Medicare Part C in Ohio
Ohio Medicare Part C plans are the third portion to Medicare Plans A through D, also known as “Medicare Advantage” (MA). Medicare Plan C assists patients in paying for ancillary health services not covered by Parts A or B. Beneficiaries who have Medicare Part C plans in Ohio are still enrolled in Parts A and B, but do not receive coverage through Original Medicare; rather, these participants are covered by Medicare Advantage. Download our free guide to review more information about Part C Medicare plans. Review information on what Medicare Plan C covers, what it costs and how you can sign up in the sections below.
What is Medicare Part C in Ohio?
Medicare Part C in Ohio is not to be confused with Medicare supplemental insurance. Although Medicare Plan C enhances the coverage of Medicare Plan A and Medicare Plan B, Medicare supplemental insurance does not replace Original Medicare. Instead, Medicare supplemental insurance is used as an addition to Parts A and B, unlike MA, which is plan that replaces Original Medicare.Participants who recognize this distinction can then identify the benefits to choosing a Medicare Part C plan, versus a supplemental plan. Medicare Plan C consolidates many of the hospital benefits of Part A, such as inpatient visits and other services with the medical benefits of Medicare Part B, such as limited prescription drug coverage and vaccinations. As an added benefit, plans in Medicare Part C also include coverage for vision, dental and hearing services. Learn more about the different Medicare plans available by downloading our complimentary guide.
Ohio Medicare Part C Coverage and Services
Functioning as a hybrid plan, MA as part of Medicare Part C in Ohio gives patients the flexibility to receive hospital, medical and ancillary health care services within a single plan. Note that most Medicare Advantage plans are offered by private insurers, and not the federal government. However, all Medicare Plan C policies must cover the same services provided by Original Medicare, meaning that although MA policies are privately held, your hospital and medical insurance coverage will remain standard across all MA plans.
The key differences between MA plans in Medicare Part C lie in the ancillary benefits that they offer: vision, dental and hearing. These benefits may exist as part of Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Medical Spending Accounts (MSAs) and other plan options. As such, the doctors that will accept coverage for ancillary benefits under these plans will vary from one to the other.
Ohio Medicare Part C Cost and Fees
In the state of Ohio, Medicare Part C cost structures consolidate the benefits available within Parts A and B. As a result, the pricing structure for services covered by Original Medicare is roughly the same within MA. There is still a monthly premium for Medicare Part B that is based on the participant’s income, with the addition of a monthly premium for most MA plans.
Some insurers within plans for Medicare Part C may charge copayments for medical services and doctor visits, which are often lower than the out-of-pocket cost of being uninsured. Other insurers may charge coinsurance payments for items such as durable medical equipment.The out-of-pocket costs for Medicare Part C have yearly limits. Once you have reached your limit within the coverage year, you will not be liable for any other out-of-pocket payments for the rest of the period.These aspects of the Ohio Medicare Part C cost vary across each MA insurer’s plans. Review this information in depth before choosing your Medicare coverage. Note that Medicare Advantage plans do not include coverage for hospice care under Medicare Part C, but hospice is covered by Medicare Part A. As such, additional fees may apply. Also consider that each year, your plan must send you "Evidence of Coverage" and "Annual Notice of Change” documents, which summarize your plan’s details, what you pay and any changes to your coverage and charges you should know about. Review this information if you are ever interested in switching your MA plan.
How to Enroll in Medicare Part C in Ohio
In order to join an OH plan in Medicare Part C, you must already be covered by Original Medicare (Parts A and B). These plans have automatic enrollment for most beneficiaries, but some other candidates must submit an application before receiving benefits. If you are not already enrolled in Original Medicare, you can complete the process online through the Social Security Administration’s website or in person at a Social Security office.If you are currently covered under another health care plan and want to switch to Medicare Part C, you must apply during either a General or Special Enrollment Period. If you are insured by your employer or an employment union, be sure to contact them before enrolling in Medicare Plan C. In some cases, enrollment in a Medicare Advantage policy under a Medicare C plan can cause you to lose your current benefits. However, some participants can maintain coverage in both MA and other policies. Learn more about Medicare Part C in our free, downloadable guide.