There are several different Medicare Advantage plans in Ohio offered in 2025 to choose from. Our website helps provide the resources available that can help you find the perfect plan to suit your needs.
This blog post will guide you through the essentials of Medicare Advantage plans in Ohio, their benefits, types, enrollment process, financial assistance, and available resources to help you make an informed decision.
Medicare Advantage is a federal health insurance program that provides coverage for U.S. adults aged 65 and over, as well as younger individuals with specific disabilities and medical conditions.
In Ohio, there are over 216 Medicare Advantage plans available from private health insurance providers, offering additional benefits compared to Original Medicare.
As 42% of eligible Ohio residents have chosen Medicare Advantage plans, you should evaluate your options by considering:
This will help you make an informed choice.
Ohio Medicare Advantage plans offer benefits beyond Original Medicare, including prescription drug coverage, routine examinations, and dental, vision, and hearing benefits, frequently at a more economical rate.
We will further examine these added benefits in the subsequent part.
Many Medicare Advantage plans in Ohio include prescription drug coverage, giving seniors access to essential medications at an affordable price.
These plans often offer additional benefits, such as routine examinations, and dental, vision, and hearing benefits, which are typically not covered by Original Medicare.
The cost of Medicare Advantage plans in Ohio can be lower than Original Medicare, providing seniors with comprehensive coverage and extra benefits at a more affordable rate. This makes Medicare Advantage an attractive option for those seeking cost savings and increased convenience in managing their healthcare.
You need to scrutinize the plan details or get in touch with the Medicare Advantage plan provider for specifics about the frequency of routine exams and the scope of dental, vision, and hearing benefits provided.
Grasping these extra benefits will assist in selecting a plan that satisfies your specific healthcare requirements.
Ohio Medicare Advantage plans fall into four main categories:
Each plan type offers varying levels of flexibility, price, and additional benefits, making it essential to understand the differences between them.
HMO and PPO plans are the most common types of Medicare Advantage plans, with the following characteristics:
When deciding on a Medicare Advantage plan in Ohio, it’s imperative to take into account the plan type and its features to find a plan that best matches your healthcare needs and budget.
Eligibility for enrollment in Ohio Medicare Advantage plans is based on:
These individuals are eligible for Medicare in Ohio.
There are specific enrollment periods for Medicare Advantage plans in Ohio, such as:
To determine eligibility for a Special Enrollment Period, contact 1-800-MEDICARE.
By grasping the eligibility criteria and enrollment periods, you can ensure a seamless transition to a Medicare Advantage plan that satisfies your needs.
When examining Medicare Advantage plans in Ohio, you should evaluate aspects like:
You can use the plan finder tool on Medicare’s website to compare the costs and coverage of various Medicare plans in your area.
Coverage among Medicare Advantage plans in Ohio can vary, with some plans offering additional benefits not covered by Original Medicare, such as:
Additionally, the type of plan, whether it’s an HMO or PPO, can impact the coverage and provider network available.
To comprehend and compare provider networks in Ohio’s Medicare Advantage plans, examine the different health insurance companies that offer them and contrast their ratings.
Evaluate the specific plans each company provides and compare their benefits and coverage options to find a plan that fits your healthcare needs. It’s essential to compare Medicare Advantage plans to make an informed decision.
Prescription drug coverage is an essential component of many Medicare Advantage plans in Ohio, as it includes various prescription drugs. Most HMO and PPO plans, as well as all SNP plans, offer prescription drug coverage similar to that of Medicare Part D. However, the extent of coverage, cost, and convenience may vary among plans.
PFFS plans may or may not provide prescription drug coverage, making it necessary to carefully review the plan details before selecting a PFFS plan.
In addition to Medicare Advantage plans, there are 24 stand-alone Medicare Part D plans available in Ohio for 2023, providing another option for prescription drug coverage.
When choosing a Medicare Advantage plan in Ohio, it’s imperative to consider the prescription drug coverage the plan offers and verify that it satisfies your medication requirements.
Financial assistance for Ohio Medicare beneficiaries is available through the state’s Medicaid program, which can help cover premiums and services for eligible individuals.
To qualify for Medicaid, applicants must meet specific income and resource/asset level requirements, such as possessing no more than $2,000 of countable assets and meeting the equity limit for a home, which is $603,000 in 2021.
Medicaid offers coverage to Medicare beneficiaries through the Qualified Medicare Beneficiary (QMB) program, which assists with Medicare premiums, deductibles, and coinsurance.
To apply for Medicaid and receive financial assistance, visit your local county Job and Family Services office or call the Medicaid Consumer Hotline at (800) 324-8680. Ensure you meet the citizenship, Social Security Number, and residency requirements before applying.
Various resources and support are available for Medicare beneficiaries in Ohio. The Ohio Senior Health Insurance Information Program and the Medicare Rights Center are two organizations that provide trained, unbiased counselors to help you make informed decisions about Medicare Advantage plans.
In addition to these organizations, Medicare.gov and CMS’s website are valuable resources for understanding the different components of Medicare coverage and comparing plans available in your ZIP code.
Utilizing these resources can help you make an informed decision about the best Medicare Advantage plan for your needs.
Feel free to utilize these resources and support organizations to aid in navigating the complexities of Medicare Advantage plans in Ohio and ensure you choose a plan that meets your healthcare needs and budget.
Several top-rated Medicare Advantage plans in Ohio have received five-star ratings from CMS, indicating excellent performance in customer service, member experience, and quality of care.
Some of these Medicare Advantage HMO plans include Devoted Health’s Devoted CORE Ohio (HMO) Devoted GIVEBACK Ohio (HMO), and PrimeTime Health Plan.
However, plan availability varies by ZIP code and county, so it’s necessary to verify which of these top-rated plans are available in your area using Medicare.gov’s plan finder tool by entering your ZIP code.
Considering the ratings and performance of Medicare Advantage plans in Ohio can help you select a plan that provides high-quality care and customer service, ensuring a positive healthcare experience.
In conclusion, understanding the various Medicare Advantage plans available in Ohio, their benefits, types, enrollment process, and available resources can help you make an informed decision about your healthcare coverage.
By weighing factors such as coverage, cost, convenience, and provider networks, you can find a plan that meets your unique healthcare needs and budget.
Don’t hesitate to utilize the resources and support available to Ohio Medicare beneficiaries to ensure a smooth and positive healthcare journey.
Medicare Advantage plans can be costly and limit access to specialists and facilities, which can be a significant disadvantage for those who require these services. Additionally, many plans come with an annual maximum out-of-pocket cost that can still leave patients with high expenses.
Due to excessive prior authorization denial rates, slow payments from insurers, and billing fraud allegations, many people are leaving Medicare Advantage plans.
Medicare Advantage Plans come in four main varieties: Health Maintenance Organization (HMO) plans, Preferred Provider Organization (PPO) plans, Private Fee-for-Service (PFFS) plans, and Special Needs plans (SNPs).
In Ohio, the average Medicare Advantage premium is $16.03 per month in 2023 and $16.63 per month in 2024. There are 224 Medicare Advantage plans available in Ohio.
In Ohio, Medicare Advantage plans are available in the form of HMOs, PPOs, PFFSs, and SNPs.
ZRN Health & Financial Services, LLC, a Texas limited liability company
Russell Noga is the CEO of ZRN Health & Financial Services, and head content editor of several Medicare insurance online publications. He has over 15 years of experience as a licensed Medicare insurance broker helping Medicare beneficiaries learn about Medicare, Medicare Advantage Plans, Medigap insurance, and Medicare Part D prescription drug plans.