Ohio Medicare Supplement Plans (Medigap)

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Ohio Medicare Supplement plans were created to work with Medicare to supplement your traditional Medicare coverage. These policies were created to provide coverage for what’s not covered by Original Medicare. This includes out of pocket expenses such as deductibles, copayments and coinsurance.

Medigap plans are the same as Medicare Supplement policies. These are sold by private insurance companies, and are available to you through those carriers. Ohio Medicare options are broken down into parts and plans.

Ohio Medicare Benefits Explained

There are four major parts to Ohio Medicare, and there are Medigap plans.

Ohio Medicare

  • Part A – Ohio Medicare Part A is part of Original Medicare, and covers hospitalization.
  • Part B – Medicare Part B covers medical expenses that occur when you’re not in the hospital. This is also part of original Medicare. Coverage includes doctors, tests, and outpatient surgery, among other things.
  • Part C – Medicare Part C is also known as Medicare Advantage. This doesn’t work with parts A & B, rather, it’s an alternative to Original Medicare. It’s offered privately through insurance companies, and sometimes includes additional benefits. Part C still does have limitations, however.
  • Part D – Medicare Part D is prescription drug coverage.
  • Medicare Supplements/Medigap – Medicare Supplements cover what Original Medicare does not. They work with your Medicare plan and provide you with additional support. Original Medicare combined with a Prescription Drug Plan and Medigap will give you the most comprehensive healthcare coverage.

What Benefits does Medicare Cover in Ohio?

In Ohio, Medicare provides coverage for services which are deemed medically necessary by a physician. The beneficiary is expected to pay a 20% coinsurance on these services, as well as additional out-of-pocket costs. This is why a Medigap plan is necessary to cover the gap. Depending on your needs, you can find out which of the 10 Ohio Medicare Supplement plans would work best for you by filling out the form provided.

Qualifying for Ohio Medicare Supplement Plans in 2018

In order to qualify for Ohio Medicare Supplement plans, you must be at least 65 years old and enrolled in Medicare Part B. It’s important to enroll in Part B as soon as you’re eligible. That way you’re able to avoid what’s known as the “Part B Late Penalty”.

The Part B Late Penalty occurs when you don’t sign up for Part B when you’re first eligible. If this happens, you’ll have to pay a penalty, plus wait for the General Enrollment period.

The paid penalty for Medicare Part B increases your premium by 10% for each full 12-month period you wait. It’s calculated based on the standard premium of $134 per month. These numbers can add up quickly. Check here for details and examples.

Medicare Eligibility for Disabled Individuals Under 65 in OhioEligibility for Medicare for Disabled in Ohio

If you have received disability benefits from Social Security, or certain disability benefits from the Railroad Retirement Benefits for 24 months, you’ll automatically get Parts A and B.

Some carriers offer plans to those under 65 who are currently on disability. Federal law does not require insurance providers to offer Medicare Supplement Insurance for people who are disabled and under age 65. If you’re on disability in Ohio, please call us for more information concerning plans available to you.

How to Enroll for Ohio Medicare Supplement Plans

Open Enrollment for Medicare Supplements begins the first day of the month once you’re 65 and enrolled in Medicare Part B. If your birthday was September 31st, and your Medicare Part B effective date was October 15th, then Open Enrollment for you begins November 1st. Your Open Enrollment period is effective for six months. What this means is that during that time, you’re granted Guaranteed Issue.

Guaranteed Issue rights means that insurance companies can’t turn you down for a Medicare Supplement, or Medigap, policy. They must cover your pre-existing health conditions and cannot charge you extra because of them.

Without these rights, your application may go through the underwriting process, which could result in higher premiums or even denial of coverage due to your health.

In Ohio, you’ll also be granted guaranteed issue if your employer plan is ending and the employer sponsored plan is primary to Medicare. However, you must apply for Medigap no later than 63 days after the latest of these dates:

  • The date your coverage ends
  • Date you were notified that coverage was ending
  • The date on a claim denial

You can apply for Medigap starting 60 days before you lose coverage. Your guaranteed issue rights will end 63 days after you lose coverage.

Missing Your Open Enrollment Period

Even if you miss your Open Enrollment Period, all hope is not lost. You can enroll in a Medigap plan at any time. It just may be more difficult. If you’re already enrolled in a Medigap plan, you may not be able to switch plans and retain guaranteed issue.

It can also be more difficult to find Medicare Supplement coverage after the Open Enrollment Period if you have a disability or pre-existing condition. If you do find a plan, your premium cost may be higher.

There are certain situations where a beneficiary can enroll in Medicare Part B outside of the normal enrollment periods. This is called the Medicare Special Enrollment Period.

The Special Enrollment Period provides you with the chance to enroll in Medicare Part B outside of the General Enrollment period or outside your Initial Enrollment Period. You can also make changes to your Medicare coverage when certain life events occur.

Medigap Premiums in Ohio

Cincinnati Medicare

Medigap cost is determined by the carrier, not the state. The price can vary and is based off many different factors, which include age, sex and location.

