Medicare plays a key role in providing health and financial security to beneficiaries residing in Ohio. With more than 2.3 million Ohio beneficiaries enrolled in Medicare, we’ll cover some very important information below about Medicare in Ohio. We want to help you better understand your options and make the decision-process as seamless as possible once you’re ready to enroll in Medicare or discover different coverage options.

Who Qualifies for Medicare in Ohio?

Medicare covers most Ohio residents who are 65 or older, and it also covers disabled Ohio residents. In general, Medicare enrollment in Ohio works the same way as it does in the rest of the country. If you qualify for Original Medicare, also known as Part A and Part B, it will help cover 80% of your health care costs.

When you’re first eligible for Medicare, you have a 7-month Initial Enrollment Period to sign up for Part A and/or Part B. If you’re eligible for Medicare when you turn 65, you can sign up during the 7-month period that:

  • Begins 3 months before the month you turn 65
  • Includes the month you turn 65
  • Ends 3 months after the month you turn 65

In most cases, if you don’t sign up for Part B when you’re first eligible, you’ll have to pay a late enrollment penalty. You’ll be responsible for paying this penalty for as long as you have Part B, and you could have a gap in your health coverage.

Once you reach Medicare eligibility, you can begin choosing additional coverage options to help pay for the remaining 20% of your medical expenses through Medicare Advantage (Part C), Medigap, and/or a Medicare Prescription Drug (Part D) plan.

Who Qualifies for Medicare

Ohio Medicare Enrollments

1,270,054

Original Medicare Plans
(Part A and B)

1,097,295

Medicare Advantage & Other Health Plans

1,023,921

Stand-alone Medicare
Part D (Drug plans)

2,367,349

Total Medicare Beneficiaries
in Ohio

Ohio Medicare Advantage Plans (Part C)

More than 43% of Ohio Medicare beneficiaries select Medicare Advantage plans.

Medicare Advantage plans are private, Medicare-approved insurance companies. They provide all of your Original Medicare benefits and often include extra benefits such as drug, dental, and vision coverage.

The Medicare Advantage Open Enrollment Period runs from January 1 to March 31. During this period, Medicare beneficiaries in Ohio who are already enrolled in a Medicare Advantage plan can switch to a different Medicare Advantage plan or drop their Medicare Advantage plan and enroll in Original Medicare instead.

As of 2020, 178 Medicare Advantage plans are available in Ohio. The average monthly Medicare Advantage premium is $70.28 in 2020. $0 is the lowest monthly premium for a Medicare Advantage plan in Ohio.

According to the Centers for Medicare and Medicaid Services (CMS), as of May 2020, there are 1,097,295 beneficiaries enrolled in Medicare Advantage and other plans in Ohio. More than 43% of Ohio Medicare beneficiaries were enrolled in a private Medicare Advantage plan in 2019. 100% of people with Medicare have access to a Medicare Advantage plan.

Ohio has a very robust Medicare Advantage market. Depending on your county, Ohio Medicare beneficiaries can select from between 15 and 60 Medicare Advantage plans. Medicare Advantage plans are available in all 88 counties in Ohio.

Ohio Medicare Supplement (Medigap) Insurance Plans

Ohio doesn’t require Medigap insurers to ensure access to plans for disabled Medicare beneficiaries under age 65.

Medigap plans are used to supplement Original Medicare, covering some or all of the out-of-pocket costs (for coinsurance and deductibles) that beneficiaries would otherwise incur if they only had Original Medicare on its own. Typically, Medigap plans are popular for those who want little to no copay when they access healthcare services.

There are two initial times to enroll in a Medigap plan before and after you turn 65:

  • 6 months prior to turning 65
  • Once you turn 65, your 6 month period begins the month you enroll in Part B.

During this period, an insurance company can’t use medical underwriting. 

There are currently 56 insurers that offer Medigap plans in Ohio. Although the majority of states have ensured at least some access to Medigap plans for people under age 65, Ohio doesn’t require insurers to offer plans to people under age 65.

Ohio Medicare Prescription Drug Coverage (Part D)

Original Medicare doesn’t cover outpatient prescription drugs. However, Medicare beneficiaries can get prescription coverage via a Medicare Advantage plan, an employer-sponsored plan (offered by a current or former employer), or a stand-alone Part D plan. Medigap plans don’t cover prescription drugs unless they’re covered under Part B.

