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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 the part of Ohio you live in.
The Medicare Advantage (Part C) program in Ohio works the same way as in the rest of the country. Also known as Medicare Part C, the Medicare Advantage program offers an alternative way to get your Original Medicare benefits (through private insurance companies that contract with Medicare). While Original Medicare is administered by the federal government, your insurance company coordinates your care under Medicare Part C.
Medicare Advantage is simply another way to get your Original Medicare coverage – this means Medicare Part A (hospital insurance) and Part B (medical insurance). However, hospice care is still covered directly through Medicare Part A instead of through a Medicare Advantage plan. Many plans go beyond Part A and Part B, offering benefits that Original Medicare doesn’t cover, such as routine vision, routine dental, and prescription drug benefits.
Eligibility for Medicare Advantage is the same in all states, including Ohio. To sign up for a Medicare Advantage plan, you must:
Ohio beneficiaries who meet eligibility requirements can enroll in a Medicare Advantage plan or make changes to their coverage during the following periods:
There are several different types of Medicare Advantage plans. Not every plan may be available in your part of Ohio.
Here’s an overview of the some types of Medicare Advantage plans.
Most Medicare Advantage plans include prescription drug benefits. Medicare Advantage Prescription Drug plans provide your Medicare Part A, Part B, and Part D (prescription drug) benefits under a single plan. You need to continue paying your Part B premium, along with any premium the Medicare Advantage plan may charge.
In most cases, you can’t enroll in both a Medicare Advantage plan and a stand-alone Medicare Prescription Drug Plan. If you’re enrolled in a certain type of Medicare Advantage plan that doesn’t include this coverage, such as a Medicare Savings Account plan or a Private Fee-for-Service plan that doesn’t come with prescription drug coverage, you may be able to enroll in a stand-alone Medicare Part D Prescription Drug Plan.
Considering all the different types of Medicare Advantage plans, along with the fact that costs and benefits vary, you can see why it may be important to carefully review all of your available options. To start comparing Medicare Advantage plans in Ohio, just enter your zip code where indicated on this page to search for plans in your service area.
Some factors that may affect your choice of Medicare plan might include your current and future health needs, budget, provider choice, and whether you take prescription 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 the plan you sign up for covers all of your prescriptions, or you could end up paying a lot more out-of-pocket. A plan’s formulary (list of covered prescription drugs) may change at any time. You will receive notice from your plan when necessary. Remember that regardless of the Medicare plan you go with, you’ll have to keep paying the Part B premium.
You can also view the following page for more information on other types of Medicare coverage in Ohio:
*Out-of-network/non-contracted providers are under no obligation to treat Preferred Provider Organization (PPO) plan members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.