Table of Contents
- Medicare Advantage Plans in Ohio
- Medicare Advantage Providers in Ohio
- Top-Rated Medicare Advantage Plans in Ohio
- Medicare Resources in Ohio
- How to Find the Best Medicare Advantage Plan in Ohio
- Frequently Asked Questions (FAQs)
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If you’re considering enrolling in a Medicare Advantage plan (also known as Medicare Part C) in Ohio to meet your various health insurance needs, you’re not alone.
According to recent Census data estimates, approximately 2 million people ages 65 and older live in Ohio, accounting for more than 17% of the state’s total population. Considering that Ohio’s average life expectancy is 77 years, maintaining health insurance coverage after retirement is crucial for both physical and financial well-being.
If you’re looking for the best Medicare Advantage plan for your specific needs, Forbes Health is here to assist you with your search. Using the snapshot of your state’s market below, you can gain a better understanding of how many plan options you have, who the providers tend to be and how much you can expect to pay each month for a plan. You can also download our checklist of easy-to-follow steps for a streamlined Medicare Advantage enrollment experience.
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Let Us Help You Find the Right Medicare Coverage
- Choose between Medicare Advantage or Medicare Supplement options
- As simple as entering your basic information to compare plans right away
- Easy to distinguish between plan options with straight-forward information
- Plan options from Aetna, Anthem, BCBS, Cigna, Humana, and more
- Licensed, experienced and dedicated Medicare professionals are here to help you navigate your options
Medicare Advantage Plans in Ohio
Since Medicare Advantage plan eligibility is largely dependent on where you live, we gathered data specific to an urban, suburban and rural location in Ohio to show how plan availability, monthly premium rates and in-network maximum out-of-pocket amounts can vary.
Franklin County | Allen County | Summit County | ||||
---|---|---|---|---|---|---|
Number of residents enrolled in a plan* | 102,243 | 9,882 | 71,340 | |||
Number of plan contracts available* | 223 | 161 | 190 | |||
Number of plan contracts utilized*** | 39 | 24 | 42 | |||
Number of health insurance companies providing plans** | 12 | 12 | 16 | |||
Health insurance companies providing plans** | Aetna Medicare Anthem Blue Cross and Blue Shield CareSource Humana Lasso Healthcare Medical Mutual of Ohio MediGold Molina Healthcare of Ohio The Health Plan UnitedHealthcare Wellcare Wellcare by Allwell | Aetna Medicare Anthem Blue Cross and Blue Shield CareSource Humana Lasso Healthcare Medical Mutual of Ohio Molina Healthcare of Ohio Paramount Elite Medicare Plans SummaCare Medicare Advantage Plans UnitedHealthcare Wellcare Wellcare by Allwell | Aetna Medicare Anthem Blue Cross and Blue Shield CareSource Cigna Devoted Health Humana Lasso Healthcare Medical Mutual of Ohio Molina Healthcare of Ohio Paramount Elite Medicare Plans PrimeTime Health Plan SummaCare Medicare Advantage Plans The Health Plan UnitedHealthcare Wellcare Wellcare by Allwell | |||
Average monthly premium of these plans** | $41 | $43 | $35 | |||
Average monthly out-of-pocket maximum of these plans** | $4,932 | $4,884 | $4,634 | |||
Source: Centers for Medicare and Medicaid Services (CMS) *Data from May 2022 **Data from October 2021 ***Plans with less than 10 enrollees are excluded from this data point by CMS ****State averages based on data points for three presented counties |
Medicare Advantage Providers in Ohio
A variety of private health insurance providers offer Medicare Advantage plans in Ohio, including:
- Aetna Medicare
- Anthem Blue Cross and Blue Shield
- CareSource
- Cigna
- Devoted Health
- Health Alliance Medicare
- Humana
- Lasso Healthcare
- Medical Mutual of Ohio
- MediGold
- Molina Healthcare of Ohio
- Paramount Elite Medicare Plans
- PrimeTime Health Plan
- SummaCare Medicare Advantage Plans
- The Health Plan
- UnitedHealthcare
- UPMC for Life
- Wellcare
- Wellcare by Allwell
Plan availability varies by ZIP code, so not all providers listed above offer Medicare Advantage plans in all counties in Ohio.
