Medicare Advantage Plans in Kentucky

Known as Part C or “MAPD,” Medicare Advantage in Kentucky is a Medicare plan that contains three parts in one plan: hospital insurance, medical insurance, and a prescription drug plan.

Where Original Medicare is made up of Medicare Part A and Medicare Part B, Medicare Part C or Medicare Advantage is made up of Part A, Part B, and Part D. This plan is provided by private health insurance companies and has additional coverage and benefits that Original Medicare and other plans do not.

Benefits and coverage options may include:

  • Vision and hearing
  • Dental and Over-the-Counter Prescription Allowance
  • SilverSneakers

With a Medicare Advantage plan in Kentucky, Medicare beneficiaries will have a network service area to serve them. In addition, they will have their own primary care physician, hospital, and any other facilities to choose from in the network.

For those with either a disability or End-stage Renal Disease, enrollment into a Medicare Advantage plan can occur before 65.

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Top-rated Medicare Advantage Providers in Kentucky

Popular Medicare Advantage Plan Types in Kentucky

Best for network freedom: Medicare Advantage PPO 

PPO plans will have more extensive networks with no referrals and monthly premiums ranging from $0 to $100.

Best for lowest out-of-pocket: Medicare Advantage HMO 

HMO Plans use a referral network; most companies offer $0 monthly premiums.

Best for low income or health conditions: Medicare Advantage D-SNP

Dual eligible SNP is for those with Medicare and Medicaid, a severe or disabling chronic illness, you need nursing home level care, or entering a facility that qualifies for SNP coverage.

The D-SNP plan works with an individual’s Medicaid plan and helps with expenses for:

– Part B premium

– Copays

– Coinsurance

– Deductibles

– Monthly premiums

Kentucky Enrollment Facts

1. Number of people enrollment in Medicare Advantage in Kentucky: 345,202

2. Number enrolled by plan, specifically the three plans below:

Local HMO: 63,792

Local PPO: 149,323

Regional PPO: 49,551

3. Percentage of Medicare beneficiaries enrolled in Medicare advantage in Kentucky: 36%

4. Number of people enrollment in Medicare Advantage nationwide: Expected to reach 29.5 million in 2022

How much does Medicare Advantage in Kentucky cost?

HMO and PPO plans in most states cost $0 per month. It is more common, however, for PPO plans to have a premium.

In Kentucky, a plan will vary from one service area to another.

The average MA monthly premium is $14.02 in Kentucky. The average monthly premium for a Medicare Advantage plan with prescription drug coverage would be $44.64.

How much do Advantage Plans cost in Kentucky?

PPO Plan $0.00 to $14.02

HMO Plan $0.00

When can I enroll in a Medicare Advantage plan?

Initial Enrollment Period/IEP

Eligibility for IEP occurs at 65, and you can join Medicare Part A and Part B health plans. Enrollment typically occurs within three months of an individual turning 65.

Open Enrollment Period/Annual Election Period

Open Enrollment Period: October 15 until December 7

You can join, drop, or make changes to a plan during this time. Coverage for Part C starts the following year on January 1, but only if the plan is completed by December 7.

Medicare Advantage Open Enrollment Period

January 1 through March 31

You can switch or join Original Medicare or a Medicare Supplement plan during this enrollment period.

Special Enrollment Periods/Special Circumstances

Special circumstances could include any of the following:

  • Address changes
  • The plan with Medicare changes
  • Loss of current coverage
  • Coverage through an employer (VA/TRICARE/PACE)
  • Eligibility for both Medicare and Medicaid Extra Help
  • Dropping a Medigap/Medicare Supplement plan
  • State Pharmaceutical Assistance Program enrollment
  • Special needs or disability

5-star Special Enrollment Period

December 8 until November 30

This star rating enrollment can only be used once for your Kentucky Medicare Advantage plan. Plans are rated with satisfaction surveys. Surveys compare plans based on their quality and performance. The 5-star rating is the highest given to a plan.

Special Enrollment Periods/Extra Help

Extra Help is classified as being eligible for Extra Help, Medicare or Medicaid, or State Pharmaceutical Assistance Program.

Ready to Learn More?

We help educate Medicare beneficiaries on their Medicare Advantage options and help them go through the process of reviewing and comparing plans. We work with most of the nation’s top-rated Medicare Advantage carriers. Give us a call today, or request a quote online to learn more about plan options.

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