If you’re shopping for Medicare plans in Kentucky, you’ve got a lot of options to consider. Medicare is a national health insurance program for older adults and people with certain disabilities, but there are more options than just the coverage available through the federal government.
Medicare is more than just a single health plan. It’s made up of different parts.
- Part A is hospital insurance. It covers a portion of the costs of inpatient care services you get when you’re in the hospital, a limited stay in a skilled nursing facility, or during hospice care, plus some limited home health services.
- Part B is more general health insurance. It helps pay the costs for doctor’s visits, outpatient care, medical supplies, and preventive care.
Together, parts A and B are what’s known as original Medicare. These are the parts you get from the federal government. If you or your spouse has worked for at least 10 years, you likely won’t need to pay a premium for Part A. This is because you likely already paid for it through a payroll tax.
Part B does have a premium, which varies based on factors such as your income.
While original Medicare helps pay for a great deal, there are a lot of gaps, too. Original Medicare doesn’t cover any costs for prescription drugs, or dental, vision, or hearing services. And while it covers a portion of inpatient and outpatient health care services, the coverage isn’t 100 percent.
Copays, coinsurance, and deductibles can add up, especially if you have a chronic condition that requires you to see a doctor frequently.
Medicare supplement plans
Medicare supplement plans are plans designed to fill in the gaps, which is why they are sometimes called Medigap plans. You can purchase a Medicare supplement plan from a private insurance company in addition to your original Medicare.
Medigap plans may help cover out-of-pocket costs such as copays and coinsurance and may offer additional coverage such as a dental or vision. One specific type of Medicare supplement plan is Part D. This is Medicare’s prescription drug plan.
Medicare Advantage plans
There’s another type of coverage you can purchase from a private insurance company that offers an “all-in-one” alternative to enrolling in original Medicare and Medicare supplement insurance. Medicare Advantage plans are full replacements for original Medicare. These are sometimes referred to as Part C plans.
Medicare Advantage plans offer all of the same coverage as parts A and B, plus additional benefits that you might get from a Medicare supplement plan, including prescription drug benefits.
Medicare Advantage plans also frequently include perks such as fitness programs, health coaching for promoting wellness, and support for managing health conditions, as well as discounts.
Medicare Advantage and Medicare Part D prescription drug plans are subject to change every year. Updated plan information for 2021 should become available on October 1, in advance of Medicare’s Annual Election Period beginning October 15. Healthline.com will provide updated 2021 plan information once it is announced by the Centers for Medicare & Medicaid Services (CMS).
If you’re interested in enrolling in a Medicare Advantage plan in Kentucky, you can purchase one from any of the following private insurance companies. These are listed in order from highest to lowest Medicare Kentucky enrollment.
- Compcare Health Services Insurance Corporation
- Sierra Health and Life Insurance Company Inc.
- Arcadian Health Plan Inc.
- WellCare Health Insurance Company of Kentucky Inc.
- Anthem Insurance Companies Inc.
- Aetna Life Insurance Company
- United Mine Workers of America Health and Retirement
- University Health Care Inc.
- Highmark Senior Health Company
- UnitedHealthcare of Kentucky Ltc.
- C and O Employees’ Hospital Association
- Mutual of Omaha Medicare Advantage Company
- Signature Advantage LLC
Not all of these plans are available in all counties. Your options vary depending upon your county of residence.
Medicare eligibility depends on age or health status. To be eligible you must meet one or more of the following criteria:
- You must be age 65 or over.
- You must be younger than age 65 and have a qualifying disability.
- You must be any age and have end stage renal disease (ESRD). This means you have permanent kidney failure and require dialysis or a kidney transplant.
Your first opportunity to begin the Medicare enrollment process begins 3 months before your 65th birthday and continues for 3 months after. This is your initial enrollment period. At this time, it usually makes sense to at least enroll in Part A since you likely won’t need to pay a premium for it.
If you or your spouse continues working, you may choose not to enroll in Part B right away. In these cases, you’ll qualify for a special enrollment period later on.
There also is an open enrollment period every year during which you can enroll for the first time in a Medicare plan or switch plans if desired.
When you’re ready to enroll, it’s important to do your homework. If you’re considering Medicare Advantage, keep in mind that these plans come in a variety of plan designs with different costs and features.
You’ll want to make sure the plan you choose makes sense for you.
- Consider costs. How much are the premiums? How much will you pay out of pocket when you see a doctor or fill a prescription?
- Review the provider network. Check to make sure there are doctors and hospitals convenient to you. If you already have relationships with specific healthcare providers, see if they’re in the network, too.
- How is the plan structured? Will you need to select a primary care provider and get referrals to see specialists?
- See what other people are saying about their coverage. Look for reviews online or ask friends or acquaintances who have Medicare coverage what they like or don’t like about their plans.
These resources can be helpful if you’d like to learn more about your Medicare options:
When you’re ready to take the next steps, take time to further investigate your plan options. You can use the list above as a starting point for researching Medicare Advantage plans in Kentucky. Or you might consider working with an agent who has expertise in selling Medicare coverage who can help you understand which individual plans might best suit your needs.
If your initial enrollment period has already begun, you can fill out the online application on the Social Security Administration website. You can also apply by phone by calling 800-772-1213, or in person by visiting a local Social Security office.
The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products. Healthline Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. jurisdiction. Healthline Media does not recommend or endorse any third parties that may transact the business of insurance.