Top-Rated Medicare Advantage Plans in Ohio
CMS rates Medicare Advantage (Part C) and Part D prescription drug plans annually to reflect the experience of being enrolled in such coverage. The agency uses a scale of one to five stars, with one star representing poor performance and five stars representing excellent performance. The following plans available in the state of Ohio in 2023 earned five-star ratings from CMS.
- Devoted Health
- Devoted CORE Ohio (HMO)
- Devoted GIVEBACK Ohio (HMO)
- Devoted PRIME Ohio (HMO)
- Medical Mutual of Ohio
- MedMutual Advantage Access (PPO)
- MedMutual Advantage Preferred (PPO)
- MedMutual Advantage Premium (PPO)
- MedMutual Advantage Select (PPO)
- MedMutual Advantage Choice (HMO)
- MedMutual Advantage Classic (HMO)
- MedMutual Advantage Plus (HMO)
- MedMutual Advantage Secure (HMO)
- MedMutual Advantage Signature (HMO)
- PrimeTime Health Plan
- PrimeTime Health Plan Aultimate (HMO-POS)
- PrimeTime Health Plan Basic – MA Only (HMO-POS)
- PrimeTime Health Plan Classic (HMO-POS)
- PrimeTime Health Plan Plus (HMO-POS)
- SummaCare Medicare Advantage Plans
- SummaCare Medicare Amber (HMO)
- SummaCare Medicare Emerald (HMO-POS)
- SummaCare Medicare Garnet (HMO)
- SummaCare Medicare Jade with Bene-FlexTM (HMO)
- SummaCare Medicare Ruby (HMO)
- SummaCare Medicare Sapphire (HMO-POS)
- SummaCare Medicare Topaz (HMO)
- UPMC for Life
- UPMC for Life HMO Deductible Rx (HMO)
- UPMC for Life HMO No Rx (HMO)
- UPMC for Life HMO Rx (HMO)
- UPMC for Life HMO Rx Choice (HMO)
- UPMC for Life HMO Rx Enhanced (HMO)
To determine which of these plans might be available in your area, enter your ZIP code in Medicare.gov’s plan finder tool. The tool also displays each plan’s rating from CMS.
Compare Top Medicare Plans From Major Carriers
- Chat with a licensed insurance agent today
- Compare plans online
- Plan options from Aetna, Anthem, BCBS, Cigna, Humana, and more
- Medicare open enrollment runs from October 15th through December 7th
Medicare Resources in Ohio
If you live in Ohio and are looking for additional information about available Medicare plans and assistance with selecting the best coverage for your health care needs and budget, here are a few resources to help you get started.
Ohio Department of Insurance: This government website provides helpful articles and explainers detailing the various types of insurance potentially available to you, what coverage they provide, how to apply or enroll, counseling, events and more.
Ohio Area Agencies on Aging: These agencies throughout the state provide Medicare support with knowledgeable and experienced staff available to answer questions, among other services.
Medicare Resource Center: Located in Columbus, Ohio, this center employs specialists who can help you navigate your Medicare options and compare top insurance providers to find the right plan for you. Ohio residents can visit in person or call or email for remote assistance at no cost.
While not exclusive to the state of Ohio, Medicare.gov and CMS’s website are two additional excellent tools for learning about the various components of Medicare coverage. You can also search for plans available in your ZIP code and compare options via Medicare.gov’s plan finder tool.
How to Find the Best Medicare Advantage Plan in Ohio
With that snapshot of your state’s Medicare Advantage coverage in mind, it’s time to consider the details involved in identifying the best plan for you and your health needs, from in-network hospitals and providers to drug formularies and deductibles. For those approaching the age of 65, navigating another qualifying event or reviewing their plan options ahead of the Medicare Advantage Open Enrollment period (which runs from January 1 to March 31 annually), we created the downloadable checklist below to help simplify enrollment.
Your Medicare Advantage Plan Shopping Checklist (Text Version)
Medicare Advantage Plans By State
Compare Top Medicare Plans From Blue Cross Blue Shield, a Forbes Health 5-Star Rated Carrier
Click Get A Quote or call 1-877-898-0206 to speak with a licensed insurance agent.
On Medicare Enrollment's Website
Frequently Asked Questions (FAQs)
What is Medicare Advantage (Medicare Part C)?
