Key Takeaways
Original Medicare in Kentucky is an option at age 65. It features hospital and medical coverage with the option of adding drug and supplemental coverage (called Medigap).
Medicare Advantage in Kentucky (Part C) replaces Original Medicare (Part A and B) but offers the same Part A and B benefits and coverages as Original Medicare. Along with Part A and B benefits, Medicare Part C often bundles additional services like dental, hearing, vision and prescription drug coverage.
While 20% of Medigap plans available to Original Medicare beneficiaries offer the protection of an out-of-pocket maximum, all Medicare Advantage plans feature an out-of-pocket maximum.
The Kentucky Derby, the crown jewel of horse racing and a crowning achievement for the state of Kentucky, evokes images of patrons in playful attire sipping mint juleps on a sparkling spring day.
But conditions aren’t always idyllic, and down on the track, the horses that can adapt to the changing climate have a leg up.
It’s much the same with health insurance. No one has any concerns about their plan when the sun is shining on them, but are you prepared for the rainy days? GoHealth is here to get you on track with Medicare in Kentucky.
Find a local Medicare plan that fits your needs
Who Qualifies for Medicare in KY?
If you’re a U.S. citizen and are age 65 or older, you qualify for Medicare in Kentucky. It’s as simple as that.
Medicare is a federal program that provides affordable healthcare for older Americans nearing retirement.
You’re also eligible regardless of your age if:
- You have End Stage Renal Disease or Lou Gehrig’s disease (also known as Amyotrophic Lateral Sclerosis or ALS).
- You have received 24 monthly payments of Social Security Disability Insurance or Railroad Board benefits.
You can enroll in Part A (also known as “hospital insurance”), Part B (“medical insurance”) or both. Once enrolled in Part A and B (known collectively as Original Medicare), you have the option to add Part D to cover a portion of your prescription expenses. You may also choose to add Medigap, which is supplemental coverage that helps fill in the gaps in out-of-pocket costs like copays and coinsurance.
Medicare Advantage in Kentucky offers an alternative. Medicare Advantage (also known as Part C) replaces Original Medicare while offering the same coverages as Part A and B and bundling Part D and supplemental coverage along with benefits like dental and vision coverage.
How do I Apply for Medicare in KY?
Your choices for applying for Medicare in KY include:
- Enrolling online with the Social Security Administration. [i]
- Enrolling over the phone at 1-800-772-1213 (TTY: 1-800-325-0778).
- Visiting a local Social Security office. [i]
If you are receiving Social Security benefits before you turn 65, you may be automatically enrolled in Original Medicare. If not, you have to apply. Your first chance to sign up is during your Initial Enrollment Period, which starts three months before the month of your 65th birthday.
Are you eligible for cost-saving Medicare subsidies?
What is the Income Limit for Medicaid in KY?
It depends on who you are.
Each state has its plan for administering Medicaid, a federal/state program founded alongside Medicare in 1965 that helps those facing a financial need and/or disability regardless of age. Kentucky offers coverage for the youngest of children to the oldest of adults. Those aged 19-up are eligible if their income is 138% or less than the Federal Poverty Level, [i] but some programs for children expand coverage up to 218% of the Federal Poverty Level. [i]
Who is Eligible for Medicaid in Kentucky?
In addition to Medicaid programs for adults, children, pregnant women, and the disabled, Kentucky offers a Presumptive Eligibility program during the Covid-19 State of Emergency. This Medicaid program provides temporary managed care to Kentucky residents under age 65 who don’t have medical insurance. [i]
What extra benefits and savings do you qualify for?
What is the Most Common Medicare Supplement Plan?
Medicare supplement plans, also known as Medigap plans, are available to people enrolled in both Parts A and B of Original Medicare and help fill in coverage gaps. All 10 of the standard Medigap plans offered by private insurance companies are available in Kentucky. However, different insurers may charge different rates for the same plans based on a variety of factors. Medigap should be added in the six months after your Original Medicare coverage begins to ensure eligibility without medical questions.
