Any retirement-age individual 65 years or older has the option to enroll in the Medicare program sponsored by the federal government. It is possible to put off enrollment until sometime after age 65, but doing so might lead to fees and financial penalties later on down the road. Enrolling in Medicare at the appropriate time ensures that you will receive Medicare Parts A and B at the lowest possible cost. Parts A & B, also known as Original Medicare (or Traditional Medicare), help to cover many of your basic health expenses during your golden years. See the table below for specifics on what benefits Part A and B offer.
Coverage and Benefits
The Medicare program is designed to be as low-cost as possible so that you can receive quality care once you retire and begin living on a fixed income. The specific prices for Part B can be found here, which include a monthly premium and an annual deductible. Part A is usually free, assuming you have a significant work history (at least 10 years or 40 quarters will be enough). Anything less than that, however, and you will likely have to pay a premium before you will start receiving Part A Medicare benefits.
Did you know that you do not have to accept all of your Medicare benefits once you qualify? For some people, Part A benefits are sufficient. Many seniors out there have other ways to pay for doctor visits, outpatient care, and medical necessities (Part B benefits) and/or prescription drugs (Part D benefits). If you don’t need prescription drug coverage or a Medicare Part C plan, then you have the option to reject Part B coverage, as well.
Obviously, the opposite of the scenario above is true: if you decide to purchase Part D prescription-drug benefits, or if you decide to purchase a Medicare Part C insurance plan, you will have to accept and pay for Part B benefits in one way or another. With prescription Part D coverage, accepting and paying for Part B benefits is mandatory; otherwise, you will be ineligible for Part D coverage. with Medicare Part C, health insurance benefits which are identical to Medicare Part B will be included as part of your base package.
|Medicare Part A (Hospital Coverage)
||Medicare Part B (Medical Insurance)
|Medicare Part C (Medicare Advantage)
||Medicare Part D (Drug Coverage)
Kentucky Medicare and Supplement Insurance Programs
In Kentucky, there are 793,271 Medicare beneficiaries right now. Of that grand total, nearly a full one-fourth (24%) are enrolled in a Medicare Advantage program of their choosing. A comparable 21%, or 166,587 people, are supplementing their Original Medicare via Medigap supplement insurance. The remaining 436,299 beneficiaries, or 55%, have neither Medigap nor a Medicare Advantage policy. Either they have an employer-sponsored alternative, or they are satisfied with Original Medicare by itself.
Of course, you can’t start shopping around for a Medicare supplement policy before you enroll in Medicare Parts A & B. Feel free to click that link if you are unsure of your Medicare enrollment status.
Should Kentucky Residents Look Into a Medicare Supplement Policy?
Just for clarification, supplement insurance is completely optional. There are no state or federal laws which say you have to supplement Original Medicare with additional coverage. However, it may be in your best interests to at least strongly consider doing so. Original Medicare isn’t perfect – there are gaps in its coverage and benefits which, if left unchecked, could leave you with hundreds or even thousands of dollars in the following expenses:
|Medicare Part A Costs||Medicare Part B Costs|
There are many wonderful things about living in Kentucky – rising healthcare costs, unfortunately, isn’t one of them. As a senior citizen, your health care costs will become more expensive as you get older. This is an unfortunate fact of life. Conversely, the amount of money you have available to spend on your care will shrink year after year. In order to get the most affordable healthcare possible, you’re most likely going to have to invest in a supplemental insurance plan for your Medicare coverage.
Yes, your Medicare benefits are extensive and cost-saving. Unfortunately, there are some very expensive medical needs which Medicare will not cover. For those costs, if you don’t purchase some form of Medicare health insurance supplement, you’re going to be responsible for them yourself. They can amount to tens of thousands of dollars of dead or more, usually in the later years of your life when you can afford at the least.
But don’t worry – many of these plans are highly affordable and provide effective coverage for the inherent gaps in Medicare. Different plans offer different benefits. Some only concern themselves with coverage gaps in Medicare Parts A & B in order to keep their premiums affordable. Other packages may completely replace your Medicare benefits, but offer you more coverage in return – for a price, of course. Depending on your needs, one of these plans could be better for you than the other.
