Eligibility for Obamacare in Ohio

What are the requirements to apply for the Affordable Care Act in Ohio? When you begin exploring who is eligible for Obamacare in Ohio and how to qualify for ACA coverage, it is helpful to start with some crucial facts about what the Affordable Care Act is, and why it was created. Obamacare refers to two complementary pieces of federal legislation governing health care insurance for patients in Ohio. These Acts made health care insurance and quality health care services available to patients who previously did not have access to health care. Under the new Obamacare coverage eligibility requirements, significantly, a larger amount of Ohioans qualify for free or low-cost health care services through Medicaid. Many individuals or families who do not qualify for Medicaid are now eligible for special-cost deductions and benefits if they enroll in health care insurance plans available through the ACA health care Marketplace. Who is eligible for ACA coverage? To learn more about how to qualify for ACA coverage in Ohio, continue on to the sections below.

Who is eligible for Obamacare in Ohio?

“What are the requirements to apply for the ACA?” is a question commonly asked by Ohio residents exploring their health care insurance options who are unsure of how to qualify for ACA plans potentially available to them. Currently, there are very few Obamacare coverage eligibility requirements in Ohio:

  • You must be a United States citizen or a legal immigrant
  • You cannot be enrolled in Medicaid or another form of publicly funded health insurance
  • You cannot be incarcerated

Individuals and families that meet these basic requirements are eligible for Obamacare, and qualify to purchase ACA health insurance plans. It is important to note that under Obamacare coverage eligibility requirements, insurance companies are not allowed to refuse coverage to individuals who purchase new health insurance plans on account of pre-existing conditions. ACA rules also deny insurers the right to restrict plan-holders’ access to benefits or treatments associated with any pre-existing conditions they may have. Download our free guide to read more about Obamacare eligibility requirements.

What are the Affordable Care Act income requirements in Ohio?

Not everyone who is eligible for Obamacare will qualify for special benefits that typically make Obamacare insurance plans more affordable and accessible, even though the Marketplace is open to almost anyone who wishes to qualify for ACA coverage. Additional Affordable Care Act income requirements are used to determine those benefits. Specifically, the cost reductions are based on an assessment of one’s income as a percentage of the Federal Poverty Level. Tax credits and subsidies are available on a sliding scale to applicants with incomes of more than 100 percent, but less than 400 percent, of the Federal Poverty Level. The top of the sliding scale is limited to a predetermined percentage of total income. Learn more about Federal Poverty Levels by downloading our comprehensive guide.

Who is not eligible for Obamacare in Ohio?

Even though Obamacare coverage eligibility requirements allow many patients to obtain the health coverage they need, there are individuals that are not eligible for Obamacare coverage. Those that are incarcerated cannot learn how to qualify for ACA coverage successfully. In addition, you will not meet the requirements to apply for ACA in Ohio if you are not a citizen of the U.S. or a legal immigrant.

Although incarcerated individuals are not eligible for ACA health care coverage, they can, in some instances, learn to apply for Medicaid. Medicaid will not cover any health care costs while the individual is incarcerated, but applying in advance can prevent gaps in coverage and care when the individual is released. As they do not qualify for ACA health care plans, individuals who are incarcerated are not required to pay the individual mandate penalty for not having health insurance during the time they are detained. Release from incarceration is a “qualifying event” under Obamacare coverage eligibility requirements, and it initiates a Special Enrollment Period for the newly freed individual. For a short time after his or her release, a formerly incarcerated adult can select and purchase a qualifying new health care plan eligible for Obamacare or from an alternative health care provider.

Individuals who are not eligible for ACA Obamacare because they are not United States citizens may qualify for health care assistance through two programs in Ohio. The first is the Alien Emergency Medical Assistance program, which does not meet ACA qualifications, but can help cover the cost of emergency medical care for noncitizens. If you do not qualify for Obamacare coverage eligibility requirements, but have been in the United States for less than eight months and have an income at or below the Federal Poverty Level, you may be eligible for assistance under the Refugee Medical Assistance program. In either case, applicants can expect to receive benefits largely equivalent to those available under Medicaid coverage.

Who doesn’t need to enroll in Obamacare in Ohio?

In accordance with Affordable Care Act income requirements, individuals or families with incomes at 100 percent or less of the Federal Poverty Level should not attempt to apply for the Affordable Care Act. Those who do will be directed to seek assistance from Ohio’s Department of Medicaid instead. You do not need to learn how to qualify for ACA coverage if you are already enrolled in Medicaid and/or Medicare. Moreover, it is illegal for anyone to sell a Marketplace plan to an individual they know to be enrolled in Medicare.

In addition, you do not need to enroll in Obamacare coverage if you already have health insurance from a private source, such as employer-sponsored coverage that meets the requirements of the individual mandate provision of the ACA. Most new plans purchased from the general insurance market or through an employer or another source will meet these standards.

Still, Obamacare eligibility qualifications in Ohio do not apply to veterans and the family members of veterans who are covered by U.S. Department of Veterans Affairs (VA) health care programs that meet the ACA’s individual mandate component. Learn more about ACA eligibility and coverage by downloading our informative guide.

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Ohio Health Services

What Health Care Services Can I Receive in Ohio?

The state of Ohio offers various types of health services to residents, and these health programs include Medicare for the elderly, Medicaid for those in need, and more. To find out how you can apply for these medical assistance benefits, or how you can automatically be enrolled in certain programs, download our comprehensive health services guide.


Who Can Get Health Benefits in Ohio?

While Ohio offers various health service programs for residents of the state, applicants must meet certain eligibility requirements in order to qualify for the programs. Eligibility requirements often depend on income and whether or not the applicant falls into a certain category, such as seniors, pregnant women and children. Find out if you might be eligible for the benefits of these health care programs by downloading our guide.