Call Us
Menu

Medicare in Ohio

The right questions and answers are important for getting up to speed on Medicare in OH

Reviewed by: Selah Lee, Licensed Insurance Agent. Written by: Andrew Hall.

Key Takeaways

  • Medicare in Ohio is health insurance available to all legal U.S. residents aged 65 and older. The federal government partially funds it through taxes.

  • Original Medicare (Parts A and B)Original Medicare is a fee-for-service health insurance program available to Americans aged 65 and older and some individuals with disabilities. Original Medicare is provided by the federal government and is made up of two parts: Part A (hospital insurance) and Part B (medical insurance). helps cover hospital and medical costs. Medicare AdvantageMedicare Advantage (Medicare Part C) is health insurance for Americans aged 65 and older that blends Medicare benefits with private health insurance. This typically includes a bundle of Original Medicare (Parts A and B) and Medicare Prescription Drug Plan (Part D). in Ohio combines Parts A and B and often bundles Part DMedicare Prescription Drug Plan (Part D) is prescription drug coverage for people enrolled in Medicare. Part D is optional and is offered by private insurance companies. and other services.

  • The price of Medicare in Maryland starts with standard costs but is adjusted based on details like your work history and income.

 

If you have a question about Rock ‘n’ Roll, chili, or the Buckeyes, ask someone from Ohio. If you have a question about Medicare in Ohio, ask GoHealth!

Who Qualifies for Medicare in Ohio?

Eligibility for Medicare in OH begins at 65 for U.S. citizens, unless you qualify for benefits before 65. If you’re living with a disability or a railroad retiree and have received Social Security benefits for 24 months, you may qualify for Medicare in OH. If you qualify for Medicare in OH and you are wondering about costs or how to enroll, we’ve got you covered.

How do I get Medicare in Ohio?

When you’re ready to enroll in Medicare in OH, you have more than one option:

  • A licensed GoHealth agent can help you compare plans and enroll at no cost.
  • You can enroll in Medicare at your local Social Security Office.
  • You can call the Social Security Administration to enroll in Medicare.
  • You can enroll in Medicare online at ssa.gov
  • You can mail a signed and dated letter to Social Security that includes your name, Social Security number, and the date you would like to be enrolled in Medicare in OH.

How much does Medicare cost in Ohio?

The cost for Medicare in OH will be the same for most Ohioans. Still, some plans and premiums may vary based on different factors, such as:

  • Income Level
  • Assets and Resources
  • Extra Coverage
  • Original Medicare or Medicare Advantage

As you can see, there’s a lot to consider when you’re getting started with Medicare. But, that’s where a GoHealth licensed insurance agent can help. You can save time by letting GoHealth compare costs, find savings, and match your needs to a plan that fits your budget.

What Are the Different Plans of Medicare?

If you’re new to Medicare in Ohio, it’s best to consider the four different plans of Medicare.

Naturally, your next question may be one of the following: What is the best Medicare plan in Ohio? What is the best Medicare Advantage plan in Ohio? Or, what is the best Medicare Supplement plan in Ohio?

The answer to each is the same. When it comes to Medicare in OH, your health needs will determine which plan best meets your needs. Whether you choose Original Medicare or Medicare Advantage, the different parts of Medicare can work alongside each other to cover your needs. A GoHealth licensed insurance agent can help you compare different plans to make sure your benefits and costs align with your needs and budget.

What Are the 4 Types of Medicare Advantage Plans?

If you’re new to Medicare in Ohio, you may not know about the four types of Medicare Advantage plans: HMO, PPO, PFFS, or SNP. If you’re familiar with only Original Medicare (Part A and Part B), sometimes called traditional Medicare, let’s take a closer look at your Medicare Advantage options.

As a refresher, Medicare Advantage (Part C) replaces Original Medicare (Part A & B) but offers the same Part A and B benefits or coverage as Original Medicare. Along with receiving Part A and B benefits, Medicare Part C often bundles additional services like dental, hearing, vision and prescription drug coverage. Here are the four types of Medicare Advantage plans:

Who Has the Best Medicare Advantage Plan for 2021?

As is the case most often, there is not a single Medicare Advantage plan that is “best” for everyone. You need to find a plan that best meets your needs. For example, a Five Star-rated Medicare Advantage plan that doesn’t include a provider you need would not be “best” for you, even though it has a high Star Rating. Likewise, a high rated Part D plan that doesn’t offer your prescription at an affordable price may not be “best” for you.

What is the Medicare Star Rating System?

