Medicare in Ohio

Last Updated : 09/16/20184 min read

Eligible Medicare beneficiaries in Ohio may have several Medicare coverage options. You can receive your coverage through Original Medicare, Part A and Part B. If you sign up for Original Medicare, you can decide to add a stand-alone Medicare Part D Prescription Drug Plan, Medicare Supplement plan, or both.

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Alternatively, you can enroll in a Medicare Advantage plan (Medicare Part C), which includes at least the same coverage provided by Original Medicare  Part A and Part B benefits (except hospice care); you get these benefits through a private insurance company instead of directly through Medicare. Medicare Part C plans can include other benefits as well, like routine vision and dental services, and prescription drug coverage. If you enroll in a Medicare Advantage plan, please note that you will continue to pay your Part B premium.

Types of Medicare coverage in Ohio

  • Medicare Part A covers inpatient hospital care, while Medicare Part B is for medical services such as doctors’ visits and preventive care. Original Medicare doesn’t include prescription drug coverage.
  • Medicare Advantage is also known as Medicare Part C. As described above, these plans are offered by private insurance providers. With a Medicare Advantage Prescription Drug plan, it’s possible to get all your Medicare coverage in one plan.
  • Medicare Part D Prescription Drug Plans provide stand-alone prescription coverage that can be added to existing Original Medicare, Part A and Part B, coverage.
  • Medicare Supplement insurance, also called Medigap, is optional insurance that covers “gaps” in Original Medicare coverage, like premiums, deductibles, coinsurances, and, in some cases, foreign travel emergency care.

Local resources for Medicare in Ohio

  • Medicare Savings Programs (MSPs) in Ohio: If you meet certain limited-income requirements, these programs can help pay for your Medicare premiums, coinsurance, and deductibles.
  • Ohio State Health Insurance Counseling and Assistance Program (SHIP): Ohio’s SHIP program is specifically called the Ohio Senior Health Insurance Information Program (OSHIIP). It helps educate residents about Medicare and other health insurance matters. This free resource is funded in part by a grant from the Centers for Medicare and Medicaid Services (CMS).

How to apply for Medicare in Ohio

To be eligible for Medicare in Ohio, you must be age 65 or older (or under 65 with certain disabilities) and either a United States citizen or a legal permanent resident of at least five years. In some cases, you won’t have to take any action to enroll in Original Medicare; you’ll be registered automatically if you get Social Security Administration (SSA) benefits or Railroad Retirement Board (RRB) benefits before age 65.

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You’re also entitled to Medicare benefits if:

  • You have amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s disease). You’re automatically enrolled in Medicare the same month your Social Security benefits start.
  • You have End-Stage Renal Disease (ESRD). You need to sign up for Medicare coverage; it doesn’t happen automatically. Contact the Social Security office (information below).

A “Welcome to Medicare” packet will arrive in the mail a few months before you turn 65 or when you qualify through disability, letting you know that you have been successfully enrolled. Because you are required to pay a Medicare Part B premium, you will have the option of refusing this coverage. Your packet will include opt-out instructions. If you don’t enroll in Medicare Part B when you’re first eligible, but decide to enroll later, you might face a late-enrollment penalty.

To apply for Medicare if you’re not automatically enrolled, you can visit your local Social Security Administration office, enroll online, or sign up over the phone. See contact information below.

  • Visit the Social Security website.
  • Call Social Security at 1-800-772-1213 (TTY users should call 1-800-325-0778), Monday through Friday, 7AM to 7PM.
  • If you worked for a railroad, call the Railroad Retirement Board at 1-877-772-5772 (TTY users call 312-751-4701), Monday through Friday, 9AM to 3:30PM.

When looking to enroll in a Medicare plan such as the ones described above, you may apply by contacting the plan directly or by calling 1-800-MEDICARE (TTY users call 1-877-486-2048), 24 hours a day, seven days a week. You can also talk to a licensed insurance agent at an insurance broker such as eHealth; see below for more information.

After reading about these alternatives that you have in Ohio, do you have questions? I’m here to help. You can find out more about me by viewing my profile if you click on the “View profile” link beside my photo. Would you like to arrange a phone call with me, or have me email you more information? Just follow the links below. To browse through some options on your own, click the Compare Plans button on this page.

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