Elevance Medicare Advantage Plans Ohio 2025

Discover Elevance Health’s Medicare Advantage Offerings in Ohio

Elevance’s Medicare Advantage plans are not just health plans; they are comprehensive healthcare solutions designed with you in mind. In Ohio, Elevance Health offers an array of Medicare Advantage Plans, such as HMOs, PPOs, and SNPs.

These plans cater to a diverse range of healthcare needs and preferences, from HMO, HMO DSNP, and LPPO, to RPPO plans. But it’s not just the variety that sets Elevance Health apart. The quality of their plans, gauged by the CMS Star Ratings, is also commendable.

For 2023, Elevance Health’s affiliated Medicare Advantage plans achieved an impressive 4 out of 5 Stars from CMS. This high rating signifies that a significant number of consumers in Ohio will enjoy top-rated healthcare services.

The diversity and quality of Elevance Health’s Medicare Advantage plans in Ohio play a crucial role in providing personalized healthcare experiences. With such a variety of plans, you are bound to find a plan that best fits your healthcare needs and preferences.

Plan Variety and Flexibility

The variety of Elevance Health’s Medicare Advantage plans in Ohio is designed to cater to different healthcare needs and preferences, offering flexibility and choice. Their plan options include:

• HMO

• HMO DSNP

• LPPO

• RPPO

Each plan type has unique features that cater to different healthcare needs. For instance, Health Maintenance Organizations (HMOs) require beneficiaries to choose a primary care physician who manages their care and use in-network providers for their healthcare services.

This setup is ideal for individuals who prefer having a central healthcare advisor.

On the other hand, Preferred Provider Organizations (PPOs) offer more flexibility by not requiring a primary care physician and covering out-of-network services, although at a higher cost compared to in-network services.

This flexibility makes PPOs a suitable choice for individuals who prefer having a broader selection of healthcare providers. With such variety and flexibility, you can choose a plan that best caters to your healthcare preferences, lifestyle, and budget.

Enhanced Supplemental Benefits

Elevance Health’s Medicare Advantage plans go beyond baseline health coverage to provide enhanced supplemental benefits for a holistic healthcare experience. These plans may offer dental, vision, and hearing coverage.

But that’s not all. Elevance Health’s plans may also enhance access to hearing aids by offering an allowance for the purchase of over-the-counter hearing aids. Furthermore, their ‘Essential Extras’ initiative may allow members in Ohio to choose services that best fit their needs, such as:

• dental

• vision

• hearing

This comprehensive approach contributes to high consumer experience scores and reflects the positive impact on overall health and quality of life.

Customizing Your Medicare Experience

Elevance Health understands that each individual has unique healthcare needs, preferences, and circumstances. That’s why they offer options to customize your Medicare experience.

A key aspect of this customization is the inclusion of prescription drug coverage in their Medicare Advantage plans. Ensuring that your medication needs are adequately covered can lead to better health outcomes and lower out-of-pocket costs for medications.

By customizing your Medicare experience, you can ensure that your healthcare plan aligns with your personal health needs and lifestyle.

Prescription Drug Coverage Inclusion

One of the key benefits of Elevance Health’s Medicare Advantage plans is the potential inclusion of prescription drug coverage. Most of their Medicare Advantage Part C plans in Ohio include Prescription Drug (Part D) coverage, providing an all-in-one plan solution for members.

This integration means that you can manage your health and medication needs under one plan, simplifying your healthcare experience.

Special Considerations for Dual Eligible Individuals

Elevance Health acknowledges the unique needs of individuals who are eligible for both Medicare and Medicaid, often referred to as ‘dual eligible’ individuals. To cater to this special group, Elevance Health offers a range of Special Needs Plans in Ohio, including Dual Eligible Special Needs Plans (D-SNPs).

These plans are designed to address the fragmented care journey often experienced by dual-eligible individuals due to managing the separate eligibility requirements and rules of Medicare and Medicaid.

The utilization of Dual Eligible Special Needs Plans has demonstrated positive effects on healthcare access for members, leading to increased primary care visits and reductions in hospitalizations and readmissions. Moreover, D-SNPs provide a higher level of coordination between Medicare and Medicaid services than other plans, aiming to improve health outcomes for dual-eligible individuals.

