2021 Ohio Medicare Plans

Ohio Medicare plans are available to Ohio citizens that are 65 years or older. It is also offered to younger people with disabilities. This state is also the leader in health coverage and health research.

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Ohio Medicare Insurance Trends

According to the Centers for Medicare & Medicaid Services (CMS), the Medicare coverage plans for 2021 include the following:

  • Over 2 million Oklahoma residents are enrolled in a Medicare plan.
  • The Medicare Advantage monthly premium in Ohio decreased from $21.85 in 2020 to $20.69 in 2021.
  • Ohio offers 202 Medicare Advantage plans available in 2021, compared to 178 plans in 2020.
  • All Ohio residents with Medicare can purchase a Medicare Advantage plan, even plans with $0 premiums.
  • There are 30 stand-alone Medicare Part D plans available in Ohio for 2021. In 2020, there were just 28 plans.
  • All Ohio residents with a Part D plan have access to a lower monthly premium than they paid in 2020.
  • There are 12 different Medigap plans offered in Ohio this year.

Medicare Offered in Ohio

Ohio offers two options for Medicare plans. One is Original Medicare, and the other is Medicare Advantage. They both still have specific parts or “options” within the plan. Here are the components:

Original Medicare

Ohio Original Medicare includes Medicare Part A and Part B. It is offered to residents over 65 or those with disabilities or certain health conditions.

Ohio Medicare Part A Plans

Medicare Part A coverage includes the following:

  • Inpatient hospital care and support: Any tests, treatments, or care for patients in the hospital.
  • Short-term nursing home: If you require care from a health aide at home after hospital release, Medicare covers this while you recover.
  • Hospice care: If you have chosen hospice care, Medicare will cover most healthcare costs. 
  • Part-time at-home healthcare: If you require skilled nursing facility assistance, Medicare will cover the stay and services for a certain duration.

Medicare Part A only covers the costs of an emergency room visit if you’re admitted to the hospital to treat the illness or injury that brought you to the ER. 

Medicare Part A coverage does not include the following:

  • First three pints of blood: If a hospital receives blood from the blood bank, you may not be required to pay anything. However, if the hospital must get specific blood for you, you may be required to pay for it out-of-pocket.
  • Private hospital rooms: Inpatient care does include a stay in a semi-private room. However, you are not necessarily entitled to a private room during your hospital stay.
  • Long-term care: Medicare Part A is designed to provide care for injury or acute illness. If you require long-term care, such as a nursing home, you will likely have to pay for residential care out of pocket.

Ohio Medicare Part B Plans

Medicare Part B covers outpatient care, including medical services required to treat a medical condition. It also covers certain preventative care measures, including screening, specific vaccines, and mental health services. 

Medicare Part B coverage includes the following:

  • Most essential doctor visits if they are from a Medicare-approved supplier
  • Medically vital outpatient hospital care, including emergency hospital services and same-day surgical services
  • Certain vaccines, including the annual flu shot and pneumonia shot
  • Hepatitis B vaccine for those at medium or high risk
  • Screenings and tests for:
    • Depression
    • Diabetes
    • Hepatitis C
    • Heart disease
    • STIs
    • Lung cancer and other cancers
    • Colonoscopy
    • Pap smears, X rays, blood tests, mammograms

Medicare Part B coverage does not include the following:

  • Long-term hospital or custodial care
  • Dental care and dentures
  • Eye exams
  • Cosmetic surgery 
  • Foot care
  • Acupuncture

Ohio Medicare Advantage

Medicare Advantage Part C is an alternative to Part A and Part B Medicare. There are a variety of these types of plans with various premiums and coverage. Part C plans may offer some or all of the following:

  • All Original Medicare coverage 
  • Prescription drug coverage
  • Dental and vision coverage
  • Gym memberships or fitness programs
  • Adult day-care programs
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Medicare Supplement Plans 

Original Medicare cannot cover all healthcare services. Medicare supplement (Medigap) plans in Ohio help cover certain gaps in Original Medicare coverage. They can be purchased in addition to having the part A and B plans. In 2021, here are some of the companies offering Medigap plans:

  • Aetna 
  • Cigna 
  • Humana 
  • BCBS
  • Lumico
  • USAA
  • Colonial Penn

 Ohio Medicare Enrollment

Unless you meet the qualifications for automatic enrollment, you need to sign up for Medicare during an enrollment period. Use Medicare’s online eligibility tool if you are unsure if you qualify.

Requirements

  • You are 65 or older, and you or your spouse worked and paid Medicare taxes for at least 40 quarters.
  • You are under age 65 and collect benefits from Social Security or the Railroad Retirement Board for at least 24 consecutive months.
  • You have ESRD or ALS. 

Enrollment Period Dates

Initial Enrollment Period

This is a seven-month window that allows you to sign up for a plan

Begins 3 months before the month you turn 65

Ends 3 months after the month you turn 65

Medicare Open Enrollment Period

This is when you can sign up for a plan, switch a plan or leave a plan

Begins Starts October 15th

Ends December 7th

Special Enrollment Period

Special enrollment periods allow you to enroll outside the regular enrollment periods under specific circumstances. 

General Enrollment Period

This is when you can sign up for Medicare Part A and/or Part B if you didn’t sign up when first eligible or if you’re not qualified for a Special Enrollment Period.

Starts January 1st

Ends March 31st

Medicare Advantage Open Enrollment Period

This is when you can switch or leave a Medicare Advantage Plan

Starts January 1st

Ends March 31st

Ohio Enrollment Tips & Advice

  • Costs: You may be required to pay higher monthly premiums for Ohio Medicare plans that offer drug coverage or have additional dental and vision benefits. Consider each plan’s out-of-pocket coverage maximum as well.
  • Coverage Types: Medicare Advantage in Ohio can offer dental, vision, hearing coverage for residents. Look into the coverage you desire prior to enrolling.
  • Network Provider: Those with Original Medicare can visit any doctor who accepts Medicare. However, Medicare Advantage plans usually have a provider network, and you should ask your doctor about this. 
  • Check CMS star rating: Medicare provides a 1 to 5 rating of how effective each Part C and Part D plan was in the previous year.

How Do I Enroll In A Medicare Plan?

Before applying, consider the various types of Ohio Medicare plans. Coverage Haven helps residents find the best coverage for themselves. These three steps will help you prepare:

  1. Determine whether you were enrolled in Medicare Part A, Part B, or Original Medicare
  2. Decide whether you want Part B or want to defer
  3. Review Medicare Advantage plans in the area
  4. If you choose Original Medicare, consider Part D options or Medigap

If you have any questions about Ohio Medicare and your eligibility for supplement or advantage plans, speak to one of our licensed agents today. Our agents will discuss your Medicare options and help find a plan that works for you.

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