Private Health Insurance Basics

Ohioans receive insurance coverage through public programs such as Medicare, Medicaid and military coverage or private forms of coverage such as employer-sponsored insurance, the ACA marketplace and direct-purchase plans. The brief focuses on private coverage.

Private Health Insurance Basics covers:

• Sources of health insurance in Ohio
• How health insurance works
• Managed care
• Regulation of private health insurance

Since its founding in 2003, HPIO has published “basics” guides on key health policy issues, including Ohio Public Health Basics 2025 and Ohio Medicaid Basics 2025. These guides support data-driven policies that improve health, advance health equity and increase the value of healthcare spending in Ohio.

4-page executive summary

Glossary of private health insurance terms

3 key findings for policymakers

• Health insurance protects against negative health and financial outcomes, including premature death, medical debt and more.
• Employer-sponsored insurance is the most common form of health coverage in Ohio. Individual plans differ in terms of costs and benefits.
• The cost of private health insurance has increased significantly for Ohioans in recent years, including for employer-sponsored coverage and ACA marketplace plans.

Additional resources

• Health Insurance Terminology Basics Blog (State Health Access Data Assistance Center)
• The Regulation of Private Insurance (KFF)
• What Consumers Need to Know About Health Coverage That Doesn’t Comply with the Affordable Care Act (Commonwealth Fund)
• Medicaid Basics (Health Policy Institute of Ohio)
• Health Insurance Guide (Ohio Department of Insurance)
• The Affordable Care Act 101 (KFF)