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Ohio Medicare Benefits

Medicare is a national health plan designed mainly to help the country's senior citizens. People with certain health problems may also qualify for Medicare if they are not yet 65 years old, but the majority of Medicare beneficiaries are 65 or older. Medicare plans and benefits are mostly standardized, so they are the same in Ohio and across the U.S. The state of Ohio does offer Medicare information services and help with costs and premiums however.

  1. Original Medicare

    • Original, or traditional, Medicare is made up parts A and B. These were the first Medicare policies established and offer the same benefits all over the United States. Part A offers inpatient hospital benefits, as well as coverage for home health services and hospice care. Part B has benefits for preventive services such as health screenings, annual doctor's visits and benefits for outpatient hospital care. Part A is often free, but does have copays, coinsurance costs and deductibles, while B requires premiums as well as coinsurance, excess use fees, copays and deductibles. Ohio has a Medicare Premium Assistance Program (MPAP) which helps Medicare beneficiaries who have low incomes and few assets to afford Medicare coinsurance, premiums and deductibles. To enroll, you will need to provide proof of age and income, documentation of your resources and information about any other health insurance you may have.

    Medicare Advantage

    • Medicare Advantage (MA), also called Part C Medicare, allows people using Medicare to bundle their Part A and B benefits with additional ones such as vision, dental or hearing. Medicare Advantage is bought from private insurance companies, which set their own premium, deductible, copay and coinsurance rules. According to the Medicare Information Source website, 100 percent of Medicare beneficiaries in Ohio have access to Medicare Advantage plans which have no monthly premium. Medicare Advantage in Ohio is offered in different ways, such as HMO and PPO plans, special needs insurance for people with specific health conditions and private fee-for-service plans. Medicare recipients in Ohio can get help from the Ohio Senior Health Insurance Information program regarding MA enrollment, choices and avoiding predatory salespeople.

    Medicare Part D

    • Medicare Part D is an optional Medicare plan which provides coverage for prescription drugs. Part D is also sold by private companies and can be gained through Medicare Advantage or purchased as a stand-alone plan. Part D coverage does come with what is called a "doughnut hole," a gap in coverage once the retail cost of your prescriptions meets an initial coverage limit. Ohio has several programs to help fill in the doughnut, such as Ohio's Best Rx and the Golden Buckeye Card prescription drug discount plans.

    Medigap

    • Medicare users in Ohio can also buy Medicare supplement policies, called Medigap or MedSup. Medigap is not mandatory, but does help pay for premiums, copays and deductibles, as well as offering additional benefits such as foreign-travel emergency care. Ohio MedSup only covers one person, and no MedSup policy has benefits for vision or dental services, eyeglasses, prescription drugs, hearing aids, private-duty nursing care or long-term care.

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