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Individuals & Families

Losing Medicaid? AultCare has great options for affordable coverage.

When Can I Purchase Health Insurance?

Losing Medicaid is considered a qualifying life event, and you have up to 60 days to enroll in a plan.  Enroll by the end of the month for the first of the following month's effective date.

You must be enrolled by December 15, 2023 for a January 1, 2024 policy effective date.  Enrollments from December 16, 2023 to January 15, 2024 will have a policy effective date of February 1, 2024.

Individual Health Insurance can be purchased during the Annual Open Enrollment period (November 1 to January 15). If you have a qualifying life event, you are eligible for a special enrollment period outside of the Annual Open Enrollment. You must sign up within 60 days of the qualifying life event. Qualifying life events are changes in your situation – such as getting married, having a baby, or losing group health coverage (healthcare.gov). Download the Healthcare.gov checklist.

Qualifying life events include:

  • Losing Medicaid Coverage
  • Changes in the household (marriage, divorce, new child, death)
  • Changes in residence
  • Loss of group health insurance (losing existing coverage or losing eligibility)
  • Other qualifying events (becoming a U.S. citizen, leaving incarceration, etc.)

Please note, this is a small list of qualifying life event examples. Certain circumstances do not apply. You can learn more or view a full list of qualifying life events here.

 

Find Out My Premium Cost

 

We take your healthcare personally. Because you matter, we believe you deserve access to the best in healthcare with AultCare health insurance plans. AultCare offers health plans for young adults, students, self-employed individuals, early retirees, individuals, and families.

We have health plans for employers, individuals and their families, and those who are Medicare-eligible. AultCare’s attention to our members, and our service focus on you, separates us from other insurance companies. That's one of many reasons why more than 95% of AultCare clients renew with AultCare year after year. AultCare has always been committed to accuracy and improving processes.

You can find AultCare plans that cover essential health benefits of the Affordable Care Act (ACA) on the Marketplace or directly from AultCare. The Marketplace is a service operated by the federal government for those searching for an individual plan. Subsidies may be available through the Marketplace for those who qualify.

The Premier Select Network is a narrow, cost-effective AultCare network available with access to quality care at local hospitals for individuals and families.

If you are searching for health insurance for yourself or your family, you can easily shop for an AultCare insurance plan on or off the Marketplace. At AultCare, you matter. AultCare offers accessible, personalized customer service to our community because we know how important it is for our community to have access to affordable healthcare.

AultCare offers individual and family healthcare plans

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What Types of Health Plans Does AultCare Offer?

As you compare different AultCare individual health plans, you may find some plans are denoted as Premier Select Network and Select & Traditional Networks.

The Select Network has lower monthly premiums with access to local providers. Be sure to check the network directory to verify if your provider is part of the network.

Premier Select Network:

The Premier Select Network

  • Access to area hospitals in Stark, Summit, Tuscarawas and Wayne counties and physicians associated with these facilities
    • Hospitals include*:
      • Aultman Hospital
      • Aultman Alliance Community Hospital
      • Cleveland Clinic Mercy Hospital
      • Akron Children’s Hospital
      • Cleveland Clinic Akron General Medical Center
      • Cleveland Clinic Union Hospital
      • Aultman Orrville Hospital
  • Narrow market
  • High-quality care at a lower price
  • Less expensive than the Select Network and Traditional Network

*This is not a comprehensive list. All Cleveland Clinic locations in Ohio are in-network. Additionally, all University Hospital locations in the state of Ohio are in-network.

Select Network:

Select Network

  • Access to area hospitals within Stark, Summit, Tuscarawas, Carroll and Wayne counties and physicians associated with these facilities.
  • Hospitals include*:
    • Aultman Hospital
    • Aultman Alliance Community Hospital
    • Cleveland Clinic Union Hospital
    • Akron Children’s Hospital
    • Wooster Community Hospital
    • Trinity Hospital Twin City
    • Aultman Orrville Hospital
  • High-quality care at a lower price
  • Less expensive than the Traditional Network

* This is not a comprehensive list. All Cleveland Clinic locations in Ohio are in-network. Additionally, all University Hospital locations in the state of Ohio are in-network.

Where Can I Purchase Individual Health Plans?

There are differences to purchasing your AultCare health insurance on or off the Marketplace...

On the Marketplace:
  • Available in Stark, Carroll, Tuscarawas, and Wayne counties
  • Eligible for a tax credit* and cost-share reduction** plans
  • Receive a 1095-A form from the government during tax time
Off the Marketplace:
  • Broader area offered
  • Not eligible for tax credit* or cost-share reduction**
  • Receive a 1095-A form from AultCare during tax time
  • Lower-cost plan options may be available
*Advanced Premium Tax Credit (APTC)- A tax credit based on income estimates and household size. It can be used to help lower your monthly premium payments. The credit can be applied to any plan on the Marketplace. ** Cost-Share Reduction (CSR) - A discount often referred to as “extra savings” that lowers your deductible, copayments and coinsurance. These discounts are can only be applied to Silver plan designs on the Marketplace.

Metal-Level Plans Offered:

AultCare offers several plan options to meet your needs. All plans cover essential health benefits, including both Medical and Pharmacy benefits.

Gold Plan
  • Have higher premiums
  • Lower out-of-pocket costs
  • Co-payments
Silver Plan
  • Lower premiums than Gold
  • Higher out-of-pocket costs than Gold
  • Co-payments
  • Cost-share reduction savings available for Silver Plans on the Marketplace
Bronze Plan
  • Lowest premium offered
  • Highest out-of-pocket costs
  • HSA-eligible plan designs
  • Co-payments

What Other Information do I need to know?

What is a 1095-A Form?

A 1095-A form includes information about a Marketplace plan you had in the past year. You may be eligible for a tax credit to help offset the costs of health coverage for those who qualify. A 1095-A form will provide information needed to claim the tax credit. You can learn more about the 1095-A form here.

If your household income is greater than 138 percent of the federal poverty level (FPL) you may be eligible for the Advanced Premium Tax Credit (APTC) to help pay for health insurance through the Marketplace. If your income is between 138 and 250 percent of the FPL, you may also be eligible for additional cost-sharing reductions to help lower your out-of-pocket expenses. Household incomes below 138 percent of the FPL may be eligible for Medicaid or other types of coverage.

Download a Glossary of Medical Terms