October 6, 2016
Medicare beneficiaries living in Ohio may have several Medicare plan options in addition to the federally-administered Original Medicare, Part A and Part B. Through the Medicare Part C program, Medicare beneficiaries may receive their Medicare benefits from Medicare Advantage plans offered by Medicare-approved private insurance companies. Through the Medicare Part D program, beneficiaries may receive Medicare prescription drug coverage either from Medicare Advantage Prescription Drug plans or stand-alone Medicare Part D Prescription Drug Plans. If you decide to stay with Original Medicare, another option you may have is to sign up for a Medicare Supplement (Medigap) plan to help pay for Original Medicare’s out-of-pocket costs.
Unlike Medicare Part A and Part B, available Medicare plans vary depending on where you live.
Original Medicare consists of Medicare Part A (hospital insurance) and Part B (medical insurance). It is the health insurance program created and administered by the federal government. Part A covers inpatient hospital care, skilled nursing and nursing home care, home health care and hospice care; Part B covers doctor’s visits and preventive services such as annual wellness exams, outpatient medical and mental health care, durable medical equipment.
To be eligible for Original Medicare, you must be 65 or older and a U.S. citizen or legal permanent resident of five continuous years or more. People who are younger than 65 may be eligible for Medicare if they have certain health conditions such as amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease) or if they’ve collected disability benefits for 24 continuous months or more from the Social Security Administration (SSA) or the Railroad Retirement Board.
Many beneficiaries are enrolled automatically, provided they already receive benefits through either the Social Security Administration (SSA) or the Railroad Retirement Board (RRB). In these cases, the red, white, and blue Medicare membership card is mailed to you approximately three months before your coverage begins, along with a “Welcome to Medicare” packet that contains educational information concerning the program.
Eligible beneficiaries in Ohio who are not enrolled automatically can apply for Medicare during the Initial Enrollment Period (IEP), a period that begins three months before you turn 65, includes your birthday month, and ends three months after your birthday month (for a total of seven months). It’s usually best to sign up during the IEP. If you don’t, you can enroll during the General Enrollment Period (January 1 – March 31 annually), but you could have to pay late enrollment penalties.
If you’re still working at the age of 65 and/or covered under an employer’s or union’s group health plan (or a spouse’s plan), you can delay enrolling in Medicare Part B. Before the group health plan coverage ends, you can sign up for Part B during a Special Enrollment Period without a late enrollment penalty.
People who are not eligible for social security benefits and those with end-stage renal disease (ESRD) are not automatically enrolled in Medicare. Contact the SSA for details (see contact information below).
To sign up for Medicare, you can go to your local SSA office or register online. You can also enroll by telephone:
There are Medicare plan options in Ohio besides Original Medicare. The best time to sign up for these plans is often during the Initial Enrollment Period.
Medicare Supplement plans can only be used to help with Original Medicare costs. You must stay enrolled in Part A and Part B for your hospital and medical coverage. In addition, keep in mind that prescription drug coverage isn’t included in these plans, so if you want help with your medication costs, you should enroll in a stand-alone Medicare Prescription Drug Plan.
Specific plan types and premium amounts may vary depending on where you live in the state.
If you’d like to sign up for a Medicare prescription drug plan, the best time to do so is usually during your Initial Enrollment Period. You can also sign up during the Annual Election Period (from October 15 to December 7), but if you don’t sign up when you’re first eligible, you could pay a Part D late-enrollment penalty if you are without creditable coverage for at least 63 consecutive days after your initial enrollment period ends. Creditable coverage means prescription drug coverage that provides approximately the same coverage as Medicare Part D.
There are numerous resources at your disposal at Medicare.gov. Many of these are established to assist you with any Medicare questions you might have, as well as providing answers to additional questions you may have.
Learn more about how Medicare plans work in Ohio including:
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