Insurance Questions? We Have Straight Answers.

Yes. Ohio expanded Medicaid in 2014 under then-Governor John Kasich, and continues to cover adults earning up to 138% of the Federal Poverty Level — about $20,800 for a single adult or $43,000 for a family of four in 2025. The Ohio Department of Medicaid manages coverage through five managed care organizations: Buckeye Health Plan, CareSource, Molina Healthcare of Ohio, Paramount Advantage, and United Healthcare Community Plan. Over 1.4 million Ohioans have gained coverage through expansion. Our advisors always check Medicaid eligibility first — if you qualify, it's usually the best coverage available.

Ohio's ACA marketplace is served by six major carriers: Medical Mutual of Ohio (the state's largest, home-grown insurer), Anthem Blue Cross Blue Shield, CareSource, Molina Healthcare, AmeriHealth Caritas, and Ambetter from Buckeye Health Plan. Regional players include SummaCare in Northeast Ohio (affiliated with Summa Health) and Paramount in the Toledo region. For group/employer coverage, UnitedHealthcare, Aetna, and Humana are also active. The right carrier for you depends heavily on which Ohio county you live in and which hospitals and doctors you want in-network.

Healthy Start and Healthy Families is Ohio's Medicaid program for pregnant women, infants, children, and parents with limited income. Healthy Start covers pregnant women and children up to age 19 with household income up to 206% of the Federal Poverty Level. Healthy Families covers parents and caretaker relatives. Coverage includes doctor visits, prescriptions, hospital care, dental, vision, and prenatal/maternity care at no cost. Apply through Ohio Benefits (benefits.ohio.gov) or with help from a Buckeye Benefits advisor.

Open Enrollment for ACA plans runs November 1, 2025 through January 15, 2026 for 2026 coverage. Outside that window, you need a Qualifying Life Event to trigger a 60-day Special Enrollment Period — losing job-based coverage, moving to a new ZIP code in Ohio, getting married, having a baby, aging off a parent's plan at 26, or a household income change. Ohio Medicaid is open year-round if you qualify by income. Short-term health plans and some off-exchange products are also available outside Open Enrollment in Ohio.

Medical Mutual of Ohio (MMO) is Ohio's largest health insurer and one of the few remaining regional mutual insurance companies in the United States — meaning it's owned by its policyholders, not by Wall Street shareholders. Founded in Cleveland in 1934, MMO has roots in nearly every Ohio community. For many Ohioans the MMO SuperMed PPO offers the broadest Ohio hospital network and the most flexibility for specialist access across all 88 counties — including Cleveland Clinic, University Hospitals, OhioHealth, and most rural Ohio hospitals.

Network access to Cleveland Clinic and University Hospitals varies meaningfully by plan and tier. Medical Mutual SuperMed PPO and most Anthem PPO plans include both health systems. Some narrower HMO marketplace plans — particularly lower-premium options — restrict to one system or the other. MetroHealth is included on most Cleveland-area marketplace plans. Our advisors verify provider networks for every Cleveland-area client before enrollment — we will not let you enroll in a plan that drops your current doctor or hospital.

Columbus's tech boom has created a large self-employed, freelance, and contractor population. Self-employed Ohioans typically have three main options: (1) ACA marketplace plans with premium tax credits — most self-employed earners qualify for meaningful subsidies; (2) HSA-eligible High Deductible Health Plans paired with tax-deductible HSA contributions; (3) Health-sharing ministries or short-term plans for healthy individuals (with significant caveats around pre-existing conditions). For a sole proprietor or LLC earning $60K–$120K in Central Ohio, ACA marketplace with subsidies almost always wins. Our advisors specialize in helping Columbus freelancers navigate these tradeoffs.