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Medicare Advantage Plans in Ohio

Medicare Parts A and B are not your only choices for healthcare after age 65. Medicare Advantage plans in Ohio are another option. Unlike Medicare Parts A and B, you get Medicare Advantage from a private insurance company. These plans offer different coverage that may be more beneficial for your needs.

The Medicare Advantage Plans Available

Original Medicare, or Medicare Parts A and B, offers basic coverage, whereas Medicare Advantage plans offer broader coverage. Each plan varies but may include:

  • Dental
  • Vision
  • Prescription Drug Coverage
  • Wellness Benefits

The types of Medicare Advantage plans in Ohio include HMO, PPO, and PFFS plans. Each plan has its advantages depending on your medical needs. For example, HMO plans may have the lowest premiums, but they have the smallest network of doctors and hospitals. You’ll also need a referral to see a specialist.

PPO plans offer the largest network of doctors and hospitals, and you don’t need a referral to see a specialist, but they do have higher premiums. Although your co-pay or co-insurance amount will be higher, PPO plans allow you to visit out-of-network doctors; some people prefer the flexibility even if it comes at a higher cost.

PFFS or Private Fee-for-Service plans work on a case-by-case basis. You don’t have a network of doctors; instead, you ask the doctor you want to see if they’ll accept the PFFS contract. You must do this each time you see the doctor for treatment.

Eligibility for Medicare Advantage Plans in Ohio

In order to qualify for a Medicare Advantage plan, you have to meet certain criteria:

  • Have Medicare Part A and B (or be eligible for them).
  • Live in the service area of the program offered.
  • Not suffer from end-stage renal disease

An insurance agent can help you determine if you meet all the requirements.

Initially, you can enroll in Medicare Part C during the seven-month time period that begins three months before your 65th birthday and ends three months after your birthday month. If you don’t enroll during this time, you have two other options.

You can enroll during the Open Enrollment period, from October 15 to December 7 each year. You can also change from Original Medicare to Medicare Advantage plans in Ohio during this time.

From January 1 to March 31, you can switch from a Medicare Advantage plan to Original Medicare. You can also switch Medicare Advantage plans during this time, but you cannot switch from Original Medicare to Medicare Advantage.

Medicare Advantage Prescription Drug Plans

Medicare Advantage plans in Ohio combine healthcare coverage with prescription drug coverage. If you have standard Medicare, you get Medicare Part A and Part B separately. Part B is coverage you choose; Part A is automatic. You must then also select a Medicare Part D plan for prescription coverage.

If you don’t have prescription drug coverage, consider Medicare Part D. Even people that don’t take prescriptions now can save money by opting for Part D. Medicare charges a penalty to beneficiaries that don’t have prescription coverage for 63 consecutive days after the initial enrollment period. Credible prescription coverage aside from Medicare Part D includes:

  • Medicare Advantage Plans (Medicare Part C)
  • Prescription Coverage From an Employer or Union

If you don’t have any of the above when signing up for Part D, Medicare charges 1 percent of the “national base beneficiary premium” multiplied by the number of months you did not have coverage. Medicare rounds the premium to the closest $0.10 and adds the amount to your Medicare premium.

Paying Your Medicare Part B Premium

Even if you enroll in one of the Medicare Advantage plans in Ohio, you’ll still pay your Medicare Part B premium. Shopping around to find the Medicare Advantage plan with the lowest premium can save you the most money.

Premiums and requirements vary per insurance company. You can shop for plans outside of your county; just be aware of the service area. Also, pay close attention to the co-pays and deductibles. Are you comfortable affording both? Don’t fall for a low premium only to find out the hard way that you have a high deductible that you can’t afford.

When it comes to Medicare Advantage plans in Ohio there are many options available. Examine the details of each plan carefully and compare prices. Remember, you can enroll three months before you turn 65 years old, and you also have the option to change plans each year during the Open Enrollment Period, which gives you some leeway as your medical needs change throughout the years.

The goal is to find the plan that suits your needs while offering the best savings on medical costs.

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