Table of Contents

Medicare Plans by State

STATE -Select-
  • Alabama
  • Arizona
  • Arkansas
  • California
  • Colorado
  • Connecticut
  • Delaware
  • Florida
  • Georgia
  • Hawaii
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana
  • Maine
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Mississippi
  • Missouri
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York
  • North Carolina
  • North Dakota
  • Ohio
  • Oklahoma
  • Oregon
  • Pennsylvania
  • Rhode Island
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Vermont
  • Virginia
  • Washington
  • West Virginia
  • Wisconsin
  • Wyoming
Page Reviewed / Updated – December 20, 2023
Reviewed by Dr. Brindusa Vanta, MD

Medicare is a federally funded health care program for adults aged 65+ and younger people with qualifying disabilities. As of 2022, 65 million Americans have enrolled in Medicare, with seniors comprising 57.3 million. As of 2023, 2.4 million reside in Ohio, at an annual cost of $13 billion, based on 2021’s figures. However, Ohioans appear to be switching to Medicare Advantage. Figures for 2023 reveal 51% of eligible residents have purchased a plan, 2.36% more than the previous year and above the 48% national average. The pace is accelerating, as the number of Ohioans moving to Medicare Advantage increased by 5.86% more in 2023 than in 2022. 

Original Medicare is the foundation program, comprising two parts: A and B. Part A covers essential care costs, such as nursing home care, hospital stays and certain facets of home health care. Part B covers outpatient care, including doctors’ services, medical transportation and medical supplies and equipment. Most people don’t pay a premium for Part A, but everyone pays a premium for Part B, which is $164.90 in 2023. Part D exclusively covers prescription drug costs. As each prescription differs and drugs are assigned different tiers based on cost, premiums can vary greatly. Medicare doesn’t cover co-pays, coinsurance or deductibles, but seniors can purchase Medicare Supplement Insurance, known as Medigap, to cover out-of-pocket expenses.

Medicare Advantage, also known as Part C, blends the coverage provided by Parts A and B, minus hospice care, into one plan. Ohioans have a choice of 216 plans in 2023, 14 more than in 2022. While the Centers for Medicare and Medicaid Services (CMS) administer Original Medicare, approved private insurance companies manage Medicare Advantage Plans. The initial premium is 0%, but this increases as beneficiaries tailor their coverage, adding options such as hearing, dental and vision care. As a result, Ohio’s median monthly premium is $16.03, which is more affordable than 2022’s average of $18.17.

This guide covers different ways Ohio’s seniors can get more from Medicare. It explains coverage options and lists nonprofits that provide direct assistance, often for little or no cost.

Options for Medicare Coverage in Ohio

Original Medicare is the most popular choice for Ohio seniors, but it isn’t the only option available. Ohio residents have a lot of other options to get coverage, and Medicare-eligible seniors are free to craft a care plan that better meets their needs. Along with the federal program, there are several privately offered alternatives to choose from.

Original Medicare (Parts A & B)

Original Medicare beneficiaries qualify for the same services wherever they are in the country. This includes while they’re vacationing or if they move to another state. Medicare hardly ever pays for medical care in other countries, so beneficiaries are strongly advised to purchase appropriate insurance before they start their journey. 

Original Medicare beneficiaries must pay for their medical care when they receive it. They must also pay an annual deductible for Parts A and B, which are, in 2023, $1,600 and $226, respectively. Medicare will subsequently cover 80% of the final cost, with the senior covering 20%.

Who Should Consider Original Medicare

Original Medicare may be a good option for those who:

  • Travel frequently within the United States
  • Don’t need extra benefits such as home-delivered meals and coverage for over-the-counter medication
  • Want to choose their own prescription drug coverage

Medicare Advantage (Part C)

Medicare Advantage’s appeal is its flexibility. There are five standard plans:

  • Health Maintenance Organization (HMO)
  • Preferred Provider Organization (PPO)
  • Private Fee-for-Service plans (PFFS)
  • Special Needs Plans (SNPs)
  • Medicare Savings Account (MSA)

Private insurance companies approved by the CMS can tailor these plans to provide customers with the coverage they want and need. For example, a senior with a chronic illness can get appropriate coverage with an SNP plan, while someone wanting more control over their medical expenses may choose an MSA plan. Whichever plan the senior adopts, it will comply with the rules and regulations imposed by the CMS.

