Once you reach the age of 65, the odds are good that your medical needs will begin to increase. You may need to visit the doctor more often, receive more outpatient care, and you may even require an occasional hospital visit. However, for most people on a fixed or retired income, meeting these medical needs can be financially stressful. For this reason, the federal Medicare program exists. The base of the program, Parts A and B, cover the increasing need for doctor’s visits and hospital stays for elderly individuals who enroll in the program.
Coverage and Benefits
The program is designed to keep costs down while covering most of what retirement age individuals require to maintain good health. Part B, which covers things like doctor office visits and outpatient treatment, has a fixed monthly premium, as well as a yearly deductible for all enrollees. Part A might be free if you have a 10-year employment history (a total of 40 quarters in all). However, if your cumulative work history amounts to less than that, you may have to pay additional fees for Medicare Part A and its associated hospital visit coverage.
Once you qualify for Medicare, you will have a big decision to make: do you accept Part A benefits only, or do you accept and pay for Parts A and B together? Sometimes, Part B coverage is optional. This includes things like doctor visits, outpatient procedures, and certain medical supplies. Part A coverage, on the other hand, is reserved for hospital treatments and end-of-life care.
Beyond Medicare Parts A & B, your ability to reject Part B benefits may be compromised depending on what other types of coverage you need. People who need many different types of coverage sometimes choose a Medicare Advantage (Part C) plan instead. These plans, however, take away the optional nature of Part B. You will receive those benefits no matter what. You will also have to buy Part B coverage if you instead decide to stay with Original Medicare but want to purchase Part D prescription coverage.
|Medicare Part A (Hospital Coverage)
||Medicare Part B (Medical Insurance)
|Medicare Part C (Medicare Advantage)
||Medicare Part D (Drug Coverage)
What Type of Medicare do Kansas Residents Have?
There are 448,215 Kansas citizens 65 or older currently taking advantage of the Medicare Program. A modest 13% of those (or 58,267 individuals) have effectively replaced their Original Medicare (Parts A and B) with a Medicare Advantage policy. And additional 44% (or 196,048 beneficiaries) have chosen to supplement their Medicare with a Medigap policy (we’ll talk more about those later). Finally, the remaining 43% (192,732 people) have either decided to hold off on supplementing their Medicare coverage, or have some other form of supplement policy, perhaps through an employer.
Are you enrolled in Medicare yet? You can’t start looking for a Medicare supplement until you are. For more information, click the link above.
Why Should Kansas Residents Supplement Medicare?
Well, the issue goes beyond just Kansas. Anyone age 65 or older who has successfully enrolled in Medicare Parts A and B should seriously consider supplementing their Medicare coverage. As comprehensive as the plan tries to be, it doesn’t quite cover everything. And the things it doesn’t cover can cause you some serious financial trouble if you aren’t prepared to pay for:
|Medicare Part A Costs||Medicare Part B Costs|
If you are relatively new to the Medicare program and are already in fairly good health, you may not think that a supplement policy is necessary. That may be true for now, but you can’t predict what sort of health problems may develop later on down the road. Most prefer to put such worries at ease with either a Medicare Advantage plan, or a Medigap policy. We’ll go into the pros and cons of each plan now.
The rolling prairies of Kansas make this state a beautiful place to live, even in the face of rising healthcare costs. Senior citizens are especially vulnerable to these rate hikes because they no longer have a steady income, but their health care needs are constantly increasing. Some companies have stepped in to try and help seniors manage their health care costs during their retirement years. These companies sell different forms of Medicare supplement insurance to protect you from coverage gaps.
Yes, there are many gaps in traditional Medicare coverage which can become very expensive if you are not careful. There are gaps in both Part A, and Part B of Original Medicare. Extended hospital stays, blood transfusions, and mounting coinsurance payments are just a small part of those gaps. But they can take a large chunk out of your savings if you do not protect yourself against them.
Thankfully, these Medicare supplement plans are an affordable solution to taking on these massive expenses on your own. You can purchase a policy which protects you from the gaps in coverage alone, or you can go for something more complex which offers you additional coverages. Depending on your personal circumstances, when plan maybe better than the other. It’s up to you to make the decision.
