If you live or are moving to Ohio and you’re looking for Medicare coverage options, then you’ve come to the right place. There is an alternative way to get your Original Medicare (Part A and Part B) benefits through a Medicare Advantage plan. Medicare-approved private insurance companies offer these Medicare Advantage plans. They are in contrast to Original Medicare which is a government run health-care program.
A Medicare Advantage plan (Medicare Part C) must cover at least the same level of benefits as Original Medicare (Part A and Part B). You may get additional benefits with Medicare Advantage plans that Original Medicare does not provide. These benefits include wellness programs, prescription drugs, routine vision or dental. Original Medicare does not provide routine vision or dental, or wellness programs and there is a limit to the medication coverage.
You generally can choose between several types of Medicare Advantage plan options. Depending on where you live, there will be specific plan options available to you. The two most popular types of medicare plan options are Health Maintenance Organization (HMO) plans and Preferred Provider Organization (PPO) plans. An HMO plan is cheaper but you only have a network of providers you can see (unless emergency). Plus you’ll have a primary care doctor and you’ll need a referral from your primary care doctor to see a specialist. With a PPO, you have more flexibility when it comes to the provider you’d like to choose. You can choose to see a provider outside the network, although the cost sharing may be higher.
If you don’t want provider networks and want the greatest provider flexibility, a Private Fee-for-Service (PFFS) may be the right fit for you. You can choose any provider to get health-care services from. For every service, the provider must accept the Private-Fee-for-Service plan’s terms and conditions and agree to treat you.
If you are an individual with unique health needs, you may qualify for a Special Needs Plan. If you:
- Have Medicaid and Medicare (dual eligibles)
- Live in an institution (like a nursing home)
- Have specific chronic conditions
Then you can qualify for a Medicare Advantage Special Needs Plan. If you don’t meet the eligibility criteria, then you cannot join. Special Needs Plans can vary depending on the location you live. One advantage of a Special Needs Plan is that it will meet the unique needs of the beneficiaries in the plan. For instance, if a beneficiary has cancer, the Special Needs Plan includes a network of providers who specialize in treating cancer patients.
A Medicare Savings Account (MSA) is another Medicare advantage plan option if you don’t mind having high out-of-pocket costs. You generally must pay a high deductible every year before the plan covers your health care. You will get a medical savings account every year in which the plan will deposit money into. You can use this money to cover your medical-health care costs prior to paying your annual deductible.
What to know about Medicare Advantage Prescription Drug plans in Ohio
There are certain Medicare Advantage plans in Ohio that offer prescription medication coverage. They offer both medical and prescription medication coverage under one single plan called Medicare Advantage Prescription Drug Plans.
If you are an Original Medicare enrollee and want prescription drugs then you have to enroll in a stand-alone prescription drug plan. Having all your benefits covered under one single plan like a Medicare Advantage Prescription Drug plan is a convenient option. With Original Medicare, your prescription drug coverage comes under a separate plan.
It is highly recommended to sign up for Medicare Part D plans even if you don’t presently take prescription drugs. You should do this right as you’re first eligible if you don’t have other prescription drug coverage. If you go without creditable prescription drugs for 63 consecutive days, you may owe a late-enrollment penalty for Part D if you sign up later.
Comparing Medicare Advantage plans in Ohio
You should understand the pros and cons to each Medicare enrollment plan before signing up to one. The area you live in will determine the availability and costs of each Medicare Advantage plan. Medicare Advantage plans in Ohio will change from county to county. For instance, a plan that you choose can charge more or less than an identical plan in another county. You can also choose a Medicare Advantage plan that has free monthly premiums. However, analyze the plan further as it may have other costs that are higher, like deductibles or copayment. Plus with every Medicare Advantage plan you need to still pay your Medicare Part B premium.
Want to know more about Medicare Advantage plans in your area in Ohio? Then enter your zip code on this page and compare the best Medicare plan option that fits your needs. If you want a Medicare Advantage Prescription Drug plan and need to match it by your present prescription drugs, you can do that as well.