Medicare is the federal government’s health insurance plan for people age 65 and older, as well as some younger people with disabilities. As your 65th birthday approaches, you may be wondering about how to sign up for Medicare in Ohio.
This article provides an overview of Medicare plans in Ohio, including current Medicare Advantage options and things to consider when shopping around.
The Centers for Medicare & Medicaid Services (CMS) reported the following information on Medicare trends in Ohio for the 2021 plan year:
- A total of 2,378,285 Ohio residents were enrolled in Medicare.
- The average Medicare Advantage monthly premium decreased in Ohio compared to last year — from $21.85 in 2020 down to $20.69 in 2021.
- There are 202 Medicare Advantage plans available in Ohio for 2021, compared to 178 plans in 2020.
- All Ohio residents with Medicare have access to buy a Medicare Advantage plan, including plans with $0 premiums.
- There are 30 stand-alone Medicare Part D plans available in Ohio for 2021, compared to 28 plans in 2020.
- All Ohio residents with a stand-alone Part D plan have access to a plan with a lower monthly premium than they paid in 2020.
- There are 12 different Medigap plans offered in Ohio for 2021.
Ohio residents have two options for Medicare coverage: original Medicare and Medicare Advantage.
Original Medicare has two components:
- Part A (hospital insurance). Medicare Part A helps pay for inpatient care you receive in the hospital, as well as hospice care and home health care. If you have a qualified hospital stay, it also covers short-term care in a skilled nursing facility.
- Part B (medical insurance). Medicare Part B helps pay for medically necessary doctor services, outpatient hospital services, and preventative services. It also covers durable medical equipment, such as wheelchairs.
Medicare Advantage in Ohio
Medicare Advantage (Part C) plans are an alternative to original Medicare. They’re offered by private companies, and they need to cover all services included in Medicare parts A and B. Most plans include Part D drug benefits, too.
Many Medicare Advantage plans also cover extra services that original Medicare doesn’t, such as dental, vision, and hearing care.
If you’re interested in Medicare Advantage plans in Ohio, there are many options available. Here are some of the carriers offering Medicare Advantage plans in Ohio for 2021:
- Aetna Medicare
- Anthem Blue Cross and Blue Shield
- Bright Health
- Lasso Healthcare
- Medical Mutual of Ohio
These companies offer plans in many counties in Ohio. However, Medicare Advantage plan offerings vary by county, so enter your specific ZIP code when searching for plans where you live.
Medicare supplement plans in Ohio
Original Medicare doesn’t pay for all healthcare costs. Depending on your needs, you may decide to get Medicare supplement insurance, also called Medigap. These policies can help you pay for deductibles, coinsurance, and copayments.
In Ohio, many insurance companies offer Medigap plans. As of 2021, some of the companies offering Medigap plans in Ohio include:
- AARP – UnitedHealthcare
- Anthem Blue Cross and Blue Shield – Ohio
- Colonial Penn
- Garden State
- Heartland National
- Mutual of Omaha
- State Farm
In total, you have 12 different Medigap plans (including high-deductible versions of plans F and G) that are available to choose from this year if you live in Ohio.
If you live in Ohio, you’re generally eligible for Medicare if you’re in one of the following groups:
- you’re 65 years or older
- you’ve received Social Security Disability Insurance (SSDI) for at least 24 months
- you’ve been diagnosed with end stage renal disease (ERSD) or amyotrophic lateral sclerosis (ALS)
To find out if you’re eligible for Medicare, you can use Social Security’s online benefit eligibility screening tool. This tool isn’t an application for Medicare.
You may be enrolled in Medicare automatically in some cases. For example, if you’re receiving Social Security retirement benefits, you’ll be automatically enrolled in Medicare parts A and B when you turn age 65.
If you’re under 65 and receive SSDI checks, you should be automatically enrolled at the start of your 25th month on SSDI.
If you won’t be automatically enrolled, keep reading to learn how you can sign up.
When to enroll
When your first become eligible for Medicare at 65, you can sign up for parts A and B during your initial enrollment period. This 7-month period starts 3 months before the month of your 65th birthday, includes your birthday month, and ends 3 months after the month you turn 65.
If you don’t sign up for Medicare parts A and B during your initial enrollment period, you can sign up later during the general enrollment period. The general enrollment period occurs every year between January 1 and March 31.
Some people are allowed to sign up for parts A and B at other times of the year during a special enrollment period (SEP). If you or your spouse are working, and you have a group health plan from that job, the SEP lets you sign up at anytime. There’s also an 8-month SEP that starts the month after you leave your job, or the month after your employer’s group health plan ends, whichever comes first.
Unless you make another choice, you’ll have original Medicare. Some people may prefer to join a Medicare Advantage plan.
When you first become eligible for Medicare, you can sign up for a Medicare Advantage plan during your 7-month initial enrollment period. You can also switch from original Medicare to a Medicare Advantage plan between October 15 and December 7 every year.
Tips for enrolling in Medicare in Ohio
If you’re deciding between original Medicare and Medicare Advantage, or if you’ve already decided on Medicare Advantage, it can be hard to choose the right plan for your needs. As you shop around for a plan, you may want to keep the following considerations in mind:
- Costs. You may need to pay a higher monthly premium for plans that offer drug coverage or other extra benefits, such as dental and vision care. Don’t forget to consider each plan’s annual out-of-pocket maximum.
- Types of coverage. Medicare Advantage plans in Ohio may offer dental, vision, and hearing coverage, and some plans may cover perks like fitness memberships. Determine what types of coverage you want or need before you choose a plan.
- Provider network. People with original Medicare can see any doctor who accepts Medicare, but Medicare Advantage plans usually have a provider network. Before you sign up for a plan, ask your doctor if they’re in the network.
- Ratings. The Centers for Medicare & Medicaid Services (CMS) rates Medicare Advantage plans based on many factors, such as plan performance and customer service. The CMS Five-Star Rating System can help you find quality plans in Ohio.
- Other coverage. You may have other health coverage, such as from a union or former employer. If you leave your current plan, you may not be able to rejoin later. Contact your insurer to find out how your existing coverage is affected by Medicare.
To learn more about Medicare Ohio, visit these resources:
What should I do next?
If you’re ready to enroll in Medicare, you can:
- Visit the Social Security website to apply for Medicare online, or stop by your local Social Security office.
- Visit Medicare.gov to search for drug plans (Part D) or Medicare Advantage plans that are available in your area.
- More than 2.3 million Ohio residents were enrolled in Medicare in 2020.
- There are several private insurance companies offering various types of Medicare Advantage and Medigap plans in Ohio.
- Overall, monthly premium costs have decreased for 2021 Medicare Advantage and Part D plans in Ohio.
- There are also several Medigap plan options if you live in Ohio and are looking for additional coverage.
This article was updated on October 2, 2020 to reflect 2021 Medicare information.
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