• When Ohioans sign up for a health plan, and the Ohio health insurance company denies a claim deemed medically unnecessary, consumers may request an independent external review.

• The reviews are supposed to be conducted by licensed, unbiased doctors. Although these physicians nationally-appointed by independent review organizations, the Department of Insurance determines the final appointment.

• Only accountholders of a major Ohio health insurance plan or health maintenance organization program have the right to appeal rejected claims and preauthorized services, as defined in the Health Carrier External Review Act.

• Although the Patient Protection and Affordability Care Act promises to foster health exchanges, offer grant for small businesses that sponsor their own group coverage, Ohioans should remember that specific medical condition health plans and plans, sponsored by small business employers are not protected by the laws of the Health Carrier External Review Act.

• Prior to subscribing to a major Ohio health insurance plan, review the policy’s legal description regarding the Health Carrier External Review and its terms for expedited external reviews. The time span should not exceed 30 days.

• Although, some analysts predict that it gives major Ohio health insurance companies more credence than health exchanges, it depends on what type of benefits policyholders require. 

Just as consumers should compare Ohio health quotes, Ohioans should evaluate the pros and cons of obtaining Ohio health insurance from a major provider versus a self employed or small group sponsored plan. Contac 1 (866) 522-5953

According to the Ohio Department of Insurance, Governor Strickland advises Ohioan parents to:

“…Inquire with their employer or Ohio medical insurance provider about the dependent age change.”

Prior to the national health care reform, now dubbed the PPACA–children and step children were covered up to the age of 19 or 23  (If they were full-time students) remain under a parents’ Ohio medical insurance policy.

With the new law in place, insurance agencies have to supply parents with the details pertaining to the availability of Ohio medical insurance coverage. Although insurance providers are required to extend coverage for single dependents, individuals as well as families are advised to compare the cost of adding or keeping dependents on a policy to the cost of an individual plan.

President of Ohio Life and Health, Michael Novelli advises Ohioans to do the following when comparing policies:

1)    Obtain several Ohio health insurance quotes.

2)    Compare the deductible of a family versus and individual deductible

3)    Review the difference between the premiums for an individual policy for the monthly/annual cost of adding an independent to the family policy.

4)    Remember to review policies based on the hospital and physician network, out-of-pocket expenses, co-insurance, co-payments and other pertinent medical care costs.

Seek free, unbiased, professional advice from a licensed Ohio medical insurance agent when you dial 800.522.5953.

• Requires a rate cap, enabling residents to access basic Ohio health insurance through the state-mandated, Open Enrollment Health Insurance Program.

• There is a restriction on how much insurance companies can charge Ohioans, who have a pre-existing or chronic disease (in example: cancer, diabetes, cancer and heart disease), and who opt for an individual medical policy from the private insurers through the program. 

• Consumers, in need of Ohio health insurance, and who want to take advantage of the program, have little time to lose. Once, insurers meet an undisclosed quota, they are not required to take on any other individuals, until the quota falls below the target. 

• Pre-existing medical conditions are subject to a 12-month waiting period for medical treatment. 

• Also, some insurance shoppers, who lost their medical coverage, should secure a new Ohio health policy within 63 days; otherwise, medical coverage has a 90-day waiting period.

• Individuals, who are considered Federally Eligible Individual (FEI), are entitled to a waived waiting period. Ohioans who qualify for the FEI benefits include the following criteria:

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  •  Eighteen-months of continuous medical coverage via (an employer group health insurance plan (COBRA, Medicare and Medicaid).
• • All continuation of benefit options have already been exhausted (i.e. COBRA). 
  • The previous Ohio health insurance was not terminated due to failure to pay premiums Also note that, in order for FEI’s to obtain immediate medical coverage, they must be enrolled in an open enrollment plan by the 63rd day subsequent to losing the previous health benefits. 

For additional resources pertaining to the new Ohio health insurance reform, President and licensed agent, Mike Novelli of OhioLife and Health.com  offers complimentary advice as well as medical quotes to Ohio consumers.

**Remember to obtain more than one medical quote to compare the premiums, deductibles and other out-of pocket costs.