A plan in Cincinnati will not cost the same as a plan in Cleveland. Each carrier also uses one of three rating methods to then determine cost. These are:

  • Community Rated – Community-rated pricing means everyone pays the same rate for a policy.  Age is not a factor. With this policy, your premium will not increase as you get older, but it may increase due to other factors.
  • Issue Age Rated – Issue age rated Medigap pricing bases your premium on the age you were when you first bought your policy. If you’re older when you get your policy, you’ll pay more. Once the premium has been set, it will not increase because of your age. However, it may increase due to other factors.
  • Attained Age Rated – Attained-Age-Rated Medigap pricing bases your premium on your current age.  This is true no matter when you bought your policy, so your pricing will increase as you age.

Top Ohio Medicare Supplement Plans

Medicare supplement plans are based on ten letter plans. The benefits for these plans are the same nationwide, but pricing may differ based on the carriers pricing. The same Ohio senior health insurance in Dayton, Ohio can cost more or less than that plan in Toledo.

These top plans offer things like travel coverage, something not covered by traditional Medicare Part A or B.

Plan N in Ohio

Plan N is one of the more affordable plans. It may not offer as much coverage as other plans. However, it does cover hospitalization deductibles for Medicare Part A. It also will cover Medicare-approved stays in a skilled nursing facility. Hospice care is covered by Medicare Part N, and so is home health care after your Medicare Part B deductible is paid. Other services covered by Part N include:

  • First 3 Pints of Blood
  • Foreign Travel
  • Many Gaps in Medicare Part A & B

Medicare Plan N does not cover the Medicare Part B deductible. It also does not cover excess charges that a doctor may charge a Medicare patient. However, this is not an issue in Ohio, as there are no excess charges.

Plan F in Ohio

Plan F has the most comprehensive coverage benefits out of all ten Medigap plans available.  It can also cost the most, but actual costs will depend on your carrier and location.

Plan F pays the 20% copay due at a doctor’s office, as well as your deductible costs from a hospital stay our outpatient surgery.

Plan F also picks up the remainder of any bill that traditional Medicare plans won’t cover, which means you’ll never have to pay out of pocket for medical expenses.

Plan G in Ohio

Plan G a popular plan because it offers the same benefits as Plan F.  The difference is that Plan G doesn’t cover your Part B deductible. This can make it a more affordable option for people who still want excellent coverage.

Plan High Deductible F in Ohio

Plan HDF, or Plan F High Deductible, offers the same coverage as Plan F.  The difference is you’ll be responsible for medical expenses until your designated high deductible is met.

For 2018, this is $2,240. The reason some people opt for this Plan is that the premium is significantly lower than traditional Medicare Supplement Plan F.

Medicare Advantage Plans in Ohio

A Medicare Advantage policy is available through private insurers approved by Medicare. It covers Medicare Part A and B services, and may provide additional coverage as well. However, there are limitations with Medicare Advantage plans. These include cancellation restrictions and coverage limitations. You can avoid these by opting for a Medigap plan instead.

Ohio Prescription Drug Plans for Medicare

Medicare Part D is a prescription drug policy which will cover most medications prescribed by your doctor, but not over-the-counter medicine. There are a few prescriptions they also won’t cover, such as weight loss drugs.

In some cases, you may incur the Part D penalty. This occurs if you do not have valid prescription drug coverage at the time you qualify for Traditional Medicare. In this instance, you’ll incur a penalty for each month you went without Part D coverage. The penalty is calculated by Medicare and is deducted from your Social Security benefits for life.

How to Apply for Medicare in Ohio

If you’re a Medicare beneficiary, you need to protect yourself financially for services not covered by your Original Medicare plan. With the right coverage, you can ensure that the 20% not covered by Medicare is taken care of.

We can help you discover the right plan for you, and can provide assistance with all Medicare options including Ohio Medicare Supplement plans, Medicare Advantage, and Part D PDP plans. To compare rates or even get more assistance, fill out the quote form provided on our website.

Medicare Resources in Ohio

When it comes to assistance for Medicare costs, beneficiaries unfortunately have very few options.  Luckily, there is a health insurance information program to help those looking to understand these options.

The State Health Insurance Assistance Programs (SHIPs) offer free counseling and advice to Medicare beneficiaries.

The insurance information program in Ohio (OSHIP) can help explain your options one-on-one, or with your family or caregiver.

Interesting Facts About Ohio Medicare Beneficiaries

  • The total number of Medicare beneficiaries in 2015 was just over 2.1 million, that’s about 19% of the total population
  • In 2013, 17% of those beneficiaries were disabled and the remaining 83% attained the age of 65
  • Just under 1% of beneficiaries in the state had End Stage Renal Disease in 2013

FAQ’s People are Asking in Ohio About Medicare

Does Medicare cover assisted living in Ohio?

  • Medicare does not cover assisted living. If a senior must stay in a nursing care facility short-term after hospitalization, these costs may be covered. But Medicare does not pay for long-term stay in an assisted living facility. The best way to make sure you’re covered for assisted living is to purchase a long-term care insurance policy.

Where can I compare Medicare Supplement Plans in Columbus Ohio?

  • You can compare Medicare Supplement plans in Columbus Ohio by filling out our form. An agent specializing in senior health insurance information will get in touch with you shortly.

Does the Cleveland clinic accept medicare?

  • The Cleveland clinic does accept Medicare, but there will still be out-of-pocket costs. Make sure you get a supplement health plan to cover these costs.

Ohio Medicare Supplement plans are are sold by private insurance carriers. There are a variety of plans available through those carriers. They help to supplement the cost of out-of-pocket expenses not paid for by Medicare.