Medicare Help

Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD). Our trained staff can help you find the coverage and plans that are right for you.

Older adult couple look at Medicare help on a laptop

Information and Help with Medicare in Southeast Ohio

Call our advice line to talk to a specialist about any question you have, including questions about our Medicaid and Medicare services.

Program Details & Resources

Our Advice Line provides Medicare beneficiaries with free, objective, health insurance information and one-on-one counseling through a program called the Ohio Senior Health Insurance Information Program (OSHIIP). Our OSHIIP-trained staff can help answer your questions about Medicare, Medicare prescription drug coverage (Part D), Medicare Advantage options, Medicare supplement insurance, long-term care insurance, and other health insurance matters.

Original Medicare Part A Hospital  |  Part B Medical + Medicare Supplement + Prescription Drug Coverage

  • Original Medicare Part A Hospital and Part B Medical: Fee-for-service coverage under which the government pays your health care providers directly for your Part A and/or Part B benefits.
  • Medicare Supplement (secondary insurance): Sold by private insurance companies to fill “gaps” in Original Medicare coverage. Others may have coverage through a retirement health plan or Medicaid.
  • Prescription Drug Coverage: Private companies approved by Medicare run these plans. Plans have different costs and cover different drugs.

Medicare Advantage Plans (HMOs and PPOs Part C)

  • Offered by private companies that contract with Medicare to provide Part A and Part B benefits. Plan types include health maintenance organizations (HMOs), preferred provider organizations (PPOs), private fee-for-service plans and more. These plans take the place of Original Medicare and most include the Part D prescription drug benefit.

Part D is Medicare’s comprehensive prescription drug coverage benefit and is available to anyone eligible for Medicare Part A or Part B. People with Medicare may enroll in Part D coverage through either a stand-alone plan or a Medicare Advantage plan. People on Medicare who choose not to enroll and have no other drug coverage may pay more for late enrollment.

Plans change every year. So can your health. Even if you are happy with your current Medicare plan, compare all your prescription drug and health coverage options. You might find a plan with better coverage.

  • Check if your prescriptions are included on a plan’s formulary and if your health care providers are in a plan’s network.
  • Remember that a low monthly premium may not always be the best overall value for your specific needs.
  • Review a plan’s estimated total costs to you, including deductible and other out-of-pocket costs.
  • Check if Medicare Advantage plans offer extra benefits, like vision, hearing, or dental coverage.
  • If you take insulin, a benefit caps costs at $35 for a month’s supply of each insulin covered by Medicare.

Individuals needing assistance with enrollment may call Ohio’s Medicare hotline at 1-800-686-1578, review the Medicare & You 2024 handbook (located below), or visit www.medicare.gov/plan-compare.

2024 Medicare and You Guide

If you are struggling with your prescription drug costs, Extra Help is a Medicare program that can help people with limited income and resources pay for Medicare drug coverage (Part D) premiums, deductibles, coinsurance, and other out-of-pocket costs.

A call to our Advice Line can help you determine if you qualify to save an average of $3,900 on your prescription drug costs through the Medicare “Extra Help” program, also known as Low-Income Subsidy (LIS) or Medicare Savings Programs (MSPs).

What Counts As Income And Resources?

Resources include money in a checking or savings account, stocks, bonds, mutual funds, and Individual Retirement Accounts (IRAs). Resources don’t include your home, car, household items, burial plot, burial expenses (up to $1,500 per person), or life insurance policies. Income includes any money received from social security, pensions, employment, interest and more.

If you qualify for Extra Help, Medicare will pay:

  • All or most of the monthly premium
  • All or most of the annual deductible
  • Most of your copayments/co-insurance 
  • Full coverage during the donut hole

In 2023, drug costs for most people who qualify were no more than $4.16 for each generic drug and $10.35 for each brand name drug. Look on the Extra Help letters you receive, or contact your plan to find out your exact costs.

Advice Line

Older Adults & Caregivers

We connect older adults, individuals with disabilities, and their caregivers with relevant program and enrollment information.

Need immediate help for yourself or a loved one?

Community Leaders

We provide local community leaders with up-to-date strategic data, program information, and funding opportunities.

Need funding for a project in your community?

Are you a service provider?