Last Updated on
October 6, 2016
In Kentucky an alternative way for Medicare beneficiaries to obtain the benefits of Original Medicare Part A and Part B is Medicare Advantage (Part C). Private insurance companies contract with Medicare to offer Medicare Advantage plans locally. If you opt to receive your Medicare coverage from a Medicare Advantage plan, you can enroll in a plan that is available where you live in Kentucky.
In Kentucky and throughout the United States, the federal government requires Medicare Advantage plans to offer at least the same level of benefits as Original Medicare Part A (hospital insurance and Part B (medical insurance). With the exception of hospice care, which continues to be covered under Part A, you receive all of your Medicare benefits from the private insurance company that offers the Medicare Advantage plan in which you choose to enroll. Some Medicare Advantage plans offer lower deductibles and copayments that may further reduce their members’ out-of-pocket expenses for Medicare covered health services; some plans even offer extra benefits, like wellness programs and prescription drug coverage, allowing beneficiaries to have more comprehensive coverage than under Original Medicare.
If the Medicare Advantage alternative is of interest to you, it’s important to understand what you need to enroll in a Medicare Advantage plan. First, you must have Medicare Part A and Part B. Second, you must live in the service area of the Medicare Advantage plan you choose. Third, in most cases you can’t enroll in a Medicare Advantage plan if you have end-stage renal disease, a condition for which Original Medicare has normally will cover.
You can sign up with a Medicare Advantage plan during your Initial Coverage Election Period (ICEP), usually when you’re first eligible for Medicare. This time period is generally the same as your Initial Enrollment Period, which begins three months before you turn 65, includes your birthday month, and ends three months after that month.
If you delay enrollment in Medicare Part B your ICEP will begin three months before your Part B start date. For example, if you signed up for Medicare Part B during Medicare’s General Enrollment Period (from January 1 to March 31), your Part B start date would be July 1, so your ICEP would be April 1 through June 30.
If you didn’t sign up for a Medicare Advantage plan during your Initial Coverage Election Period, or if you want to switch to a different Medicare Advantage plan, you can do so during the Annual Election Period, also called the Fall Open Enrollment season, which runs from October 15 to December 7 each year. Your new coverage goes into effect on January 1 of the following year.
In some situations, you might qualify for a Special Election Period. These situations include, but are not limited to: moving to a new address where your Medicare Advantage plan isn’t available; losing your current coverage; or experiencing changes in your current plan that affect your health benefits. The timing of Special Election Periods is not standardized like the enrollment periods discussed above; instead, a Special Election Period occurs when your circumstances change, usually when you have a life-changing event or a change in your health coverage that could jeopardize your receiving Medicare benefits to which you are entitled if you had to wait until one of these annual enrollment periods.
Finally, if you’re already enrolled in a Medicare Advantage plan in Kentucky (as in any state), but want to switch back to Original Medicare (Part A and Part B), you can make this change during the Medicare Advantage Disenrollment Period, which runs from January 1 to February 14 each year.
Here’s a quick look at the various types of Medicare Advantage plans, but please remember not every type of plan is necessarily available in every part of Kentucky.
Remember that if you decide to sign up for a Medicare Advantage plan, you continue paying your Medicare Part B premium in addition to any premium the plan may charge.
As a Medicare beneficiary in Kentucky, you may find it useful to compare all the Medicare Advantage plans available in your area.
The availability and costs of Medicare Advantage plans generally depend on your county of residence, the insurance company offering the Medicare Advantage plan, and the plan’s specific benefit details. You may find that some Medicare Advantage plans in Kentucky offer premiums as low as $0, but you should also consider the plan’s other costs such as copayments and deductibles. (Keep in mind that you continue to pay your monthly Medicare Part B premium, no matter which Medicare Advantage plan you choose.) Some further considerations to keep in mind when selecting a Medicare Advantage plan:
With all these options, you can see why it’s important to compare Medicare Advantage plans to find one that offers benefits and costs suited to your personal health and budget requirements.
To start comparing Medicare Advantage plans in Kentucky right away, enter your zip code above for a list of plans available in your area. You can also enter your prescription drug needs to further customize your search and cost estimates.
To get more information about Medicare in Kentucky, you can review the following resources:
* Out-of-network/non-contracted providers are under no obligation to treat Preferred Provider Organization (PPO) plan members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.