Who Should Consider Medicare Advantage

Medicare Advantage can be a good choice for seniors who:

  • Want a single premium bill for their entire coverage plan
  • Want more precise control over their costs and benefit structure
  • Need services Original Medicare doesn’t offer, such as dental and vision care
  • Are looking for routine medical services at a relatively low and predictable cost
  • Prefer the convenience of managed care

The Top 10 Medicare Advantage Plans in Ohio

Ohio seniors have access to several popular and highly rated Medicare Advantage plans. The table below lists some of the top providers and cost data current as of August 2023. More information about Part C is on the Medicare Advantage Plans in Ohio page. 

Enrollment Medicare Star Rating Monthly Cost Range Plan Types
Anthem Blue Cross and Blue Shield 315,836 3

$0 – $87

UnitedHealthcare 228,770 4 $0 – $295 PPO, HMO
Aetna Medicare 195,135 3.5 $0 – $198 PPO, HMO
Humana 116,622 4 $0 – $150 PPO, HMO, PFFS
Highmark Inc. 88,385 4.5 $0 – $79 PPO
Blue Cross Blue Shield of Michigan 47,360 4 $0 HMO
Medical Mutual of Ohio 36,155 5 $0 – $200 PPO, HMO
SummaCare Medicare Advantage Plans 23,323 5 $0 – $170 HMO
Devoted Health 21,096 5 $0 – $19 PPO, HMO
Cigna 14,389 2.5 $0 – $78 PPO, HMO

Medicare Prescription Drug Coverage (Part D)

Original Medicare doesn’t pay for most prescription drugs through Part A or B coverage. Instead, seniors purchase separate prescription drug policies, also called Part D coverage. Medicare contracts with private health insurance companies to provide this coverage. There are multiple plans to choose from with varying monthly premiums, which beneficiaries pay in addition to their Original Medicare premiums. While seniors don’t have to purchase prescription drug coverage when they’re first eligible for Medicare, not obtaining this coverage at this time may result in late enrollment penalties they pay for as long as they have Medicare if they enroll later.

Each prescription drug plan has its own formulary, or list of covered drugs. Formularies are typically split up into tiers. The tier a medication is in determines how much the insurance company pays and how much the beneficiary pays for it. Lower-level tiers are usually made up of generic and low-cost brand name drugs, while higher tiers are composed of more expensive brand name and specialty drugs. In most cases, the lower the tier, the lower the policyholder’s cost-sharing responsibility.

Who Should Consider Medicare Prescription Drug Coverage

Seniors who may benefit from prescription drug coverage include those who:

  • Currently take prescription medication or expect to in the future
  • Want to avoid late enrollment penalties
  • Want to reduce out-of-pocket prescription drug expenses

Medicare Supplement Insurance (Medigap)

While Original Medicare provides coverage for many medical costs, seniors may still have significant out-of-pocket expenses. These may include copays, coinsurance and deductibles. Seniors may be able to reduce their cost-sharing obligations by purchasing a Medigap plan. These plans can only be used with Original Medicare. It’s illegal for private insurance companies to sell Medigap plans to those with Medicare Advantage plans.

In Ohio, there are 10 types of Medigap plans, eight of which are available to new enrollees. Plans are standardized, meaning policyholders get the exact same coverage from a given plan regardless of the health insurance provider they buy it from. For more information on Medigap plans, seniors can refer to the Best Medicare Supplement Companies of 2023 page.

