Introduction to Medicare Supplement in Ohio (Medigap)

A Medicare Supplement plan is also called a Medigap plan, and is a “supplemental” type of insurance coverage that helps fill-in the “gaps” left by basic Medicare (Parts A & B). Medicare only covers a portion of healthcare expenses and can leave you with a large financial liability if you don’t have the proper protections in place, like Medigap insurance. In order to be eligible for a Medicare Supplement plan, you must at least have basic Medicare Parts A and B.

Federal Regulations for Medicare Supplements

Medicare Supplement plans are designed and regulated by the federal government (CMS) the Centers for Medicare and Medicaid services. This means that all insurance companies are required to offer the same coverage and benefits for the plans they offer. There are 10 Medigap plans currently offered on the market, and those are plans lettered A through N. Plan F, C, G, and N are the 4 most popular plans in Ohio. With this standardization, you have the comfort knowing that you will get the same benefits regardless of which company you enroll with—price is the only difference between companies.

Medigap Enrollment In Ohio

Hundreds of thousands of individuals are covered by Medigap plans in Ohio. Below is a chart that shows the total number of people covered by each plan type. Plan F is the most popular, and Plan M is the least popular plan type for individuals living in Ohio.

Plan Type A B C D E F G H I J K L M N
Enrollment 4,479 5,514 79,902 14,866 4,378 143,972 28,006 1,174 4,839 19,023 1,140 11,777 3 20,855

Plan Coverage & Cost

Medicare Supplement plans range in price by state, county, zip code, and individual—based potentially on gender, age, height/weight, tobacco status, and possibly other factors. Each insurance company will generally require slightly different health screening questions and charge different rates. The chart below shows the different plans and starting from cost for each plan type.

Most Popular Medicare Supplement Plans in Ohio

As you can tell from our enrollment statistics by plan type from above, Medigap Plan F is the most popular option for senior citizens living in Ohio. Plan F has long been the most popular plan since its inception. It is an easy sell for agents. Plan F covers 100% of the gaps in Medicare coverage and has the most benefits out of any Medigap plan. Plan F is also the most expensive plan, as you would guess. Agents also typically get paid the highest commission when selling Plan F, so it is important to understand the benefits to determine if this plan is truly best for your needs.

By contrast, Plan G only had 28,006 individual enrollments. That is only about 1/16 the amount of people enrolling in Plan G compared to Plan F, yet the benefits are very similar and the price difference can be quite large. If you study the benefits on Plan G vs. Plan F, you will realize that the “Medicare Part B Deductible” is the only difference between plans—Plan G does not cover this. However, the Medicare Part B deductible for 2015 is only $147. Yet, if you look at the premium difference, Plan F generally costs about $300-$400 per year more than Plan G. If you are willing to simply pay the deductible ($147 in 2015) yourself, you could save that $300-400 per year in your own pocket and still come out ahead with at least $200 or so annual savings after your deductible is paid. This savings can mean a big deal for people living on a fixed income.

Helpful Medigap Tips & Tricks

Doctor/Provider Network Restrictions

When it comes to network restrictions, Medicare Supplement insurance is one of the least restrictive plan types. As long as your doctor accepts Medicare, you can choose any doctor or hospital nationwide, in any state. This makes it especially desirable for those living in rural areas, people who like to travel, or those who spend time living in different places (snow birds). With a Medicare Supplement plan you have the freedom of choice to choose the doctors that you want. No referrals or pre-certification is necessary unlike like most traditional types of insurance plans.

Doctors List

Drug, Vision and Dental Coverage

Unfortunately Medicare Supplement insurance in Ohio not cover Drugs, Vision, or Dental care. If you enroll in a Medigap plan, you will need to shop independent providers to purchase this type of coverage. Medicare Part D is the federal Drug program for people on Medicare. Medicare works closely with and regulates insurance companies offering drug plans to Medicare recipients.

There is no federal Dental or Vision plan created specifically for Medicare recipients. In order to purchase this type of insurance, you would be required to purchase a plan directly through a private insurance company. However, you will need to be aware that when shopping for a Dental or Vision plan, the options may be more limited due to your age, and the monthly premiums may also be more expensive.

Enrollment Options & Best Time To Enroll

There are several enrollment options and ways to qualify for a Medicare supplement plan. You may or may not be required to answer health questions, and pre-existing conditions also may or may not affect you. To read more about the enrollment options below, please see our Medigap Enrollment Options page. It’s best to speak with a licensed agent to determine what plans are available to you based on your individual needs.

  • Initial Enrollment Period: 6-month timeframe when you first enroll in Medicare to purchase a Medigap plan with no health questions asked, guaranteeing your coverage.
  • Guaranteed Issue: This means that an insurance company must accept your coverage regardless of your health status. This commonly happens when you are losing an employer or group health plan.
  • Annual Enrollment Period (AEP): Many individuals get confused with this timeframe and believe it is the only time to shop and change insurance plans. The AEP does not pertain to Medigap insurance; you can actually shop and change Medigap plans at anytime throughout the year.
  • Underwritten: If you need to answer health questions, this means you will go through the underwriting process and the company will review your health history to determine if you will be eligible for coverage or not.

Free Look Period

Medicare mandates that Medigap insurance companies offer a “Free Look Period” to individuals enrolling in a new Medicare Supplement plan. This provision allows an individual to purchase a Medicare supplement plan and have 30 days to look it over to determine if they still would like to keep it. If for some reason you decide that you do not want to keep the plan, and are still within your 30-day free look period—you are able to cancel the policy and receive a full refund. This is Medicare’s way of making the shopping process a hassle-free experience. Speak with the plan directly before you enroll to learn about any restrictions or exclusions regarding the free look period.

What Medigap Plan Is Best For Me?

Compare Medigap Plans Online

Comments are closed.