Medicare in Kansas

In Kansas, 553,336 individuals are enrolled in Medicare, in 2022. This represents almost 19% of the total population. Kansas spends around $4.2 billion on Medicare costs, which amounts to about $7,800 per beneficiary.

For many older adults in Kansas, Original Medicare is the option they choose. Part A is the coverage for hospital stays, nursing homes, hospice care and some home health care. who paid Medicare payroll taxes for enough years qualifies for Part A for free. Also, those married to someone who paid these taxes can receive the coverage. Medicare Part B is for preventative care and outpatient medical services. It has a premium, and the standard premium in 2022 was $170.10 each month.

For Medicare beneficiaries, Part D provides prescription drug coverage, and they add this to Original Medicare. Medicare supplement plans, called Medigap, come from private health insurance companies. These cover the out-of-pocket costs of Original Medicare plans. Seniors who prefer managed care may opt for Medicare Part C also known as Medicare Advantage plans. Over 24% of Medicare users in Kansas chose Medicare Advantage in 2021. These cover the same services as Medicare Part A and B, but with additional coverage options the insurance company wishes to add. Most Advantage plans include prescription coverage (Part D), while Medigap is not needed with these plans Their costs vary depending on what the policy covers.

Seniors looking at their options for Medicare in Kansas can use this guide to get a comprehensive overview of their choices, along with thoughts on how they can personalize their coverage. They can also find a list of resources to assist them in making the right decisions regarding health care coverage.

Options for Medicare Coverage in Kansas

Older adults in Kansas have many options for Medicare coverage. Original Medicare is a good fit for some, but those who need a different choice can select one of the state’s many Medicare Advantage plans. With these varied options, seniors can easily customize a plan that fits their needs and budget, or they can add additional coverage to Original Medicare.

Original Medicare (Parts A & B)

Original Medicare is administered by the Centers for Medicare & Medicaid Services (CMS) and is open to seniors aged 65 and over, along with those under 65 years old, but with certain disabilities or end-stage kidney disease. It includes two parts. Part A covers inpatient hospital care, nursing home and skilled nursing care, hospice and home health care. Part B, or medical coverage, pays for medically necessary goods and services such as durable medical equipment, mental health services and emergency medical transportation. 

Unlike most private Medicare plans, Original Medicare’s provider network isn’t limited to the beneficiary’s geographic region, making it easier to obtain services while traveling within the country. In most cases, Medicare doesn’t pay for health services the individual receives outside the United States. 

Under this program, seniors pay for services as they receive them. They must pay an annual deductible, which is $1,556 for Part A and $233 for Part B in 2022. After they’ve paid this amount, Medicare covers all eligible services at 80%. Beneficiaries pay the remaining 20% out of pocket.

Who Should Consider Original Medicare

Original Medicare may be a good option for those who:

• Travel frequently within the United States
• Don’t need extra benefits such as home-delivered meals and coverage for over-the-counter medication
• Want to choose their own prescription drug coverage

Medicare Advantage (Part C)

Medicare Part C is also known as Medicare Advantage. Seniors purchase this alternative to Original Medicare through traditional insurance providers. It offers all of the benefits of Original Medicare, except for hospice coverage which remains covered under Medicare Part A. The Advantage plans often cover prescription drug coverage, dental and vision care and in some cases, even over-the-counter medications. Because Medicare Advantage plans come from private insurers, the out-of-pocket costs, such as deductibles and copayments, vary from plan to plan. Coverage options also can differ. However, these plans almost always have out-of-pocket limits, which makes them different from Original Medicare.

Medicare Advantage plans fall into one of four main plan types. These include Preferred Provider Organization (PPO), Health Maintenance Organization (HMO), Private Fee For Service (PFFS) and Special Needs Plans (SNPs).

Who Should Consider Medicare Advantage

Medicare Advantage works well for many seniors, including those who:

• Could qualify for low premiums due to good overall health
• Need control over their out-of-pocket costs
• Like the idea of a managed plan

• Need coverage not provided by Original Medicare

The Top 10 Medicare Advantage Plans in Kansas

Kansas has many different Medicare Advantage plans. The table below lists the top options based on the number of people enrolled while also providing information about associated costs and coverage as of April 2022. More information on Medicare Advantage is available on the Medicare Advantage Plans in Kansas page.

Medicare Prescription Drug Coverage (Part D)

Original Medicare doesn’t pay for most prescription drugs through Part A or B coverage. Instead, seniors purchase separate prescription drug policies, also called Part D coverage. Medicare contracts with private health insurance companies to provide this coverage. There are multiple plans to choose from with varying monthly premiums, which beneficiaries pay in addition to their Original Medicare premiums. While seniors don’t have to purchase prescription drug coverage when they’re first eligible for Medicare, not obtaining this coverage at this time may result in late enrollment penalties they pay for as long as they have Medicare if they enroll later.

Each prescription drug plan has its own formulary, or list of covered drugs. Formularies are typically split up into tiers. The tier a medication is in determines how much the insurance company pays and how much the beneficiary pays for it. Lower-level tiers are usually made up of generic and low-cost brand name drugs, while higher tiers are composed of more expensive brand name and specialty drugs. In most cases, the lower the tier, the lower the policyholder’s cost-sharing responsibility.

Who Should Consider Medicare Prescription Drug Coverage

Seniors who may benefit from prescription drug coverage include those who:

• Currently take prescription medication or expect to in the future
• Want to avoid late enrollment penalties
• Want to reduce out-of-pocket prescription drug expenses

Medicare Supplement Insurance (Medigap)

While Original Medicare provides coverage for many medical costs, seniors may still have significant out-of-pocket expenses. These may include copays, coinsurance and deductibles. Seniors may be able to reduce their cost-sharing obligations by purchasing a Medigap plan. These plans can only be used with Original Medicare. It’s illegal for private insurance companies to sell Medigap plans to those with Medicare Advantage plans.

For more information on Medigap plans, seniors can refer to the Best Medicare Supplement Companies of 2022 page.

Who Should Consider Medicare Supplement Insurance

Good candidates for Medigap may be those who:

• Have ongoing health issues and expenses
• Travel overseas often
• Want to access an expanded network of health care providers
• Expect to need health services not covered by Original Medicare

Medicare Resources in Kansas

Medicare beneficiaries and those who believe they can receive Medicare coverage in Kansas have several resources they can tap to help them get the most out of their coverage or choose the right coverage option. These organizations offer free resources and education for older adults who can benefit from Medicare programs.