You have a wide range of Medicare and other senior health insurance options available to you in Shelby County. To make shopping easier, use the navigation links below to show specific plan types. Click here to learn more about your Medicare options.
To speak with a Medicare adviser, call us toll-free at 877-549-1452 (TTY 411). Our telephone hours are 6AM to 5PM PST, Monday through Friday.
Shelby County Medicare Insurance Options
Traditional Medicare coverage – that's Part A and Part B – are not based on where you live in Shelby County or Ohio. This is not true of Medicare Part C and Part D, or Medigap plans. Private Medicare insurance is regional, and costs and availability vary widely.
As if all of the various health insurance options aren’t confusing enough, you also need to make sure your doctor accepts the insurance you want, or find a doctor that does. Some doctors only work through insurance networks, while others treat patients with Original Medicare (and Medicaid). Some doctors do both.
Our goal is to help you find all of the information you need to narrow your plan options to a small number so you can get on the phone with licensed adviser and make your final election for the year. In our experience, people who take a little more time investigating their options generally have better results with their healthcare.
Medicare Advantage Insurance in Shelby County
If you're concerned that Original Medicare might be too expensive (you pay 20% of all costs), then a Shelby County Medicare Advantage plan is the first option you need to explore. It's the private health insurance alternative that replaces your Medicare Part A and Part B benefits with a managed care plan (HMO or PPO), or a private fee-for-service plan (available in limited areas).
For most Shelby County seniors cost is a factor, so let's talk about it. You have plans as low as $20.00 per month and some as high as $70.00 per month. It's not always true that the higher the premium the more benefits and coverage you get. Be a good shopper and compare. Be sure to compare prescription drug benefits. There are 3 plans that give you prescription drug coverage and 1 that don't include it.
There are several different type of plans, including Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Private Fee-for-Service (PFFS), and Medical Savings Account (MSA). HMO and PPO plans are the most common. We identify the plan type and its benefits on each plan page.
If you're on a fixed budget and have good health, look for a plan with a $0 monthly premium. What this means to you is that all of the extra benefits have no additional monthly cost to you. What you pay is your monthly Medicare Part B premium and the co-payments outlined by the plan. Just realize these plans are, most often, the most basic available.
Are you aware that Medicare Advantage has an annual out-of-pocket spending limit? This feature, called the Maximum Out-of-Pocket (MOOP) expense, is what safeguards you from the threat of high medical bills. Each year the Centers for Medicare and Medicaid Services (CMS) sets the maximum and an alternative minimum MOOP that plans may offer, so be sure to look for it when comparing your health insurance options.
A full thirty-three percent of all Medicare beneficiaries enroll in Medicare Advantage each year. The reason is simple: it's a cost-effective alternative to Original Medicare. We encourage you to learn more by visiting our Medicare Advantage Frequently Asked Questions and Medicare Advantage Coverage pages.
Medicare Supplement Insurance in Shelby County
The only relief Ohio seniors have from the high cost of medical bills is additional insurance. That's because Original Medicare does not set limits on your annual out-of-pocket expenses. It's a serious risk that you need to consider. If you plan to keep your Original Medicare, the solution is Medicare Supplement insurance (Medigap).
A Medigap policy is indemnity insurance that pays the portion of your bill not paid by Medicare (up to the limits of the policy). There are ten lettered plans in Ohio (A through N) that are all standardized. So, no matter what carrier you choose, the lettered plan will be the same, only the premium will be different.
It's critical that you understand how Medigap works. It does not give you extra healthcare benefits. If Medicare does not cover a healthcare expense, Medigap does not cover it. That includes your prescriptions, hearing aids, eye glasses, dental exams and other items that Medicare does not cover. Medigap works with everything covered under Medicare Part A and Part B.
Medicare Prescription Drug Plans in Shelby County
In addition to no out-of-pocket limits, Original Medicare does not cover your prescription medications. It covers medications you need while hospitalized as an inpatient, but for outpatient care you must pay all costs or enroll in a Ohio Medicare Part D plan (PDP) to get cost assistance.
You have a variety of options available to you throughout Ohio. This year there are a total of 7 prescription drug plans available, each with its own formulary. Monthly premiums start at just $26.80 and go up to $95.90 per month for the most inclusive extended plan. While shopping and comparing, don't forget to look at the annual deductible. This is what you will pay at the pharmacy before assistance begins.
Don't make the mistake of enrolling in a Medicare Part D plan because it's cheap. Your prescription drug insurance is important. Learn more about it by reading Medicare Part D Frequently Asked Questions and Medicare Part D Coverage.
How-To Find a Medicare Doctor in Shelby County, Ohio
We've recently added all Shelby County Medicare doctors (primary care physicians for now) to MedicareWire.com. Doctors who treat Medicare patients are listed by city or town. We have school information, years of experience, hospital affiliations and insurances for doctors in Anna, Botkins, Fort Loramie, Houston, Jackson Center, Maplewood, Port Jefferson, Sidney, and surrounding areas.
This page was last updated on: 11/12/2014.