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.
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, medical supplies, and preventive care.
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 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.
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 (Part C) are full replacements for original Medicare.
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.
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.
Medicare eligibility depends on age or health status. To be eligible you must meet one or more of the following criteria:
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.
This article was updated on November 13, 2020, to reflect 2021 Medicare information.
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