Selecting Your Plan As A Medicare Enrollee
To select a plan, call STRS Ohio toll-free at 8882277877. You may select a new plan up to three months after your 65th birthday. The effective date of coverage under your new plan will be the first of the month following notification to STRS Ohio, if received by the 15th of the month. There will be no interruption in your health care coverage.
Be aware, your plan selection cannot be processed until STRS Ohio receives proof of Medicare enrollment. This applies even if you are selecting a plan offered by your current plan administrator. STRS Ohio must receive proof of Medicare enrollment by the 15th of the month to begin your participation in the plan the first of the following month. Any delay in submitting this proof will delay your enrollment in the plan you select as a Medicare enrollee.
Note: If you change plan administrators, your medical deductible and out-of-pocket maximums will transfer to the new plan administrator only if you move between an Aetna plan and a Medical Mutual plan.
Medicare Initial Enrollment Period
If you are receiving a Social Security check prior to age 65:
- Social Security automatically enrolls you in Medicare Parts A and B, and
- Social Security mails you a Medicare card.
If you are not receiving a Social Security check:
- You will need to sign up for Medicare in person at a Social Security office or online at ssa.gov/medicare.
Medicare charges a lifetime penalty of 10% for each 12-month period you are eligible for Medicare Part B but do not sign up for it.
The penalty does not apply when you are enrolled in an employer health plan. See Working Past Age 65.
To have your Medicare coverage effective the month you turn 65, sign up as soon as you are eligible. When you enroll during the last four months of your Initial Enrollment Period, your Medicare coverage is delayed.
See below for more details.
Extra Fees For Late Enrollments And Higher Incomes
Medicare charges late enrollment penalties if you delay enrollment in Medicare Part B or go 63 days or more without Medicare Part D or creditable prescription drug coverage. This additional cost will be charged as long as you have Medicare coverage. Also, Medicare Part B and Part D enrollees with higher annual incomes are subject to monthly Medicare surcharges. Surcharges vary by income levels set by Medicare Failure to pay surcharges will result in cancellation of your STRS Ohio medical coverage. Visit www.ssa.gov for more information.
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When To Enroll In Medicare If I Am Receiving Retirement Benefits:
If youre already collecting Railroad Retirement Board or Social Security retirement benefits when you turn 65, you will automatically be enrolled Medicare Part A and Medicare Part B if you sign up for Medicare Part B at the time you sign up for retirement benefits.
If you live outside of the 50 United States or D.C. , you will automatically be enrolled in Medicare Part A, but will need to manually enroll in Medicare Part B.
How To Apply For Medicaid In Ohio By Mail
Potential beneficiaries can also complete Medicaid application form by mail. Download, print and fill out the Medicaid application form and mail them to the Department of Job and Family Services office nearest to your residence. The Medicaid application must also be signed and dated. If the application is not signed and dated, it will not be accepted and the applicant will not receive healthcare coverage. Learn more about the various application methods by .
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When Is The Medicare Advantage Open Enrollment Period:
The Medicare Advantage Open Enrollment Period is a limited annual enrollment period. It goes from January 1 March 31 every year. During this time, you can:
- Switch Medicare Advantage plans, if you already have a Medicare Advantage plan
- Disenroll from your Medicare Advantage plan and return to Original Medicare.
You cannot use this period to make most other coverage changes. However, if you decide to drop your Medicare Advantage plan, you can also use this period to join a stand-alone Medicare prescription drug plan, since Original Medicare doesnt include prescription drug coverage.
Outside of the Annual Election Period and the Medicare Advantage Open Enrollment Period, you cannot generally make changes to your Medicare Advantage plan unless you qualify for a Special Election Period.
Your Plan Options Will Change
After you submit proof of Medicare enrollment to STRS Ohio, your STRS Ohio plan options will change. Plans for Medicare enrollees include the Aetna Medicare Plan, the Medical Mutual Basic Plan or a regional plan if available in your area.
You can review your new plan options and premiums in your Online Personal Account or call STRS Ohio for this information.
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Medicare Enrollment In Ohio
As of September 2020, there were 2,382,039 residents covered by Medicare in Ohio, amounting to more than 20 percent of the states population.
For most Americans, Medicare coverage enrollment goes along with turning 65. But Medicare eligibility is also triggered for younger people if they have been receiving disability benefits for 24 months, or have kidney failure or ALS. Nationwide, 15 percent of Medicare beneficiaries nearly 10 million people are under age 65. In Ohio, 16 percent of Medicare beneficiaries are under 65.
Disabled beneficiaries make up the largest share of Medicare enrollees in Alabama, Arkansas, Kentucky, and Mississippi, where 22 percent of Medicare beneficiaries are under age 65. But just 9 percent of Hawaiis Medicare beneficiaries are eligible due to disability.
Time to sign up for Medicare? Find Medicare Advantage and Medicare supplement insurance plans in your area.
How Do I Know If I Should Be Dual Eligible
Beneficiaries can find out if theyre eligible for Medicaid by contacting their Medicaid office. An Internet search for Medicaid offices in a beneficiarys state should provide the number to call but beneficiaries should make sure they are contacting a government office before sharing any personal information.
