The Best Medicare Supplement (Medigap) Plans in Ohio

Despite the comprehensive health care coverage that many U.S. seniors receive through Original Medicare (Medicare Parts A and B), beneficiaries may still be left with high out-of-pocket costs for copays, deductibles and other medical expenses. 

Medicare Supplement insurance, also called Medigap, is insurance that's sold by private companies. Medigap plans work in conjunction with Original Medicare to cover some of the deductibles, copays or other costs remaining on services and supplies after Medicare reimbursement.

Over 52% of Original Medicare beneficiaries in Ohio have a Medicare Supplement plan.

What Are the Best Ohio Medicare Supplement Plans?

Beneficiaries who want to supplement their Medicare coverage with a Medigap policy have 10 different plan types to choose from, and each is identified by a letter of the alphabet. Benefits are standardized by plan letter, so no matter which plan you select, you can be sure you’ll get the same benefits regardless of who issues the policy.

Medigap Benefits

Available benefits through Medigap include:

• Part A and B coinsurance
• Part A and/or B deductibles
• Blood for transfusions
• Hospice care copays
• Skilled nursing facility coinsurance
• Medical services received while traveling abroad
• Outpatient treatment costs that exceed Part-B-approved amounts
• 365 days of inpatient hospital care after Part A benefits are depleted

Although some benefits are standard for all 10 plans, each Medigap plan letter offers a different overall selection of benefits. The percentage of reimbursement for covered services may also vary. For a detailed comparison of benefits and coverage amounts by plan letter, see the accompanying chart.

What Else You Should Know Before Purchasing a Plan

Although Medigap is sold by private insurers, plans must adhere to federal guidelines. Here are a few other things you should consider before purchasing a policy:

• Pre-existing conditions: If you have a pre-existing condition, you’re still eligible for Medigap coverage. However, you may be subject to a wait period before reimbursement begins, and services and supplies received during the wait period won’t be covered.
  
  
• Annual spending limits: Some Medigap plans don't limit annual out-of-pocket spending. For seniors undergoing expensive or recurring treatments, this can lead to high medical expenses despite supplemental coverage. If you want to limit out-of-pocket spending, check out Plans K and L, which pay 100% of covered services and supplies after meeting the relevant criteria.
  
  
• Plan selection: Because Medigap is sold by private insurance companies, each issuer may offer a different selection of plans. All Medigap issuers must sell Plans A, C and F, but the sale of other plans is optional.
  
  
• Plan popularity: Plans F, G and N are the most popular Medigap plan types currently on offer. They're often more affordable due to lower premiums, especially in areas where Plans F and G are available with high-deductible options. Unfortunately, high deductibles mean you’ll have to spend more before your Medigap coverage begins.
  
  
• Plan eligibility criteria: Plans C and F restrict enrollment to seniors who were eligible for Part B prior to 2020. That’s because Medigap plans sold to new enrollees after this date aren’t permitted to cover the Part B deductible.

Each Medigap plan has pros and cons that may vary by purchaser. When deciding which plan to buy, consider how much insurance you can afford and then weigh the benefits of each plan against its cost.

How Do I Enroll in an Ohio Medigap Plan?

Enrollment in Ohio Medigap plans is done through private insurers. Ideally, you should purchase a policy during your Medigap six-month open enrollment period, which begins the month you turn 65 and are enrolled in Medicare Part B. Under federal law, all seniors enrolled in a Part B plan have a guaranteed right to purchase a Medigap policy at this time, and companies may not charge any applicant higher premiums, even if they have health risks.

If you haven’t yet retired and still receive insurance from your employer, your Medigap enrollment period won’t open until you retire and join a Part B plan. The same six-month timeframe applies.

Although you may still be able to purchase a Medigap plan after the six months are up, coverage is no longer guaranteed.

Outside of your Medigap open enrollment period, companies may legally use medical underwriting criteria to determine an applicant’s risk and can deny coverage to high-risk seniors. Your risk profile may also be used to assess premiums, and individuals with underlying medical conditions may have to pay substantially more for a policy.  

Guaranteed Issue Rights

Guaranteed issue rights define situations under which beneficiaries may be guaranteed enrollment in a Medigap plan outside of the formal enrollment period without the risks associated with medical underwriting.

If you have a guaranteed issue right, federal law mandates state:

• A Medigap insurer must sell you a policy of your choice.
• The issuer must cover all pre-existing conditions.
• You may not be charged more for a policy due to underlying medical conditions or other health risks.

These protections typically apply to seniors who've lost other health coverage or have experienced coverage changes in a fundamental way. That may include common situations such as:

• Reverting to Original Medicare after losing a Medicare Advantage policy: This can happen when a plan is discontinued completely or eliminates service in a particular geographic area. Protections may also extend to Advantage plan enrollees who move out of their coverage area or have exercised a trial right to MA and then reverted back to Original Medicare.
  
  
• Losing prior Medigap coverage: Medicare beneficiaries who previously maintained Medigap insurance but relinquished it because of a company’s bankruptcy, misleading practices or plan terms that violated federal policies may be eligible to purchase a new plan under these federal protections.
  
  
• Losing Medicare SELECT coverage: Medicare enrollees who’ve lost coverage through a supplemental SELECT policy when they move out of the plan’s service area may purchase a Medigap policy.
  
  
• Losing group coverage through an employer or union: Medicare-eligible individuals who lost the health benefits provided by an employer or a union may be eligible to purchase a Medigap plan.

To protect your right to purchase a Medigap plan through a guaranteed issue right, make sure to keep accurate records of the circumstances surrounding the termination of your prior coverage. That should include any available documentation, including notices, letters or claim denials.

Helpadvisor.com is owned and operated by Tranzact, the parent company of TZ Insurance Solutions LLC, which is the owner/operator of MedicareSupplement.com and other websites mentioned on HelpAdvisor and which has a financial relationship with some of the carriers listed on HelpAdvisor.