Medicare Advantage Plans in Kentucky

Medicare Advantage is a type of health insurance for older adults and people with certain disabilities and is managed by Medicare-approved private insurance companies. Also known as Part C or MA, this type of health coverage includes the same services as Original Medicare Parts A and B and often bundles with additional coverage, such as prescription drugs, dental, vision and other services. Part C should not be confused with supplemental Medicare plans or Medigap insurance, although they can include some of the same benefits. 

Since the start of Medicare Advantage in the late 1990s, enrollment in private health insurance for seniors has grown significantly. In Kentucky, 41.7% of the eligible population had a MA plan in 2021. This is slightly less than the overall average for the United States, which is 42%. There are six counties in the Bluegrass State with more than 50% enrollment, and only two counties have less than 30% participation. 

This guide gives Kentucky seniors the information they need to decide if Medicare Advantage is the right option for their health care needs. They can learn about the types of plans available, compare costs between providers and find out what types of health care products and services their area covers. 

The Top 10 Medicare Advantage Plans in Kentucky

There are many private health insurance companies that offer Medicare Advantage plans in the Bluegrass State. The table below lists the top 10 plans by total enrollment figures across the state as of April 2022. A plan’s popularity may or may not be related to its Medicare rating, based on surveys that measure how satisfied beneficiaries are with their MA insurance. These ratings are updated every fall and are subject to change. Cost information may also change as each insurance company has to renew its contract with the federal government every year. Since most companies offer multiple plans, the table lists their costs in a range. Medicare.gov has the most up-to-date information. 

How Medicare Advantage Plans Work in Kentucky

Private insurance companies in Kentucky offer a few different types of Medicare Advantage plans: Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Private Fee-for-Service (PFFS) and Special Needs Plans (SNPs). Medical savings accounts may be available in some communities. Premiums, deductibles, copays and other costs can vary significantly between types of plans. More information about these coverage options is below.

What Medicare Advantage Plans Cover in Kentucky

With a Medicare Advantage plan, seniors get coverage for preventative screenings, inpatient hospital services, durable medical equipment, skilled nursing facilities, home health care, outpatient care and physician services. These are the same benefits covered under Parts A and B. It’s possible for Medicare Advantage to cover a variety of additional care services, such as dental, hearing and vision. Special Needs Plans may include coverage for health care that treats certain chronic conditions. 

*Select plans offer this coverage

** Most plans offer this coverage

Eligibility for Medicare Advantage in Kentucky

Seniors who have Original Medicare Parts A and B are eligible to switch to a Medicare Advantage plan. To qualify for Original Medicare, a person must be a U.S. citizen or legal immigrant 65 years or older. Younger people with disabilities and end-stage kidney disease may also be eligible. The only other requirement for Part C is to live in the service area for a particular plan. Some HMOs and PPOs may only cover providers in certain counties and cities, so it would not be possible to receive services outside that network. Seniors may need to search for plans by zip codes to see if they live in a provider’s service area. Decisions need to made by the enrollment periods below:

• Initial Coverage Election Period: This is the initial 7-month period, coinciding with one’s 65th birthday, during which everyone is eligible to enroll in a Medicare Advantage plan.
• Annual Election Period (AEP): Also referred to as the Open Enrollment Period, this the time of year when anyone over 65 can enroll in Medicare Advantage for the first time or change to a new plan.
• Medicare Advantage Open Enrollment Period: During this period, those who are already enrolled in Medicare Advantage can switch to a different plan or switch back to Original Medicare.

Additionally, Medicare Advantage plan participants can change their plan outside of these enrollment periods under certain qualifying circumstances, such as moving to a new state.

How to Find & Choose a Medicare Advantage Plan in Kentucky

Navigating the many intricacies of Medicare Advantage plan types, insurers, and the specific plan options available by region can be a difficult and time-consuming task. Below are several resources we’ve created to help you through the process.

First is a downloadable PDF that you can use as a guide to help you compare plans as you research. Finally, we have listed a number of organizations that you can contact with experts that will help you determine whether Medicare Advantage is right for you and what plans you should consider.

State-Wide Medicare Advantage Resources

Local Medicare Advantage Resources