Ohio residents look for health care options

With Washington, Monroe, Morgan and Noble counties only covered on the open exchange health insurance market by one insurer, many local residents may be in search of new health care providers this month.

“I can’t go to (Memorial Health System) with the insurance, my nurse practitioner is in Belpre with PARS Primary Care,” said Bill Gossett, who is a small business owner in Marietta that until 2015 was self-insured. “But I had a back surgery in 2015 and got insurance a few months before that. It turned out good though I’m not sure how it will work out this year.”

For some it has been more affordable in the past to just pay the tax penalty associated with a lack of health insurance. In 2017, for a full year without coverage the penalty was $695 per adult and $347.50 per child.

“I have a cousin who says it’s too costly to get insurance and he couldn’t afford it,” said Gossett. “But even the fine was hard.”

Charlie Clay, 33, works three jobs including owning his own business, but says paying the fine is still a better option for him.

“Health insurance is so expensive for pretty crappy coverage on the marketplace,” he said.

“I just go to Quick Care and pay it on my own if I get sick but I’ve not been stuck with huge expenses and I don’t have a child. If something happens I’ll deal with it but I would rather put that money for a premium into product in my store.”

The largest health care provider in the four counties, the Memorial Health System, does not accept CareSource Marketplace insurance, meaning patients that were able to see their family doctors while on a marketplace plan last year cannot this year.

“Memorial Health System made multiple attempts to contract with CareSource but has never received a contract. Please note this does not affect Ohio Medicaid CareSource members,” said Jennifer Offenberger, senior director of marketing and service excellence for the Memorial Health System.

Previously the system had cited a difficulty in getting paid as a barrier for working with the insurance company but Offenberger noted that those patients undergoing longterm treatment or those who find themselves in an emergency situation would still be accepted.

“All CareSource Insurance patients currently undergoing treatment, for example, in the Strecker Cancer Center, will be able to continue that treatment, we will not postpone or deny continued treatment,” she said. “We are also able to care for patients in an emergency situation through our Emergency Departments and provide one ER followup visit. However, due to the financial burden this incurs for our patients and our system, we are unable to see them or schedule them for any other office visits, tests, procedures or other services.”

But across the river in West Virginia at Camden Clark Medical Center, Ohio CareSource patients are accepted.

“Right now we are accepting CareSource from both sides of the river,” said Sean Smith, vice president of operations for Camden Clark. “Since 2016 we have seen 177 Ohio CareSource patients in our hospital and we can absolutely take more patients.”

Offenberger said patients who wish to self-pay but are covered by CareSource present a complicated process.

“Memorial Health System’s policy is to not accept patients with insurance coverage as a self-pay patient as it is in the patient’s best interest to take full advantage of their insurance coverage due to many services being cost prohibitive for the patient when care is provided by out of network providers,” she said. “(But) Memorial Health System hoped to assist the few hundred patients in our system that needed to find an alternative. We care about our community and wanted patients to understand their options during open enrollment in December. We ran advertising to let CareSource Marketplace Plan members know that there are two products available to them that we are in network with, The Health Plan and Medi-Share. Our hopes were these might be alternatives for those choosing plans on the Marketplace.”


Healthcare Covered by CareSource, The Only Marketplace Provider Locally Available

Washington County

* First Settlement Physical Therapy.

* Issa Salameh, Dentist.

* Heartland of Marietta, Nursing.

* Frederick Humphrey, Internal Medicine.

* Daniel McGraw, Vascular Surgery.

* Arbors at Marietta, Nursing, Rehabilitation.

* Mahar Tahbaz, Nephrology.

* Steven Downer, Podiatry.

* Parkersburg Neurological Associates.

* Johnny Piersol, Chiropractor.

* Worthington Center Management, Mental Health, Psychiatry.

* Jane Cases, Internal Medicine, Endocrinology.

* Alli Guo, Internal Medicine, Endocrinology.

* Brian Eaton, Chiropractor.

* Physicians Outpatient Surgery Center.

* James Markley, Optometrist.

* Marietta Health Care Physicians, Family Practice.

* Central Ohio Neurological Surgeons.

* Ohio Valley Eye Physicians.

* Marietta Healthcare, Skilled Nursing.

* Cambridge Home Health Care.

* Interim Healthcare of Southeast Ohio, Home Health.

Monroe County

* Monroe Family Health Center, Family Practice, Internal Medicine.

* Swiss Valley Foot and Ankle Center.

* Jason Just, Chiropractor.

* Interim Healthcare of Southeast Ohio, Home Health, The Eye Center of Monroe County.

Morgan County

* Muskingum Valley Health Centers, Podiatry, Dentistry, Pediatrics, Social Work, Nursing, Surgery, Pediatric and Adult Psychiatry, Family Practice, Internal Medicine, OB-GYN, Preventive Medicine.

* Riverside Landing Nursing and Rehabilitation.

* Morgan Vision Clinic.

* Interim Healthcare of Southeast Ohio, Home Health.

Noble County

* Local Public Health Services Collaborative, Family Practice, Preventive Medicine.

* Welch Urgent Care and Wellness Center, Nursing.

* Doudna Chiropractic.

* Summit Acres Home Care.

* Superior Med Inc, Family Practice.

* Purvis Chiropractic.

Source: CareSource