July 22nd 2024
By Ari Parker
Learn what you need to know about Medicare Part D plans in Ohio, from the prescriptions they cover to the average monthly cost.
By Ari Parker
While Medicare Part D can be a source of confusion for many, it’s a critical component of your healthcare coverage. Part D provides coverage for your prescription drugs and important vaccinations. In this article, we'll discuss Part D plans in Ohio, so you can find a plan that covers your prescription needs.
There are 20 Medicare prescription drug plans in Ohio, and the average monthly premium is $42.
Most Medicare Advantage plans offer prescription drug coverage, and there are a total of 154 Medicare Advantage plans across Ohio.
Focusing on your medications and preferred pharmacies will help you find the best Ohio Part D coverage for your needs.
Original Medicare, which is made up of Medicare Part A and Medicare Part B, doesn’t cover prescriptions. But, as we age, we often require more prescriptions to manage our health. That’s why Medicare Part D exists—to provide prescription coverage to those on Medicare.
There are two ways you can get Part D coverage. The first is through a standalone Part D plan that stacks on top of your Medicare coverage. The second is through a Medicare Advantage plan that includes Part D coverage. At this point in time, most Medicare Advantage plans provide Part D coverage, but if you’re enrolled in one that doesn’t, you can still get a standalone Part D plan.
The first cost you need to know about is the cost of your coverage. Part D plans and Medicare Advantage plans both come with monthly premiums. The average monthly premium paid for a Part D plan in Ohio is $42.
Many Medicare Advantage plans have $0 premiums, making them attractive for bundled coverage. It’s important to note that you’ll still be responsible for your Part B premium, regardless of whether or not your Medicare Advantage plan has a premium. There are also several other factors you need to consider when looking at Ohio Medicare Advantage plans.
Two things that may affect your monthly cost are:
A Part D IRMAA surcharge, which some high-income individuals pay
Extra Help, which offers financial assistance to low-income individuals
Your monthly premium is a fixed amount you owe for coverage. If you need prescriptions, you’ll also be responsible for out-of-pocket costs. There are a few types of out-of-pocket costs you need to know about:
Deductibles
Copays
Coinsurance
These three costs vary from one plan to another and affect how much you will pay for your prescriptions in a year. It’s worth noting that different prescriptions will also have different costs, depending on which drug tier they’re on. Learn more about drug tiers.
Enrolling in or switching between Part D plans requires an enrollment period. Most people first enroll during their Initial Enrollment Period. The most common time to switch is during Medicare’s Open Enrollment Period, which occurs every year from October 15th through December 7th.
In some cases, you may use a Special Enrollment Period or the General Enrollment Period to obtain prescription coverage. It’s important to understand when you can and should enroll to avoid the Medicare Part D late enrollment penalty. Not sure when to enroll? We can help with that! Just give us a call at 855-900-2427 to get your Medicare questions answered.
In Ohio, 55% of people have drug coverage through a Medicare Advantage plan versus a standalone prescription drug plan. Securing prescription coverage is often cheaper through a Medicare Advantage plan because of low premiums associated with these plans. That said, it’s important to compare all your prescription coverage options to find the one that saves you the most. Let’s take a look at some of the details for both Medicare Advantage plans and Part D plans in Ohio.
Seven insurance carriers offer 20 different prescription drug plans in Ohio. These insurance providers are:
Aetna Medicare
Anthem
Cigna
Humana
Mutual Omaha Rx
UnitedHealthcare
Wellcare
Ohio Part D premiums range from $0 for the Wellcare Value Script plan to $108.80 for the Humana Premier Rx plan. The average cost of an Ohio Part D plan is $42, which is a bit lower than the national average of $48. This is just the cost of your plan. As we mentioned before, your out-of-pocket costs for prescriptions will depend on the plan you choose and the prescriptions you take. You can get a sense of how much you’ll pay for your plan and prescriptions by entering your medications and pharmacies into the Medicare plan tool. You can also reach out to us to get a quick and painless comparison of costs.
On average, the cost of Part D coverage is cheaper with a Medicare Advantage plan. That said, when looking at Medicare Advantage plans, it’s important to understand the pros and cons of Medicare Advantage versus Original Medicare. You also need to consider plan networks and copay and coinsurance amounts for healthcare services, in addition to your prescription costs.
Medicare doesn't have to be confusing. To start, write down your prescriptions and your preferred pharmacies. Note how often you need to take your prescriptions and what your regular dosage is.
This information can help you compare options and find a plan that covers your prescriptions at the lowest cost. It can always be helpful to talk through decisions with someone. Our Medicare Advisors at Chapter can quickly compare your costs for different Ohio Medicare plan options. Most importantly, we always have your best interests at heart! Get started by calling us at 855-900-2427 or scheduling a time to chat.
