Medicare in Kentucky

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  • Choose the right Medicare coverage for you. This guide to Medicare in Kentucky highlights the available plans and gives you some information about enrollment.

What Kentucky Medicare Plans Are Available?

Medicare in Kentucky provides insurance options to many older adults as well as younger individuals that receive Social Security benefits for illness or disability. Navigating the Medicare program requires an in-depth understanding of its various components. 

Medicare is divided into different parts, each of which addresses a unique aspect of the larger system. 

Part A: This is the original component of Medicare and the one that deals with inpatient care in a hospital, hospice, skilled nursing or surgical facility. There are no monthly premiums attached to this plan for those that paid into the system from traditional means of employment. Those that did not can purchase Part A for a monthly premium. 

Part B: This component of Medicare covers preventative care and in-office physician's visits. There is a monthly premium for this segment of the program, though it is based on income for maximum affordability. Enrollment is required in this program as soon as an individual becomes eligible to avoid incurring a penalty for late registration. 

Part C: This program is also known as the Medicare Advantage program. It serves as a replacement for the original components. Advantage plans must cover everything covered by Parts A and B but can cover more, including vision and dental. Those that utilize an Advantage plan have the choice between a health maintenance organization (HMO) or preferred provider organization (PPO). 

Part D: Part D is the prescription drug benefit and can also be purchased as a stand-alone policy. Like Part B, there is a monthly premium attached to this component, and it is also based on income. 

Medigap: This is another word for Medicare supplemental insurance. These policies act as a gap for the costs of health care not covered by the traditional Medicare options. This includes coinsurance, deductibles and copayments. 

Roughly 21% of Kentucky residents are enrolled in Medicare, with 29% of those individuals choosing Advantage plans. There are 35 Advantage plans available in Kentucky, and 57 insurance providers offering Medigap plans. However, the state does not require those insurers offering Medigap coverage to do so for those under the age of 65. 

Who Is Eligible for Kentucky Medicare?

Automatic eligibility for Medicare in Kentucky extends to those age 65 and older who have paid into the payroll tax system through traditional employment as well as to some younger people with stipulated health issues or disabilities. 

Individuals age 65 and older who have not paid into the system can purchase a policy on their own. 

For those who automatically qualify, enrollment happens roughly 4 months before the individual's 65th birthday. 

How Do I Enroll in Medicare in Kentucky?

Those who are not automatically enrolled in Medicare must do so in the period that extends from three months prior to the month of their 65th birthday to three months after that months. Those interested in a plan may enroll after this time, but may incur a penalty for doing so. 

There are also other enrollment periods in place. The first takes place from January 1 to March 31 and coverage begins July 1. The second is from October 15 through December 7 and coverage begins January 1. Those who had employer-sponsored coverage or another standalone policy that suddenly ended can enroll at any time without penalty. 

Those eligible to enroll can do by visiting the Social Security Administration website at www.SocialSecurity.gov to sign up. Those looking to enroll can call (800) 772-1213 Monday through Friday from 7 a.m.-7 p.m. or visit their local Social Security Administration office. 

Contact Information for Kentucky Medicare, Medicaid and Insurance Help

To get more information about Kentucky Medicare, Medicaid and additional insurance help, take advantage of the numerous local resource offerings. 

HelpAdvisor: To help better understand the complexity of Medicaid qualification and enrollment requirements, HelpAdvisor offers a comprehensive outlay of information that can be instrumental in helping beneficiaries to learn more about the options available to them. 

Kentucky State Health Insurance Assistance Program (SHIP): Kentucky's SHIP program provides assistance and counseling to individuals on making the most informed decisions on Medicare coverage. The program can be reached online or via phone at (877) 293-7447. 

Medicare Savings Program: Those struggling to pay Medicare premiums might be able to qualify for financial assistance through the Kentucky Medicare Savings Program. Call (502) 564-6890 for more information.