Medicare Supplement Plans in Ohio

Seniors approaching age 65 are almost certainly wondering how to go about identifying the best Medicare Supplement plans in Ohio. Original Medicare consists of Parts A and B, and while it covers most inpatient and outpatient health care needs, it does have deductibles, copays, coinsurance, limitations in coverage, and simply gaps in coverage. For example, original Medicare does not cover:

• Prescription drug costs
• Dental care
• Vision care
• Hearing exams and hearing aids
• Life insurance

Medicare Part D can be obtained in addition to Parts A and B in order to cover prescription drug costs. It is a very good idea to enroll in Part D because, without a prescription drug plan, your healthcare costs could be astronomical. Many prescription drugs today are quite expensive and the average senior in the US takes around five different prescribed medications every day.

Medicare Supplement plans in Ohio do not cover anything that is not covered by Original Medicare. They are intended to pay for the deductibles, copays, and coinsurance fees that Original Medicare charges beneficiaries out of pocket, and also to extend coverage benefits that Original Medicare Part A and Part B provide, such as hospitalization and skilled nursing facility care.

If a senior wants insurance coverage for eyeglasses and dental work, they can purchase insurance plans that provide these benefits in addition to obtaining a Medigap plan. Alternatively, some Medicare Advantage plans provide a package deal that covers everything. However, it should be kept in mind that many Medicare Advantage plans are run by an HMO and thus may have rules about only using in-network healthcare providers, which may be a major disadvantage for seniors who enjoy traveling or live in a different location during the winter. Advantage plans may have other restrictions and limitations; it is important to read the fine print carefully before selecting one if you decide an Advantage plan is better for you than Original Medicare.

Overview of Medicare Supplement Plans in Ohio

Medigap plans in Ohio cover:

• All Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are exhausted
• Part A hospice care coinsurance and copayments (Plans K and L only cover part of these fees)
• Part B coinsurance and copayments (Plans K and L only cover part of these fees)
• The first three pints of blood (Plans K and L only cover part of these fees)
• Some plans cover the Part A deductible
• Some plans cover skilled nursing facility care coinsurance fees
• Some plans cover Part B excess charges
• Some plans provide benefits for medical care required during foreign travel

Starting in 2020, seniors will not be able to enroll in a Medigap plan that covers the Part B deductible. If a senior enrolled in a plan that does cover the Part B deductible prior to 2020, they can keep their plan. The deductible for Medicare Part B is expected to be $198 per year in 2020, which will be part of a senior’s yearly out-of-pocket costs. Seniors who find themselves struggling with the fees they are expected to pay for medical care can apply to the MPAP program for financial assistance. This program is provided through Medicaid.

You may be puzzled to see that none of the Medicare Supplement Plans in Ohio appear to cover home health assistance; this is because home health assistance is provided through regular Medicare if a senior needs it and meets the criteria to qualify for it. These criteria generally just include being homebound. The assistance provided is fully covered and has no coinsurance or copays.

These plans also don’t specifically cover preventive care since it is covered by regular Medicare. Seniors can make a yearly wellness visit to their doctor, undergo recommended screenings and tests, and receive vaccinations, all covered by Medicare. However, most Medicare Supplement plans in Ohio will cover any copays or coinsurance fees for your preventive care.

Only two plans cover Part B excess charges, so it may be a good idea to find out if your doctor accepted the assignment (meaning, the doctor agreed to only charge the amount Medicare reimburses doctors for each service) or charges above the amount Medicare is willing to pay (excess charges), because in that case, the patient is expected to pay the excess charges. If you really like your current doctor who has not accepted the assignment, it is in your best interests to enroll in a plan that covers excess charges.

It is a really good idea to consult an expert insurance agent about your needs, possible future needs, financial situation, and health status before selecting a health insurance plan. Picking the best Medicare Supplement Plans in Ohio for you can be very complicated, requires making cost-effectiveness calculations, and involves trying to predict the future as best you can. A plan with a lower monthly premium may seem attractive, but such plans also tend to provide fewer benefits, and if you develop an acute or chronic health condition in the future your out-of-pocket costs could be considerable, especially if you need care at a skilled nursing facility. Only Plans K and L have out-of-pocket cost limits.

Medicare Supplement Plans in Ohio: Enrollment Statistics

The five largest counties in Ohio by population are:

• Franklin
• Cuyahoga
• Hamilton
• Summit
• Montgomery

Approximately 11.7 million people reside in Ohio; among these, 14% are 65 years of age or older (around 1.6 million). Of these, 1.4 million are enrolled in Medicare Parts A and B, and around one-third of these are also enrolled in a Medicare Supplement plan. Presumably, most of the other seniors in the state are enrolled in Medicare Advantage programs or have health plans through an employer. Plan F is overwhelmingly the most popular Medicare Supplement Plan in Ohio (note that Plan F will no longer be available to seniors who enroll in Medicare for the first time starting in 2020) followed by Plan N coming in a distant second. The least popular plans are K and M, with a grand total of only three people in the entire state selecting Plan M. Plan K provides only very limited benefits, explaining its unpopularity, but Plan M is practically identical to Plan N so its lack of popularity is unclear.

How Many Medicare Supplement Plans in Ohio Are There?

There are about ten standardized Medicare Supplement plans in Ohio plus the high-deductible option for Plan F. These plans are standardized across private insurance companies, namely that Plan G obtained from say Aetna offers the exact same benefits as Plan G obtained from a different private insurance company, such as Blue Cross Blue Shield. These plans are standardized across the entire country except in three states that offer their own standardized plans.

When Can I Enroll in a Medicare Supplement Plan

The best time to enroll in a Medicare Supplement plan is during your open Medigap enrollment period. This period starts during the month you turn 65 and enroll in Original Medicare and extends for six months after that. During open enrollment, you can purchase the plan of your choice from any insurance company that offers it and also enroll in a plan that provides drug coverage.

If for some reason you don’t enroll in Medigap during your open enrollment period, you can still purchase a Medigap plan but outside of your open enrollment period the insurance company can require you to undergo a physical or submit health records, and they can decide to not sell you the plan that you want based on your current health status.

If you enroll in a Medicare Advantage program when you first became eligible for Medicare and decide to switch to Original Medicare within 12 months of enrolling in the Medicare Advantage plan, you can drop the Medicare Advantage plan and select any Medicare Supplement Plans in Ohio that you want from among the Medicare plans available in your state and also enroll in a prescription drug plan (Part D).

If you had a Medigap policy but decided to try a Medicare Advantage plan and within 12 months decide you don’t like it and want to return to Original Medicare, in most cases you can get your previous Medigap policy back. You can also enroll in Part D to obtain prescription drug benefits.

There are three different methods insurance companies use to select and adjust Medigap premiums. In Ohio, the vast majority of Medicare Supplement plans are attained-age rated, which means your health insurance premium will increase each year as you get older. As long as you pay your monthly premiums, an insurance company cannot refuse to renew your Medigap insurance regardless of your age or any health issues you may develop in the future.

Additional Resources About Medicare Supplement Plans in Ohio

For assistance with Medicare in Ohio, you can contact COAAA for advice and information about the available health plans. If you have any other questions about Medicare Supplement Plans in Ohio, give us a call at 800-974-0552.