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Ohio Medigap Under 65

Are you enrolling in Medicare due to a disability? Looking for Ohio Medigap under 65? Unfortunately, you are out of luck.

Although it varies nationwide for those on Medicare and under 65, Ohio is a state in which Medicare supplement insurance is not available. Your options are to remain on Original Medicare and Part D or choose an Ohio Medicare Advantage plan specific to your needs. Advantage plan companies in Ohio offer MAPD plans short for Medicare Advantage plans that include Prescription Drugs. Networks vary depending on each plan type. HMO’s, PPO’s and SNP’s are most common.

Medicare Advantage plans in Ohio

These private insurance plans are offered by companies like Aetna, Anthem Blue Cross and Blue Shield, Gateway, Humana, Medical Mutual, United Healthcare, etc.  By law, these companies must provide benefits at least as good as Medicare. Many of these Ohio Medicare Advantage plans include additional benefits like prescription drugs. Confirm that your primary doctor and facilities are in Ohio Companies Medicare Advantage Plan networks. We can help.



If you are already receiving Medicare, the new Ohio healthcare exchanges will not allow you to enroll through the Federal Marketplace at http://healthcare.gov. The Ohio Marketplace will not affect your Medicare choices.

One small exception is those disabled individuals in Ohio that are currently waiting for their 24 months to pass to become eligible for Medicare. In some cases, depending upon your income and household size, you may be eligible for subsidies on health insurance benefits through the exchange. Use the calculator below to determine your subsidy and premium and find out if a new “on-exchange” plan may be right for you.






Medigap Under 65 old? Are you eligible? Check Here!

A Side Note from the Editor

Medicaid expansion in Ohio and the problem with income guidelines.

Ohio has expanded its Medicaid program under the Affordable Care Act.. Now,  low-income adults even without dependent children are eligible. Eligibility breakdown below:

  • Adults at household income up to 133 percent of poverty (138 percent after the built-in 5 percent income disregard).
  • Children at household income up to 206 percent of poverty.
  • Pregnant women with household income up to 200 percent of poverty.

You are now wondering, what is ‘poverty’? Check out the government established Federal Poverty Levels(FPL) below. To put this into plain English, a family of four can make up to $33,534 per year and still qualify for free healthcare. That is roughly $2800 per month, or equivalent to earning about $16 per hour assuming a 40 hour workweek. Even more interesting is that same family of four could make up to $50,000 per year and their children would still qualify for free healthcare. As more employers are choosing not to provide health coverage to employees, this is proving to be quite the math problem for a majority of Ohioans.

Ohio dental insuranceIf one’s wage takes them over medicaid monthly income limits, it is not worth it! This happens often for low wage workers($16/hr and below), and in some cases, they have no idea how this all works. How should they? It’s very confusing! There are thousands of people in this situation just in Ohio alone. Take for example this same family now gets a .50 cent raise taking them to an annual salary of just over $$34,000 per year. They are no longer eligible for Medicaid – this essentially calculates to a huge loss of real spendable income – based on maximum healthcare expenditure (not including insurance premiums and dental care costs), as roughly 20% of this family’s income now required to go toward healthcare costs.

Lowest Maximum Annual Spend for a family making $34,000 and no longer eligible for Medicaid:

The amounts below are 2016 numbers and used for calculating eligibility for Medicaid and the Children’s Health Insurance Program (CHIP). 2015 numbers are used to calculate eligibility for savings on private insurance plans for 2016.

  • $11,880 for individuals
  • $16,020 for a family of 2
  • $20,160 for a family of 3
  • $24,300 for a family of 4
  • $28,440 for a family of 5
  • $32,580 for a family of 6  – and so on…        * courtesy of Healthcare.gov