Ohio's marketplace offers HMOs exclusively, but I can still help you obtain a nationwide PPO. If you're paid on 1099s, here's how I'd compare plans based on your earnings, medical needs and type of work.
Hi, I'm Sam. I'm a health insurance broker licensed in 36 states, and I work by phone with Ohio 1099 contractors who need their own plans. That includes HVAC workers in Columbus, delivery drivers around Toledo and designers in Cincinnati.
If you're an Ohio contractor getting paid one invoice at a time, there are a few coverage rules worth understanding. The marketplace offers HMOs exclusively, Medicaid eligibility extends further than it does in many other states, and Ohio has a continuation law for people leaving W-2 employment. Here's what that means for your choices.
This year, Ohio residents can choose among 189 individual medical plans on HealthCare.gov. Every single one is an HMO, with no PPO available.
I can help you get nationwide PPO coverage in Ohio through a private insurer rather than the marketplace. The insurer reviews your health to determine pricing, and the network includes physicians and hospitals throughout every state. If you're healthy and your contracts take you between counties or across state borders, I'd compare a quote.
When applying through HealthCare.gov, report your estimated net self-employment earnings for the coverage year. That's your 1099 income after deducting supplies, vehicle costs, tools, software, materials and other business expenses. Include your spouse's earnings too, and revise the estimate whenever your income changes.
In Ohio, your income generally puts you into one of three situations. Medicaid expansion reaches adults earning up to 138% of the federal poverty level. Above that, premium tax credits can reduce marketplace costs when you're eligible. Beyond the credit limits, you pay the entire premium. The distinction matters because Medicaid eligibility usually prevents you from receiving the marketplace credit.
In that situation, a HealthCare.gov HMO will generally cost you the least because that's the only place the credit can be used.
Every one of Ohio's 88 counties has plans, with between 3 and 9 insurers depending on location. All the choices are HMOs, so make sure your physicians participate before focusing on premiums. Remember, these plans generally cover out-of-network treatment only for emergencies.
Next step: Bring your 1099 records or an approximate profit figure. We'll estimate your income and find an HMO network that includes your doctors.
If you're paying the full premium and frequently travel for contracts, the marketplace's HMO-only selection may not be appealing. I'd compare a private nationwide PPO instead.
The application includes questions about your health. Based on those answers, the carrier may approve coverage, decline it or approve it while excluding a named condition. Healthy contractors often qualify for premiums below the marketplace's full price, with a network that reaches their work locations. Since benefits vary between policies, we'll examine them together before you decide.
Next step: Give me a call. I'll compare a nationwide PPO quote for your household with the Ohio marketplace HMOs offered in your county.
When a major customer disappears, your annual income might fall enough to qualify for Medicaid. Ohio's expansion covers adults earning no more than 138% of the poverty level, and applications are accepted throughout the year. That makes it an important fallback.
Pay attention when income changes. A new contract could move you beyond Medicaid eligibility and into marketplace premium-credit territory. Report the increase and change coverage accordingly.
Next step: If your contracts aren't bringing in much this year, call me. We'll compare Medicaid and marketplace coverage and plan the timing of any change.
Ohio's continuation law may allow you to retain coverage from an insured employer group policy for as long as 12 months. You generally need three consecutive months of prior coverage and must satisfy the remaining legal requirements. Depending on your employer, federal COBRA could also be available.
When employer coverage ends, you also qualify for a special marketplace enrollment opportunity. Before choosing, compare the price of keeping your former policy against a credit-supported HMO and a nationwide PPO.
Next step: Contact me before your employment ends. We'll put continuation coverage, marketplace plans and a nationwide PPO next to each other.
Straight answers, no sales pitch.
No. Ohio's marketplace has 189 individual medical plans, and every one is an HMO. I can help healthy contractors obtain a private nationwide PPO.
Yes, depending on earnings. Ohio's Medicaid expansion covers adults up to 138% of the poverty level, with enrollment available year-round.
It may be possible. Ohio permits up to 12 months of insured group coverage continuation when statutory conditions are met. Federal COBRA could apply as well.
Report your expected yearly self-employment profit after deducting business costs, and revise the figure whenever it changes.
Tell me which Ohio county you live in, who needs to be insured and approximately how much profit your 1099 work brings in. I'll price your choices and help determine whether Medicaid, a marketplace HMO or a nationwide PPO makes sense.
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