Medicare in Kentucky
Key Takeaways
- Original MedicareOriginal Medicare is a fee-for-service health insurance program available to Americans aged 65 and older and some individuals with disabilities. Original Medicare is provided by the federal government and is made up of two parts: Part A (hospital insurance) and Part B (medical insurance). in Kentucky is an option at age 65. It features hospital and medical coverage with the option of adding drug and supplemental coverage (called Medigap).
- Medicare AdvantageMedicare Advantage (Medicare Part C) is health insurance for Americans aged 65 and older that blends Medicare benefits with private health insurance. This typically includes a bundle of Original Medicare (Parts A and B) and Medicare Prescription Drug Plan (Part D). in Kentucky (Part C) replaces Original Medicare (Part A and B) but offers the same Part A and B benefits and coverages as Original Medicare. Along with Part A and B benefits, Medicare Part C often bundles additional services like dental, hearing, vision, and prescription drug coverage.
- While 20% of Medigap plans available to Original Medicare beneficiaries offer the protection of an out-of-pocket maximum, all Medicare Advantage plans feature an out-of-pocket maximum.
The Kentucky Derby, the crown jewel of horse racing and a crowning achievement for the state of Kentucky, evokes images of patrons in playful attire sipping mint juleps on a sparkling spring day.
But conditions aren’t always idyllic, and down on the track, the horses that can adapt to the changing climate have a leg up.
It’s much the same with health insurance. No one has any concerns about their plan when the sun is shining on them, but are you prepared for the rainy days? GoHealth is here to get you on track with Medicare in Kentucky.
Who Qualifies for Medicare in KY?
If you’re a U.S. citizen and are age 65 or older, you qualify for Medicare in Kentucky. It’s as simple as that.
Medicare is a federal program that provides affordable healthcare for older Americans nearing retirement.
You’re also eligible regardless of your age if:
- You have End Stage Renal Disease or Lou Gehrig’s disease (also known as Amyotrophic Lateral Sclerosis or ALS).
- You have received 24 monthly payments of Social Security Disability Insurance or Railroad Board benefits.
Medicare Advantage in Kentucky offers an alternative. Medicare Advantage (also known as Part C) replaces Original Medicare while offering the same coverages as Part A and B and bundling Part D and supplemental coverage along with benefits like dental and vision coverage.
Let’s find your ideal Medicare Advantage plan.
How Do I Apply for Medicare in KY?
Your choices for applying for Medicare in KY include:
- Enrolling online with the Social Security Administration.[i]
- Enrolling over the phone at 1-800-772-1213 (TTY: 1-800-325-0778).
- Visiting a local Social Security office.
What Is the Income Limit for Medicaid in KY?
It depends on who you are.
Each state has its plan for administering Medicaid, a federal/state program founded alongside Medicare in 1965 that helps those facing a financial need and/or disability regardless of age. Kentucky offers coverage for the youngest of children to the oldest of adults. Those aged 19 and up are eligible if their income is 138% or less than the Federal Poverty Level, but some programs for children expand coverage up to 218% of the Federal Poverty Level.
Find the Medicare Advantage plan that meets your needs.
What is the Most Common Medicare Supplement Plan?
Medicare supplement plans, also known as Medigap plans, are available to people enrolled in both Parts A and B of Original Medicare and help fill in coverage gaps. All 10 of the standard Medigap plans offered by private insurance companies are available in Kentucky. However, different insurers may charge different rates for the same plans based on a variety of factors. Medigap should be added in the six months after your Original Medicare coverage begins to ensure eligibility without medical questions.
All 10 plans, lettered from Plan A to Plan N, cover 100% of Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits run out. All 10 also pay at least 50% of Part B coinsurance and copayments.
Each plan offers a specific mix of benefits, but just two of them (Plans K and L) protect you with an out-of-pocket maximum. Medicare Advantage plans, by contrast, are required to include the benefit of an out-of-pocket maximum.
Which Company Has the Best Medicare Advantage Plan?
Original Medicare can be used nationwide, while Medicare Advantage plans are usually aligned with a network of providers in your area. Since there are numerous Medicare Advantage plans, it is common for one or more to include your preferred doctor, and the network concept is among the reasons Medicare Advantage in Kentucky often offers affordable rates.
One way to compare Medicare Advantage plans is by their Medicare Star Rating. The Centers for Medicare & Medicaid Services assigns a rating of one to five stars (five being the best) to individual Medicare Advantage plans. If you’re already on a Medicare Advantage plan and it’s not five-star plan, you are offered the opportunity to switch to a five-star plan each year.
