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Ohio is a beautiful state and has a lot to offer those who make it their home. It has great places to work, learn, and play, plus fantastic food and solid sports teams. Ohio also leads the country in the number of Medicare plans offered: more than 25 per county!
Doesn’t that just mean choosing one is more confusing? Not really. It means you have far more options than your peers in the surrounding states. Once you know what to look for in a Medicare plan, you can start comparing plans online.
Use the Insurify Medicare Advantage comparison tool to find plans that are available in your county. All you need is your ZIP code and a few minutes. Try it now!
Ohio has more than 1,000 Medicare Advantage plans. It’s not hard to find one to fit your healthcare needs. If you want to find the best plan for you, be sure to start with your needs first.
That means asking yourself about your healthcare preferences, noting any special care you require, and making a list of all the medications you take on a regular basis. Only when you’re clear on your needs should you start comparing plans in your area.
That being said, we compiled and analyzed a list of the best plans available in Ohio. ranked them based on several factors. Those factors including the entire cost of the plan, the variety of services offered, and the CMS rating– based on user-reported quality of care. For more information on our ranking procedure, see our methodology page.
Best Medicare Advantage Plans In Ohio
1. Anthem MediBlue Prime Select (HMO) - Score: 81.30
2. Anthem MediBlue Preferred Plus (HMO) - Score: 77.59
3. Anthem MediBlue Preferred (HMO) - Score: 77.59
4. Anthem MediBlue Essential (HMO) - Score: 77.59
5. SummaCare Medicare Amber (HMO) - Score: 75.05
6. Anthem MediBlue Plus (HMO) - Score: 73.89
7. Anthem MediBlue Extra (HMO) - Score: 73.89
8. SummaCare Medicare Topaz (HMO) - Score: 73.43
Now that we ’ve got the rundown, let’s take a closer look at each plan.
#1. Anthem MediBlue Prime Select
Insurify Composite Score: 81.30
Monthly Premium: $0
Annual Drug Deductible: $0
Out-of-pocket Maximum Limits: $3,650
Counties Served: Cuyahoga, Lorain, Geauga, Lake, Summit, Portage, Medina
Though this plan has a limited service area compared to other Anthem plans, it packs a lot of benefits into the plan. The first thing you should notice is the $0 monthly premium, drug deductible, and health deductible. Plus a very low out-of-pocket limit.
But this plan also offers low-cost prescription copays, and low-cost visits to see primary care, preventive care, and specialist doctors. Finally, you should also note that this plan offers generous coverage for hearing, preventive dental, and routine vision.
This far-reaching plan offers you a ton of perks. You’ll find low-cost prescriptions, doctor’s visits, and emergency care. Plus you get hearing, preventive dental, and routine vision coverage. But you’ll also get low-cost comprehensive dental coverage (rare indeed).
Add to that low-cost foot care and a covered wellness program and you can see why this plan was awarded second place.
Here’s a low cost plan with a large network. The benefits of a large network should not be taken lightly. You get access to more doctors, hospitals, and clinics. This means you have options with nearly every health condition that might come your way.
And all that for a $0 monthly premium, no drug deductible, and a fairly low out-of-pocket limit. Plus you’ll get low-cost drug copays, doctor’s office visits, emergency care, and diagnostic services. Add to that the hearing, preventive dental, and routine vision coverage, and you can see why this plan made the list.
With a huge network for coverage, this plan gives you a lot of flexibility. You should also note the low drug deductible (plus no health deductible) and the low out-of-pocket limits. Further exploration will show you low-cost (though certainly not the lowest you can find) drug prescriptions for Tier 1 and Tier 2 drugs.
And when you go to the doctor, you’ll be happy to find low or no-cost copays for basic care. That includes preventive care, primary care, hearing, preventive dental, and routine vision. On the downside, you won’t get comprehensive dental coverage, and copays for mental health and specialist visits are higher than most on this list.
Though this plan doesn’t offer prescription drug coverage, there’s still a lot to love. First, that low out-of-pocket threshold will help you keep your budget reigned in. Plus, there is no health plan deductible.
Add to that low and no-cost preventive and primary care visits, plus routine hearing, dental and vision. Not to mention, low copays for specialist, emergency, and diagnostic care.
Though this plan comes with a higher monthly premium, it pays off in low costs for actual use. Not to mention a low out-of-pocket limit. You’ll pay just $2 for Tier 1 prescriptions and just $10 for Tier 2. Plus you’ll pay nothing for “Select Care Drugs.”
You’ll also enjoy $0 copays for preventive care and primary care office visits. Plus $0 copays for preventive dental, comprehensive dental, and routine vision. Copays for other common care, like an urgent care visit or seeing a specialist, are still low.
This is the final Anthem plan on our list. You’ve probably noticed the higher monthly premium, drug deductible, and out-of-pocket limit. But don’t despair. Costs there pay off by offering lower prescription copays and $0 copays for comprehensive dental.
And the standard bells and whistles of Anthem plans are still available here. You’ll get $0 preventive and primary care. Plus low-cost Hearing, preventive dental, and routine vision. Plus, wellness programs are still supported.
#8. SummaCare Medicare Topaz
Insurify Composite Score: 73.43
- - Monthly Premium: $0
Annual Drug Deductible: $150
Out-of-pocket Maximum Limits: $3,900
Counties Served: Geauga, Cuyahoga, Columbiana, Carroll, Wayne, Lorain, Lake, Medina, Trumbull, Mahoning, Summit, Stark
Though this plan comes with a drug deductible, there’s no deductible for the health plan. And that’s in addition to the super-low out-of-pocket maximum limit.