Medicare uses a Star Rating System to measure how well Medicare Advantage and Part D plans perform. Plans are rated by category and assigned one overall star rating for its performance. Medicare reviews plan performance annually and ratings can change from year to year.

Medicare Advantage Plans are rated in five different categories:

  1. Staying healthy: screenings, tests, and vaccines
  2. Managing chronic (long-term) conditions
  3. Plan responsiveness and care
  4. Member complaints, problems getting services, and choosing to leave the plan
  5. Health plan customer service

Part D plans are rated in four different categories:

  1. Drug plan customer service
  2. Member complaints, problems getting services, and choosing to leave the plan
  3. Member experience with the drug plan
  4. Drug pricing and patient safety

Medicare in Ohio by the Numbers

Thousands of older adults enroll in Medicare every day across the United States. The latest CMS data shows that 2,183,761 people are enrolled in Medicare in Ohio. The total number of beneficiaries enrolled in Medicare Advantage in Ohio is 1,003,655. The previous year, 917,952 enrolled in Medicare Advantage. Medicare Advantage participation in Ohio went from 42.82% to 45.95% year over year. If you’d like to dive deeper into how Medicare in Ohio breaks down across the state, we provide a glance at who is using Medicare, and how.

Outline of Ohio
2,183,761
Beneficiaries with Part A & Part B
1,003,655
Medicare Advantage Beneficiaries
45.96%
Medicare Advantage Participation Rate
54.23%
% Female
45.77%
% Male
1
Average HCC Score
$10,306.13
Actual Per Capita Costs
17.10%
% Eligible for Medicaid
34.32%
% of Beneficiaries with an Emergency Department Visit
18.17%
Hospital Readmission Rate
87.33%
% Non-Hispanic White
7.79%
% African American
1.14%
% Hispanic
3.74%
% Other/Unknown

Table reflects the latest Beneficiary Demographics data: 2018, All Beneficiaries by State, Centers of Medicare & Medicaid Services (CMS)

Average HCC Score: The Hierarchical Condition Category score gauges a population’s overall health. The score is based on a value of 1.0. Populations with an HCC score of less than 1.0 are considered relatively healthy. The score can be used to estimate health costs.

Ohio Medicare Resources & Contacts

Beneficiaries spend an average of $10,306.13 each year on Medicare in Ohio. To be certain you are not leaving anything on the table, give us a call. A GoHealth licensed insurance agent can assess your coverage or explain which Ohio-based resources, like these, may be able to help:

Ohio Department of Insurance

1-614-644-2658

https://insurance.ohio.gov/wps/portal/gov/odi/home

What should I know about the Ohio Department of Insurance?

File complaints, report fraud and request public records while learning more about health insurance in Ohio

Ohio Medicaid

1-800-324-8680

https://medicaid.ohio.gov/

What should I know about Ohio Medicaid?

See if you qualify for state-funded health insurance for eligible Ohioans

 

Ohio Department of Health and Human Services

1-614-466-3543

http://www.ohdhhs.gov/contact

What should I know about the Ohio Department of Health and Human Services?

Connect with Ohio-based programs and health initiatives designed to support Ohioans’ health

Ohio Department of Veterans Services

1-614-644-0898

http://www.dvs.ohio.gov

What should I know about the Ohio Department of Veterans Services?

Assists Ohio veterans with educational, consumer, health and community resources

Nationwide Resources

Speak with an insurance agent that is licensed in Ohio about your Medicare questions.

1-855-792-0088 TTY: 711

Monday - Friday, 8 AM - 9 PM CT

Medicare & Medicaid

If you have general questions about Medicare in OH, or need help with current Medicare benefits.

1-800-MEDICARE (1-800-633-4227)

Social Security Administration

You can reach the SSA by phone for general questions. Not all questions can be answered over the phone.

Also, SSA.gov provides online resources for the following: Review information, apply for benefits, or manage your account online

Speak to SSA Representative, Monday - Friday, 8 AM - 7 PM ET

Medicare Learning Guides

Healthcare is personal. So is choosing insurance. If you are new to Medicare, a beneficiary researching options, or a caregiver, we have tailored Medicare Guides for you.

Previous Next

New to Medicare Guide

Helpful information to get you started with enrolling in Medicare.

Medicare Beneficiary Guide

For those currently enrolled in Medicare.

Medicare Plans Guide

Costs, coverage and enrollment details for each Medicare plan.

Low Income & Medicare Guide

For individuals with a qualifying income status.

A Caregiver’s Guide

For those helping a loved one with Medicare.