Information about Medicare Advantage Plans in Ohio

Quick links:

• Average 2019 Costs
• Eligibility & Enrollment
• Finding Top-Rated Plans
• List of Plans Available
  • Plans by Carrier
  • Plans by County
  • Plans by Type
• Local Resources

41 percent of Medicare beneficiaries in Ohio were enrolled in a Medicare Advantage (Medicare Part C) plan in 2019.¹

There are 2,787 different Ohio Medicare Advantage plans in 2019.¹ It's important to find out which ones are offered where you live, because not every Part C plan is available in all locations in Ohio.

A licensed insurance agent can help you compare the costs, availability and benefits of Medicare Advantage plans in your area of Ohio.

Average costs of MA Plans in Ohio

The average Ohio Medicare Advantage plan premium in 2019 is $22 per month.

That average is affected by the 810 available plans that feature $0 monthly premiums.

• Average monthly premium cost in 2019 (weighted): $22
• Average in-network out-of-pocket spending limit: $4,571
• Average deductible in 2019 (weighted): $56.55¹

Medicare Advantage plan premiums, deductibles and out-of-pocket costs may vary greatly depending on where you live and the plan you have.

For more local information, we list the average costs for 2019 Medicare Advantage plans in Ohio by county below in this guide.

A licensed insurance agent can help you compare Medicare Advantage plan costs in your area.

Or call 1-800-557-6059 1-800-557-6059 TTY Users: 711 24/7 to speak with a licensed insurance agent.

Medicare Eligibility & Enrollment

If you want to sign up for an Ohio Medicare Advantage plan, you must first be enrolled in Original Medicare (Medicare Part A and Part B).

If you meet the following requirements, you may be eligible for Medicare at age 65:

• You are a U.S. citizen or permanent legal resident who has lived in the U.S. for five consecutive years.
  
  
• You or your spouse have worked long enough to be eligible for Social Security or Railroad Retirement benefits.
  
  
• You or your spouse are government employees who have paid Medicare payroll taxes.

You may also be eligible for Medicare benefits under 65 if:

• You have been receiving Social Security disability benefits or certain Railroad Retirement Board disability benefits for at least 24 months.
  
  
• You have Lou Gehrig's disease (amyotrophic lateral sclerosis, or ALS).
  
  
• You have End-Stage Renal Disease (ESRD), and you or your spouse have paid Social Security taxes for a certain length of time.

Please note that you may not qualify for most Medicare Advantage plans if you have ESRD.

If you have End-Stage Renal Disease, you may be able to enroll in an Ohio Medicare Special Needs Plan (SNP) that is specifically designed to help meet your health care needs.

How to sign up for a Medicare Advantage Plan in Ohio

Your first opportunity to enroll in an Ohio Medicare Advantage plan is during your Medicare Initial Enrollment Period, or IEP.

Your Medicare IEP is a seven-month period that begins three months before you turn 65, includes the month of your birthday and continues for three more months after your birthday.

Once your IEP ends, you can typically only sign up for a Medicare Advantage plan in Ohio during one of the following times:

Medicare Advantage Open Enrollment Period: January 1 – March 31

From January 1 to March 31 every year, you may switch Medicare Advantage plans or drop your Medicare Advantage plan and return to Original Medicare.

If you return to Original Medicare during this period, you will also have the opportunity to sign up for a Medicare prescription drug plan (Medicare Part D) during this enrollment period.

Medicare Annual Enrollment Period (AEP): October 15 – December 7

From October 15 to December 7 every year, you may enroll in a Medicare Advantage plan or switch from one Medicare Advantage plan to another.

You may also disenroll from your existing Medicare Advantage plan and return to Original Medicare.

During AEP, you may also join, switch or drop a Medicare Part D plan. 

Medicare Special Enrollment Periods (SEP)

You could potentially be granted a Medicare Special Enrollment Period (SEP) at any time throughout the year if you meet certain qualifying circumstances.

Call to speak with a licensed insurance agent to find out if you qualify for a Medicare Special Enrollment Period.

Or call 1-800-557-6059 1-800-557-6059 TTY Users: 711 24/7 to speak with a licensed insurance agent.

Top-rated Medicare Advantage Plans in Ohio 2020

Each year, the Centers for Medicare & Medicaid Services (CMS) issues star ratings that evaluate Medicare Advantage plans across several key areas using a system of one to five stars.²

Plans are evaluated annually, so plan ratings can change from year to year.

In order for a Medicare Advantage plan to be considered a top-rated plan, it must have four or more stars out of five stars.

There are 1,276 top-rated 2019 Medicare Advantage plans in Ohio that are rated four stars or higher, which accounts for almost half (46 percent) of the plans available in Ohio in 2019.