Medicare Advantage (Medicare Part C) is a type of health insurance provided by private insurance companies to U.S. adults ages 65 and up, as well as younger individuals with certain disabilities and health conditions. The federal government pays a flat fee per enrollee to the insurance companies, which then provide the core benefits of Original Medicare, payment to care providers and oftentimes additional benefits.
What is every Medicare Advantage plan required to include?
Every Medicare Advantage plan must include the benefits provided by Original Medicare Part A and Part B. Original Medicare Part A covers 80% of hospital stays, skilled nursing, home health care and hospice care. Original Medicare Part B covers 80% of doctor’s visits, preventative care, mental health services, physical therapy, occupational therapy, lab services and other outpatient services.
How does Medicare Advantage differ from Medicare Supplement (Medigap)?
Medicare Advantage plans serve as a substitute for Original Medicare, providing that same coverage plus additional benefits like prescription drugs coverage (Part D). Meanwhile, Medicare Supplement plans (commonly known as Medigap plans) are sold by private insurance companies to people enrolled in Original Medicare to help fill the gaps of that coverage. There are 10 types of Medigap plans—with letter names ranging from A to N—that provide standardized coverage and help pay for deductibles, coinsurance, copays and more. Another important difference to note: Medigap policies don’t cover prescription drugs. A person enrolled in Original Medicare who wants prescription drug coverage needs to purchase a separate Medicare Part D plan in addition to any Medicare Supplement plan.
FAQs
What is the best Medicare Advantage plan for 2023? ›
- Best Overall: AARP / UnitedHealthcare.
- Best Overall, Runner up: Aetna.
- High Medicare Star Ratings: Blue Cross Blue Shield.
- Great for Nationwide Coverage: Humana.
- Best for Customer Satisfaction: Kaiser Permanente.
- Lowest Cost: Cigna.
AARP/UnitedHealthcare is the most popular Medicare Advantage provider with 28% of all enrollment.
Will Medicare Advantage plans go up in 2023? ›Premiums. The vast majority of Medicare Advantage plans for individual enrollment (89%) will include prescription drug coverage (MA-PDs), and the share of MA-PDs that charge no premium (other than the Part B premium) has increased from 59% in 2022 to 66% in 2023.
What will the Medicare Advantage star ratings be in 2023? ›The average Medicare Advantage Star Rating in 2023 is 4.15 stars. This rating reflects that most Medicare Part C plans have above-average ratings. However, in 2022, the average star rating was 4.37, showing a 0.22 star decrease.
What is the biggest disadvantage of Medicare Advantage? ›- Limited service providers. If you choose one of the more popular Medicare Advantage plan types, such as an HMO plan, you may be limited in the providers you can see. ...
- Complex plan offerings. ...
- Additional costs for coverage. ...
- State-specific coverage.
Network restrictions are another common reason why beneficiaries leave their Medicare Advantage plans. With Medicare Advantage plans, staying within your policy's network is key to paying the lowest possible costs for health services. Going out of your network could mean high fees or no coverage.
Is Humana Medicare Advantage a good plan? ›The company's average Medicare star rating is 4.3 out of 5, and most of the plan's members are in highly rated plans. Humana is one of the largest providers of Medicare Advantage plans, with more than 5.1 million members enrolled in 2022.
What is the most popular AARP Medicare Supplement plan? ›By and large, Plan F is the most popular Medicare Supplement plan due to its coverage of more out-of-pocket Medicare costs than any other Medigap plan type.
What is the out-of-pocket maximum for Medicare Advantage in 2023? ›Medicare Advantage (Part C): In 2023, the out-of-pocket maximum for Part C plans is $8,300 for approved services, but individual plans can set lower limits if they wish. Part D cost sharing does not apply towards your Medicare Advantage plan's MOOP.
What will the Medicare donut hole be in 2023? ›The Medicare Part D donut hole or coverage gap is the phase of Part D coverage after your initial coverage period. You enter the donut hole when your total drug costs—including what you and your plan have paid for your drugs—reaches a certain limit. In 2023, that limit is $4,660.
When can I change my Medicare Advantage plan for 2023? ›
Medicare Advantage Open Enrollment Period.
From January 1 – March 31 each year, if you're enrolled in a Medicare Advantage Plan, you can switch to a different Medicare Advantage Plan or switch to Original Medicare (and join a separate Medicare drug plan) once during this time.
