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.
The Centers for Medicare & Medicaid Services (CMS) reported the following information on Medicare trends in Kentucky for the 2021 plan year:
- A total of 942,126 residents of Kentucky are enrolled in Medicare.
- The average Medicare Advantage monthly premium decreased in Kentucky compared to last year — from $21.07 in 2020 to $17.07 in 2021.
- There are 98 Medicare Advantage plans available in Kentucky for 2021, compared to 81 plans in 2020.
- All Kentucky residents with Medicare have access to buy a Medicare Advantage plan, including plans with $0 premiums.
- There are 12 different Medigap plans offered in Kentucky for 2021.
Medicare is more than just a single health plan. It’s made up of different parts.
Together, parts A and B are what’s known as original Medicare. These are the parts you get from the federal government.
- 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, certain medical supplies, and preventive care.
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.
Medicare Advantage in Kentucky
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. Medicare Advantage (Part C) plans are full replacements for original Medicare.
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:
- Aetna Medicare
- Anthem Blue Cross and Blue Shield
- Lasso Healthcare
Not all of these plans are available in all counties. Your options vary depending on your county of residence or ZIP code.
Medicare supplement plans in Kentucky
Medicare supplement (Medigap) plans are designed to fill in the gaps from original Medicare. Medigap plans may help cover out-of-pocket costs such as copays and coinsurance.
You can purchase a Medicare supplement plan from a private insurance company in addition to your original Medicare coverage. In 2021, some of the companies offering Medigap plans throughout Kentucky include:
Medicare eligibility depends on age or health status. To be eligible you must meet one or more of the following criteria:
- be age 65 or over
- be any age and have a qualifying disability
- be any age and have end stage renal disease (ESRD) and amyotrophic lateral sclerosis (ALS)
When can I enroll in Medicare Kentucky plans?
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.
Tips for enrolling in Medicare in Kentucky
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:
More than 900,000 Kentucky residents are enrolled in Medicare. There are several private insurance companies offering various types of Medicare Advantage and Medigap plans throughout the state. There are also several Medigap plan options if you live in Kentucky and are looking for additional coverage.
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.