Medicare Plan Options
To accommodate the diverse care needs of Buckeye seniors, the state’s Medicare program features several plans to choose from. If you aren’t managing any chronic conditions, then Original Medicare may be enough to handle your medical bills. If you’re looking for more robust coverage, then Ohio’s Medicare Advantage program may be a better fit. Alternatively, a prescription drug and Medigap plan may be added to your Original Medicare policy to give you more control over your out-of-pocket costs.
Original Medicare is the basic health insurance plan that you’re enrolled in automatically if you collect Social Security upon turning 65. This plan is made up of two parts, including hospital insurance, or Part A, and medical insurance, or Part B. To get care, you can go to any Medicare-registered health care provider accepting new patients. In most cases, you don’t need to pick a primary care provider or get a referral to see a specialist. Costs include your monthly premium, the deductible, and copays for services, and there’s no maximum annual out-of-pocket limit for what you pay.
Medicare Advantage Plans
If you’re looking for more comprehensive coverage, then a Medicare Advantage Plan may be a better fit. These plans are provided by private health insurance companies and are another option for getting your Part A and B benefits. They also usually include extra benefits, such as prescription drug coverage and vision and dental coverage, which can help you save money on your health-related expenses. As with Original Medicare, you pay your Part B deductible. Some plans have additional monthly deductibles, although a lot of plans don’t. Depending on your plan, you may have to meet a deductible before your coverage begins paying for services, and you likely have copays for office visits and medications.
Medicare Prescription Drug Coverage Plans
Medicare prescription drug coverage, or Part D, is an optional coverage you can add to your Original Medicare policy and certain types of Medicare Advantage Plans. These plans cover some of the cost of prescription drugs. Even if you don’t take medications when you first sign up for Medicare, it’s a good idea to make sure you have creditable prescription drug coverage to avoid coverage delays and a late enrollment penalty fee. Part D plans have varying monthly premiums, deductibles, and scopes of coverage.
Medicare Supplement Insurance Plans
Medicare Supplement Insurance policies, or Medigap, are sold by private companies to help you cut down on out-of-pocket expenses, such as deductibles and copays. Some plans also cover the health care services you get while traveling abroad. To sign up for this coverage, you must have both parts of Original Medicare. A policy only covers one person, so if you and your spouse both want Medigap, you have to sign up for two plans. Regardless of the company you purchase from, the plans are standardized, making it easy to compare prices and coverage.
Medicare in Ohio by the Numbers
|People enrolled in Original Medicare||Average plan cost||Annual state spending per beneficiary||Spending per beneficiary compared to the national average|
|1,270,501||Plan A: $0 to $471 per month*
Plan B: $148.50 per month**
*Most people pay no premium, but this can vary depending on how long they paid Medicare taxes.
**This is the average number, but it can vary based on income.
Medicare Resources in Ohio
Finding the right Medicare policy is easier with the help of experts who understand how to assess your coverage needs, find and compare plans, and predict out-of-pocket expenses. Fortunately, several agencies in Ohio provide free Medicare options counseling. The following departments and agencies connect you with unbiased options counselors who can answer questions about your Medicare benefits and help you choose a policy that’s affordable and fits your health care needs.
Ohio Senior Health Insurance Information Program
The Ohio Senior Health Insurance Information Program is the statewide program that offers you free, unbiased health insurance information. Through this program, you can meet one-on-one with trained volunteers who can give you more in-depth information on Original Medicare’s benefits and coverage limits. They can help you determine which Medicare Advantage, Medigap, and prescription drugs plans are available in your region. They can also help you find out if you qualify for financial assistance programs to reduce your premiums and prescription drug costs.
Contact Information: Website | 800-686-1578
Ohio Area Agencies on Aging
Ohio has 12 Area Agencies on Aging, each of which plans and administers services to those aged 60 and over in designated regions. Through your local AAA, you can get in touch with OSHIIP counselors who provide free Medicare assistance. These counselors aren’t affiliated with any health insurance companies or licensed to sell policies, but they’re trained to answer any questions you have about your coverage, what policies are available to you, and how you can lower your out-of-pocket expenses.
Contact Information: Website | 866-243-5678
Ohio Department of Insurance
The Ohio Department of Insurance regulates insurance policies sold in the state and advocates on behalf of state residents, ensuring their insurance claims are handled fairly. Through the department, you can get more information on Medicare’s eligibility criteria, including criteria for those younger than 65. The department maintains a list of OSHIIP coordinators, a directory with contact information for agencies and organizations for Medicare beneficiaries, and comprehensive information on Medicare Savings Programs in the state.
Contact Information: Website | 614-644-2658
Pro Seniors is a nonprofit organization that assists Ohio residents in handling Medicare-related legal problems that may arise. It operates the state’s Senior Medicare Patrol, which helps you learn about preventing Medicare fraud and scams. Its volunteers can also assist you if you find a claim or charge on a Medicare statement for a service you didn’t receive or that your doctor didn’t order.
Contact Information: Website | (513) 345-4160 or (800) 488-6070
Learn More From Our Sources
- Medicare | How Original Medicare works | Last accessed June 2021
- Medicare | Medicare Advantage Plans (Part C) | Last accessed June 2021
- Medicare | Medicare Part D Enrollment | Last accessed June 2021
- Medicare | What’s Medicare Supplement Insurance (Medigap)? | Last accessed June 2021
- Medicare | How to compare Medigap policies | Last accessed June 2021