Assisted living facilities primarily help residents with non-medical needs. Although minor and infrequent medical services, such as first-aid for a wound, can sometimes be met on-site by nurses. These communities may sometimes also be called ALFs, residential care facilities, retirement homes, or long-term care facilities.
The financial options available to help pay for senior care is dependent on, among other things, the type of care that is required. If you are just beginning the research process on how to pay for long-term care, it is helpful to have an idea about the type of care you or your loved one currently requires, as well as to anticipate future needs. In addition, it is important to be familiar with the associated eldercare terminology.
Can using home care technology help your family save money caring for an aging loved one? The answer is most certainly “Yes”. Our goal is not to provide a comprehensive list, but rather to make sense of those that are available on the market today and can reduce the care hours required by elderly persons. As such, they can reduce a family’s out-of-pocket care costs or reduce the hours they spend providing care themselves.
Medicare Advantage (Part C), a privately offered alternative to Original Medicare (Parts A and B), has grown in popularity over the years. Despite the growing popularity of Medicare Advantage, some seniors face obstacles that prevent them from truly understanding how it works and who it benefits. Common mistakes about Medicare Advantage include misunderstanding its differences from Original Medicare, getting it confused with other forms of private Medicare insurance (like Medigap or Part D), or not understanding how to look up or evaluate plans.
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.
HMO, PPO, PFFS
Anthem Blue Cross and Blue Shield
Blue Cross Blue Shield of Michigan
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.
Coverage Available With Medicare Parts A & B?
Coverage Available With Medicare Advantage?
Durable Medical Equipment
*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.
Initial Coverage Election Period
3 Months Before One’s 65th Birth Month
3 Months After One’s 65th Birth Month
Annual Election Period (AEP)
Medicare Advantage Open Enrollment Period
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.
Kentucky State Health Insurance Assistance Program (SHIP)
The Kentucky State Health Insurance Assistance Program is a state-sponsored insurance resource for seniors seeking help with choosing and enrolling in a Medicare plan. Assistance includes comprehensive education in plan options and opportunities, such as confidential and unbiased one-on-one phone and in-person counseling, presentations to community groups and the distribution of educational materials regarding Medicare. SHIP also works closely with the Department for Public Health Kentucky Prescription Assistance Program to help seniors maintain access to affordable prescription drugs. All seniors in Kentucky, as well as their family members and caregivers, can use the free resources available through SHIP.
Seniors can access SHIP at 877-293-7447, the state-wide hotline number, or 502-564-6930.
Department for Aging and Independent Living (DAIL)
The Department for Aging and Independent Living is a state-offered resource that provides programs and services for aging adults in Kentucky. With a full range of comprehensive care, DAIL focuses on Medicare resources, assisted living, caregiver support, participant-directed services and supported living programs. Seniors, caregivers and family members are welcome to contact DAIL at any time to ask questions, including about Medicare resources in Kentucky. DAIL can also connect seniors with area support services, like local nonprofits and Area Agencies on Aging. Services from DAIL are free to those living in Kentucky.
Kentucky Disability Benefits 101 is a Kentucky-related branch of the World Institute on Disability. While the focus of this organization is on disabled adults, it also provides valuable information about Medicare, including Medicaid interaction for those who are low-income or disabled and require additional benefits. This organization offers comprehensive Medicare information on its website, including how to enroll and the differences between each Medicare Part. The site includes definitions and other information that can help seniors compare plans and understand costs and benefits. Seniors can also learn more about Medicare Savings Programs available in Kentucky. Estimator tools are available to provide a high-level snapshot of potential benefits eligibility. The Kentucky Disability Benefits 101 site is free to use.
The Legal Aid Network of Kentucky is a valuable legal resource for low-income individuals in need of assistance with a wide variety of civil legal issues, including Medicare. The Network’s website provides comprehensive information on Medicare, including eligibility, plans and benefits options. This service offers free access to an attorney for basic questions on civil, noncriminal matters, including Medicare. The Ask a Lawyer feature lets Kentucky residents submit a question to a licensed volunteer attorney for free. Using this feature requires registration, but there’s no fee or subscription required.
Bluegrass Area Agency on Aging and Independent Living
The Bluegrass Area Agency on Aging and Independent Living is one of Kentucky’s Area Agencies on Aging, and it covers residents in the Bluegrass region, which includes Anderson, Bourbon, Boyle, Clark, Estill, Fayette, Franklin, Garrard, Harrison, Jessamine, Lincoln, Madison, Mercer, Nicholas, Powell, Scott and Woodford Counties. As a comprehensive resource for aging members of the Bluegrass community, the Bluegrass Area Agency on Aging and Independent Living provides area resources for assisted living and day programs, health and financial benefits, Medicare and Medicaid, and other essential services. Counseling for Medicare services is available for seniors living in the service area. Resources through the Agency are free to those living locally.
The Office for Aging & Disabled Citizens is a government entity operated through the Resilience and Community Services program in Louisville, Kentucky, that advocates for seniors in the metro area. This resource offers assistance to seniors in numerous ways, including connections with nonprofits, Medicare and Medicaid support, disability assistance and access to affordable meals. In addition to providing Medicare support, the Louisville Office for Aging & Disabled Citizens also operates a Medicare Patrol program that ensures seniors aren’t victims of Medicare abuse or fraud. All residents of Louisville are welcome to use the government resources provided through this office.
Seniors can contact the Louisville Office for Aging & Disabled Citizens at 502- 574-4377.