All 10 plans, lettered from Plan A to Plan N, cover 100% of Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits run out. All 10 also pay at least 50% of Part B coinsurance and copayments.
Each plan offers a specific mix of benefits, but just two of them (Plans K and L) protect you with an out-of-pocket maximum. Medicare Advantage plans, by contrast, are required to include the benefit of an out-of-pocket maximum.
Which Company has the Best Medicare Advantage Plan?
When it comes to Medicare plans in Kentucky, Original Medicare can be used nationwide, while Medicare Advantage is usually aligned with a network of providers in your area. Since there are numerous Medicare Advantage plans, it is common for one or more to include your preferred doctor, and the network concept is among the reasons Medicare Advantage in Kentucky often offers affordable rates.
One way to measure Medicare Advantage plans is by their Medicare Star Rating. The Centers for Medicare & Medicaid Services assigns a rating of one to five stars (five being the best) to individual Medicare Advantage plans. If you’re already on a Medicare Advantage plan and it’s not five-star plan, you are offered the opportunity to switch to a five-star plan each year. [i]
While the rating system can shed light on Medicare Advantage plans’ performance, it’s not as easy as just picking the highest-rated plan. A GoHealth licensed insurance agent, without obligation, can help you compare plans and find the one that’s the right fit for you.
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Medicare in Kentucky by the Numbers
Thousands of older adults enroll in Medicare every day across the United States. The latest CMS data shows that 899,546 people are enrolled in Medicare Part A and B in Kentucky. The total number of beneficiaries enrolled in Medicare Advantage Increased from 334,472 to 384,748 year over year. Medicare Advantage participation in Kentucky went from 37.79% to 42.77% year over year. If you’d like to dive deeper into how Medicare in Kentucky breaks down across the state, we provide a glance at who is using Medicare and how.
Medicare
Kentucky
899,546 Beneficiaries with Part A & Part B
384,748 Medicare Advantage Beneficiaries
42.77% Meducare Advantage Participation Rate
53.07% Female
46.93% Male
92.48% Non-Hispanic White
4.72% African American
0.65% Hispanic
2.14% Other/Unknown
22.69% Eligible for Medicaid
1.01 Average HCC Score
$9,791.83 Actual Per Capita Costs
18.97% Hospital Readmission Rate
29.18% of Beneficiaries with an Emergency Department Visit
334,472 Medicare Advantage Beneficiaries, Previous Year
Increased Medicare Advantage, Year over year
37.79% Meducare Advantage Participation Rate, Previous Year
See more +
Table reflects the latest Beneficiary Demographics Data: Medicare Geographic Variation – by National, State & County
Average HCC Score: The Hierarchical Condition Category score gauges a population’s overall health. The score is based on a value of 1.0. Populations with an HCC score of less than 1.0 are considered relatively healthy. The score can be used to estimate health costs.
Kentucky Medicare Resources & Contacts
Beneficiaries spend an average of $9,801.70 each year on Medicare in Kentucky. To be certain you are not leaving anything on the table, let us help. A GoHealth licensed insurance agent can assess your coverage or explain which Kentucky-based resources, like these, may be able to help:
Nationwide Resources
Medicare Learning Guides
Healthcare is personal. So is choosing insurance. If you are new to Medicare, a beneficiary researching options, or a caregiver, we have tailored Medicare Guides for you.
Medicare guide
Before 65 Guide
Understanding health insurance before age 65, especially when considering early retirement
Medicare guide
Medicare Plans Guide
Costs, coverage and enrollment details for each Medicare plan
Medicare guide
Medicare Beneficiary Guide
For those currently enrolled in Medicare
Medicare guide
Low Income and Medicare Guide
For individuals with a qualifying income status
Medicare guide
A Caregiver’s Guide
For individuals with a qualifying income status
