Ohio health insurance Marketplace guide

To qualify for health coverage through the Marketplace in Ohio, you must:⁶

• Live in Ohio
• Be either a United States citizen or national, or be lawfully present
• Not be incarcerated
• Not be enrolled in Medicare
  

Eligibility for financial assistance (premium subsidies and cost-sharing reductions) depends on your income and how it compares with the cost of the second-lowest-cost Silver plan in your area – which depends on your age and location. In addition, to qualify for financial assistance with your Marketplace plan you must:

• Not have access to affordable health coverage through your employer. If your employer offers coverage but you feel it’s too expensive, you can use our Employer Health Plan Affordability Calculator to see if you might qualify for premium subsidies in the Marketplace.  
• Not be eligible for Medicaid or CHIP.
• Not be eligible for premium-free Medicare Part A.⁷
• File a joint tax return if you’re married⁸ (with very limited exceptions)⁹
• Not be able to be claimed as a tax dependent by someone else.⁸

In Ohio, you can sign up for an ACA-compliant individual or family health insurance between November 1 and January 15 during open enrollment. Your coverage starts on January 1 if you enroll by December 15. But if you apply between December 16 and January 15, your coverage will begin on February 1.¹⁰ 

Due to a federal rule change that was finalized in 2025, the open enrollment window will be shorter starting in the fall of 2026. At that point, for coverage effective in 2027 and future years, the enrollment period will end on December 15, and all plans selected during open enrollment will take effect January 1.

Outside of the annual open enrollment window, you may be eligible to enroll if you experience a qualifying life event, such as giving birth or losing other health coverage. Native Americans can enroll year-round, without a specific qualifying life event.

To enroll in a Marketplace plan in Ohio, you can: 

• Visit HealthCare.gov, a platform where you can shop, compare, and buy individual and family health plans. 
• Purchase individual and family health coverage with the help of an insurance agent or broker, a Navigator or certified application counselor.
• Enroll via an approved enhanced direct enrollment entity.¹¹
• You can also call HealthCare.gov’s contact center by dialing 1-800-318-2596 (TTY: 1-855-889-4325). The call center is available 24 hours a day, seven days a week, but it’s closed on holidays.

You can find affordable health insurance options in Ohio through HealthCare.gov – the ACA Marketplace. 

Under the Affordable Care Act, you may qualify for income-based subsidies, known as Advance Premium Tax Credits (APTC). These credits can reduce your premium and lower your overall costs. 

During the open enrollment period for 2025 coverage, more than nine out of ten Ohio Marketplace enrollees qualified for APTC. The subsidies averaged about $500/month, and the average net premium paid by subsidy-eligible enrollees was about $79/month (including those who paid full price, the average net premium was about $126/month).¹²

Source: CMS.gov¹²

If your household income isn’t more than 250% of the federal poverty level, you may also be eligible for cost-sharing reductions (CSR). CSRs help lower your deductibles and out-of-pocket expenses. With APTCs and CSRs, an ACA plan may be a cost-effective health insurance option.

For those with limited incomes, free or very low-cost health insurance is also available through Medicaid. Use our guide to see if you qualify for Medicaid in Ohio.

Eleven insurers will offer Marketplace coverage in Ohio in 2026, with varying coverage areas:⁴

• Buckeye Community Health Plan
• CareSource Ohio, Inc.
• Community Insurance Company (Anthem BCBS)
• Medical Health Insuring Corp. (MedMutual)
• Molina Healthcare of Ohio, Inc.
• Oscar Buckeye State Insurance Corp
• Oscar Insurance Corporation of Ohio
• Paramount Insurance Company
• Summa Insurance Company, Inc.
• UnitedHealthcare of Ohio, Inc.
• Antidote Health Plan of Ohio

That’s down from 13 participating insurers in 2025,¹³ as both Aetna Health and AultCare¹⁴ are exiting the individual market at the end of 2025 (Aetna is exiting the individual market in all states where it offers coverage in 2025).

Enrollees with Aetna or AultCare coverage will need to select a new plan for 2026, during the open enrollment period that begins November 1, 2025.

Plan availability varies from one area to another, but residents in nearly all areas of Ohio could choose from at least five insurers’ plans for 2025 coverage.⁵

The following average rate changes have been proposed for Ohio’s Marketplace insurers for 2026, calculated before premium subsidies are applied:⁴ 

Source: Ohio Rate Review Submissions⁴

The proposed average rate changes, which amount to a weighted average increase of about 19.8%,¹⁵ are calculated before premium subsidies (premium tax credits) are applied. Most Ohio exchange enrollees receive premium tax credits, so they don’t pay the full premium.¹⁶

For those who qualify for subsidies, changes in plan rates and subsidy amounts determine their net rate change. This is particularly important to understand for 2026 coverage. Unless Congress extends the federal subsidy enhancements that have been in effect since 2021, subsidies will shrink in 2026, and be available to fewer people. If that happens, after-subsidy premiums will increase substantially.

For perspective, here’s how average unsubsidized premiums have changed in Ohio over the years:

• 2015: Average increase of 4%¹⁷
• 2016: Average semi-weighted increase of 9.4%¹⁸
• 2017: Average semi-weighted increase of 17.3%¹⁹
• 2018: Average increase of 34%²⁰
• 2019: Average increase of 6.3%²¹
• 2020: Average decrease of 7.7%²²
• 2021: Average decrease of 0.4%²³
• 2022: Average increase of 4.8%²⁴
• 2023: Average semi-weighted increase of 6.85%²⁵
• 2024: Average increase of 7.8%²⁶
• 2025: Average increase of 3.9%.²⁷

During the open enrollment period for 2025 coverage, a record high 583,443 people enrolled in private health plans through Ohio’s Marketplace.²⁸

The surge in enrollment in recent years is primarily due to the American Rescue Plan (ARP) making ACA’s premium subsidies more substantial. Under the ARP, subsidies are larger and more widely available. And this has been extended through the end of 2025 by the Inflation Reduction Act.²⁹ But as noted above, coverage will become much less affordable in 2026 if Congress lets the subsidy enhancements expire at the end of 2025.

The enrollment growth in 2024 and 2025 was also partially due to the “unwinding” of the pandemic-era Medicaid continuous coverage rule. Medicaid disenrollments resumed in Ohio in the spring of 2023, after being paused for three years. More than 190,000 Ohio residents transitioned from Medicaid to a Marketplace plan during the unwinding process. ³⁰

Source: 2014,³¹ 2015,³² 2016,³³ 2017,³⁴ 2018,³⁵ 2019,³⁶ 2020,³⁷ 2021,³⁸ 2022,³⁹ 2023,⁴⁰ 2024,⁴¹ 2025²⁸

Healthcare.gov: This is the federal website where you can enroll in a health insurance plan through the ACA Marketplace. 

Ohio Medicaid: Eligible individuals and families can enroll in Medicaid, which provides low-cost or free health coverage. You can also enroll in Medicaid through Healthcare.gov or call (800) 318-2596.

Ohio Department of Insurance (ODI): To receive assistance with insurance and Medicare, call an ODI representative at (800) 686-1526. 

Ohio Department of Job and Family Services: You can get help if you’re struggling to afford health coverage or want to know more about Medicaid eligibility or benefits.

Ohio Senior Health Insurance Information Program (OSHIP): OSHIP offers free health insurance information to people on Medicare.