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Ohio Health Insurance Marketplace / Exchange / Affordable Care Act (ACA) | United States Department Of Health And Human Services (HHS)

200 Independence Ave. Sw, Hubert H Humphrey Bldg., Washington, DC 20201

Eligibility

Ages 18 and older in the United States who enroll during open enrollment period. Some may qualify for “special enrollment” if they have had a "qualifying life event" at other times, such as starting or leaving a job, certain changes in income, and/or changes in family size (for example, if they have marry, divorce, or have had a baby). Those living in the United States, including U.S. citizens, U.S. nationals and non-citizens who are lawfully present as of January 1, 2014. Individuals age 26 and younger are permitted to receive coverage through their legal guardians' plan. Individuals on Medicare and Medicaid will NOT be affected by the Marketplace. Individuals who are incarcerated are not eligible.

Required documents

None needed to get general information. To apply for coverage and financial help, must provide name, address, phone number, Social Security number, date of birth, household size, citizenship status, income and information about eligibility for other insurance.

Hours

*November 1, 2024-January 15, 2025. November 1-December 15 for coverage that starts January 1, 2025. *Those who enroll or change plans between December 16, 2024 and January 15, 2025 will have coverage that starts February 1, 2025. *Line is open 24 hours a day, 7 days a week for hotline and online (closed major holidays). *A Special Enrollment Period (SEP) extends enrollment for those who lost Medicaid or coverage under the Children's Health Insurance Program (CHIP)between March 31, 2025, and July 31, 2025. No proof of qualifying life event is required for these participants. *In other cases, a Special Enrollment Period (SEP) is available within 60 days of a qualifying life event outside of open enrollment.
https://www.healthcare.gov

Application process

Telephone call center 24 hours a day, 7 days a week or access web site for help determining what services to use and check on available subsidies. Those requesting other types of special enrollment must contact the call center. Those who appear eligible for Medicaid will have their information forwarded to the appropriate state agency.

Fees

Free to apply. Insurance plans purchased through the Marketplace require monthly premiums, deductibles and co-payments. The amount of those fees is based on the level of coverage chosen, the participant's age, where they live and whether they smoke. Those whose income is between 100-400% FPL are eligible for financial help. Individuals and families who did not have health coverage in 2017 are subject to a fee or “individual responsibility payment” when they file their 2017 taxes. The fee, whichever is higher is what will be paid: 2.5% of annual household income (the maximum penalty is the national average premium for a Bronze plan) or $695 per person ($347.50 per child under 18 in which the maximum penalty per family using this method is $2,085).

Service area

United States

Description

Provides information on eligibility, the application process, and benefits offered by insurance plans approved by the Affordable Care Act. Every plan covers 10 "Essential Health Benefits," which include emergency, outpatient, mental health and substances abuse services, as well as prescription drugs (dental coverage is only required in plans for those under the age of 18). Offers financial help to pay for plans. Removes lifetime limits on coverage and accepts those with pre-existing conditions.

Data provided by

211 Cleveland

Providing organization

United States Department Of Health And Human Services (HHS)

Administers federal health and human services programs nationally. Works cooperatively with state, local, and tribal governments. Operating divisions include National Institutes of Health, Food and Drug Administration, Centers for Disease Control and Prevention, Indian Health Services, Health Resources and Services Administration, Substance Abuse and Mental Health Services Administration, and Agency for Healthcare Research and Quality.