There are several changes to Ohio Medicare Advantage plans for 2026. Many insurance companies are shrinking their coverage areas. Others are cancelling plans for those who are already enrolled.
With these changes, Ohio residents need help finding suitable coverage to fit their needs and budget. Fortunately, there are many HMO and PPO options available and several will have $0 monthly premiums.
And a new Ohio Medicare program for those who are also eligible for Medicaid called Next Generation MyCare FIDE (Fully Integrated Dual Eligible) is rolling out across the state.
Who Offers Medicare Advantage Plans In Ohio?
Several carriers are competing for consumers’ Medicare Advantage insurance business in 2026. Some, like Medical Mutual of Ohio, will not be renewing popular plans for 2026. Instead, they will offer new plans in the 44 counties that are affected.
Humana, Aetna, Anthem Blue Cross Blue Shield, Cigna Healthspring, United Healthcare AARP, and Devoted are some of the bigger insurance companies offering Medicare Advantage insurance in Ohio for 2026. Other smaller regional carriers like Aultcare, Summacare, Medigold, and Paramount will have plans in select counties where they have robust network agreements.
Many of these companies will eliminate some Advantage plans in certain areas. Aetna is eliminating its Smart Fit Medicare Advantage plan while UHC, Anthem, and Humana will either discontinue plans or no longer accept new members.
Annual Notice Of Change (ANOC) forms are on the way. If you’re unsure of the status of your Advantage plan, call us, and we will help you.
Guaranteed Medicare Rights: Loss of Medicare Advantage
It’s also important to note that if your Advantage plan does not renew, you get a Special Election Period (SEP) window. This Guarantee Issue window allows you to return to Original Medicare and purchase certain Ohio Medicare Supplements with no medical underwriting. (This might be a Plan F for some and a Plan F for others.)
These SEPs do not come along often, so if you’re looking to use your Guaranteed Medicare Rights to purchase a Supplement (Medigap) plan, this might be a good opportunity to do so.
Medicare Advantage Plans For Dual Eligibles
Beginning in 2026, MyCare is transitioning to Next Generation MyCare for those who are dually eligible. These are QMB+, SLMB+ & FDBE residents in Ohio.
These FIDE (Fully Integrated Dual-Eligible) special needs plans are designed to provide integrated benefits, coordinated care, provider support, and added benefits to those who are eligible. There is only one ID card, is easier to manage, and it’s fully integrated for consumer ease.
In Ohio, there are three companies offering MyCare plans to those who meet certain criteria. They are Anthem Blue Cross and Blue Shield, Caresource, and Molina. Members must be 21 years or older, living in a participating county, and eligible for Medicare Parts A, B, and D while also having full Medicaid benefits.
Plans will be rolled out over the course of 2026. Larger metropolitan areas (like Columbus, Cleveland, Cincinnati, and Toledo) are first, while the more rural areas will occur over the course of the year. This will happen in three tranches. Enrollments will be available year-round, however.
Understanding C-SNP Medicare Advantage Plans
Other specialized Medicare Advantage plans in Ohio are called Chronic Special Needs Plan, or C-SNP for short. These policies are designed for certain sub-populations who have severe disabling chronic conditions like heart or lung disease, ESRD, diabetes, cancer, dementia, or autoimmune conditions.
These policies offer special benefits, including care coordination, health & wellness programs, disease management, and extras in terms of prescriptions, dental, vision, transportation, OTC allowances, and hearing aids. But most importantly, they are designed to help manage and provide extra care for those with ongoing diagnosed conditions.
Doctor verification is required within 60 days of the plan’s start date. However, these specialized C-SNP policies can provide even more assistance and benefits than a traditional Medicare Advantage plan to those who qualify.
Can I Stay On Medicare and Ohio Medicaid?
Yes, you are not obligated to choose one of the three insurance companies participating in MyCare. If for some reason their network or benefits do not serve you well, then remaining on Medicare with full Medicaid is an option.
The reason you might enroll in a Medicare Advantage SNP (Special Needs Plan) is the extra benefits. These MyCare plans offer amazing benefits and monetary perks that can be used for all kinds of qualifying items and services.
Robust dental, vision and hearing coverage are at the top of the list for value-added benefits. However, assistance with the cost of food, utilities, rent or mortgage, and pet care are just a few of the many items that can be covered by pre-loaded debit cards. One carrier is offering up to $715 each year!
Additionally, $0 prescriptions will be available for Medicare and Medicaid covered drugs. This can provide tremendous savings for enrollees. Meals after recovery and unlimited rides to and from healthcare providers are also included with some MyCare SNP insurance plans.
Ohio Medicare Disability Insurance Under Age 65
If you are eligible for Medicare due to disability in Ohio, you may know that insurance companies do not offer Medicare Supplement plans. This means you can stay on Medicare and enroll in a stand-alone Part D plan, or explore your Medicare Advantage options.
In many cases, you might be better off with an Advantage plan for the benefits these plans provide. And once you turn 65, you will then be able to shop and enroll in a Supplement, but not before. Those are the rules as of now. Other states do allow for Medigap plans under age 65, but not Ohio right now.
If you are unsure of what path might suit you best, then contact us to discuss your situation. We will help you compare both options.
Contact Us for Medicare Advantage Guidance
At Hyers and Associates, we’ve been helping Ohio Medicare-eligible consumers for nearly three decades. And with all of the recent changes to Medicare and Medicaid, it’s a good time to review your options. One of our fully licensed agents will help you find the insurance that best meets your needs.