Finding Medicare Plans in Ohio
There are different Medicare plans in Ohio to choose from. But finding the right coverage can be strenuous. We don’t think it should be. We’ve done the research to help you navigate the Medicare plans in Ohio to find the right coverage for you.
What is Medicare and Who’s Eligible for It?
Medicare is a federally sponsored health insurance program for people 65 and older and people under the age of 65 with certain disabilities or illnesses. Typically, people qualify for Medicare plans in Ohio upon reaching 65 years of age. Persons under the age of 65 can qualify for Medicare if they have received Social Security Disability Insurance (SSDI) for the past 24 months or have been diagnosed with Amyotrophic Lateral Sclerosis (ALS) or End-Stage Renal Disease.
To qualify for Medicare, you must be a citizen or permanent resident, having lived in the US for the past 5 years. In addition, you or your spouse must have worked at a job that contributed to your Medicare coverage via Social Security deductions for a minimum of 10 years.
We’re here to help if you’ll be turning 65 within the next six months or need help determining your eligibility for Medicare plans in Ohio. Call us to speak with a licensed insurance agent.
What Medicare Plans are Available in Ohio?
Original Medicare Part A and Part B
Original Medicare is the federal part of Medicare and has two components:
Medicare Part A (Hospital Insurance): This part covers inpatient services, like hospital admissions, skilled nursing facility care, and hospice.
Medicare Part B (Medical Insurance): This part covers outpatient services and supplies, as well as durable medical equipment. It also covers some services that prevent or detect illnesses at an early stage, such as flu shots, cardiovascular screenings, and diabetes screenings.
Services generally not covered by Original Medicare include:
- Long-term care (custodial care)
- Most outpatient prescription drugs
- Hearing aids
- Eye exams and eyeglasses
- Most dental care and dentures
- Routine foot care
- Cosmetic surgery
Medicare Advantage Plans (Part C)
A Medicare Advantage (Part C) plan provide an alternative to Original Medicare coverage. All Medicare Advantage plans are available through private insurance companies contracted with Medicare and must provide the same coverage as Original Medicare (except for Hospice, which is still covered by Part B). These plans can include additional benefits not covered by Original Medicare, like vision, dental, and prescription drug coverage. You must be enrolled in Parts A and B before being enrolled into a Medicare Advantage plan. Premiums can start at $0 and increase depending on the level of coverage selected. In addition to the premium charged by the plan, you will continue paying your Part B premium.
To learn more about Medicare Advantage plans, click here.
Medicare Prescription Drug Plans (Part D)
Medicare Prescription Drug plans, also referred to as Part D, are provided and coordinated by private insurance companies contracted with Medicare. These plans provide coverage for prescription medications, which are generally not included in Original Medicare or Medigap coverage. Any beneficiary can sign-up for Medicare Part D as long as they are eligible for Original Medicare, Part A and/or Part B and permanently reside in the service area of a Medicare Prescription Drug Plan. Medicare Prescription Drug coverage is optional, but if you don’t enroll in Part D as soon as you’re eligible, you might pay a late-enrollment penalty if you enroll later.
Medicare Part D comes in the form of a stand-alone Medicare Prescription Drug Plan, working alongside Original Medicare, or with a Medicare Advantage plan known as a Medicare Advantage Prescription Drug Plan.
Out-of-pocket expenses for prescription drugs and monthly plan premiums will vary from plan to plan. Each medication covered by a Medicare Prescription Drug plan has a set cost in the form of a co-pay or coinsurance according to a tiered system. Every Medicare Prescription Drug plan has a formulary for your reference, allowing you to pick the plan with the lowest cost for your prescription needs.
To learn more about Medicare Prescription Drug plans, click here.
Medicare Supplement Plans (Medigap)
As we mentioned earlier, Medicare beneficiaries are still responsible for paying a portion of their medical bills. This is where Medicare Supplement plans, also called Medigap plans, come in. Many people who decide to stick with Original Medicare Part A and Part B can also enroll in a Medigap Plan to fill in coverage gaps. These plans are available through private insurance companies approved by Medicare and work alongside your Original Medicare to pay for things that Original Medicare doesn’t cover, like copays and deductibles. If you’re staying on Original Medicare Part A and Part B, a Medigap plan is a consideration to help reduce your out-of-pocket expenses.
To learn more about Medicare Supplement plans, click here.
When Can I Enroll In A Plan?
Medicare Advantage and Medicare Prescription Drug Plans
Most people are first eligible to enroll in Medicare plans in Ohio during their Initial Enrollment Period (IEP). Your IEP begins three months before the month of your 65th birthday and lasts through the following 3 months. This means that you have a total of 7 months to enroll.
Once this period ends, you’ll be able to make changes to your Medicare Advantage or Medicare Prescription Drug coverage during the Annual Election Period (AEP). The AEP runs from October 15th to December 7th every year.
Key Fact: The General Enrollment Period (GEP) allows you to enroll in Original Medicare if you missed your IEP. This period occurs from January 1st to March 31st every year. Immediately following this period, you’ll be able to select a Medicare Advantage plan from April 1st to June 30th each year.
Medicare Supplement Plans
Once you’ve enrolled in both parts of Original Medicare (Parts A and B), you can select the Medigap plan of your choice during your Medigap Open Enrollment Period. This 6-month period begins the month you are both 65 or older and enrolled in Medicare Part B.
Important Note: If you fail to enroll in a Medigap plan during your Medigap Open Enrollment Period, you’re subject to higher premiums or denial of coverage entirely.
Special Enrollment Periods
Some major life changes, like moving into a new coverage area or transferring to or from a care facility, are qualifying life events for a Special Enrollment Period (SEP). An SEP allows you to enroll or make changes to your coverage outside of the standard enrollment periods. Our licensed insurance agents can help determine your eligibility for a Special Enrollment Period.
How Can I Compare Plans?
MedicareMatchup makes it convenient to compare the Medicare plans available in Ohio. We work with trusted partners to find the right plan for your budget and medical needs. You can use the form below to instantly compare Medicare plans online. You can also speak with a licensed insurance agent by calling us.
Additional Medicare Resources in Ohio
Ohio Senior Health Insurance Information Program (OSHIIP) provides Medicare beneficiaries with free, objective health insurance information and one-on-one counseling.
Ohio Medicare Savings Program may cover deductibles and coinsurance for Medicare Part B. Additionally, the Low-Income Subsidy (LIS), or “Extra Help” program, may help pay for Medicare Part D monthly premiums, deductibles and co-pays. Individuals on Medicare with limited income and resources also may be eligible for financial assistance for medical expenses not covered by Medicare.
Sources: Medicare.gov; www.insurance.ohio.gov; https://aging.ohio.gov