You’ll also find low copays for Tier 1 and Tier 2 prescriptions. Plus no copay for preventive or primary care office visits. This plan also offers basic hearing, dental, and vision coverage.
How Much Does Medicare Advantage Cost in Ohio?
Your costs will depend on a few factors including where you live and what health conditions you’re treating (if any). However, you should be prepared to pay around $70 for your premium and $250 for your deductible.
But remember: your premium and deductible are only part of the total cost equation. Also consider the cost of copayments, which should be between $20 and $50. Most importantly, you should look for a plan that has a cap on out-of-pocket costs. Without this cap, one medically necessary procedure could cost you tens of thousands of dollars!
As you can see, the plan with a $0 monthly premium is not the least expensive plan in use. While it’s true that you may not reach your out-of-pocket maximum, you should be prepared for the full breadth of annual expenses.
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Who Is Eligible for Medicare in Ohio?
Medicare is a nationwide health insurance program for citizens or legal residents aged 65 and over. Exceptions to this eligibility rule include those who have end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS). Ohioans can begin enrolling in Medicare up to three months before or as late as three months after their 65th birthday.
Enrollment is automatic for those eligible for both Medicare and Medicaid and those who receive Social Security Disability before age 65. Registration can be done by going to your local Social Security office or calling 1 (800) 772-1213; TTY users can call 1 (800) 325-0778.
Once enrolled, you can search for and compare Medicare Advantage plans online. Insurify makes it easy to find the best plan without having to leave your home to meet with an insurance agent. With just your ZIP code, you can compare plans in your service area, including:
Medicare Advantage plans
Special Needs Plans
Medicare Advantage plus Part D
Stand-alone Part D
How Does Medicare Advantage Differ from Medicare Original?
Original Medicare is also known as Part A and Part B. You can add Medigap and stand-alone:
Bear in mind that each plan comes with a stand-alone premium. These plans work together to give you comprehensive and affordable medical coverage. Just remember that you’ll pay individual premiums for each plan you add.
Medicare Advantage (also known as Part C ) is an alternative to Medicare Original. You will still enroll in Part A and Part B and have to pay the Part B premium.
The majority of Medicare Advantage plans in Ohio include prescription drug plans, or the equivalent of Medicare Part D. Most plans will also include at least one additional benefit, such as:
If a plan doesn’t include additional coverage, you can still add a stand-alone plan to cover care.
Medicare beneficiaries in Ohio who have end-stage renal disease (ESRD) and other chronic health conditions are not eligible for Medicare Advantage. Instead, they will enroll in Special Needs Plans tailored to their conditions.
What Types of Medicare Advantage Plans Are Available in Ohio?
In Ohio, there are five types of Medicare Advantage plans. Each type has a unique feature that sets it apart from the others. Here’s a brief look at them:
Health Maintenance Organizations ( HMOs ) require you to use doctors and hospitals within their network. Referrals from your primary doctor are needed to see a specialist.
Preferred Provider Organizations ( PPOs ) offer greater flexibility in choosing care providers, but you will pay less for ones in your network.
Private Fee -for-Service ( PFFS ) plans have set rates outlining the amount the insurer will pay and your coinsurance portion. You can use any doctor who accepts PFFS, but make sure to double-check this before you receive care or you will pay the entire portion of the bill.
Special Needs Plans ( SNPs ) are for people who have chronic long-term illnesses or are in long-term care facilities. These plans meet the specific needs of the individuals they cover.
Medical Savings Accounts ( MSA ) are high- deductible Medicare plans with a savings account component.
FAQ: Ohio Medicare Advantage
The Open Enrollment Period for Medicare Advantage runs from January 1 to March 31. You can switch to a new Medicare Advantage plan or go back to Original Medicare during this time. Note that this time frame is different from the time frame for Original Medicare, from October 15 to December 7. You can call 1 (800) MEDICARE, or 1 (800) 633-4227, with questions. TTY users can call 1 (877) 486-2048.
No, you cannot have both Medicare Advantage and Medigap. Medigap is only available if you sign up for Original Medicare. It fills the gaps in coverage of Medicare Part A and Part B, whereas Medicare Advantage is an alternative to Original Medicare.
You will need to check your Medicare Advantage plan options to see what coverage you can use when traveling or spending extended time in another state. While Medicare is a nationwide program, Medicare Advantage is run by a private insurance company and uses provider networks to keep costs down.
Save Money by Comparing Plans in One Place
The best way to know that you’re getting the right Medicare plan for your needs is to compare them against other plans—in cost and value.
Before you start your comparison shopping, decide on what you need most in your Medicare Advantage plan. If medications are top of mind, a prescription drug plan may be more important than keeping your network. Your friend who travels out of state five months at a time will prefer a plan that offers more flexibility.
Features to consider when comparing Medicare plans:
Out-of-pocket maximum limits
Prescription drug coverage
Preventative medicine and wellness programs
Size of network and variety of medical care providers
Tired of the expensive co-payments and hidden fees with your current Medicare plan? Maybe it’s time for a change. Enter your ZIP code in the Insurify Medicare comparison tool and see which plans are available in your area. You can get better Medicare today!
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Charlotte EdwardsInsurance Writer
Charlotte Edwards is a freelance writer with a passion for educating others in the areas of personal finance, health, and education. An educator-turned-writer, she has written for publications worldwide over the past decade. In her spare time, she enjoys reading, watching classic movies, and spending time with her husband and two children. You can learn more about her work and life abroad at www.livinginchinawithkids.com.