Medicare is a federally mandated benefit that is available to people in every state. In Ohio, Medicare Advantage plans (Part C) are available as an alternative to traditional Medicare (parts A and B), if that is your choice. Some of these plans include prescription drug coverage, as well as other benefits, such as vision, and dental. If you prefer, you may also opt into Medicare Part D as an Ohioan.
Medicare supplement insurance plans are also available in Ohio, for people age 65 ad older who wish to purchase them from private insurers. These plans are also referred to as Medigap.
Medicare plans in Ohio vary in cost and scope from county to county. In addition to original Medicare, Medicare Advantage plans are available in all 88 counties throughout the state. You should be able to find a plan that provides the best type of coverage for you.
Medicare Part A refers to hospital coverage. Medicare Part A is available to most Americans and is typically free. When there is no cost associated with Part A, it is referred to as premium-free. In Ohio, as in every state, you are eligible for premium-free Medicare Part A if:
- you are 65 years old and you or your legal spouse paid enough Medicare taxes while working throughout your lifetime (a total of 10 working years)
- you have received benefits from Social Security or the Railroad Retirement Board for 24 consecutive months, no matter what your age
- you have end stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS)
If you do not meet any of those requirements, you may still be able to purchase Part A for a monthly premium rate. This rate will be determined by the amount of Medicare taxes you or your spouse paid while working, as well as the amount of time you worked.
For Medicare Part B coverage, you’ll pay a monthly premium and an annual deductible. You’ll need to meet your annual deductible before your medical services start to be covered.
As with original Medicare plans nationwide, you will be responsible for 20 percent of most medical services you incur after your deductible is met.
Ohio residents are eligible for Medicare Part C, provided that they are enrolled in Part A and Part B. In addition, you must live within the plan’s service area.
People with end stage renal disease are not eligible for Medicare Part C in Ohio.
Most Medicare Part C plans in Ohio also include prescription drug coverage.
The enrollment dates for Medicare Part C are the same in Ohio as they are in the rest of the country. You can enroll during:
- Initial enrollment: when you first become eligible for Medicare 3 months before through 3 months after your 65th birthday
- Medicare because you are disabled: during the 3-month period prior to receiving your 25th disability benefit, through to the 3-month period after that date
- General enrollment: January 1 through March 31 every year
- Open enrollment: October 15 through December 7 every year
There are many Medicare Part C providers in Ohio, including Humana, Trinity Health, and Aetna. Premiums and copay costs for Part C plans vary, based upon the type of plan you purchase.
You can compare the costs of Medicare Advantage plans at Medicare’s plan finder tool.
Medicare Part D is prescription drug coverage. You are eligible for Medicare Part D if you have or are enrolling in original Medicare. Some Medicare Advantage plans include prescription drug coverage, eliminating your need for a separate Part D plan.
You can enroll in Medicare Part D at the same time you enroll for Medicare, during your initial enrollment period. This 7-month period starts 3 months before your 65th birthday and ends 3 months after that date.
If you have a disability, you can enroll in Part D during the 7-month period that begins 3 months before the 25th month of disability benefit payments, and ends 3 months after that date.
You can also enroll for Medicare Part D during general enrollment along with Part B, if you miss the initial enrollment period.
If you have creditable drug coverage through a group health plan, you may be able to hold off on getting Medicare Part D. If you lose this coverage, you must enroll in Medicare Part D within 63 days of the triggering event.
If you miss signing up for Part D during any of these viable enrollment periods, you may still be able to get it at a later time. However, you will most likely incur a late enrollment penalty, which will increase the cost of your monthly premium for Part D permanently.
Medigap policies help pay for out-of-pocket expenses, such as deductibles, coinsurance and copayments. In some instances, they may also pay for services that are not covered by original Medicare. MedSup policies are standardized under federal law, as well as under Ohio state law.
Medigap plans vary in terms of cost and coverage. Based on what they offer, they may be listed as one of 10 Medigap plans.
In Ohio, a specific type of Medigap plan known as Medicare Select is an available option in all counties. Medicare Select plans require that you use specific hospitals and sometimes, specific doctors. If you buy a Medicare Select plan and find that it does not fit your needs, you may change it to another MedSup plan within 12 months after purchase.
Medigap plans require that you pay a monthly premium. Since they are purchased from private insurance companies, these costs vary. You can access a comprehensive list of private insurers and MedSup plan premium costs here.
Get help enrolling in Medicare in Ohio
If you need additional information or help enrolling in Medicare in Ohio, these organizations can help:
- Ohio Senior Health Insurance Information Program (OSHIIP): 800-686-1578
- Ohio Department of Aging: 800-266-4346
- Local Area Agency on Aging: 866-243-5678
- Centers for Medicare and Medicaid: 800-MEDICARE (800-633-4227)
- Social Security Administration: 800-772-1213
Medicare is a federal program which is available to residents of Ohio. You’ll have several different plans to choose from to get the coverage and rates that meet your needs. The dates for enrollment in Ohio for Medicare parts A, B, C, D, and Medigap are the same as those throughout the rest of the country.
This article was updated on October 22, 2020 to reflect 2021 Medicare information.
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