Medicare Advantage (Part C)Medicare Advantage (Medicare Part C) is health insurance for Americans aged 65 and older that blends Medicare benefits with private health insurance. This typically includes a bundle of Original Medicare (Parts A and B) and Medicare Prescription Drug Plan (Part D). is a private insurance product that expands on the essential services offered as part of Original Medicare (Parts A and B)Original Medicare is a fee-for-service health insurance program available to Americans aged 65 and older and some individuals with disabilities. Original Medicare is provided by the federal government and is made up of two parts: Part A (hospital insurance) and Part B (medical insurance)..
Medicare Advantage plans can combine elements of Medicare Parts A, B, and D.
Medicare Advantage plans in Kentucky must offer the same services as Medicare Part AMedicare Part A, also called "hospital insurance," covers the care you receive while admitted to the hospital, skilled nursing facility or other inpatient services. Medicare Part A is part of Original Medicare. and Medicare Part BMedicare Part B is the portion of Medicare that covers your medical expenses. Sometimes called "medical insurance," Part B helps pay for the Medicare-approved services you receive., but additional covered services can vary.
The cost of your Medicare Advantage plan in Kentucky will depend on the services you choose and where you live.
If you’re eligible for Medicare Advantage in Kentucky, you have plan options — but it’s essential to know how these plans work and what benefits are available. Like Original Medicare, Medicare Advantage plans provide Part A and Part B benefits, but your plan is administered by a private insurance company approved by Medicare. Most Medicare Advantage plans offer additional benefits like Part D or vision coverage. We will dive deeper into coverage and enrollment details in this article.
Keep reading to learn more about Medicare Advantage plans in Kentucky.
Find a local Medicare plan that fits your needs
Medicare Advantage is available to anyone who qualifies for Original Medicare and is required to cover at least what Original Medicare (Parts A and B) covers. So, who is eligible for Medicare? If you are a U.S. resident age 65 and older, you qualify. Also, individuals can be eligible for Medicare under the age of 65 if they have specific disabilities and receive Social Security benefits.
In 2022, 98 Medicare Advantage plans are being offered in Kentucky. However, not every plan is available in every part of the state. Availability depends on the insurance company offering the plan and where you live. Medicare Advantage plans typically use provider networks to deliver services to plan beneficiaries, so it’s essential to ensure your providers and needs are covered by Medicare Advantage plans in your area.
Medicare Part A covers services you receive in the hospital or nursing home, also known as inpatient care. Medicare Part B covers outpatient care. This can include wellness visits, examinations in your doctor’s office, or therapy sessions.
While Medicare Parts A and B cover these general areas of care, a Medicare prescription drug plan—called Part D—is an optional add-on that covers your prescriptions. Many Medicare Advantage plans include Part D coverage and other services, including:
- dental care
- hearing aids
- medical transportation
- lab testing
- home medical equipment and supplies
The federal government sets rules on who is eligible and what Medicare Advantage plans include for Medicare and Medicaid Services, but different states may have additional rules, too.
What does a Medicare Advantage plan in Kentucky cover?
Medicare Advantage plans in Kentucky cover everything Original Medicare covers, plus additional services that can include dental care and hearing aids. Many Part C plans in Kentucky also include prescription drug coverage.
The cost of Medicare Advantage plans in Kentucky varies based on where you live and what coverage you want to include. You can find and shop plans in your area by entering your zip code at Medicare.gov. Another option is to contact GoHealth. Our licensed insurance agents can research your options and help you find the right plan for your needs.
The average cost of a Medicare Advantage plan in Kentucky is $14.02 per month in 2022. Some people may also qualify for a no-cost monthly premium. In Kentucky, 100% of people with Medicare are eligible for these plans. Keep in mind that you’ll typically still need to pay your Part B premium each month ($170.10 in 2022), though some Part C plans can pay for part or all of this cost.
Your costs will also depend on rules set by your individual plan. Many Medicare Advantage plans require you to receive care within a particular network of providers to receive the maximum coverage for your healthcare services.
Can I buy a Medicare Advantage plan in Kentucky?
Anyone eligible for Original Medicare can opt to purchase a Medicare Advantage plan. Plan offerings vary by zip code in most areas. The cost of your plan will depend on where you live, what services you want included, and the plan provider you choose. Several plans are available in most areas to fit a variety of needs and budgets.
Are you eligible for cost-saving Medicare subsidies?
The federal government sets Medicare Advantage eligibility since Medicare is a federal public health insurance program.
Medicare is available to:
- people who are 65 and older
- people with end-stage renal disease (ESRD)
- people with amyotrophic lateral sclerosis (ALS)
- people with disabilities who qualify for Social Security
In addition to specific eligibility rules, Medicare also has set periods for when you can enroll. You can sign up for Medicare during the three months before and after the month you turn 65, or after you have been receiving disability benefits from the Social Security Administration for at least 24 months.
If you are interested in a Medicare Advantage plan, it may be best to consider this option when you first enroll in Medicare. Whether you opt to enroll in Original Medicare and add a Part D prescription plan (you can also add Medicare Supplement Insurance, known as Medigap) or choose a Medicare Advantage plan with prescription coverage, it’s usually a good idea to start your coverage immediately.
If you wait to sign up for Medicare, a late enrollment penalty will be added to your premiums. Medicare Parts A, B and D all have enrollment penalties, and some will last as long as you have Medicare.
If you miss your Initial Enrollment Period, you may qualify for a special enrollment period. These timeframes can open based on certain circumstances, like a new disability, changes to your eligibility, or a move to an area where your current plan isn’t offered.
Whether or not to include prescription drug coverage in your Medicare Advantage plan is up to you. Most plans offer options with and without drug coverage.
Without a Part D plan added to your Medicare Advantage coverage, you should expect to either enroll in a separate Part D plan, or pay the entire cost of your outpatient prescription medications. You may be able to enroll in a Medicare Advantage plan with prescription drug coverage at certain times of the year. Not signing up for Part D drug coverage when you are first eligible, however, could mean you’re stuck paying an enrollment penalty for the rest of your life. This penalty will be added to your regular monthly premium.
What extra benefits and savings do you qualify for?
Before 65 Guide
Understanding health insurance before age 65, especially when considering early retirement