Medicare Supplement and Advantage Plans in Ohio for 2025
This page provides a comprehensive overview of Medicare Supplement (Medigap) Plans A through N and Medicare Advantage (Part C) plans available in Ohio for 2025. Medigap plans help cover out-of-pocket costs not paid by Original Medicare (Parts A and B), while Medicare Advantage plans offer an alternative way to receive Medicare benefits through private insurers, often including additional benefits like prescription drug coverage, dental, vision, and hearing.
Medicare Supplement (Medigap) Plans A through N
Medicare Supplement Insurance, or Medigap, is private insurance designed to cover costs not paid by Original Medicare, such as copayments, coinsurance, and deductibles. Medicare supplement plans are standardized by the federal government and labeled A through N, with each offering a specific set of benefits. Plans are sold by private insurers, and while coverage for a given plan is identical across companies, premiums vary. Note that Massachusetts, Minnesota, and Wisconsin have different standardization, and some plans (e.g., C and F) are unavailable to those newly eligible for Medicare after January 1, 2020.
Key Notes
- Eligibility: Enrollment in Original Medicare (Parts A and B) is required.
- Standardization: Benefits for each plan are consistent across insurers, but premiums differ.
- Availability: Plans C and F are not available to those newly eligible after January 1, 2020. Plans H, I, and J are discontinued.
- High-Deductible Options: Plans F and G offer high-deductible versions ($2,800 deductible in 2024).
- Cost-Sharing Plans: Plans K, L, M, and N involve more out-of-pocket costs for lower premiums.
- Coverage Gaps: Medigap does not cover prescription drugs (requires Part D), dental, vision, hearing, or private-duty nursing unless specified.
Summary of Medicare Supplement Plans
Plan A
- Overview: Basic plan with core benefits and lowest premiums.
- Coverage:
- 100% Part A coinsurance and hospital costs (up to 365 additional days).
- 100% Part B coinsurance/copayments.
- First 3 pints of blood.
- Part A hospice care coinsurance/copayments.
- Not Covered: Part A/B deductibles, skilled nursing, foreign travel, Part B excess charges.
- Best For: Those seeking minimal coverage and low premiums.
Plan B
- Overview: Adds Part A deductible coverage to Plan A.
- Coverage:
- All Plan A benefits.
- 100% Part A deductible ($1,632 per benefit period in 2025).
- Not Covered: Part B deductible, skilled nursing, foreign travel, excess charges.
- Best For: Those wanting hospital deductible coverage.
Plan C
- Overview: Comprehensive, but not available to those newly eligible post-2020.
- Coverage:
- All Plan A and B benefits.
- 100% Part B deductible ($240 in 2025).
- 100% skilled nursing facility care coinsurance.
- 80% foreign travel emergency care ($250 deductible, $50,000 lifetime max).
- Not Covered: Part B excess charges.
- Best For: Pre-2020 eligibles seeking near-complete coverage.
Plan D
- Overview: Like Plan C, excluding Part B deductible.
- Coverage:
- All Plan A and B benefits.
- 100% skilled nursing coinsurance.
- 80% foreign travel emergency care.
- Not Covered: Part B deductible, excess charges.
- Best For: Comprehensive coverage without Part B deductible.
Plan F
- Overview: Most comprehensive, not available post-2020. High-deductible option available.
- Coverage:
- All Plan C benefits.
- 100% Part B excess charges.
- Not Covered: None of standard Medigap benefits.
- Best For: Pre-2020 eligibles wanting no out-of-pocket costs for covered services.
Plan G
- Overview: Nearly as comprehensive as Plan F, excluding Part B deductible. High-deductible option available.
- Coverage:
- All Plan D benefits.
- 100% Part B excess charges.
- Not Covered: Part B deductible.
- Best For: Extensive coverage with moderate premiums.
Plan K
- Overview: Cost-sharing plan with out-of-pocket limit.
- Coverage:
- 100% Part A coinsurance/hospital costs.
- 50% Part B coinsurance, blood, hospice, skilled nursing, Part A deductible.
- 100% after out-of-pocket limit ($7,000 in 2024).
- Not Covered: Part B deductible, excess charges, foreign travel.
- Best For: Cost-sharing for lower premiums.
Plan L
- Overview: Like Plan K, with higher coverage and lower limit.
- Coverage:
- Same as Plan K, but 75% for Part B coinsurance, blood, hospice, skilled nursing, Part A deductible.
- 100% after out-of-pocket limit ($3,510 in 2024).
- Not Covered: Same as Plan K.
- Best For: Balanced cost-sharing and limits.
Plan M
- Overview: Moderate premiums with partial Part A deductible coverage.
- Coverage:
- All Plan A benefits.
- 50% Part A deductible.
- 100% skilled nursing coinsurance.
- 80% foreign travel emergency care.
- Not Covered: Part B deductible, excess charges.
- Best For: Middle ground between cost and coverage.
Plan N
- Overview: Balances affordability with copays for some services.
- Coverage:
- All Plan A benefits.
- 100% Part A deductible.
- 100% skilled nursing coinsurance.
- 80% foreign travel emergency care.
- 100% Part B coinsurance, except $20 office visit/$50 ER copays (if not admitted).
- Not Covered: Part B deductible, excess charges.
- Best For: Comprehensive coverage with predictable copays.
Medicare supplement Enrollment Notes
- Open Enrollment: Best time is the 6-month period starting when you’re 65 and enrolled in Part B, with guaranteed issue rights.
