fits your family’s health needs and budget. Assisters are allowed to help you over the phone in this pandemic. Ohio has a team of federally-certified Navigators at HRS ERASE who can assist people anywhere in the state. Call them at 855-894-2711
I am also a federally-certified assister and would be glad to help you understand the options you are looking at. You can reach me at 513-236-9872.
More about Medicaid
Here is the 2020 eligibility chart. Note that the limits are higher for children, so you may be able to cover your children for free, including vision and dental care, even if you don’t qualify as an adult. You can apply online at benefits.ohio.gov. Even if you have coverage through your job, you can switch to Ohio Medicaid if your income falls within the eligibility limits, which are set every January. For the Medicaid expansion, the eligibility limit goes up to 138% of the Federal Poverty Level. Enrollment is determined by Ohio’s county Job and Family Services offices, based on the household income over the preceding 30 days. You can apply online at https://benefits.ohio.gov
Many people do not realize that expanding Medicaid eligibility to adults age 19-64 was a key part of the law’s quest to get affordable coverage to the 45 million Americans who were uninsured when the law went into effect. Ohio’s Governor John Kasich got the state’s Controlling Board to accept the Medicaid expansion over the objections of his Republican majority in the state legislature, leading to over 1.26 million Ohioans getting free coverage when they needed it, often between jobs. As of June, 2019, only 526,100 Ohioans were enrolled in expanded Medicaid.
The pandemic makes the need for this safety net program more obvious than ever. In June of this year, almost 24% of Ohioans were enrolled in the state’s various Medicaid programs including children, pregnant women, working age adults, the elderly, and disabled. 1,209,081 of the Ohioans enrolled were children.
Ariel Miller of Ascension & Holy Trinity, Wyoming, is a social justice advocate and a member of the diocesan Becoming Beloved Community Leadership Team.