Medicare Advantage plans are rated in the following five categories:

• Preventive care and health maintenance (which includes coverage for things like screenings, tests, vaccines, etc.)
• Management of chronic conditions
• Member experiences and the plan's performance year over year
• Member complaints, problems receiving services and member retention
• Customer service

The information for the star ratings is gathered from information that is submitted to Medicare, Medicare’s regular monitoring activities and member surveys.

List of Medicare Advantage Plans Available in Ohio in 2020

You can use our plan comparison tool to find a list of 2019 Medicare Advantage plans that are available in your area of Ohio.

Or call 1-800-557-6059 1-800-557-6059 TTY Users: 711 24/7 to speak with a licensed insurance agent.

Private insurance companies offer Medicare Advantage plans in Ohio

Call to speak with a licensed insurance agent who can help you compare the Medicare Advantage plans that are sold by insurance companies in your area.

Multiple insurance carriers may offer Medicare Advantage plans in Ohio, depending on where you live.

Private insurance companies offer Medicare Advantage plans that may be unique to the ZIP code, county or region they serve.

When you’re shopping for Medicare Advantage plans in Ohio, one way to compare Medicare plans from several different insurance companies by using some of the following information:

• The Medicare Star Ratings, which can give you an idea of a plan’s overall quality.
  
  
• Agencies like A.M. Best, Moody’s and Standard & Poor’s provide information about an insurance company’s credit rating and financial standing, which you can use to compare the financial outlook for companies in your area.
  
  
• You can read through Medicare Advantage plan reviews and testimonials from customers.

Ohio Medicare Advantage plans by county

Learn more about Medicare Advantage plans in some of Ohio's most populous counties.

• Cuyahoga County Medicare Advantage plans
• Hamilton County Medicare Advantage plans

The chart below provides some more information about 2019 Ohio Medicare Advantage plans by county.¹

• Medina County and Summit County each had 19 MA plans that featured $0 premiums in 2019. This was the highest number of $0 premium plans in any county in Ohio in 2019.

OH Medicare Advantage enrollees by plan type

You can use the chart below to learn more about the percentage of 2019 Ohio Medicare Advantage enrollees that are enrolled in each primary type of Medicare Advantage plan.¹

The major types of Medicare Advantage plans include:

• Health Maintenance Organization (HMO)
  A Medicare Health Maintenance Organization (HMO) is a type of plan that typically requires beneficiaries to use health care providers, pharmacies and hospitals that are part of the plan’s network (except in the case of emergencies).
  
  Most HMOs also typically require beneficiaries to get a referral from a primary care doctor in order to visit a specialist.
  
  
• Preferred Provider Organization (PPO)
  A Medicare Preferred Provider Organization (PPO) plan typically allows beneficiaries to seek health care services from providers outside of their plan’s network, though these services may cost more.
  
  PPO beneficiaries will typically pay less out of pocket if they visit providers within their plan’s network.
  
  PPO plans typically do not require patients to get a referral before visiting a specialist.
  
  
• Private Fee-For-Services (PFFS)
  A Private Fee-For-Service (PFFS) plan determines how much it will pay to health care providers (and how much the beneficiary will pay) at the point when care services are received.
  
  You can typically receive care from any doctor, hospital or health care provider if you have a Medicare PFFS, as long as they accept Medicare and your plan’s terms. Not all providers will accept these terms.
  
  
• Special Needs Plan (SNP)
  A Medicare Special Needs Plan (SNP) is a type of Medicare Advantage plan limited to people with certain chronic conditions and other specific characteristics.
  
  A Medicare SNP is specifically tailored to meet the needs of the beneficiaries in that plan. All SNPs include coverage for prescription drugs.

Not all of these types of plans may be available in your area. 

Call to speak with a licensed insurance agent and compare the types of 2019 Ohio Medicare Advantage plans that are available where you live.

Local health insurance resources in Ohio

• Ohio’s Senior Health Insurance Information Program provides free and objective information and assistance to the state’s beneficiaries of Medicare with the goal of helping Ohio’s seniors make the most of their insurance. The program may be reached at 800-686-1578.   
  
  
• You can also explore more information about the insurance industry in Ohio by visiting the state’s Department of Insurance website.
  
  
• Ohio Prescription Drug Assistance Programs
  The state of Ohio has a number of programs designed to help with the cost of prescription drugs. There are programs for both Medicare beneficiaries and non-Medicare beneficiaries alike that can cover the cost of premiums and cost-sharing or even lower the cost of the drugs themselves.

¹ MedicareAdvantage.com's The Best States for Medicare in 2021 report. (Oct. 27, 2020).

² Medicare evaluates plans based on a 5- star rating system.