The predominant players in the Medicare supplement insurance industry are either Medigap policies or Medicare Advantage plans. With Medicare Advantage, you purchase a private policy from a health insurance provider who promises to give you at least the same benefits you would get from Parts A and B of Original Medicare. Medigap supplement insurance, on the other hand, only covers the gaps in Original Medicare. But because these plans cover less, they are easier to understand and they tend to have a lower price tag, too.
Kansas Medigap Plans
“Medigap” policies are the ten government-approved Medicare supplement insurance policies designed to protect you from the costly “gaps” in your Medicare benefits (hence Medi-“gap”). Plans A, B, C, D, F, G K, L, M and N are available in all 50 states, including Kansas, and each plan provides the exact same benefits as outlined in the table below. The only thing that varies are cost, and provider. Otherwise, each plan is exactly the same, regardless of your location.
Top Medicare Supplement Plans in the Area
|Type||Starting From||Part A Deductible||Part B Deductible||Excess||Nursing||Travel|
|F||$127||$0||$0||100% Covered||100% Covered||100% Covered||Request Info|
|C||$99||$0||$0||Not Covered||100% Covered||100% Covered||Request Info|
|G||$100||$0||$147||100% Covered||100% Covered||100% Covered||Request Info|
|B||$108||$0||$147||Not Covered||Not Covered||Not Covered||Request Info|
|N||$89||$0||$147||Not Covered||100% Covered||100% Covered||Request Info|
|D||$116||$0||$147||Not Covered||100% Covered||100% Covered||Request Info|
|A||$130||$1||$147||Not Covered||Not Covered||Not Covered||Request Info|
|L||$81||$304||$147||Not Covered||75% Covered||Not Covered||Request Info|
|K||$55||$608||$147||Not Covered||50% Covered||Not Covered||Request Info|
|M||$105||$608||$147||Not Covered||100% Covered||100% Covered||Request Info|
Kansas Medicare Advantage Plans
Medicare Part C, which is more commonly referred to as Medicare Advantage, is another form of protection against the expensive gaps in Traditional Medicare coverage. By law, each Medicare Advantage (MA) policy has to give you the exact same benefits as Traditional Medicare. Some plans offer even more, such as vision, dental, or prescription drug coverage, in order to bring in more clients. But once you sign up for your MA plan, you transfer power from the federal government over to a private health insurance company with respect to your medical needs and benefits.
Those who sing the praises of MA admire the simplicity of only having to deal with one single company, as opposed to both a Medicare supplement insurance agency and the federal government. However, make sure that your current doctor (or doctors) are also a part of any MA network you might want to sign up for before purchasing a policy. Many HMO and PPO Medicare Advantage networks are restricted, and you might end up switching doctors if you don’t do your homework first.
Not sure whether you need a Health Maintenance Organization (HMO) or a Preferred Provider Organization (PPO)? The Medicare Advantage plan you choose will be a significant determining factor, among other things.
Comparing Medicare Advantage and Medigap Side-by-Side
The biggest difference is the amount of coverage you can get with each plan. Not only will Medicare Advantage offer you the same benefits as Medicare Parts A & B, but you can add things like prescription drug coverage, gap coverage, dental, or vision. Of course, as with any insurance policy, the more coverage you buy, the more you have to pay each month. Things become more expensive still the more you use it. Medigap is much simpler: it covers some or all of the coverage gaps of Original Medicare, and charges you one low monthly fee for your trouble. Unfortunately, prescription drug coverage is separate.
For certain seniors, Medigap policies have several advantages. Even the most basic plans will protect you from tens of thousands of dollars in costs you may incur from the gaps in Part A. With Part B, the more comprehensive plans take care of co-pays, coinsurance, and monthly premiums. You can even get benefits for foreign travel medical care. And all of this only requires one monthly premium.
Conversely, things are very different with a Medicare Advantage plan. These packages start with the same benefits you would get from Medicare Parts A and B. From there, you have the option to add coverage which will protect you from Medicare’s gaps. Even further still, you can add insurance to protect your eyes, ears, and teeth. Prescription drugs coverage is separate, but can be added to the same policy.
