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Understanding Your Ohio Health Insurance Coverage

Tracy Mcmanamon

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If you are looking for health insurance in Ohio, you may need to look at a few plans, understand their benefits, and compare them. Some plans pay for only what they regard as ‘medically necessary’. Medical necessity means a course of treatment that current medical practice considers appropriate for a particular injury or sickness. Understanding your Ohio health insurance coverage and knowing eligible benefits helps avoid claim disputes. Once you understand your benefits, get professional guidance to request an Ohio health insurance quote.

Coverage for Different Conditions

  • Pre-existing health conditions: If you have a pre-existing medical condition like heart disease, high blood pressure, cancer, type 2 diabetes, or asthma, you can find health insurance in Ohio that covers it. Health reform ensures that insurers cannot deny coverage to children because of a pre-existing condition. Starting in 2014, they are prohibited from covering anyone with a pre-existing condition. Insurance companies will also be prevented from charging higher premiums because of health status or pre-existing conditions.
  • Surgery: Most Ohio health insurance plans would cover a large portion of the cost of the surgical procedures that are considered medically necessary. Of course, the extent of coverage varies among plans. So a good strategy would be to ask your surgeon for the breakdown of costs. Compare the covered and excluded costs for care for plans before choosing one. When you calculate costs, don’t forget to include expenses for the surgeon’s fee, pre-operative tests, possible blood or other infusions, anesthesia, operating and surgical assistants, hospital stay, nursing care, and so on. Elective surgeries like a Rhinoplasty or nose surgery, for instance, would be covered if it can improve your breathing problems.
  • Pregnancy: The extent of coverage for a normal pregnancy would depend on your location, where you get prenatal care, and your insurer. Most plans cover some of the cost. Generally, the average costs of a normal pregnancy and delivery are lower in Ohio compared to that in states on the east and west coasts. Delivery by cesarean section is higher than for a normal pregnancy.

In Ohio, health plans providing maternity benefits must cover inpatient care and follow-up care for a mother and newborn. Services provided include medical, educational, and any other services in accordance with the protocols and guidelines developed by recognized national organizations. Coverage is provided for the physical assessment of the mother and newborn, medically necessary clinical tests, and more. Some Ohio health plans do not provide maternity coverage.

Get Health Insurance in Ohio with Professional Guidance

The best way to understand Ohio health insurance plans is to seek guidance from a licensed, experienced and trusted health insurance broker. Getting an Ohio health insurance quote is easy with their help. In fact, you can get quotes from many Ohio health insurance companies and request your agent for guidance to compare them and choose the right option. Getting affordable and comprehensive health insurance in Ohio is possible with the right guidance.


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