In order to protect your savings and supplement your Medicare coverage, your best bets are either Medicare Part C, which is also referred to as Medicare Advantage; or a Medigap policy, which is the short name for a Medicare supplement insurance plan. Both policies have their own advantages and disadvantages. This is because they are designed to meet the very different needs of millions of seniors across the US. Below, we’ll discuss each policy in detail and show you why these plans are so popular.
Medigap Policies Available in Kentucky
The federal government has reviewed and approved 10 different supplement policies for covering the gaps in Traditional Medicare. Each plan is assigned its own letter: A, B, C, D, F, G, K, L, M, and N. Because Medicare is the same in all 50 states, so are the Medigap supplement plans. Plan N in Kentucky will give you the exact same benefits as it would if you lived in Hawaii. The price may be different in your area, and the provider might change also. But those are the only real differences from state to state.
Top Medicare Supplement Plans in the Area
|Type||Starting From||Part A Deductible||Part B Deductible||Excess||Nursing||Travel|
|F||$108||$0||$0||100% Covered||100% Covered||100% Covered||Request Info|
|C||$112||$0||$0||Not Covered||100% Covered||100% Covered||Request Info|
|G||$110||$0||$147||100% Covered||100% Covered||100% Covered||Request Info|
|B||$93||$0||$147||Not Covered||Not Covered||Not Covered||Request Info|
|N||$82||$0||$147||Not Covered||100% Covered||100% Covered||Request Info|
|D||$98||$0||$147||Not Covered||100% Covered||100% Covered||Request Info|
|A||$68||$1||$147||Not Covered||Not Covered||Not Covered||Request Info|
|L||$80||$304||$147||Not Covered||75% Covered||Not Covered||Request Info|
|K||$53||$608||$147||Not Covered||50% Covered||Not Covered||Request Info|
|M||$107||$608||$147||Not Covered||100% Covered||100% Covered||Request Info|
Kentucky Medicare Advantage Plans
According to statistics, Medicare Advantage (MA for short) is slightly more popular in Kentucky than Medigap insurance. That may have to do with simplicity, since MA requires that you only deal with one single entity (a private health insurance company). MA plans essentially transfer control and responsibility of your Medicare benefits from the government to a private company. Sometimes, this may yield additional benefits, like prescription drugs, at a slightly higher cost. You will never receive fewer benefits from MA, though, because that is against the law.
One quick word of advice: before you sign the dotted line on a MA policy, look carefully into the HMO or PPO network your plan relies on. Sometimes, the reason MA is the cheaper option is because they restrict their network of providers to a limited number of physicians. If keeping your current doctor is important to you, then make sure that doctor is a member of your MA plan’s network before switching.
FYI: HMO stands for “Health Maintenance Organization” and PPO is short for “Preferred Provider Organization”.
Specific Differences in Medigap and Medicare Advantage
Medicare Advantage and Medigap cover very different things. Medicare Advantage policies are usually much larger and more complex than a simple, streamlined Medigap insurance plan. At the same time, however, Medicare Advantage gives you the option to add coverages to your policy which Medigap won’t. Not all seniors need this extra coverage, though. And if you don’t require the comprehensive coverage offered by Medicare Part C, you’ll have the chance to save a lot of money by paying one low monthly premium for Gap coverage from a Medicare supplement insurance plan.
When it comes to a Medigap policy, you are only paying for the coverage gaps which already exist in Medicare Parts A & B. Some smaller plants, like Plan A, restrict themselves to covering holes in Part A coverage – such as extended hospital stays or blood transfusions. Comprehensive plans like Plan F can include many more benefits, including premium payments, coinsurance, and potentially some foreign travel medical insurance.
Medicare Advantage gives you more options than most of the 10 plans available from Medigap insurance providers. However, sometimes the amount of choice can be overwhelming. These policies start by offering the same exact coverage Medicare Parts A & B do – gaps and all. Adding extra coverage which provides for these gaps may cost you extra. So will options such as prescription drugs, dental, and/or vision. However, in certain areas, you can still save a lot of money with a large, cumbersome Medicare Advantage plan.
At the end of the day, it all comes down to what you need. Some seniors may need additional coverages such as dental or vision; others may have perfect vision or not require much dental care. Some seniors may live in a large city where the restrictive Medicare Advantage networks won’t make a difference; Others may live in more sparsely populated areas where this lack of choice is detrimental to their health. still others may find comfort in the guarantees that come with a Medigap policy. Medicare Advantage plans aren’t quite so secure.