Just keep in mind that larger, more comprehensive insurance policies will naturally cost you more money. With Medicare Advantage, this isn’t just a more expensive monthly premium – this can also increase your costs as far as coinsurance, co-pays, and other out-of-pocket expenses are concerned. Furthermore, there are fewer guarantees that you will remain covered as you age and your health care needs begin to change. Lastly, Medicare Advantage plans are not as widely accepted by doctors or medical facilities as Medigap insurance. All of these factors must be carefully considered before you make such a substantial purchase.
We are sure you probably have more questions. We are here to help. Feel free to contact one of our representatives. They have the information you need to make the best decision possible and to find you an affordable quote for a Medigap policy in your area.
It’s hard to say which form of coverage is the superior policy. What works well for some might be too complicated or expensive for another. Below, our Frequently Asked Questions will highlight exactly how Medigap and Medicare Advantage are different from one another:
|Questions||Medicare Advantage||Medicare Supplement|
|How are expenses covered under each plan?||For the most part, the government will pay a large chunk of your premium. Any remaining unpaid premiums, deductibles, or other typical insurance expenses will be your burden||You will need to pay a low monthly premium. You may also need to pay for certain amounts of coinsurance or co-pays assuming you purchase a less comprehensive plan|
|Will I still have to pay for Part B?||Yes||Yes|
|What will it cost me?||The more you use your insurance, the more it will cost you. It may start out more affordable if the government pays for 100% of your monthly premium; but doctor visits, hospital treatments, and medical supplies could send your costs going up from there||For starters, you will have to pay a monthly premium which many seniors find affordable. Comprehensive plans like Plan F pay for your Medicare deductibles and coinsurance; less comprehensive plans may leave those expenses up to you|
|What will the plan cover?||Optional coverages include dental, prescriptions, vision, and Original Medicare gap coverage. At the very least, however, you will get the exact same coverage as you would with Medicare Parts A & B||Medigap policies are targeted to protect you from the gaps in your Medicare coverage. They don’t provide dental, vision, or prescription drug coverage|
|Is it easy to budget my health care expenses?||It can be difficult to budget on a Medicare Advantage plan if you have high maintenance healthcare needs||A Medicare supplement insurance policy makes budgeting easier. You know you’ll have to pay the same low premium each month, and you’ll know how much your other premiums, co-pays, and coinsurance expenses will be based on the coverages your policy offers|
|Is my plan guaranteed? Or can it be cancelled?||Your provider may cancel your coverage at any time at their discretion. They can also change your rates whenever and by however much they feel appropriate||Your coverage can only be cancelled if you no longer qualify for Medicare, if you stop paying your premiums, or if your provider becomes financially unstable|
|Do I have to clear a pre-approval or pre-certification process?||You will be pre-screened by the private insurance companies standards, and you may be rejected if they think you will be too expensive to cover||Any senior who qualifies for Medicare benefits will automatically qualify for a Medigap policy|
|Am I limited to specific doctors or hospitals?||Medicare Advantage is sometimes more affordable in large cities because the restrictive networks limit care to only the most affordable doctors and hospitals||Medigap insurance is universally accepted wherever you can get medical care via Medicare|
|What type of plan is best for me?||Recently retired city-dwellers with reasonably good health can be expected to save a decent amount of money with a Medicare Advantage plan||If you don’t live in a high density population area, if your health care needs are more demanding, and if you are farther along in years, you may want to look more closely at a Medicare supplement insurance policy like Medigap|
Resources for Kansas Medicare Beneficiaries
We’ve included a directory of Medicare supplement resources and contact information below relevant to all Kansas residents. Managing your health care needs is a highly complicated and personal issue. This article alone can give you helpful and informative knowledge, but it cannot answer all of your questions. Contacting the offices and agencies below, however, can also help:
Choose at least one topic area you are interested in: Select All
Help with my Medicare options & issues
Other insurance programs
Complaints about my care or services
General health & health conditions
Claims & billing
Health care facilities & services in your area
Important Medicare-Related Healthcare 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.