Medicare in Ohio
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 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.
- Medicare in Ohio 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 and permanent residents. If you’re living with a disability or are a railroad retiree and have received Social Security benefits for 24 months, you may qualify for benefits before 65. If 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 may vary based on factors such as:
- Income level
- Assets and resources
- Extra coverage
- Whether you have Original Medicare or Medicare Advantage
Find the Medicare Plan that works for you.
What Are the 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), 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 Part A and B benefits, Medicare Part C usually bundles additional services like dental, hearing, vision, and prescription drug coverage. Here are the four types of Medicare Advantage plans:
Can I bundle multiple benefits into one plan?
Who Has the Best Medicare Advantage Plan?
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 highly 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:
- Staying healthy: Screenings, tests, and vaccines
- Managing chronic (long-term) conditions
- Plan responsiveness and care
- Member complaints, problems getting services, and choosing to leave the plan
- Health plan customer service
Part D plans are rated in four different categories:
- Drug plan customer service
- Member complaints, problems getting services, and choosing to leave the plan
- Member experience with the drug plan
- Drug pricing and patient safety
Thousands of older adults enroll in Medicare every day across the United States. The latest CMS data shows that 2,269,020 people are enrolled in Medicare Part A and B in Ohio. The total number of beneficiaries enrolled in Medicare Advantage increased from 1,061,016 to 1,147,579 year over year. Medicare Advantage participation in Ohio went from 47.78% to 50.58% 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.
2,269,020 Beneficiaries with Part A & Part B
1,147,579 Medicare Advantage Beneficiaries
50.58% Medicare Advantage Participation Rate
53.97% Female
46.03% Male
87.30% Non-Hispanic White
7.21% African American
1.15% Hispanic
4.34% Other/Unknown
15.26% Eligible for Medicaid
0.99 Average HCC Score
$10,140.62 Actual Per Capita Costs
18.68% Hospital Readmission Rate
29.09% % of Beneficiaries with an Emergency Department Visit
1,061,016 Medicare Advantage Beneficiaries, Previous Year
Increased Medicare Advantage, Year over year
47.78% Medicare Advantage Participation Rate, Previous Year
Table reflects the latest Beneficiary Demographics Data: Medicare Geographic Variation – by National, State & County
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.
Let’s find your ideal Medicare Advantage plan.
Ohio Department of Insurance
https://insurance.ohio.gov
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
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
https://odh.ohio.gov/help-center
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
https://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 a GoHealth insurance agent that is licensed in Ohio about your Medicare questions.
Mon – Fri, 8 a.m. – 6 p.m. CT
Centers for Medicare and Medicaid Services
You can reach the Social Security Administration 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
1-800-722-1213
TTY 1-800-325-0778
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.
Before 65 Guide
Understanding health insurance before age 65, especially when considering early retirement
Medicare Plans Guide
Costs, coverage and enrollment details for each Medicare plan
Medicare Beneficiary Guide
For those currently enrolled in Medicare
Low Income and Medicare Guide
For individuals with a qualifying income status
A Caregiver's Guide
For individuals with a qualifying income status
Sources
- Special Needs Plans (SNP). Medicare.gov.
- Medicare Benefits. SSA.gov.
This website is operated by GoHealth, LLC., a licensed health insurance company. The website and its contents are for informational and educational purposes; helping people understand Medicare in a simple way. The purpose of this website is the solicitation of insurance. Contact will be made by a licensed insurance agent/producer or insurance company. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. Our mission is to help every American get better health insurance and save money.
Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.