Jane Dotson
Medicare beneficiaries in Ohio have several options for health insurance plans. These include Medicare Advantage Plans (also known as Part C) offered by private insurers, and Original Medicare, which is provided directly by the federal government. MyCare Ohio is another option for those who receive both Medicaid and Medicare benefits, offering coordinated care with additional services such as $0 copayments for prescription drugs covered by Medicare. While Medigap plans are available in Ohio, they are not accessible to beneficiaries under the age of 65, unlike in some other states.
| Characteristics | Values |
|---|---|
| Medicare beneficiaries in Ohio can choose to get their healthcare coverage through | Medicare Advantage plans, or directly from the federal government via Original Medicare |
| Medicare Advantage plans are offered by | Medicare-approved private companies |
| Medicare Advantage plans must follow rules set by | Medicare |
| Medicare Advantage plans include | Drug coverage (Part D) |
| Medicare beneficiaries in Ohio | Can select from at least 36 Medicare Advantage plans |
| Residents of most Ohio counties have access to | 50+ Medicare Advantage plans |
| As of September 2024, more than | 56% of all Ohio Medicare beneficiaries had Medicare Advantage plans |
| The remaining Ohio Medicare beneficiaries were enrolled in | Original Medicare |
| Medigap plans are | Sold by private insurers |
| Medigap plans are | Standardized under federal rules |
| Number of insurers offering Medigap plans in Ohio | 48 |
| Medigap plans are available on a guaranteed-issue basis for six months after | Enrollees turn 65 and are enrolled in Medicare Part A and Part B |
| MyCare Ohio is a | Managed care program designed for Ohioans who receive both Medicaid and Medicare benefits |
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What You'll Learn
Medicare Advantage Plans
In Ohio, there are a variety of Medicare Advantage Plans to choose from, with over 224 plans available in 2025. These include plans from providers such as Anthem Blue Cross and Blue Shield, Devoted Health, PrimeTime Health Plan, SummaCare Medicare Advantage Plans, and UnitedHealthcare, among others. The average monthly premium for a Medicare Advantage Plan in Ohio was $16.63 in 2024, decreasing to $15.51 in 2025. There are also plans with $0 monthly premiums available.
It is important to note that Medicare Advantage Plans are subject to change. Insurance companies decide which plans are available in a state and can choose to join or leave Medicare each year. Therefore, it is recommended to review your options regularly to ensure you have the coverage you need.
If you are an Ohio resident and interested in enrolling in a Medicare Advantage Plan, you can do so during the Open Enrollment Period, which runs from October 15 to December 7. Your coverage will then begin on January 1 of the following year.
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Original Medicare
In Ohio, Medicare beneficiaries can choose to receive their healthcare coverage through Medicare Advantage plans or directly from the federal government via Original Medicare. Original Medicare is provided directly by the federal government and includes Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance).
Medicare Advantage plans are offered by private insurers and are an alternative to Original Medicare. These plans are also known as Part C and must follow rules set by Medicare. Most Medicare Advantage plans include drug coverage (Part D). Medicare Advantage plans are available in all counties in Ohio, and in 2025, all Ohio Medicare beneficiaries could select from at least 36 Medicare Advantage plans, with residents in most counties having access to 50 or more plans.
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Medigap plans
In Ohio, Medigap plans are sold by private insurers but are standardized under federal rules and regulated by state laws. This means that each Medigap plan with the same letter (e.g., Plan G, Plan K) will provide the same benefits as any other plan with that label. Medigap plans help fill the "gaps" in Original Medicare and can help pay for healthcare costs that Original Medicare (Parts A and B) does not cover, including copays, coinsurance, and deductibles.
The best time to enroll in a Medigap plan is during the Medigap Open Enrollment Period, which begins in the first month that an individual has Medicare Part B and is 65 or older. During this time, an individual cannot be denied coverage due to pre-existing health problems. If enrollment occurs after this period, an individual may be denied coverage because of a pre-existing condition.
Medigap Plan G is one of the most popular plans and offers the broadest coverage for most people. It covers out-of-pocket costs that Original Medicare does not cover, except for the Medicare Part B deductible. Plan N is another option that offers a lower premium with some copays and a small annual deductible. It may be a good choice for those primarily concerned with covering Original Medicare Part A and Part B coinsurance costs.
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MyCare Ohio
If you are eligible for MyCare Ohio and do not choose a plan, the Ohio Department of Medicaid will select a plan for you. To enrol in a MyCare Ohio plan, contact the Ohio Medicaid Consumer Hotline at 800-324-8680. Representatives are available Monday to Friday from 7 am to 8 pm and on Saturdays from 8 am to 5 pm Eastern Time.
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Medicare Part A and Part B
Medicare Part A
Medicare Part A, or Hospital Insurance, helps cover the costs of medical care received in a hospital. Most people are eligible for premium-free Part A if they meet certain requirements, such as having worked a specified number of quarters and paying Medicare taxes. Individuals can also qualify for premium-free Part A if they receive monthly Social Security or Railroad Retirement Board (RRB) benefits. Those who do not meet these criteria may have to pay a premium for Part A coverage.
Medicare Part B
Medicare Part B, or Medical Insurance, covers medical care received outside of a hospital, such as doctor's visits. Unlike Part A, individuals typically need to pay monthly premiums for Part B coverage. However, there are instances where individuals may choose to decline Part B coverage if they have employer-sponsored coverage that meets certain standards.
Enrolling in Medicare Part A and Part B
Individuals can apply for Medicare Part A and Part B by contacting the Social Security Administration. For Part A, coverage typically begins the month an individual turns 65, provided they apply within 6 months before or after their birthday. For Part B, individuals must also enroll and pay the required premiums to maintain coverage.
Medicare Advantage Plans
Medicare Advantage Plans, also known as Part C, are offered by Medicare-approved private companies as an alternative to Original Medicare. These plans combine Parts A, B, and sometimes Part D (prescription drug coverage) into a single plan. Medicare Advantage Plans are available in all counties in Ohio, and beneficiaries can choose from a variety of plan options. However, it is important to note that Medicare Advantage Plans may have specific service areas, and moving outside of these areas may result in disenrollment.
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Frequently asked questions
Medicare Insurance in Ohio is a federal and state-regulated program that provides healthcare coverage to Ohio residents.
There are two main types of Medicare plans available in Ohio: Original Medicare (Parts A and B) and Medicare Advantage Plans (Part C). Original Medicare is offered directly by the federal government, while Medicare Advantage Plans are provided by private insurers.
Original Medicare is a traditional fee-for-service program where beneficiaries can choose their own healthcare providers. Medicare Advantage Plans, on the other hand, are offered by private companies that contract with Medicare and may have specific networks of providers. These plans often include additional benefits, such as drug coverage (Part D).
Yes, Ohio residents may consider Medigap plans as supplemental coverage to their Original Medicare. These plans are sold by private insurers but are standardized under federal rules, ensuring consistent benefits across plans with the same letter designation (e.g., Plan G, Plan K). However, it's important to note that Medigap plans in Ohio are typically only available to individuals over the age of 65.
MyCare Ohio is a managed care program specifically designed for Ohio residents who receive both Medicaid and Medicare benefits. It offers coordinated care, including medical, behavioral, and long-term services, with the added benefit of having a single point of contact and seamless navigation across services. MyCare Ohio plans may also include additional benefits, such as $0 copayments for prescription drugs covered by Medicare.
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