Medicare Advantage in Ohio

If you're a Medicare beneficiary in Ohio, a Medicare Advantage plan can provide benefits beyond standard Original Medicare coverage. The specific plans available to you will depend on your zip code and county of residence.

How Medicare Advantage works in Ohio

Medicare Advantage in Ohio works in much the same way as the rest of the country. Also known as Part C, these Medicare health plans provide Original Medicare benefits through private insurance companies. Medicare Advantage plans are required to offer at least the same level of coverage you'd get in Original Medicare. Many plans go beyond this, offering benefits that Original Medicare doesn't cover, such as vision, dental, or prescription drug benefits.

Medicare Advantage is simply another way to get your Medicare coverage. While Original Medicare is administered by the federal government, in Medicare Advantage, you'd work directly with your insurance company when filing claims and handling benefit issues.

Eligibility for Medicare Advantage is the same in all states, including Ohio. To join a Medicare Advantage plan, you must:

Ohio beneficiaries who meet all eligibility requirements can join a Medicare Advantage plan or make changes to their coverage during the following periods:

Types of Medicare Advantage plans in Ohio

There are many different types of Medicare Advantage plans. Your choices as an Ohio beneficiary will depend, as mentioned, on where you live and whether you meet the plan's eligibility criteria.

Here's an overview of the some of the most common types of Medicare Advantage plans.

Some Medicare Advantage plans, known as MA-PD plans, may include prescription drug benefits. These plans provide your Part C and Part D benefits under a single plan.

If you have Medicare Advantage, you'd get your drug benefits through the health plan, not a stand-alone Medicare prescription drug plan. The exception is if you're enrolled in a Medicare Savings Account plan (which never includes drug benefits) or a Private Fee-for-Service plan (which doesn't always include it). If you're in a Medicare Savings Account plan or a Private Fee-for-Service plan that doesn't come with drug coverage, you're allowed to enroll in a stand-alone prescription drug plan. For all other types of Medicare Advantage plans, you're required to join a Medicare Advantage plan that includes drug coverage. Aside from Medicare Savings Account plans, any of the other types of Medicare Advantage plans may come with drug benefits.

Comparing Medicare Advantage plans available in Ohio

Considering all the different types of Medicare Advantage plans, along with the fact that costs and benefits vary by insurer and location, and you can begin to see why it's so important to carefully review all of your available options. When comparing Medicare Advantage plans in Ohio, always be sure to input your zip code to search for plans in your service area.

Some factors that may affect your choice of plan include your current and future health needs, budget, provider choice, and whether you take medications. If it's important that you keep seeing a particular doctor, check that the provider is in the plan's network. If you take prescription drugs, verify that any plan you join covers all of your medications, or you could end up paying a lot more out of pocket. Remember that regardless of the plan or insurance company you go with, you'll have to keep paying the Part B premium.

When you're ready to begin comparing Medicare Advantage plans in Ohio, you have many ways to do it:

Medicare has neither reviewed nor endorsed this information.

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