Medical Overview
Our medical plan, administered by OhioHealthy, allows you to access quality healthcare and provide comprehensive coverage.
Medical plan options at a glance
All of our medical plan options allow you to access healthcare from medical experts in central Ohio and across the United States. Whichever plan option you choose, choosing in-network providers or specialists, will help keep more dollars in your pocket.
HDHP + HSA
This plan offers lower premiums and a higher deductible than the PPO (which you must meet before this plan pays any benefits), and access to a special tax-advantaged savings account with matching contributions from OhioHealth.
Enhanced PPO
This plan offers higher premiums, but a lower deductible (which means the plan pays benefits sooner) than the HDHP+HSA, and copays for doctors’ office visits, urgent care and certain prescriptions.
Core PPO
This plan has the best of both worlds from the Enhanced PPO and HDHP+HSA plans. It has lower premiums than the Enhanced PPO and lower deductibles and coinsurance than the HDHP+HSA plan.
PPO Assist
This plan is for those with a lower household income (specific criteria apply), with lower premiums and healthcare costs.
Compare the plans
There are many similarities across the plans. In all of our medical plans, you can expect:
- Comprehensive healthcare, including preventive care, physician, hospital, emergency room, lab, radiology, prescription drugs, mental health and substance abuse benefits
- 100% preventive care coverage
- To pay less when you use in-network providers or specialists
- Access to telehealth doctors through Rightway
- 24/7 Nurse Advice Line
| Enhanced PPO | Core PPO | HDHP+HSA | PPO Assist+HRA
(for eligible and approved associates only) |
|
|---|---|---|---|---|
| Lower premiums | – |  |
– | |
| Lower annual deductible | |
– | – | – |
| Lower out-of-pocket maximum to limit your healthcare expenses | |
– | – | – |
| Pay out of pocket until you meet your deductible | – | – | |
– |
| Pay a copay, even if you have not met your deductible | |
|
– | |
| Contribute to a Health Savings Account (HSA), with matching contributions from OhioHealth | – | – | |
– |
Enrolling in Medicare?
If you are enrolled or planning to enroll in Medicare, read this flyer before enrolling in one of our medical plan options.
Read flyerLet ALEX help you choose
Get help with ALEX, an interactive online tool that will walk you through your benefit options and provide personal assistance in pointing out what choices make the most sense for you.
Ask AlexUnderstand our tiered provider network
The four medical plan options have a three-tier provider and facility network structure. Depending on what provider and/or facility you use, your out-of-pocket costs may be different.
You’ll save the most money when using Tier 1 providers and facilities.
Check out the Medical Plan Tier Overview
Example facilities in each tier
- Tier 1 Network (in-network preferred)
OhioHealth Physician Group (OPG), Clinically Integrated Network (CIN), Columbus Ohio Primary Care (COPC), Nationwide Children’s Hospital, Cleveland Clinic, and emergency services at any location. - Tier 2 Network (in-network)
Fairfield Medical Center, Licking Memorial Hospital, Holzer Hospital, Genesis Hospital, and out-of-area claims (Aetna wrap network). - Tier 3 Network (out-of-network)
Ohio State University (OSU), Mount Carmel Health System, Avita Health System, Adena Regional Medical Center, and Marietta Memorial.
To find what Tier your provider is in, visit OhioHealthyPlans.com or call an OhioHealthy Member Advocate at 1 (855) 571-1378.