While the rating system can shed light on Medicare Advantage plans’ performance, it’s not as easy as just picking the highest-rated plan. A GoHealth licensed insurance agent, without obligation, can help you compare plans and find the one that’s the right fit for you.
Thousands of older adults enroll in Medicare every day across the United States. The latest CMS data shows that 899,546 people are enrolled in Medicare Part A and B in Kentucky. The total number of beneficiaries enrolled in Medicare Advantage increased from 334,472 to 384,748 year over year. Medicare Advantage participation in Kentucky went from 37.79% to 42.77% year over year. If you’d like to dive deeper into how Medicare in Kentucky breaks down across the state, we provide a glance at who is using Medicare and how.
899,546 Beneficiaries with Part A & Part B
384,748 Medicare Advantage Beneficiaries
42.77% Medicare Advantage Participation Rate
53.07% Female
46.93% Male
92.48% Non-Hispanic White
4.72% African American
0.65% Hispanic
2.14% Other/Unknown
22.69% Eligible for Medicaid
1.01 Average HCC Score
$9,791.83 Actual Per Capita Costs
18.97% Hospital Readmission Rate
29.18% % of Beneficiaries with an Emergency Department Visit
334,472 Medicare Advantage Beneficiaries, Previous Year
Increased Medicare Advantage, Year over year
37.79% Medicare Advantage Participation Rate, Previous Year
Table reflects the latest Beneficiary Demographics Data: Medicare Geographic Variation – by National, State & County
Average HCC Score: The Hierarchical Condition Category score gauges a population’s overall health. The score is based on a value of 1.0. Populations with an HCC score of less than 1.0 are considered relatively healthy. The score can be used to estimate health costs.
Ready for a new Medicare Advantage plan?
KY SHIP - Medicare counseling
https://www.chfs.ky.gov/agencies/dail/Pages/ship.aspx
What should I know about KY SHIP?
Residents can get free, unbiased Medicare advice through the State Health Insurance Assistance Program.
Senior Medicare Patrol
https://louisvilleky.gov/government/health-wellness/senior-medicare-patrol
What should I know about the Senior Medicare Patrol?
This program protects Kentucky residents already on Medicare against fraud.
Public Health Kentucky Prescription Assistance Program (KPAP)
Phone lines open M-F, 8:30 a.m. to 6 p.m.
https://www.chfs.ky.gov/agencies/dph/dpqi/hcab/Pages/kpap.aspx
What should I know about KPAP?
This state program offers assistance with prescription costs for Medicare beneficiaries in the “donut hole” among others.
kynect (Kentucky Medicaid)
https://kynect.ky.gov/s/?language=en_US
What should I know about the kynect?
The program, headed by the Kentucky Cabinet for Health and Family Services, helps guide residents through their Medicaid journey.
Nationwide Resources
Speak with a GoHealth insurance agent that is licensed in Kentucky about your Medicare questions.
Mon – Fri, 8 a.m. – 6 p.m. CT
Centers for Medicare and Medicaid Services
You can reach the Social Security Administration by phone for general questions. Not all questions can be answered over the phone.
Also, SSA.gov provides online resources for the following: Review information, apply for benefits, or manage your account online
1-800-722-1213
TTY 1-800-325-0778
Speak to SSA Representative, Monday – Friday, 8 AM – 7 PM ET
Medicare Learning Guides
Healthcare is personal. So is choosing insurance. If you are new to Medicare, a beneficiary researching options, or a caregiver, we have tailored Medicare Guides for you.
Before 65 Guide
Understanding health insurance before age 65, especially when considering early retirement
Medicare Plans Guide
Costs, coverage and enrollment details for each Medicare plan
Medicare Beneficiary Guide
For those currently enrolled in Medicare
Low Income and Medicare Guide
For individuals with a qualifying income status
A Caregiver's Guide
For individuals with a qualifying income status
Sources
- Apply for Benefits. SSA.gov.
- Social Security Office Locator. SSA.gov.
- Poverty Guidelines. HHS.gov.
- Medicaid & KCHIP. KY.gov.
- Medicaid Presumptive Eligibility Application Logging. KY.gov.
- Special Enrollment Periods. Medicare.gov.
This website is operated by GoHealth, LLC., a licensed health insurance company. The website and its contents are for informational and educational purposes; helping people understand Medicare in a simple way. The purpose of this website is the solicitation of insurance. Contact will be made by a licensed insurance agent/producer or insurance company. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. Our mission is to help every American get better health insurance and save money.
Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.