Ohio Medicare Guide

Springfield Medicare Part D & Medicaid Medication Support

If you have both Medicare and Medicaid in Clark County, your prescription drug coverage works a little differently. Kim Golphin is here to help you navigate the 2026 options.

Important: We do not offer every plan available in your area. Currently we represent UnitedHealthcare, CareSource, Devoted Health, and Anthem. Any information we provide is limited to those plans we offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
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For Springfield residents who qualify for both Medicare and Medicaid—often called 'dual eligible'—managing healthcare costs is a top priority. In Clark County, your prescription drug coverage (Part D) is designed to work alongside your Medicaid benefits to help keep your out-of-pocket expenses for medications manageable.

Understanding Dual Eligibility in Clark County

Navigating the intersection of federal Medicare and Ohio Medicaid can feel complex, but it offers significant support for those who qualify. In Springfield, being dual eligible typically means you receive Extra Help, a program that assists with the costs of your Part D monthly premiums and annual deductibles.

When you visit local providers like Mercy Health Springfield or Kettering Health Springfield, your coverage ensures that the prescriptions they write are handled through a plan that recognizes your dual status. This coordination is essential for maintaining your health without financial strain.

2026 Prescription Drug Options in Springfield

For the 2026 plan year, Springfield residents have several choices for their prescription drug coverage. Choosing the right plan involves looking at which medications are covered and ensuring your preferred local pharmacies are in the network.

We focus on helping you understand the offerings from trusted carriers available in our area. By reviewing your current medication list, we can identify which plans align with the specific prescriptions your doctors at Kettering Health or Mercy Health have recommended.

The Role of Extra Help and Low-Income Subsidy

Most dual-eligible individuals in Springfield automatically qualify for 'Extra Help.' This transition means you may no longer have to pay for a separate Part D premium, and your copayments at the pharmacy counter are often reduced to very low, set amounts.

It is important to review your plan annually because drug formularies—the list of covered drugs—can change. Kim Golphin can assist you in verifying that your 2026 plan still covers the specific insulin, blood pressure medication, or other essentials you rely on.

Personalized Guidance with Medicare Options with Kim

Medicare doesn't have to be a solo journey. As a licensed agent serving Springfield and Clark County, Kim Golphin provides local, plain-English guidance to help you maximize your benefits. We take the time to listen to your needs and explain your choices without any pressure.

Whether you are new to Medicare or your Medicaid status has recently changed, we can look at the 2026 plans together. Our goal is to ensure you feel confident in your coverage so you can focus on your health and enjoying life in Springfield.

Talk to Kim today

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Frequently asked questions

What does 'dual eligible' mean for my Springfield Medicare coverage?
It means you are enrolled in both Medicare and Ohio Medicaid. In Springfield, this status usually qualifies you for programs that lower your prescription drug costs and help pay for Medicare premiums.
Do I need a separate Part D plan if I have Medicaid in Clark County?
Yes, Medicare generally becomes your primary coverage for prescriptions through a Part D plan or a Medicare Advantage plan. Medicaid then provides secondary support to help cover the costs Medicare does not.
Can I use my Part D plan at pharmacies near Mercy Health Springfield?
Most Part D plans have extensive networks that include major pharmacies and local neighborhood spots throughout Springfield. We can check if your specific pharmacy is included in the 2026 network.
What happens if my medication is not on the 2026 plan list?
If a plan changes its formulary, you may need to speak with your doctor at Kettering Health about an alternative or file an exception. We can help you compare plans during the enrollment period to avoid these surprises.
How much will I pay for my prescriptions as a dual-eligible resident?
While costs vary, most people with both Medicare and Medicaid pay very small copayments for generic and brand-name drugs. The Extra Help program significantly reduces these out-of-pocket expenses.
How can Kim Golphin help me with my 2026 Medicare choices?
Kim provides a no-obligation review of your current medications and compares them against 2026 plans from UnitedHealthcare, Anthem, CareSource, and Devoted Health to find the right fit for your needs.

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