Ohio Medicare questions, answered plainly

Nothing. Independent Medicare agents are paid by the insurance carriers when you enroll, so comparing plans, answering questions and reviewing your coverage each year is free to you. Your premium is the same whether you enroll through us, another agent or the carrier directly.

You get a Special Enrollment Period to choose a new plan and, because you lost coverage through no fault of your own, generally a guaranteed-issue right to buy a Medigap policy without health questions, usually within 63 days of the coverage ending. For 2026 Medical Mutual did not renew some plans in 44 counties and Aetna ended its Smart Fit plan, so a lot of Ohioans are in this position. Ohio has no birthday rule to fall back on later, so use the window. Call before the deadline on your notice.

No. Your six-month Medigap open enrollment at 65 is the guaranteed window, plus guaranteed-issue events such as a plan leaving your county or, under an Ohio Department of Insurance notice, losing Ohio Medicaid. Outside those, Ohio insurers can use medical underwriting.

Usually not. Ohio is one of the few states that does not require insurers to sell Medigap to people under 65, so most carriers do not. Medicare Advantage plans, including Chronic and Dual Special Needs Plans and MyCare Ohio, are available under 65, and a full six-month Medigap open enrollment begins when you turn 65.

Each accepts Original Medicare and therefore every Medigap policy. Each contracts with some Medicare Advantage plans and not others, and the lists change yearly; University Hospitals, MetroHealth, OhioHealth, Mount Carmel, TriHealth, Christ, Mercy Health, Premier, Kettering and ProMedica are the same. If a specific system is your care, we confirm the plan’s status in writing before you enroll.

Not in the plan that unlocks your HRA. OPERS deposits the allowance only when you buy a Medicare plan through Via Benefits, its connector (1-844-287-9945 for Medicare), so that enrollment has to go through Via Benefits. We help you understand the choice first — which plans include your hospital system, Medigap versus Advantage, your spouse’s timing — so the call is short. See our retiree coverage page.

Generally not. STRS Ohio and SERS Ohio enrol Medicare-eligible retirees in a group Aetna Medicare Advantage PPO that includes Part D through SilverScript, and a separate Part D plan can disrupt the group plan. Send your retirement system proof of Medicare enrollment and check with it before buying anything else.

Usually neither. TFL pays secondary to Medicare and its pharmacy is creditable drug coverage. An MA-only Advantage plan can add dental or vision without duplicating the drug benefit. Our Wright-Patterson and Defense Supply Center Columbus pages walk through it.

In most cases, yes. VA medical care is not creditable coverage for Part B, so delaying it triggers a permanent penalty and leaves you without coverage at a non-VA hospital — and in Columbus, where the Wylie center is outpatient only, that is where inpatient care happens. VA pharmacy is creditable for Part D.

Your Initial Enrollment Period is the seven months around your 65th birthday. The Annual Election Period runs October 15 to December 7; Medicare Advantage Open Enrollment runs January 1 to March 31. Moving counties, losing a plan, or qualifying for Medicaid opens a Special Enrollment Period.

Part B premium $202.90 a month, Part B deductible $283, Part A hospital deductible $1,736 per benefit period, Part D out-of-pocket cap $2,100. Higher earners pay IRMAA surcharges above $109,000 (single) or $218,000 (joint) of 2024 income. Our costs page has the full chart and calculators.

Possibly. Ohio’s Medicare Savings Programs (QMB, SLMB, QI), run through Ohio Medicaid, pay the Part B premium for people with limited income and resources, and QMB also covers Medicare’s deductibles and copays. They are not subject to estate recovery and bring Part D Extra Help automatically. Apply at benefits.ohio.gov or 800-324-8680; OSHIIP (800-686-1578) helps with the form for free.

Ohio’s program for people with both Medicare and Medicaid. It was rebuilt on January 1, 2026 as Next Generation MyCare, a fully integrated dual-eligible special needs plan run by Anthem Blue Cross and Blue Shield, Buckeye Health Plan, CareSource or Molina Healthcare of Ohio, replacing the demonstration that ended December 31, 2025. It started in the original 29 counties and was scheduled to reach all 88 by August 1, 2026; confirm your county with the Ohio Medicaid Consumer Hotline.

OSHIIP, the Ohio Senior Health Insurance Information Program, is Ohio’s State Health Insurance Assistance Program and part of the Ohio Department of Insurance since 1992: 800-686-1578, weekdays 8 to 5. You can also call 1-800-MEDICARE or use Medicare.gov. We are an independent agency, not a government program, and we say so on every page.

No. We represent a number of insurance organizations and products in Ohio, not all of them, and we will always say so. For the complete list, use Medicare.gov, 1-800-MEDICARE or OSHIIP. For help choosing among the plans we do offer, call (702) 706-6564.

Darin Weidauer holds Ohio insurance license #1616139 (NPN 18580338). You can verify it through the Ohio Department of Insurance Agent / Agency Locator at gateway.insurance.ohio.gov by searching the licence number or the NPN, or through the NIPR.

We work with Ohioans statewide by phone and video, which is how most people prefer it across 88 counties. Our sister agency has walk-in offices in Mesa and Sun City, Arizona, for Ohio snowbirds who winter there.