- State Rules: Ohio allows switching plans without underwriting during certain periods in some cases.
- Premiums: Plans F, G, N have higher premiums; K, L, M, N are more affordable with cost-sharing.
- Popularity: Plans F, G, N are most popular; Plan N averages $121/month in 2025.
Medicare Advantage (Part C) Plans in Ohio for 2025
Medicare Advantage (Part C) plans are offered by private insurers approved by Medicare, providing all benefits of Original Medicare (Parts A and B) and often including Part D prescription drug coverage and extras like dental, vision, and hearing. In Ohio, 224 Medicare Advantage plans are available in 2025, up from 217 in 2024, with an average monthly premium of $15.51 (down from $16.12 in 2024).
Key Features of Medicare Advantage Plans
- Eligibility: Must be enrolled in Parts A and B and live in the plan’s service area.
- Plan Types:
- HMO: Requires in-network providers and referrals for specialists, typically lower premiums.
- PPO: Allows out-of-network care at higher costs, more flexibility.
- Special Needs Plans (SNPs): For specific groups (e.g., dual-eligible, chronic conditions, institutional).
- Benefits: Most plans include Part D, dental, vision, hearing, and wellness programs (e.g., SilverSneakers).
- Out-of-Pocket Limits: Plans cap annual out-of-pocket costs (varies by plan).
- Star Ratings: CMS rates plans from 1 to 5 stars based on quality, member satisfaction, and performance. No 5-star plans in Ohio for 2025, but several 4.5-star plans exist.
Availability and Providers
- Number of Plans: 224 plans across Ohio, with 131 unique plans (not all available in every county).
- Counties with High Options: Cuyahoga (Cleveland) and Summit (Akron) offer 80+ plans.
- Major Providers: 29 private insurers, including:
- Aetna (4.5-star plans, HMO/PPO, $0 premium options).
- Anthem Blue Cross and Blue Shield (4-star, HMO/PPO, benefits card).
- Devoted Health (4.5-star, focus on chronic conditions).
- Humana (HMO/PPO, high customer experience scores).
- UnitedHealthcare (AARP plans, largest provider network, UCard benefits).
- Medical Mutual of Ohio (4-star, tailored to Ohioans).
- PrimeTime Health Plan (4.5-star, regional focus).
- SummaCare (4.5-star, strong local presence).
- The Health Plan (4.5-star, comprehensive benefits).
- UPMC for Life (4.5-star, HMO/PPO options).
- Wellcare, Cigna, Paramount Elite, MediGold (additional options).
- Special Needs Plans: 39 SNPs for dual-eligible (D-SNP), chronic conditions (C-SNP), or institutional (I-SNP) beneficiaries.
Plan Details
- Premiums: Average $15.51/month; $0 premium plans available statewide. Individual premiums vary by county and plan.
- Out-of-Pocket Costs: Plans set their own copays, coinsurance, and deductibles, with caps on annual spending (unlike Original Medicare).
- Additional Benefits:
- Prescription drug coverage (most plans include Part D).
- Dental (cleanings, fillings, extractions).
- Vision (exams, glasses/contacts).
- Hearing (exams, aids).
- Over-the-counter (OTC) allowances, benefits cards for groceries/utilities.
- Fitness programs (e.g., SilverSneakers).
- Network Considerations: HMO plans require in-network providers (except emergencies); PPO plans offer out-of-network flexibility. Confirm your doctors (e.g., Ohio State Wexner Medical Center) accept the plan.
- Travel Coverage: Some plans cover care outside Ohio, beneficial for frequent travelers.
Top-Rated Plans
- 4.5-Star Plans (CMS, 2025): Aetna, Devoted Health, PrimeTime Health Plan, SummaCare, The Health Plan, UPMC for Life, MediGold.
- 4-Star Plans: Anthem Blue Cross and Blue Shield, Medical Mutual of Ohio, Paramount Elite.
- Member Satisfaction: Anthem (663/1,000 points), Aetna (660/1,000) score above Ohio’s regional average (658) in J.D. Power’s 2024 study.
Enrollment and Resources
- Enrollment Periods:
- Initial Enrollment: 7 months around your 65th birthday (3 months before to 3 months after).
- Annual Enrollment: October 15–December 7, 2024, for coverage starting January 1, 2025.
- Open Enrollment: January 1–March 31, 2025, to switch plans.
- Special Enrollment: For qualifying events (e.g., moving, losing coverage).
- Considerations:
- Check provider networks (e.g., ensure Ohio State doctors are in-network).
- Review drug formularies for prescription coverage.
- Compare premiums, copays, and out-of-pocket maximums.
- Evaluate extra benefits vs. Original Medicare + Medigap costs.
Sources
- Medicare.gov: Compare Medigap and Advantage Plans
- CMS: 2025 Star Ratings, Landscape Files
- Healthline: Medicare in Ohio 2025
- MedicareAdvantage.com: Ohio Part C Plans
- U.S. News: Best Medicare Advantage Plans in Ohio
- NerdWallet: Best Medicare Advantage Plans 2025
- Forbes: Best Medicare Advantage Plans in Ohio
- KFF: Medicare Advantage 2025 Spotlight
- MedicareWire: Top-Rated Plans in Ohio
- Humana, Aetna, Anthem, UnitedHealthcare, Medical Mutual websites
This summary integrates Medicare supplement and Medicare Advantage options for Ohio residents in 2025. For personalized plan details, enter your ZIP code above or drop Dave a line. Always verify provider networks and drug coverage before enrolling.
