Medicare Plans in Ohio: Coverage and Costs (2026)

If you're turning 65 in Ohio or helping a parent sort out Medicare, you're looking at four parts, more than 200 plan choices, and costs that reset every January. The standard Part B premium for 2026 is $202.90 a month, the Part D donut hole is gone for good, and Ohio runs a free counseling service, OSHIIP, that will compare your options with you at no cost.

This guide walks through every piece of Medicare as it works for Ohioans in 2026, what it costs, the plan choices specific to the state, and how to get help paying for it.

In This Guide

• Key Takeaways
• Original Medicare: Parts A and B
• Medicare Advantage in Ohio (Part C)
• Medicare Part D: Prescription Drugs
• Medigap in Ohio
• Help Paying for Medicare in Ohio
• If You Have Both Medicare and Medicaid
• Medicare Enrollment Periods
• Free Medicare Help: Ohio OSHIIP
• Frequently Asked Questions

About these numbers: The premiums and deductibles below come from CMS for calendar year 2026, effective January 1. Medicare costs change every year. For the most current figures, contact Medicare at 1-800-633-4227 (1-800-MEDICARE) or Ohio OSHIIP at 1-800-686-1578.

Original Medicare: Parts A and B

Original Medicare is run directly by the federal government, and it comes in two parts.

Part A (Hospital Insurance)

Part A covers inpatient hospital stays, limited skilled nursing facility care, hospice, and some home health care.

The hospital deductible went up $60 from 2025. A benefit period starts the day you're admitted and ends 60 days after you leave. Get readmitted after that, and the deductible applies again.

Part B (Medical Insurance)

Part B covers doctor visits, outpatient care, preventive services, durable medical equipment, and mental health care. It doesn't cover routine dental, vision, or hearing.

• Monthly premium: $202.90 (higher if your income is above $109,000 single or $218,000 married, under the income-related adjustment)
• Annual deductible: $283
• After the deductible: you pay 20% of the Medicare-approved amount for most services

Part B is technically optional, but nearly everyone signs up. Delay past your enrollment window without other creditable coverage and you'll owe a late penalty of 10% for every 12 months you could have had it, for as long as you keep Part B.

Medicare Advantage in Ohio (Part C)

Medicare Advantage plans are an alternative to Original Medicare, sold by private insurers. They cover everything Parts A and B do, and most bundle in Part D drug coverage along with extras like dental, vision, and hearing.

Ohio is one of the better states for plan choice. About 2.56 million Ohioans are on Medicare for 2026, and the state offers roughly 212 Medicare Advantage plans, with some Ohio counties among the richest in the country for plan options. Nationally, the average beneficiary can pick from about 32 Medicare Advantage plans with drug coverage, and more than half of all Medicare beneficiaries are now in a Medicare Advantage plan rather than Original Medicare.

The Major Insurers in Ohio

Big Medicare Advantage names in Ohio include Aetna, Anthem Blue Cross and Blue Shield, Humana, UnitedHealthcare, CareSource, and Medical Mutual of Ohio, the state's largest homegrown health insurer. Plan availability and pricing differ by county, so two people in neighboring counties can see different menus.

How These Plans Work

• You keep paying your Part B premium ($202.90) on top of any plan premium, though many plans charge $0 extra.
• Plans run on networks (HMO, PPO, or HMO-POS). Confirm your doctors and hospitals are in-network before you enroll.
• Every plan caps your annual out-of-pocket spending. Original Medicare has no such cap.
• Extras vary widely. Compare the dental, vision, hearing, and over-the-counter benefits, not just the premium.

Use the Medicare Plan Finder at medicare.gov to compare plans by ZIP code. Enter your doctors and prescriptions and it shows which plans cover them and your estimated cost.

Medicare Part D: Prescription Drugs

Part D covers outpatient prescription drugs. You can get it as a standalone plan paired with Original Medicare, or built into a Medicare Advantage plan.

The Inflation Reduction Act eliminated the old coverage gap, the donut hole, so that higher-cost middle stage is gone. Part D now moves through three phases:

1. Deductible: you pay full price until you meet your plan's deductible (up to $615 in 2026).
2. Initial coverage: you pay copays or coinsurance while your plan and drug makers cover the rest.
3. Catastrophic: once your out-of-pocket spending reaches $2,100, you pay $0 for covered drugs the rest of the year.

That $2,100 cap is the number that matters most in Part D. It was $2,000 in 2025 and rises with inflation. The base premium is $38.99 a month, though actual plan premiums vary, and increases are capped at 6% a year through 2029. People who qualify for Extra Help often pay much less, sometimes nothing.

Medigap in Ohio

Medigap policies are sold by private insurers to fill the gaps in Original Medicare: the deductibles, coinsurance, and copays. They work only with Original Medicare, never with Medicare Advantage.

