As a Medicare beneficiary in Ohio, you may want to think about enrolling in a Medicare Supplement (Medigap) plan to get help paying for your Original Medicare out-of-pocket expenses. Since Medicare Supplement plans in Ohio vary depending on the zip code you live in, it may be a good idea to familiarize yourself with this type of health insurance and understand which benefits are available under each specific plan.
How Medigap plans work in Ohio
Medigap plans in Ohio can help Medicare beneficiaries pay for expenses associated with Original Medicare, Part A and Part B, including copayments, coinsurance, and deductibles. There are 10 standardized Medicare Supplement plans available in 47 US states, including Ohio. Each Medigap plan is identified by one of 10 letters (A, B, C, D, F, G, K, L, M, and N), and plans of the same letter offer the same benefits. Different types of standardized Medigap plans are available in three states: Massachusetts, Minnesota, and Wisconsin.
If you decide that a Medigap plan in Ohio is the right choice, you may sign up for a plan during your Medigap Open Enrollment Period, which begins the first day you are both age 65 or older and enrolled in Medicare Part B. This period lasts for six months and, in general, it’s the best time to sign up for Medicare Supplement insurance because of the special protections you have during this time (also known as “guaranteed-issue rights”). During this time frame, you may enroll in any Medigap plan available in your area, with the insurance company of your choosing, without being denied coverage because of pre-existing conditions or required to undergo medical underwriting. If you decide to join a Medicare Supplement plan in Ohio after your Medigap Open Enrollment Period has ended, you may be denied coverage or charged more for your insurance plan. Keep in mind that you must already be enrolled in Original Medicare, Part A and Part B, in order to join a Medigap plan in Ohio.
You also need to understand that Medigap in Ohio is designed to supplement Original Medicare (and not replace it), so you must remain enrolled in Original Medicare and continue paying your Medicare Part B premium to keep your health insurance coverage. You may also want to consider joining a Medicare Part D Prescription Drug Plan to receive prescription drug coverage, since Medigap in Ohio does not offer such coverage.
Keep in mind that in Ohio, as in as in the rest of the United States, Medigap plans aren’t designed to work with Medicare Part C and can’t be used to pay for costs you may have with your Medicare Advantage plan.
Types of Medigap plans in Ohio
As mentioned, benefits are standardized across plans of the same letter type. Take a look at the 10 types of standardized Medicare Supplement plans available in Ohio in order to understand what kind of benefits you may receive under each plan.
|Medicare Supplement Plans|
|Medicare Supplement Benefits||A||B||C||D||F*||G||K||L||M||N|
|Medicare Part A coinsurance and hospital costs up to an additional
365 days after Medicare benefits are exhausted
|Medicare Part B copayment or coinsurance||X||X||X||X||X||X||50%||75%||X||X***|
|First three pints of blood||X||X||X||X||X||X||50%||75%||X||X|
|Medicare Part A hospice care coinsurance or copayment||X||X||X||X||X||X||50%||75%||X||X|
|Skilled nursing facility (SNF) care coinsurance||X||X||X||X||50%||75%||X||X|
|Medicare Part A deductible||X||X||X||X||X||50%||75%||50%||X|
|Medicare Part B deductible||X||X|
|Medicare Part B ‘excess charges’||X||X|
|Foreign travel emergency coverage (up to plan limits)||80%||80%||80%||80%||80%||80%|
|Medicare Part B preventive care coinsurance||X||X||X||X||X||X||X||X||X||X|
|Out-of-pocket limits apply**|
If you’re seeking comprehensive coverage, you may want to take a closer look at Medicare Supplement Plan F, which covers almost 100% of Medicare-associated costs in the above benefits chart, excluding the Medicare Part B premium. Plan F also comes in a high-deductible version, where you must pay a certain amount out of pocket before the plan begins to cover costs.
You may also want to note that Medicare Supplement Plan N pays 100% of the Medicare Part B coinsurance, but does not cover up to $20 copayment on some office visits and up to $50 copayment on emergency room visits that don’t result in you being admitted as an inpatient. In addition, Medicare Supplement Plan K and Plan L have out-of-pocket limits that are subject to change each year.
Choosing a Medigap plan in Ohio
As stated above, Medicare Supplement plans in Ohio with the same letter designation don’t vary in coverage or benefits. However, each independent insurance company that offers Medicare Supplement plans can determine its own monthly premium structure. This means that if you live in Cleveland in Cuyahoga County, you may pay more or less than a resident of Cincinnati in Hamilton County for an identical Medicare Supplement plan. Before you enroll, it’s a good idea to ask the insurance company how it “rates,” or prices, its premiums. The pricing method that the insurance company uses to set its plan premiums can affect how much you’ll pay both when you enroll in the plan and later on.
Keeping in mind the possible differences in costs, it may be a good idea to compare all Medicare Supplement plans available in your area in order to choose the Medigap plan in Ohio that provides the best fit for your personal health and budget requirements.
See the following page to get additional information about other types of Medicare coverage in Ohio:
With the various Medicare Supplement plans available in Ohio, it may be a good idea to get help choosing the Medigap plan that works best for your individual budget and health needs. You can do this in a couple ways. If you’re ready to start finding plan options now, just enter your zip code into the plan finder tool on this page to view plan options in your service area and location. Or, if you’d prefer to get one-on-one assistance with your Medicare needs, call the phone number on this page to reach a licensed insurance agent.
Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program.