More than 448,000 Kansas residents currently receive Medicare benefits. If you are a Kansas resident interested in purchasing a Medicare Advantage Plan or Medigap Policy, you must be age 65 or older and entitled to or eligible for retirement benefits through Social Security or the Railroad Retirement Board. Plan specifics and availability vary with your location and needs and can be found, along with ratings, by visiting www.medicare.gov/find-a-plan. When choosing a plan, consider your current health situation and the benefits you will receive as well as the overall cost, including co-payments and deductibles which may change annually.
The Medicare Advantage Plan, also known as a Part C or MA plan, covers all your Part A and Part B Medicare benefits by contracting with a private company. Advantage Plans cover about 45,500 people in Kansas through providers including Aetna, Humana, and United World. Advantage Plan options include: the Health Maintenance Organization (HMO), Health Maintenance Organization Point-of-Service (HMO-POS), Preferred Provider Organization (PPO), and Private Fee for Service (PFFS). Kansas also offers dual eligibility and special needs plans so this may be the best option if you seek spousal coverage or if you are under age 65 and receiving Medicare due to disability.
HMO plans require that you receive care from within-network providers; you must pay for services you elect to receive out of network. The HMO-POS plan, which is frequently chosen by Kansas residents, will cover an out-of-network service if you are referred by your primary care physician. A PPO plan is similar to an HMO plan but generally covers a greater percentage of out-of-network expenses. With a PFFS plan, you can see any provider who will accept your plan’s terms. Of these plans, the majority of Kansas beneficiaries are enrolled in a local PPO.
Most Medicare Advantage Plans in Kansas also offer Medicare prescription drug coverage (Part D). To enroll in a Medicare Advantage Plan, you must live in the area serviced by the plan you join, you must have Medicare Part A and Part B, and you must not have End-Stage Renal Disease (ESRD).
The average quality rating for Medicare Advantage Plans in Kansas is 3.19. The top three best-rated plans in Kansas are: Humana Gold Plus H2649-004 (HMO), Humana Gold Plus H2649-012 (HMO), and Humana Gold Plus H2649-021 (HMO-POS).
Medigap policies are sold by private insurance companies and provide supplemental insurance intended to help pay for “gaps” in Original Medicare coverage (a deductible or copayment, e.g.). Nearly 195,000 people in Kansas hold Medigap policies. A Medigap policy cannot work with a Medicare Advantage Plan and it covers individuals only, not including spouses. To enroll in Medigap, you must have Part A and Part B Medicare benefits. Be aware that the costs of some Medigap policies may increase as you get older, so do review your options every year.
If you decide to join, switch, or disenroll from your Medicare health or drug plan for any reason, the open enrollment period begins on October 15 and ends on December 7 with changes effective on January 1 of the following year. Before you change your Medicare Advantage Plan, be sure that you will retain your prescription drug coverage. Check with your individual provider for specific restrictions and conditions that may apply. Initial enrollment in a Medigap policy is best done during the six-month period after you turn 65.
Kansas Medicare Savings Programs and the Kansas Medical Assistance Program (KMAP) assist qualifying state residents with medical expenses such as deductibles and co-payments. The Senior Health Insurance Counseling for Kansas (SHICK) program provides general Medicare-related information and can help locate funding to cover health care costs.
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