Selling to seniors means working with Medicare, Medicare Supplement (Medigap) policies, and long-term care (LTC) insurance—an area with strong consumer protections because the buyers are often vulnerable. Ohio layers its own rules and programs on top of the federal framework. This guide reviews the national fundamentals and then focuses on Ohio's open-enrollment, replacement, suitability, and long-term care specifics, plus the state counseling program that serves seniors.

National fundamentals (the quick review)

Medicare is the federal program for people 65+ (and certain disabled individuals). Its parts:

• Part A – hospital/inpatient (mostly premium-free if you or a spouse paid Medicare taxes).
• Part B – physician/outpatient (monthly premium).
• Part C (Medicare Advantage) – private plans that bundle A and B (and often drug coverage).
• Part D – prescription drugs (offered through private plans).

Medicare Supplement (Medigap) policies are sold by private insurers to fill Medicare's gaps (deductibles, coinsurance). They are federally standardized into lettered plans (A through N), so a "Plan G" offers the same core benefits from any company—insurers compete on price and service. Long-term care (LTC) insurance covers custodial and skilled care (nursing home, assisted living, home care) that Medicare largely does not cover.

Medicare Advantage and Part D

• Medicare Advantage (Part C) replaces how you receive Original Medicare—you get A and B (often plus D) through a private HMO or PPO network, frequently with extra benefits. You cannot pair Medigap with an Advantage plan.
• Part D drug plans have their own enrollment rules; going without creditable drug coverage can trigger a late-enrollment penalty.
• Original Medicare + Medigap versus Medicare Advantage is the core "either/or" choice to explain to clients.

Medicare Supplement open enrollment

The single most important consumer protection is the Medigap Open Enrollment Period: a six-month window that begins when the applicant is age 65 or older AND enrolled in Medicare Part B. During this window:

• The insured has a guaranteed-issue right—the insurer cannot deny a Medigap policy or charge more because of health.
• After the window closes, insurers may use medical underwriting (unless another guaranteed-issue right, such as certain "trial" or loss-of-coverage situations, applies).

Ohio follows this federal standard, and producers should help clients buy during the open-enrollment window to lock in guaranteed issue.

Ohio free look, disclosures, and replacement

• Senior free look (right to return): Medigap and LTC policies carry a free-look period—commonly ~30 days in the senior market—during which the buyer can return the policy for a full refund. (Verify the exact Ohio figure; treat 30 days as the standard senior-market number.)
• Outline of Coverage: the producer must deliver a standardized Outline of Coverage at or before application/delivery so the buyer can compare plans.
• Buyer's guides: the "Guide to Health Insurance for People with Medicare" (and an LTC shopper's guide for LTC sales) must be provided.
• Replacement rules: when a sale replaces existing Medigap or LTC coverage, the producer must identify the replacement, obtain a signed replacement notice, and avoid creating duplicate coverage. Selling a second Medigap policy to someone who already has one—or coverage that duplicates Medicare—is a prohibited unfair practice.
• Suitability: the producer must assess whether the recommended coverage genuinely fits the senior's needs and finances, never churning a sale.

Medicaid, long-term care, and spend-down

• Medicaid is the payer of last resort for long-term custodial care once a person's assets are largely depleted. To qualify, applicants often go through spend-down, reducing countable assets to the state limit; certain assets (a primary home within limits, one vehicle) may be exempt.
• Long-Term Care insurance shifts that risk to a private policy. Under Ohio's adoption of the NAIC LTC model, carriers must offer inflation protection and nonforfeiture benefits, must meet suitability standards, and generally cannot require prior hospitalization as a condition for benefits.

Ohio programs and partnership

• Ohio Long-Term Care Insurance Partnership: links qualified private LTC policies to Medicaid asset protection. If the policy's benefits are exhausted, the insured can shelter assets equal to the benefits the policy paid before Medicaid eligibility is determined—an incentive to buy private LTC coverage.
• OSHIIP (Ohio Senior Health Insurance Information Program): Ohio's free State Health Insurance Assistance Program (SHIP), run through the Ohio Department of Insurance, providing unbiased Medicare counseling to seniors.

Key Ohio numbers to memorize

Common exam traps

• Miscounting the open-enrollment window. It is 6 months and requires both age 65 and Part B enrollment.
• Thinking Medigap is custom per company. Plans are federally standardized (A–N); only price/service differ.
• Confusing Medicare Advantage (Part C) with Medigap. Advantage replaces how you get A/B; Medigap supplements Original Medicare—and you can't hold both.
• Selling duplicate coverage. Two Medigap policies, or coverage that duplicates Medicare, is a prohibited practice.
• Forgetting inflation/nonforfeiture must be offered on LTC, and that LTC may not require prior hospitalization.
• Assuming Medicare pays for long-term custodial care. It largely does not—that's the LTC market's purpose, with Medicaid the last resort after spend-down.

Quick recap

Senior sales center on Medicare (Parts A–D), Medigap (federally standardized plans A–N), Medicare Advantage (Part C, an either/or vs. Original Medicare + Medigap), and long-term care insurance. The headline protection is the six-month Medigap open enrollment beginning at age 65 with Part B, granting guaranteed issue. Ohio seniors get a free look (commonly ~30 days; verify), a required Outline of Coverage, and strong replacement, anti-duplication, and suitability rules. LTC policies must offer inflation protection and nonforfeiture, may not require prior hospitalization, and connect to the Ohio Long-Term Care Partnership for Medicaid asset protection after spend-down. Ohio also runs OSHIIP counseling through the Department of Insurance. Keep the open-enrollment window, the free look, and the anti-duplication rule front of mind, and senior-market questions become reliable points.