Ohio Health Insurance Guide 2025

Everything you need to know about health coverage in the Buckeye State

Medicaid Expanded

Key Facts

Medicaid Status Expanded (2014)
Marketplace Federal (HealthCare.gov)
Open Enrollment Nov 1 - Jan 15
Uninsured Rate 6.1%

Medicaid in Ohio

Ohio expanded Medicaid in 2014, providing coverage to hundreds of thousands of previously uninsured adults. The expansion group, known as "Group VIII," provides comprehensive health benefits to eligible low-income Ohioans.

Who Qualifies for Ohio Medicaid?

  • Adults ages 19-64 with income up to 138% FPL ($20,783/year for individuals) - Group VIII
  • Pregnant women with income up to 200% FPL
  • Children under 19 with income up to 206% FPL
  • Seniors and people with disabilities meeting income requirements
  • Parents/caretakers meeting income requirements
Major impact: Ohio's Medicaid expansion has covered over 700,000 adults since 2014, significantly reducing the state's uninsured rate and improving access to preventive care and treatment for chronic conditions.

Ohio Medicaid Benefits

  • Preventive care and wellness visits
  • Doctor visits and specialist care
  • Hospital inpatient and outpatient services
  • Prescription drug coverage
  • Mental health and substance abuse treatment
  • Dental services (limited for adults)
  • Vision care
  • Laboratory and X-ray services

How to Apply

You can apply for Ohio Medicaid through:

  • Online at benefits.ohio.gov
  • By phone: 1-844-640-6446
  • In person at your local County Department of Job and Family Services
  • Through a certified application counselor or navigator

Health Insurance Marketplace

Ohio uses the federal Health Insurance Marketplace at HealthCare.gov. If you earn more than 138% FPL or prefer private coverage with more plan choices, the marketplace is your best option.

Available Plan Types

  • Bronze: Lower premiums, higher out-of-pocket costs (60% coverage)
  • Silver: Moderate premiums and costs (70% coverage) - best for subsidies
  • Gold: Higher premiums, lower out-of-pocket costs (80% coverage)
  • Platinum: Highest premiums, lowest out-of-pocket costs (90% coverage)
Good competition: Ohio has multiple insurance carriers participating in the marketplace, giving consumers more choices and competitive pricing, especially in urban areas like Columbus, Cleveland, and Cincinnati.

Enrollment Periods

Open Enrollment: November 1, 2024 - January 15, 2025

Ohio Medicaid accepts applications year-round. You can also qualify for a Special Enrollment Period on the marketplace if you have a qualifying life event.

Average Costs in Ohio

Health insurance costs in Ohio vary based on your age, location, plan type, and tobacco use. Here are typical monthly premiums before subsidies:

Plan Type Individual (Age 40) Family of 4
Bronze $340 - $410 $1,100 - $1,350
Silver $430 - $530 $1,350 - $1,700
Gold $500 - $600 $1,550 - $1,950
Ohio Medicaid $0 $0
Subsidies lower costs significantly: Over 80% of Ohio marketplace enrollees receive premium tax credits. After subsidies, the average premium drops to well under $150/month for most enrollees.

Frequently Asked Questions

Has Ohio expanded Medicaid?

Yes, Ohio expanded Medicaid in 2014. Adults ages 19-64 earning up to 138% of the federal poverty level ($20,783 for an individual in 2025) qualify for Ohio Medicaid coverage through the Group VIII expansion.

What is Ohio Medicaid Group VIII?

Group VIII is Ohio's Medicaid expansion category for adults ages 19-64 with income up to 138% FPL. This group was created when Ohio expanded Medicaid in 2014. Members receive comprehensive health benefits through managed care plans.

When is Open Enrollment for Ohio health insurance?

Open Enrollment for 2025 marketplace coverage runs from November 1, 2024 through January 15, 2025. Ohio uses the federal marketplace at HealthCare.gov. Ohio Medicaid accepts applications year-round.

How much does health insurance cost in Ohio?

The average monthly premium for a benchmark Silver plan in Ohio is approximately $430-530 before subsidies. Many Ohio residents qualify for premium tax credits that significantly reduce costs, with some paying less than $100 per month after subsidies.

Need Help Finding Ohio Coverage?

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