The Centers for Medicare and Medicaid Services also maintains a list of state agencies that oversee Medicaid. Beneficiaries can see if they already have Medicaid by contacting 1-800-MEDICARE and asking whether they receive Extra Help with their prescription drug costs .
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Learn How To Apply For Medicaid In Ohio
UPDATE: In 2020, Medicaid is not expected to undergo any significant changes.
Ohio State residents who are in need of health care can find out how to apply for Medicaid through various avenues. Applicants can apply for Medicaid at any point in the year. There is no deadline to apply for Medicaid online or via any other method, because a persons income status may change overnight. As long as the applicant meets the Ohio eligibility requirements for Medicaid, he or she will be provided with coverage.
Those who are interested in completing Medicaid application forms are encouraged to check their eligibility and discover where to apply for Medicaid before proceeding to the next step. This way, an applicant can avoid wasting his or her time filling out the Ohio Medicaid application if he or she is not eligible for coverage in the first place.
Review the many different ways to apply for Ohio Medicaid below:
How To Apply For Medicaid In Ohio Online
Applicants can apply for Medicaid online through the states Medicaid website, known as Ohio Benefits. Access the self-service portal section of the Ohio Benefits website to begin the Ohio Medicaid application process. Ohio Benefits requires each applicant to create a unique username, as well as a password.
Ohio Medicaid applications are not strictly limited to the Ohio Benefits website. You can also apply for Medicaid in Ohio online through the Federal governments healthcare website. If you opt to apply for Medicaid through the Federal governments healthcare website and have questions about the application, reach out to the Federal government.
Get all the information you need in order to apply by downloading our in-depth easy guide.
When completing your Ohio Medicaid application, be sure to include your gross monthly income, rather than your net monthly income. If you have no income at all, do not enter zero dollars . The self-service portal will expedite the processing of your Ohio Medicaid application if you put in one dollar instead of zero dollars, should you currently be unemployed.
Where do you sign up for Medicaid on the web using different devices? is another query asked by many Medicaid applicants. It is important to note that some web browsers are not compatible with the online Medicaid application self-service portal.
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Medicare Eligibility Before Age 65
If youre under 65 years old, you might be eligible for Medicare:
- If you receive disability benefits from Social Security or certain disability benefits from the Railroad Retirement Board for at least 24 months in a row
- If you have amyotrophic lateral sclerosis
- If you have end-stage renal disease . ESRD is permanent damage to the kidneys that requires regular dialysis or a kidney transplant
If youre eligible for Medicare because of any of these circumstances, you may receive health insurance through Medicare Part A and Medicare Part B , which make up Original Medicare. Your enrollment in Medicare may or may not be automatic, as explained below.
Medicare Advantage In Ohio
Medicare Advantage plans are an alternative to original Medicare. Theyre offered by private companies, and they need to cover all services included in Medicare parts A and B. Most plans include Part D drug benefits, too.
Many Medicare Advantage plans also cover extra services that original Medicare doesnt, such as dental, vision, and hearing care.
If youre interested in Medicare Advantage plans in Ohio, there are many options available. Here are some of the carriers offering Medicare Advantage plans in Ohio for 2022:
- Oxford
- State Farm
In total, you have 12 different Medigap plans that are available to choose from this year if you live in Ohio.
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Who Qualifies For Medicare In Ohio
You may qualify for Medicare in Ohio if youre a U.S. citizen or a permanent legal resident who has lived in the U.S. for more than five years and one or more of the following applies to you:3
- You are 65 or older.
- You have been on Social Security Disability Insurance for two years.
- You have end-stage renal disease or Lou Gehrigs disease.
How Do I Speak To A Person At Medicare
Some people may prefer to speak to a Medicare representative over the phone, and some actions may require you to do so.
The official phone number for Medicare is 1-800-MEDICARE , TTY 1-877-486-2048. You may call Medicare 24 hours per day, 7 days per week, and help is available in both English and Spanish.
When calling Medicare, you may receive help with any of the following:
- Claim statusCheck the status on a claim that has been filed on your behalf.
- Coverage and benefitsNot sure if a service or item will be covered by your Medicare insurance? You can call to find out.
- Premium paymentsInquire about the status of a Medicare plan premium payment or ask a question about your balance.
- Preventive examsMedicare covers a number of preventive exams, and you are encouraged to call and find out which exams are eligible for Medicare coverage.
- DeductiblesNeed to know how money you have paid towards your Part A or Part B deductible? Call to find out and to find out if a particular service or item will count toward your deductible.
- Replacing a lost or stolen Medicare cardMedicare fraud can happen as a result of a lost or stolen card, so be sure to call if you lose your Medicare card.
You may also speak to someone in person regarding your Medicare eligibility or enrollment by visiting your local Social Security office.
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Whats The Difference Between Medicare And Medicaid
Medicare is a federal program that provides healthcare coverage for people with certain disabilities and those 65 years old and over. You must be a U.S. citizen or permanent legal resident to qualify for Medicare.
