Introduction to Medicare Part C in Kentucky (Medicare Advantage)

Were you aware that Original Medicare (Parts A and B) doesn’t cover all of your doctor and hospital expenses? The services it doesn’t cover – known as coverage gaps – can become very expensive over time if you don’t protect yourself with a Medicare supplemental insurance plan. Thankfully, there are a variety of such plans which exist for you to choose from. One such plan is called Medicare Advantage (Medicare Part C). It effectively replaces your current federal Medicare benefits with private health insurance coverage designed to mimic what you would normally get from Original Medicare.

Federal Regulations for Medicare Advantage

To ensure that you receive the federal Medicare benefits which you are entitled to as a retired US citizen, federal laws closely regulate Medicare Advantage policies. At the very least, your Advantage policy will include the same coverage and benefits as Medicare Parts A & B. It will also likely include additional benefits to protect against coverage gaps. Furthermore, many plans include Part D prescription drug coverage, among other ancillary benefits.

Medicare Advantage Enrollment In Kentucky

Nearly one-quarter (24%) of Medicare recipients in Kentucky have signed up for a Medicare Advantage program. All things considered, that’s a fairly significant number of seniors. Below, you can take a look at a chart which breaks down that 24% into the types of Advantage plans which Kentucky seniors are investing in:

Plan Type Enrollment Percentage
HMO Plans 59%
Local PPO Plans 13%
Special Needs Plans 11%
Regional PPO Plans 9%
Private Fee-For-Service Plans 5%
Other (Cost Plans, MSA’s, etc.) 3%

Plan Coverage & Cost

The fact that you live in Kentucky, as opposed to somewhere like Delaware, will significantly influence how much you pay for your monthly premium. If you are older, and/or enrolled in Medicare after you turned 65, it might make your plan more expensive. To get an idea of what you might be expected to pay, take a look at the estimates below:

Most Popular Medicare Advantage Plans in Kentucky

Your personal finances and medical needs will determine whether an HMO, PPO, or other type of Medicare Advantage plan is right for you. More restrictive plans, such as HMOs, will cost you less but also limit your access to medical care. More expensive plans, on the other hand, will let you see many different doctors and facilities. It all depends on your individual needs.

Helpful Medicare Advantage Tips & Tricks

Drug, Vision and Dental Coverage

While the provider network system might seem like too much of a hassle, the comprehensive coverage provides a positive trade-off for some seniors. Most other supplement insurance policies require you to purchase ancillary coverage, Such as Part D or vision benefits, separately. But you can put all of those and more onto the same Medicare Advantage plan. This puts all of your coverage under one, single, streamlined plan. Just remember that the more coverage you add, the more you will have to pay each month.

Enrollment Options & Best Time To Enroll

Unlike other supplements, it can be trickier to get covered under a Medicare Advantage plan. Because your provider is a private insurance company, they have the right to gather information about your current health status and evaluate whether or not they can afford to insure you. The closer you are to age 65, the easier it will be to avoid rejection. But if you have ESRD (End Stage Renal Disease) or other serious medical conditions, you may be denied. For more information, you can consult your state department of insurance, or visit our Medicare Advantage Enrollment Options page.

  • Initial Enrollment Period: 6-month timeframe when you first enroll in Medicare to purchase a Medicare Advantage plan.
  • Annual Enrollment Period (AEP): This timeframe runs from October 15th through December 7th every year, and during this time you can change or cancel your Medicare Advantage and part D drug plan.
  • Special Enrollment Period (SEP): During special circumstances, you may be eligible to purchase/change a plan outside of the Annual Enrollment Period. Things such as moving out of the plans’ service area, losing group health or employer coverage, a company no longer offering plans in the area, etc. are all events that could trigger a SEP.

What Medicare Advantage Plan Is Best For Me?

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