As of May 2020, There are 1,023,921 Medicare beneficiaries in Ohio enrolled in stand-alone Part D prescription drug plans and 882,947 enrolled in Medicare Advantage Prescription Drug plans. For 2020 coverage, there are 28 stand-alone Part D plans available in Ohio, with premiums ranging from about $15 to $97 per month. About 24% of people with a stand-alone Medicare prescription drug plan get Extra Help (also called the low-income subsidy, or LIS).

When deciding on a Part D plan, it’s important to evaluate several factors such as each plan’s premium, formulary, and copays since every plan is different. Learn how you can save money on your out-of-pocket costs with a Medicare Advantage, Part D, or Medigap plan, fill out this form or give us a call.

Local Medicare Health Plan Resources in Ohio

  • Ohio Senior Health Insurance Information Program (OSHIIP) provides free, objective health insurance information and one-on-one counseling to people covered by Medicare and their caregivers. OSHIIP’s hotline experts, speakers bureau, year-round outreach events, webinars, and trained local counselors educate consumers about Original Medicare, Medicare Supplemental Insurance, Medicare Prescription Drug Coverage (Part D) – Extra Help Program, Medicare Advantage, and Cost Saving Programs.
    Contact: Call 1-800-686-1578 or email [email protected]

  • The Ohio Department of Insurance is a regulatory agency and consumer protection bureau that licenses insurance agents, provides educational resources, investigates complaints, and answers questions related to Medicare, Part D drug plans, long-term care insurance, and all other policies.
    Contact: Call 1-800-686-1526 or email [email protected].

  • UHCAN Ohio is a statewide coalition representing more than 20 regional consumer advocacy groups, including Ohio Consumers for Health Coverage. This organization focuses on influencing government policies, giving consumers a voice, and ensuring that all Ohioans have access to affordable, quality medical care. The agency provides information about insurance enrollment, prescription drug assistance, Medicare Extra Help, and insurance complaints.
    Contact: Email [email protected] or call 614-505-9460

  • The Central Ohio Area Agency on Aging (COAAA) plans, funds, and delivers services that help older adults and individuals with disabilities remain safe and independent in their homes. With the assistance of area providers, COAAA arranges and coordinates services to help individuals with daily living such as homemaking, transportation, home-delivered meals, and personal care. COAAA offers education and resources to caregivers, professionals, and the public and advocates for programs and policies that benefit older adults and individuals with disabilities. COAAA manages services for 10,500 people and funds services for another 25,000 older adults in eight counties: Delaware, Fairfield, Fayette, Franklin, Licking, Madison, Pickaway, and Union. COAAA is operated under the City of Columbus Recreation and Parks Department.
    Contact: Email [email protected] or call 1-800-589-7277

  • Buckeye Hills Regional Council is a council of governments dedicated to improving the lives of residents in southeast Ohio. Their Medicaid + Medicare support services enable eligible seniors and individuals with disabilities to continue living in their homes and receive the support they need to have a quality of life.
    Contact: Call 740-374-9436 or email [email protected]

  • The Ohio District 5 Area Agency on Aging, Inc. (AAA) is a nonprofit agency that serves Ashland, Crawford, Huron, Knox, Marion, Morrow, Richland, Seneca, and Wyandot Counties. They have programs for all ages and all income levels; however, they specialize in services and programs for older adults and anyone with disabilities.
    Contact: Call 1-800-860-5799

  • Jewish Family Service: Licensed social workers and OSHIP-certified experts provide personalized Medicare counseling at Cincinnati-based Jewish Family Service. Trained professionals help seniors of all faiths compare Medicare plans, including HMOs, PPOs, and prescription drug coverage.
    Contact: Call 513-469-1188 or email [email protected].

The licensed agents that are partnered with Timefor65 can help you compare the availability, benefits, and costs of Medicare plans in your specific region of Ohio. Our process makes it easier for you to access your Medicare eligibility in Ohio so that you receive personalized, affordable, and easy-to-use coverage options and solutions. Fill out the form or give us a call at (866) 327‑0148 anytime to get a free quote or to ask any questions.

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