Recent studies from Press Ganey indicate as much as 80% of MA plans are at risk for losing at least one Star Rating across 2023. The potential financial impact could mean reduced member benefits and less funding available for creative engagement campaigns.
What is CMS Medicare Advantage Final Rule 2023? ›CMS issued its final 2023 Medicare Advantage and Part D rule that aims to expand access to care and improve health equity through lower out-of-pocket prescription drug costs and improved consumer protections, according to an April 29 press release.
What percent of seniors choose Medicare Advantage? ›Forty-five percent of Medicare beneficiaries are enrolled in Medicare Advantage plans in 2022, a share that is projected to rise to more than 50 percent by 2025.
What is the best site to compare Medicare Advantage plans? ›The Medicare Plan Finder on Medicare.gov is currently the most comprehensive tool for comparing Medicare Advantage plan benefits, prescription drug coverage and costs.
Who is the best person to talk to about Medicare? ›Medicare Beneficiary Ombudsman
If you've contacted 1-800-MEDICARE (1-800-633-4227; TTY: 1-877-486-2048) about a Medicare-related inquiry or complaint but still need help, ask the 1-800-MEDICARE representative to send your inquiry or complaint to the Medicare Ombudsman's Office.
If they don't say under budget, they end up losing money. Meaning, you may not receive the full extent of care. Thus, many doctors will likely tell you they do not like Medicare Advantage plans because private insurance companies make it difficult for them to get paid for their services.
Can I drop my Medicare Advantage plan and go back to original Medicare? ›Yes, you can elect to switch to traditional Medicare from your Medicare Advantage plan during the Medicare Open Enrollment period, which runs from October 15 to December 7 each year. Your coverage under traditional Medicare will begin January 1 of the following year.
Does getting a Medicare Advantage plan make you lose original Medicare? ›If you join a Medicare Advantage Plan, you'll still have Medicare but you'll get most of your Part A and Part B coverage from your Medicare Advantage Plan, not Original Medicare. Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
What is not covered under Medicare Advantage plans? ›Medicare Advantage Plans provide all of your Part A and Part B benefits, excluding clinical trials, hospice services, and, for a temporary time, some new benefits that come from legislation or national coverage determinations.
Are Medicare Advantage plans good for seniors? ›
For many seniors, Medicare Advantage plans can work well. A 2021 study in the Journal of the American Medical Association found that Advantage enrollees often receive more preventive care than those in traditional Medicare. But if you have chronic conditions or significant health needs, you may want to think twice.
How do I get my $144 back from Medicare? ›Call 1-800-MEDICARE (1-800-633-4227) if you think you may be owed a refund on a Medicare premium. Some Medicare Advantage (Medicare Part C) plans reimburse members for the Medicare Part B premium as one of the benefits of the plan. These plans are sometimes called Medicare buy back plans.
Do most people get Medicare Advantage? ›In 2022, nearly half of (48%) eligible Medicare beneficiaries – 28.4 million people out of 58.6 million Medicare beneficiaries overall – are enrolled in Medicare Advantage plans.
What is Humana star rating for 2023? ›We're proud to say that 96% of Humana's Medicare Advantage members are in plans rated 4 Stars or higher for 2023. 66% are in plans rated 4.5 Stars or higher.
Does Walmart own Humana? ›Humana was worth $37.5 billion at that time, and that purchase would be the largest acquisition so far for Walmart. Our topic today is revisiting the "what and why" behind Walmart's purchase Humana. What are the strategic drivers behind this partnership and why should we care?
What is the monthly cost of Humana Medicare Advantage plan? ›The projected average premium for a Medicare Advantage plan in 2023 is $18 per month, but there are other costs to consider, including co-pays and deductibles.
How much is AARP Plan G 2023? ›Which Medicare Supplement plan is the best? For most people, we recommend Medigap Plan G from AARP/UnitedHealthcare, which costs about $131 per month for a 65-year-old. This plan will give you comprehensive medical coverage from a well-rated company.
What is the Plan G deductible for 2023? ›* Plans F and G also offer a high-deductible plan in some states. With this option, you must pay for Medicare-covered costs (coinsurance, copayments, and deductibles) up to the deductible amount of $2,700 in 2023 before your policy pays anything.
Is Medicare Advantage cheaper than Medicare Supplement? ›Medicare Supplement typically has a higher monthly premium compared to Medicare Advantage. Specifically, Medicare Advantage plans could cost between $0 and $100 a month, while Supplement coverage may vary between $50 and $1,000 per month.