If you have more questions, we certainly understand. These things can be very confusing, and it’s important to know you’re making the right decision. Our helpful customer service operators are standing by to take your call right now. And if you act fast, they can help you find the most affordable insurance quotes for Medigap and other insurance policies in your area.
There are some pretty important differences between Medigap and Medicare Advantage that every consumer should be aware of before they buy. Consult the following table for examples:
|Questions||Medicare Advantage||Medicare Supplement|
|How are expenses covered under each plan?||Assuming cost in your area are relatively low, the government May pay for most or all of your monthly premium. You may still be responsible for co-insurance or co-pays||Most plans only require you to pay a low monthly premium. The more comprehensive your plan is, the less you will have to spend on co-pays, coinsurance, and Medigap Parts A & B premiums|
|Will I still have to pay for Part B?||Yes||Yes|
|What will it cost me?||The cost of your Medicare Advantage plan will rise depending on how many times you visit a doctor or Hospital. The more frequently you get medical care, the more money you will have to pay||The more comprehensive your plan, the less it will cost you. For a plan as comprehensive as plan F, for example, you only pay your monthly premium – extra expenses like coinsurance or co-pays will be taken care of|
|What will the plan cover?||At the very least, you will get the exact same coverage as Medicare Parts A & B. You have the option to aDd gap coverage to those. You can even go further and add prescription drugs, dental, and/or vision||You cannot add vision, dental, or prescription drug coverage to a Medigap policy. But it will cover all of the gaps in Medicare Parts A & B coverages for a low monthly premium|
|Is it easy to budget my health care expenses?||That depends on the amount of care you need. If you know how much care you will need and when you will need it, you can still budget fairly efficiently – although Emergency Care will get very expensive, very quickly||The ease of budgeting goes up with the number of benefits your plan provides. Some plans are so comprehensive that you only have to budget for your monthly premium – that’s it!|
|Is my plan guaranteed? Or can it be cancelled?||Unfortunately, like almost all private health insurance plans, there are very few guarantees with Medicare Advantage. Your provider has a lot of authority when it comes to cancelling your coverage||Your coverage will only be cancelled if you stop paying your premiums, or if the company goes out of business. Outside of those scenarios, your coverage is guaranteed|
|Do I have to clear a pre-approval or pre-certification process?||Pre screens are mandatory for almost all Medicare Advantage plans, and you may be rejected if you do not measure up to their standards||Assuming you already qualify for Medicare, then you are automatically pre-approved for a Medigap policy|
|Am I limited to specific doctors or hospitals?||Yes, there are restricted networks in most Medicare Advantage plans. This does keep costs low, but may restrict the quality of care you get or force you to travel long distances to get it||Just like Medicare, Medigap insurance is accepted just about everywhere|
|What type of plan is best for me?||If you are an above-average health for your age, if you have many different medical choices near you, and if you need extra forms of coverage, a Medicare Advantage plan may work better for you||Living in rural areas, being older, and having known health issues could make you an ideal candidate to save money with a Medicare supplement insurance policy|
Kentucky Residents Can Learn More Here
Managing your health care needs can be a daunting task. This article can only teach you so much. If you still have questions – and it’s likely that you do – you can contact the experts below for more information (or consult the Medicare insurance experts in your state). The more you learn, the better your eventual decision will be.
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Important Medicare Terms
- HMO: Health Maintenance Organization, this refers to a network of doctors and hospitals with a plans’ network.
- PPO: Preferred Provider Organization, this refers to a network of doctors and hospitals with a plans’ network.
- Co-Pay: Amount of money charged per visit to doctor, specialist, etc.
- Co-Insurance: A percentage required by the policyholder to pay out-of-pocket. For example, 80/20 coinsurance means the insurance company will cover 80% of the charges, and the policyholder pays the remaining 20% of the charges.
- Deductible: This is the amount of money required out-of-pocket by the policyholder before the insurance will kick-in and pay for any remaining charges. For example, a policy with a $1,000 deductible means that you must pay full healthcare costs out-of-pocket up to $1,000 before the plan will start coverage.