Ohio offers the federally standardized plans, labeled A, B, C, D, F, G, K, L, M, and N. Plans C and F are closed to anyone who became Medicare-eligible on or after January 1, 2020. Plan G is the popular choice for people newly eligible: it covers the Part A deductible, Part A and Part B coinsurance, and skilled nursing coinsurance, leaving only the $283 Part B deductible on you. Every Medigap policy sold in Ohio is guaranteed renewable, so an insurer can't drop you because your health changes.

Your strongest opening is the federal Medigap Open Enrollment Period, the six months that begin when you're 65 and enrolled in Part B. During that window an insurer has to sell you any plan it offers at the standard rate regardless of your health.

Ohio Has No General Birthday Rule

A few states, like California and Oregon, give every Medigap policyholder a yearly window to switch plans without new health questions, often called a birthday rule. Ohio does not. Once your six-month window closes, an insurer in Ohio can generally make you answer health questions before selling you a different Medigap policy. So your first six months on Medicare matter: that's when you have the strongest right to buy.

If You're Under 65 and on Medicare

People qualify for Medicare before 65 through disability, end-stage renal disease, or ALS, and for years many couldn't buy Medigap in Ohio at all. That changed on January 1, 2025. Ohio now requires any insurer that sells Medigap to people 65 and older to also offer it to Medicare enrollees who are 64 or younger, at a premium no higher than a 65-year-old's, with no pre-existing-condition exclusions. The law created a six-month enrollment window for eligible under-65 buyers, and it lets an under-65 enrollee move to another insurer's plan with the same coverage each year within 60 days of their birthday. The Ohio Department of Insurance can confirm which carriers offer these plans.

Help Paying for Medicare in Ohio

If you're on a fixed income, two programs can cut your Medicare costs sharply.

Medicare Savings Programs

Ohio runs the Medicare Savings Programs under the name Medicare Premium Assistance Programs, through Ohio Medicaid. Your county Department of Job and Family Services decides whether you qualify. They pay some or all of your Medicare premiums and cost-sharing based on income.

QMB is the most generous, covering your Part B premium and your deductibles and coinsurance, which can mean thousands of dollars saved a year. Ohio applies the federal asset test for these programs: for 2026 the resource limit is $9,950 for one person and $14,910 for a couple, indexed each year to inflation. The income limits above are tied to the federal poverty level and update each spring, so confirm the current figures with Ohio Medicaid or OSHIIP before you rule yourself in or out. To apply, use Ohio Benefits online, your county office, or the Ohio Medicaid Consumer Hotline at 1-800-324-8680.

Extra Help for Part D

Extra Help, also called the Low-Income Subsidy, pays Part D premiums, deductibles, and copays for people with limited income and resources.

• Resource limits: $16,590 for an individual, $33,100 for a married couple
• If you qualify for QMB, SLMB, or QI, you're automatically enrolled in Extra Help

Apply through Social Security at ssa.gov or call 1-800-772-1213.

If You Have Both Medicare and Medicaid

Many people who have Medicare also qualify for Medicaid, and Ohio has rebuilt how those dual eligibles get care. The state now serves them through Next Generation MyCare, which replaced the older MyCare Ohio demonstration. A dual-benefit member gets their Medicare and Medicaid benefits from a single plan, which coordinates doctors, drugs, and long-term services and supports under one roof. Ohio Medicaid chose four plans to run it: Anthem Blue Cross and Blue Shield, Buckeye Health Plan, CareSource, and Molina HealthCare of Ohio.

Next Generation MyCare launched January 1, 2026 in the 29 counties where MyCare Ohio already operated, and it expands to the rest of the state through 2026, with more counties coming online starting April 1. If your needs are more intensive, the PACE program is another fully integrated option in parts of Ohio, and an integrated Dual Eligible Special Needs Plan may fit too. For the full picture, see our guide to Next Generation MyCare in Ohio.

Medicare Enrollment Periods

Miss a deadline and you can face coverage gaps or permanent penalties. The key dates:

Changes you make during Annual Open Enrollment take effect the following January 1. That's when most people review their plan and switch.

Free Medicare Help: Ohio OSHIIP

You don't have to figure this out by yourself, and you don't have to pay a broker to help. Ohio's Ohio Senior Health Insurance Information Program, or OSHIIP, gives free, unbiased Medicare counseling. It has been part of the Ohio Department of Insurance since 1992 and works through hundreds of trained volunteers across the state.

An OSHIIP counselor can help you:

• Understand your Medicare options and what each part covers
• Compare Medicare Advantage, Part D, and Medigap plans side by side
• Apply for Medicare Savings Programs and Extra Help
• Sort out billing problems, denials, and appeals
• Work out how Medicare fits with Medicaid if you have both

Call 1-800-686-1578 and you'll reach OSHIIP or a local volunteer counselor.

Learn More

• Next Generation MyCare in Ohio
• Ohio Medicaid: Programs and Coverage
• Ohio Medicaid Eligibility and Income Limits
• Ohio Medicaid Managed Care Plans
• Caregiver Support Programs in Ohio

Find personalized help comparing your Medicare options in Ohio at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.