Coordination with State Medicaid Programs

The effectiveness of D-SNPs largely hinges on the coordination between these plans and appropriate state Medicaid programs. Such coordination is essential for delivering uninterrupted care management to those who hold dual eligibility.

However, D-SNPs exhibit varying extents of integration between Medicare and Medicaid services, affecting the consistency and quality of care provided.

Navigating the Provider Network

Elevance Health’s provider network in Ohio includes a comprehensive array of healthcare professionals and facilities, offering convenient access to affordable, quality care. From doctors and specialists to hospitals and pharmacies, Elevance Health’s network ensures that members have a wide selection of healthcare providers to choose from.

Furthermore, Elevance Health’s affiliated health plans in Ohio streamline member access to care by eliminating prior authorization requirements for common healthcare services, promoting freedom of health.

In-Network vs. Out-of-Network Providers

In-network providers are healthcare professionals or facilities that have agreed to provide services to Elevance Health plan members at pre-negotiated rates, often leading to cost savings for both the insurer and the member. By using in-network providers, members can ensure they receive quality care while minimizing their healthcare costs.

On the other hand, out-of-network providers:

• do not have agreements with Elevance Health

• can result in higher charges for services

• can lead to balance billing, where the plan covers a set allowed amount and the member is responsible for the remaining balance

Understanding the difference between in-network and out-of-network providers can help you make informed decisions about your healthcare and manage your expenses effectively.

Enrollment Made Easy

Enrolling in an Elevance Health Medicare Advantage plan is easy for Medicare-eligible individuals. To be eligible, individuals must be enrolled in both Medicare Part A and Part B. Enrollment can be initiated during various enrollment periods, such as the Initial Enrollment Period, the annual Open Enrollment Period, and the Medicare Advantage Open Enrollment Period.

Enrollment Periods and Deadlines

Understanding enrollment periods and deadlines is crucial in ensuring seamless access to your healthcare benefits. The Initial Enrollment Period for Medicare Advantage begins three months before and ends three months after an individual’s Medicare benefits start.

After this period, changes to Medicare Advantage plans can be made during the Annual Open Enrollment Period from October 15 to December 7, with new coverage commencing on January 1 of the upcoming year.

If you missed your Initial Enrollment Period, you may still enroll in a Medicare Advantage plan during the General Enrollment Period from January 1 to March 31, with coverage beginning on July 1 of the same year.

Furthermore, beneficiaries with eligible life changes may use a Special Enrollment Period to join or switch Medicare Advantage plans, with coverage typically starting the month after enrollment.

How to enroll

To enroll in a Medicare Advantage Plan, visit medicareadvantageplans2025.org, or call 1-844-350-0776 (TTY user 711) Mon-Fri 8am-9pm Est.

Living Healthier with Elevance Health Programs

Elevance Health is committed to enhancing healthcare experiences through digital innovations and comprehensive care management programs. Their Medicare Advantage plans are designed to support cultural and language diversity.

They also offer care management programs for chronic conditions that incorporate clinical support with patient education and gamified elements, creating an engaging, personalized platform for members, making them lifetime trusted health partners.

Accessing Essential Extras

Elevance Health’s Anthem Medicare Advantage plans offer ‘Essential Extras’ that empower members with the choice to allocate their allowance towards a variety of benefits, including an Anthem Medicare Advantage plan with potential coverage for:

• dental

• vision

• hearing

This allows members to more effectively manage their healthcare expenses through contract renewal.

Summary

In conclusion, Elevance Health’s Medicare Advantage plans in Ohio offer a comprehensive and personalized healthcare experience. From the variety and flexibility of plan options to the inclusion of essential extras and care management programs, Elevance Health is committed to meeting your unique healthcare needs.

By understanding plan costs, optimizing benefits, and leveraging savings opportunities, you can effectively manage your healthcare expenses while receiving high-quality care. So, take a step towards a healthier future by considering Elevance Health’s Medicare Advantage plans.