Finding Medicare Plans in Kentucky
Kentuckians have a variety of Medicare options to choose from, but finding the right coverage can be time consuming. We can help explore your options and find the coverage that’s right for you.
Who’s Eligible for Medicare Plans in Kentucky?
Medicare is a government-sponsored health insurance program for people 65 or older and some people under 65 with a qualifying condition. People generally first become eligible for Medicare once they reach 65 years of age. You may be eligible for Medicare under 65 if you have a qualifying disability or illness. Qualifying illnesses include End-Stage Renal Disease (ESRD) and Amyotrophic Lateral Sclerosis (ALS). You may also be eligible if you’ve been a recipient of Social Security Disability Insurance (SSDI) for 2 years.
In order to qualify, you must be a citizen or permanent resident, having lived in the US for the past 5 years. Additionally, you or your spouse must have worked at least 10 years in a job that contributed to your Medicare coverage through Social Security deductions.
We’re here to help if you have questions. Talk to a licensed insurance agent by calling the number above.
What Medicare Plans are Available in Kentucky?
Original Medicare Part A and Part B
Original Medicare is comprised of two parts:
Part A (Hospital Insurance) covers inpatient healthcare, like hospital care, hospice care, and nursing home care (as long as custodial care isn’t the only care needed).
Part B (Medical Insurance) covers outpatient healthcare, like ambulance services, durable medical equipment (walkers, canes, blood sugar monitors, etc.), and mental health care. Part B also covers some preventive services, like flu shots, cardiovascular screenings, and diabetes screenings.
Original Medicare doesn’t cover everything; Medicare beneficiaries still pay a portion of their medical bills through coinsurance, copays, and deductibles. For this reason, different Medicare plans are available through Medicare-approved private insurance companies for different levels of coverage.
Medicare Advantage Plans (Part C)
Medicare Advantage plans, or Medicare Part C, offer an alternative to the coverage provided by Original Medicare Parts A and B. Medicare Advantage plans provide the same coverage as Original Medicare and can also provide additional coverage, like dental, vision, and prescription drug coverage. Medicare Advantage plans with prescription drug benefits are called Medicare Advantage Prescription Drug (MAPD) plans.
In order to enroll in a Medicare Advantage plan, you must first be enrolled in both parts of Original Medicare. If enrolled in Medicare Part C, you must continue paying your Part B premium in addition to your Part C premium. There are different Medicare Advantage plans in Kentucky, offering varying degrees of coverage.
For more information about Medicare Advantage plans, click here.
Medicare Prescription Drug Plans (Part D)
Medicare Prescription Drug plans, also referred to as Part D, are provided and coordinated by private insurance companies contracted with Medicare. These plans provide coverage for prescription medications, which are generally not included in Original Medicare or Medigap coverage. Any beneficiary can sign-up for Medicare Part D as long as they are eligible for Original Medicare, Part A and/or Part B and permanently reside in the service area of a Medicare Prescription Drug Plan. Medicare Prescription Drug coverage is optional, but if you don’t enroll in Part D as soon as you’re eligible, you might pay a late-enrollment penalty if you enroll later.
Medicare Part D coverage is available as a stand-alone Medicare Prescription Drug Plan, working alongside Original Medicare, or as part of a Medicare Advantage plan known as a Medicare Advantage Prescription Drug plan (MAPD).
Out-of-pocket expenses for prescription drugs and monthly plan premiums will vary from plan to plan. Each medication covered by a Medicare Prescription Drug plan has a set cost in the form of a co-pay or coinsurance according to a tiered system. Every Medicare Prescription Drug plan has a formulary for your reference, allowing you to pick the plan with the lowest cost for your prescription needs.
For more information about Medicare Prescription Drug plans, click here.
Medicare Supplement Plans (Medigap)
Medicare Supplement, or “Medigap”, plans are designed to fill the gaps in coverage left by Original Medicare Parts A and B. Medigap plans work alongside Original Medicare to provide more comprehensive coverage. Medigap plans can reduce your out-of-pocket costs by helping pay for things that Medicare Parts A and B don’t cover, like coinsurance, deductibles, and copays.
For more information about Medicare Supplement plans, click here.
When Can I Enroll In A Plan?
Medicare Advantage and Medicare Prescription Drug Plans
You are first eligible to sign up for Medicare plans in Kentucky during your Initial Enrollment Period (IEP). Your IEP starts three months before your 65th birthday month and continues for an additional three months. This means you have a total of seven months to enroll.
Then you are able to adjust your Medicare Advantage or Medicare Prescription Drug coverage during the Annual Election Period (AEP). This period occurs once per year, from October 15th to December 7th.
Key Fact: The General Enrollment Period (GEP) allows you to enroll in Original Medicare if you missed your IEP. This period occurs from January 1st to March 31st every year. Immediately following this period, you’ll be able to select a Medicare Advantage plan from April 1st to June 30th each year.
Medicare Supplement Plans
Once you’ve enrolled in both parts of Original Medicare (Parts A and B), you can select the Medigap plan of your choice during your Medigap Open Enrollment Period. This 6-month period begins the month you are both 65 or older and enrolled in Medicare Part B.
Important Note: If you fail to enroll in a Medigap plan during your Medigap Open Enrollment Period, you’re subject to higher premiums or denial of coverage entirely.
Special Enrollment Periods
Some major life changes, like moving into a new coverage area or transferring to or from a care facility, are qualifying life events for a Special Enrollment Period (SEP). An SEP allows you to enroll or make changes to your coverage outside of the standard enrollment periods. Our licensed insurance agents can help determine your eligibility for a Special Enrollment Period.
How Can I Compare Plans?
Our goal is to make it easy for you to explore explore your options and select the right coverage. You can compare plans online and enroll by using the form below, or by calling us to speak with a licensed insurance agent.
Additional Medicare Resources in Kentucky
The State Health Insurance Assistance Program (SHIP) provides free, confidential, and unbiased counseling and resources to Medicare beneficiaries in Kentucky, their representatives, and soon-to-be Medicare beneficiaries.
Kentucky’s Medicare Savings Program provides financial assistance for Medicare beneficiaries whose income falls below a certain level to help pay for medical expenses, like premiums and deductibles.
Sources: Medicare.gov; chfs.ky.gov