Who Should Consider Medicare Supplement Insurance

Good candidates for Medigap may be those who:

  • Have ongoing health issues and expenses
  • Travel overseas often
  • Want to access an expanded network of health care providers
  • Expect to need health services not covered by Original Medicare

Medicare Resources in Ohio

It can be challenging to make sense of all the different options for Ohio Medicare. Fortunately, Ohio seniors can get help understanding all their options through several local and national resources. These agencies assist seniors with navigating the different policy options available to find the best coverage for them. The resources listed below offer one-on-one counseling about benefits, impartial advice and help enrolling in Original Medicare Parts A and B, various drug coverage options, Medicare Advantage and privately issued Medigap plans in Ohio.

Senior Health Insurance Information Program

The Ohio Senior Health Insurance Information Program (OSHIIP) provides free, unbiased information to help seniors understand the differences in coverage between Original Medicare, Medicare Advantage and the various Medigap policies. Trained volunteers can offer information about drug prescription options, Medicare Savings Programs that a senior may be eligible for and other ways to reduce out-of-pocket expenses. Assistance is also available to help seniors organize appeals for denials of coverage.

Contact Info

Seniors who need information and advice from OSHIIP can call the program at (800) 686-1578, or visit the online directory to find a specific office and contact information to schedule an in-person visit.

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Area Agencies on Aging

Ohio has 12 Area Agencies on Aging (AAA) that provide region-specific advice and assistance for seniors with a wide range of issues. Health insurance counselors working at local agencies can help seniors enroll in Medicare, Medicare Advantage and Medicaid. Local agencies can also assist seniors with nutritional support, transportation issues, civil and legal assistance and other matters related to senior living.

Contact Info

Ohio seniors who need to find their local AAA office can call (866) 243-5678 to speak with a representative or visit the Ohio Department of Aging’s online hub to schedule an appointment or sign up for services.

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Ohio Department of Insurance

The Ohio Department of Insurance is a central point for seniors to find program information, provider data, fraud alerts and other valuable information to help them make informed health coverage choices. The department can educate seniors and their families about Medicare options and provide enrollment assistance. Seniors can also use the department’s online portal as an entry point to compare private Medicare-affiliated plans and look for referrals on Medicare-related issues. Seniors can also file complaints with the department about private or public insurance issues, denials of care and other matters that require state government intervention.

Contact Info

Seniors looking for information can visit the department online or call (800) 686-1526 for general inquiries. They can refer concerns about fraud and enforcement matters to the enforcement division at (800) 686-1527.

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Ohio Health Advocates

OhioHealthy Member Advocates is a nonprofit state agency that advances the interests of seniors enrolled in Medicare. The program’s HICAP counselors give one-on-one counseling that can help seniors find their way through the various Medicare options open to them, and they provide impartial advice to help seniors pick the right one for them. OhioHealthy is also a helpful resource for seniors researching private insurance options, such as Medigap policies available in Ohio.

Contact Info

Seniors in Ohio can reach OhioHealthy Advocates by calling the main office at (844) 200-6449 or through the Nurse Advice Line at (844) 834-4375. Provider locator services are also available online.

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Senior Medicare Patrol

The volunteers who work with the Ohio Senior Medicare Patrol are an invaluable resource for seniors and families of Medicare enrollees worried about fraud and abuse relating to benefits. Program staff keeps an updated list of known issues seniors need to be wary of, and personal advice to help avoid scams is available in one-on-one and phone-consulting settings. In addition to known fraud cases, the volunteer educators of the Senior Medicare Patrol can also educate members of the public about the warning signs of a scam.

Contact Info

Seniors can reach the Ohio Senior Medicare Patrol online or by calling (513) 458-5522. Seniors can set up in-person and virtual education appointments using the SMP’s online contact form.

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Social Security Administration

The National Social Security Administration (SSA) is a valuable resource for direct information from the federal agency administering seniors’ benefits. From the SSA’s online hub, seniors can review publicly available documents relating to Medicare, including up-to-date information about upcoming changes, as well as background guides on Medicare Advantage and other programs. Seniors enrolled in Medicare can use the site to locate and apply for financial assistance and determine their eligibility for various federal programs.

Contact Info

Seniors can visit the SSA online or call the main office at (800) 772-1213. Enrollees and seniors who will soon be eligible to enroll in Medicare can find a local office through the Office Locator tool.

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