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Medicare in Kansas

October 6, 2016

Kansas residents with Original Medicare may have the option of alternative means of receiving their Medicare coverage from private insurance companies.  Private insurance companies offer a variety of Medicare plans, some of which may be available where you live.  Your options will depend on your zip code and county of residence and your personal preferences.

Original Medicare for Kansas beneficiaries

Original Medicare is the “original,” fee-for-service program that provides health insurance to adults 65 years and older and individuals under the age of 65 with disabilities. The program is administered by the federal government and works in the same way for all 50 states, including Kansas.

If you have Original Medicare, you are not restricted to receive care from designated health-care providers, inside or outside the state of Kansas.  Your out-of-pocket costs for care are generally, lower, however, if you receive Medicare covered services from a provider who accepts Medicare assignment (that is, a payment agreement with Medicare).  Therefore, it’s a good idea to always ask in advance of receiving care, if the provider accepts Medicare assignment.

Typically, you’re eligible for Medicare benefits if you’re either a United States citizen or a legal permanent resident of at least five continuous years and age 65 or older. You may qualify for Medicare before age 65 by disability; in this case, you automatically receive Medicare after 24 months of disability benefits. You may also receive Medicare, regardless of age, if you have end-stage renal disease (ESRD) or Lou Gehrig’s disease.

Original Medicare comes in two parts: Part A (hospital coverage) and Part B (medical coverage). Part A covers most inpatient care and services, including hospital and skilled nursing facility stays, hospice care, and short-term home health care. Part B covers outpatient care, such as doctor visits, preventive screenings, lab tests, and durable medical equipment.

Many Kansans receive Medicare Part A without a premium if  they’ve worked at least 10 years (40 quarters) and paid Medicare taxes during that time. Otherwise, they can still sign up and pay a monthly premium for Part A. Most people pay a premium for Part B coverage.

Not everything is covered by Original Medicare. You won’t be covered for:

  • Private-duty nursing
  • Custodial care, if it’s the only care you need
  • Long-term care
  • Prescription drugs
  • Vision care
  • Dental care
  • Dentures

Some of the above items may be covered through a Medicare Advantage plan offered by a private insurance company approved by Medicare, as discussed later in this article.

Kansas residents, like beneficiaries in other states, can enroll in Medicare Part A and/or Part B during the following periods:

  • Initial Enrollment Period (IEP): The Initial Enrollment Period is the seven-month period when most people are first eligible to enroll. It starts three months before you turn 65, includes the month you turn 65, and ends three months later.
  • General Enrollment Period (GEP): If you missed your Initial Enrollment Period, you can enroll in Part A and/or Part B during this annual enrollment for Original Medicare. The General Enrollment Period occurs from January 1 to March 31 every year. You may have to pay a penalty for Part A and/or Part B for not signing up when you were first eligible.
  • Special Enrollment Period (SEP): Outside the regular enrollment periods noted above, you may qualify for a Special Enrollment Period. For example, if you delayed Part B because you had other coverage (such as through an employer-sponsored group plan), you can enroll using an eight-month Special Enrollment Period when that group coverage or employment ends. Qualified individuals who enroll in Medicare during a Special Enrollment Period don’t have to pay a late enrollment penalty.

Medicare-eligible individuals can enroll in Original Medicare through Social Security. You can apply for Medicare at the same time that you apply for retirement benefits, or you can apply for Medicare only. You may submit your Medicare application:

  • Online at the Social Security website.
  • By phone at 1-800-772-1213. TTY users can dial 1-800-325-0778. Customer representatives are available Monday through Friday, from 7AM to 7PM.

Applicants who worked at a railroad should apply through the Railroad Retirement Board (RRB), by calling 1-877-772-5772; TTY users dial 1-312-751-4701. The RRB can be reached Monday through Friday, from 9AM to 3:30PM.

Medicare coverage options in Kansas

Kansas beneficiaries have alternative ways to receive their Medicare coverage.  Private insurance companies approved by Medicare also offer plans.  Some types of Medicare coverage, most notably prescription drug coverage (Part D), are only available through private insurance companies.

Listed below is a brief description of different types of Medicare insurance offered by private insurance companies contracted with Medicare in Kansas and nationwide.

  • Medicare Advantage (Part C) provides another way to receive your Original Medicare benefits. Private companies contract with the federal government to provide at least the same amount of coverage as Original Medicare Part A and Part B, with the exception of hospice care, which continues to be covered by Part A.  Some Medicare Advantage plans offer more coverage that Original Medicare through lower deductibles and coinsurances, for example it may include other benefits, such as routine vision, dental and/or prescription drug If you have Medicare Advantage, you must  continue to pay your Part B premium. You may have a separate premium you pay to your Medicare Advantage plan.
  • Medicare Part D is prescription drug coverage. If you have Original Medicare, you can receive Medicare prescription drug benefits by enrolling in stand-alone Medicare Part D Prescription Drug P Medicare Prescription Drug Plans are offered by private Medicare-approved insurance companies and are designed to work in coordination with Original Medicare. Some Medicare Advantage plans include prescription drug coverage (also known as MA-PD plans). In this case, you would get both your health and drug benefits all in one plan. If you have Medicare Advantage Prescription Drug plan coverage, you can’t purchase a stand-alone Medicare Prescription Drug Plan (PDP). You may have a separate premium you pay to your Medicare Prescription Drug Plan.
  • Medicare Supplement (Medigap) plans are offered by private insurance companies and can help you pay for out-of-pocket costs for services covered under Medicare Part A and Part B. These plans may pay out-of-pocket costs like deductibles and copayments, as well as benefits that Original Medicare doesn’t include, such as overseas health coverage. You must have Medicare, Part A and Part B to sign up for a Medicare Supplement plan. While you cannot have a Medicare Supplement plan and a Medicare Advantage plan concurrently, you can have a Medicare Supplement plan and a Medicare Prescription Drug Plan at the same time.

Whether you are exploring your options in the selection of a Medicare Advantage plan, a Medicare Advantage Prescription Drug plan, a stand-alone Medicare Prescription Drug Plan or a Medicare Supplement plan, remember the availability of Medicare plans in Kansas may vary by county.  The plan premiums as well as type of coverage may vary by insurance company, also.  Therefore, you may want to compare the costs and coverage of plans available where you live in Kansas.  Feel free to enter your zip code in the Plan Finder located on this page if you would like assistance refining your research of Medicare plans available where you live.

Learn more about how Medicare plans work in Kansas, including:

Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program.