What is true about Medicare Advantage out-of-pocket maximum? ›Since 2011, federal regulation has required Medicare Advantage plans to provide an out-of-pocket limit for services covered under Parts A and B. In 2022, the out-of-pocket limit may not exceed $7,550 for in-network services and $11,300 for in-network and out-of-network services combined.
Is there a lifetime maximum Medicare will pay? ›
In general, there's no upper dollar limit on Medicare benefits. As long as you're using medical services that Medicare covers—and provided that they're medically necessary—you can continue to use as many as you need, regardless of how much they cost, in any given year or over the rest of your lifetime.
What is the average out-of-pocket cost for Medicare? ›In 2022, the average out-of-pocket limit for people enrolled in MA plans is $4,972 for in-network services and $9,245 for both in-network and out-of-network services, according to KFF.
How much will Part D cost in 2023? ›The estimated average monthly premium for Medicare Part D stand-alone drug plans is projected to be $43 in 2023, based on current enrollment, a 10% increase from $39 in 2022 – a rate of increase that outpaces both the current annual inflation rate and the Social Security cost-of-living adjustment for 2023.
What is the Part B premium for 2023? ›Most people pay the standard Part B monthly premium amount ($164.90 in 2023).
How do I avoid the Medicare donut hole? ›- Buy Generic Prescriptions. ...
- Order your Medications by Mail and in Advance. ...
- Ask for Drug Manufacturer's Discounts. ...
- Consider Extra Help or State Assistance Programs. ...
- Shop Around for a New Prescription Drug Plan.
No, you can't switch Medicare Advantage plans whenever you want. But you do have options if you're unhappy with your plan. You can jump to another plan or drop your Medicare Advantage plan and change to original Medicare during certain times each year. You may be eligible to change plans at other times, too.
Why are Medicare Advantage plans being pushed so hard? ›Advantage plans are heavily advertised because of how they are funded. These plans' premiums are low or nonexistent because Medicare pays the carrier whenever someone enrolls.
Can you change Medicare Advantage plans every year? ›Typically, you can only enroll in a different Medicare Advantage Plan or switch between Original Medicare and Medicare Advantage during specific times each year. Make sure to enroll in a timely manner to avoid gaps in coverage when using these enrollment periods.
What changes are coming to Medicare in 2023? ›For 2023, the Part A deductible will be $1,600 per stay, an increase of $44 from 2022. For those people who have not worked long enough to qualify for premium-free Part A, the monthly premium will also rise. The full Part A premium will be $506 a month in 2023, a $7 increase.
What is the maximum out of pocket for Medicare Advantage in 2023? ›Medicare Advantage (Part C): In 2023, the out-of-pocket maximum for Part C plans is $8,300 for approved services, but individual plans can set lower limits if they wish. Part D cost sharing does not apply towards your Medicare Advantage plan's MOOP.
What is Medicare Final Rule 2023? ›
This final rule with comment period includes payment adjustments to hospitals under the IPPS and OPPS for the additional resource costs they incur to acquire domestic NIOSH-approved surgical N95 respirators. The payment adjustments will commence for cost reporting periods beginning on or after January 1, 2023.
Are most people happy with Medicare Advantage? ›Medicare Advantage beneficiaries are extremely satisfied with their health care coverage. 98% of beneficiaries say they are satisfied with their Medicare Advantage plan, and 97% express satisfaction with their network of physicians, hospitals and specialists.
What's the problem with a Medicare Advantage plan? ›Medicare Advantage can become expensive if you're sick, due to uncovered copays. Additionally, a plan may offer only a limited network of doctors, which can interfere with a patient's choice. It's not easy to change to another plan.
Does Medicare Advantage pay 100 percent? ›Medicare Advantage plans don't pay 100% of your medical costs. Like most health insurance, Medicare Advantage plans have a “cost-sharing” structure for many services. If your plan covers the service, it'll usually pay most of the costs and charge you a copayment or coinsurance amount. A yearly deductible may apply.
Which state has the most people enrolled in Medicare Advantage? ›Characteristic | Number of Medicare beneficiaries |
---|---|
California | 6,411,106 |
Florida | 4,680,137 |
Texas | 4,286,051 |
New York | 3,672,562 |