Medicare doesnt base your eligibility on your income level, and the program is primarily funded through payroll taxes.
Medicare has four parts. Here is a quick overview of what each part covers:
- Medicare Part A.Medicare Part A is hospital insurance. It covers you during short-term, inpatient stays in hospitals and for services like hospice. It also provides limited coverage for skilled nursing facility care and select in-home services.
- Medicare Part B.Medicare Part B is medical insurance that covers everyday care needs like doctors appointments, therapist visits, medical equipment, and urgent care visits.
- Medicare Part C.Medicare Part C is also called Medicare Advantage. These plans combine the coverage of parts A and B into a single plan. Medicare Advantage plans are offered by private insurance companies and are overseen by Medicare.
- Medicare Part D.Medicare Part D is prescription drug coverage. Part D plans are stand-alone plans that cover only prescriptions. These plans are also provided through private insurance companies.
Because Medicare and Medicaid have similar sounding names, its easy to get them confused. Heres how Medicaid is different.
It is possible to be enrolled in both Medicare and Medicaid at the same time.
Medicare Part D In Ohio
Original Medicare does not provide coverage for outpatient prescription drugs. More than half of Original Medicare beneficiaries nationwide have supplemental coverage either through an employer-sponsored plan or Medicaid, and these plans often include prescription coverage.
But Medicare Part D, created under the Medicare Modernization Act of 2003, provides prescription drug coverage for Medicare beneficiaries who do not have another source of coverage for prescription costs. Medicare Part D coverage can be purchased as a stand-alone plan or obtained as part of a Medicare Advantage plan with integrated Medicare Part D benefits. Both options are available for purchase during the annual election period that runs from October 15 to December 7 each year, with the new coverage effective January 1 of the coming year.
There are 30 stand-alone Medicare Part D plans for sale in Ohio for 2021, with premiums that range from about $7 to $88/month.
As of 2020, More than 1.9 million beneficiaries of Medicare in Ohio had Part D coverage. More than a million had stand-alone Part D coverage and nearly 900,000 had Medicare Advantage plans with integrated Part D coverage.
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Medicare For Beginners Workshops
If you’re new to Medicare or if you need help understanding your options, COAAA’s free ‘Medicare for Beginners’ workshops are a valuable resource for unbiased information to help you make informed decisions. COAAA does not represent or sell insurance products. As of this time, all presentations for 2021 will be virtual. Upcoming ‘Medicare for Beginners’ workshops via Zoom:
- Wednesday, November 17, 2021 at 2:00 p.m.
- Wednesday, December 8, 2021 at 5:30 p.m.
Registration is required. Email Andy Haggard at This email address is being protected from spambots. You need JavaScript enabled to view it. to register. If you have questions or need help navigating the Medicare system, you can call COAAA at 800-589-7277 or email This email address is being protected from spambots. You need JavaScript enabled to view it.. If you would like to view a ‘Medicare for Beginners’ workshop, which includes informational slides along with an audio presentation, simply click play on the video below.
How To Apply For Medicaid In Ohio
Finding out how to apply for Medicaid in Ohio is the next step after a potential applicant has determined his or her eligibility for Medicaid benefits. Applicants need to know where to apply for Medicaid and how to navigate the Medicaid application process in order to increase their chances of filling out a successful application and being admitted into the program. Furthermore, in addition to learning about the Medicaid application, claimants must be prepared with the supporting documents needed to verify and approve the application. Learn more about the OH Medicaid application form by reading the following topics.
Where do you sign up for Medicaid in Ohio?
Fully understanding how to apply for Medicaid benefits in Ohio is essential to a successfully submitted application, since there are a few application methods available. The easiest way to submit an application for Medicaid in OH is by using the online application process. In order to apply for Medicaid online, all a petitioner needs is access to a computer and the internet, which can be found at a local public library if a computer is not readily available. Applying for the Ohio Medicaid program online is fast and convenient, and anyone can use the online system. If a caretaker is filling out a Medicaid application on behalf of a claimant, the caretaker must make sure all supporting documents are prepared.
Information Required on the Medicaid Application Form in Ohio
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You Automatically Get Medicare
- You should already have Part A and Part B , because you have ALS and youre already getting disability benefits.
- We mailed you a welcome package with your Medicare card.
Sign up for Part B if you live in Puerto Rico or outside the U.S.
- Well mail you a welcome package with your Medicare card 3 months before your Medicare coverage starts.
Sign up for Part B if you live in Puerto Rico or outside the U.S.You get Part A automatically. If you want Part B, you need to sign up for it. If you dont sign up for Part B within 3 months after your Part A starts, you might have to wait to sign up and pay a monthly late enrollment penalty.
- Well mail you a welcome package with your Medicare card 3 months before your Medicare coverage starts.
Sign up for Part B if you live in Puerto Rico or outside the U.S.You get Part A automatically. If you want Part B, you need to sign up for it. If you dont sign up for Part B within 3 months of turning 65, you might have to wait to sign up and pay a monthly late enrollment penalty.
