Ohio Residents! Compare thousands of Ohio health insurance plans.

Get instant Ohio health insurance quotes online now!

Numerous state and federal laws make it easier for people with pre-existing conditions to get or keep health insurance, or to change from one health plan to another. A federal law, known as the Health Insurance Portability and Accountability Act (HIPAA) sets national standards for all health plans. In addition, states can pass different reforms for the health insurance plans they regulate (fully insured group health plans and individual health plans), so your protections may vary if you leave Ohio. Neither federal nor state laws protect your access to health insurance in all circumstances. So please read this guide carefully.

The following information summarizes how federal and state laws do — or do not — protect you as an Ohio resident.

How am I protected?
In Ohio, as in many other states, your health insurance options are somewhat dependent on your health status. Even if you are sick, however, the laws protect you in the following ways.

• Coverage under your group health plan (if your employer offers one) cannot be denied or limited, nor can you be required to pay more, because of your health status. This is called nondiscrimination.

• All health plans in Ohio must limit exclusion of pre-existing conditions. There are rules about what counts as a pre-existing condition and how long you must wait before a new health plan will begin to pay for care for that condition. Generally, if you join a new plan your old coverage will be credited toward the pre-existing condition exclusion period, provided you did not have a long break in coverage.

• Your health insurance cannot be canceled because you get sick. All health insurance is guaranteed renewable.

• If you leave your job, you may be able to remain in your old group health plan for a certain length of time. This is called COBRA continuation coverage or state continuation coverage. It can help when you are between jobs or waiting for a new health plan to cover your pre-existing condition. There are limits on what you can be charged for this coverage.

• If you lose your group health insurance and meet other qualifications, you can buy a conversion policy. This is an individual health plan from the company that insured your employer group. You cannot be denied coverage because of your health status, and you will not face a new pre-existing condition exclusion period. There are limits on what you can be charged for a conversion policy.

• All individual market health insurers in Ohio must have an annual open enrollment period, during which you can buy certain kinds of individual health coverage regardless of your health status. This is called guaranteed issue. You must meet other requirements to be eligible to buy individual coverage during an open enrollment period.

• If you are federally eligible, you can buy an individual health plan any time during the year. You do not have to wait for an open enrollment period. If you are federally eligible, you have additional protections when you buy either an individual health plan or a conversion policy.

• If you are a small employer buying a group health plan, you cannot be turned down because of the health status, age, or any other factor that might predict the use of health services of those in your group. All health plans for small employers must be sold on a guaranteed issue basis.

• If you are a small employer buying a group health plan, there are limits on how much your premiums can vary due to the health status, age, gender, or other characteristics of those in your group. Even within these limits, however, premiums can be significantly higher if someone in your group has a serious health condition.

• If you have low or modest household income, you may be eligible for free or subsidized health coverage for yourself or members of your family. The Ohio Medicaid program offers free health coverage for pregnant women, families with children, and elderly and disabled individuals with very low incomes.

• If your children are 18 years old or younger, do not have health insurance and meet other qualifications, you may be able to buy insurance for them through the Healthy Start or Healthy Families program.