Information about Medicare Advantage Plans in Kentucky

Quick links:

• Average 2019 Costs
• Eligibility & Enrollment
• Finding Top-Rated Plans
• List of Plans Available
  • Plans by Carrier
  • Plans by County
  • Plans by Type
• Local Resources

32 percent of Medicare beneficiaries in Kentucky were enrolled in a Medicare Advantage (Medicare Part C) plan in 2019.¹

There are 40 different Kentucky Medicare Advantage plans in 2019.¹

Call to speak with a licensed insurance agent who can help you compare the availability, benefits and costs of Medicare Advantage plans in your area of Kentucky.

You can also learn more about other types of Medicare plans that may be available in your area:

• Kentucky Medicare Supplement Plans
• Kentucky Medicare Part D Plans

Average costs of Medicare Advantage in Kentucky

Kentucky Medicare Advantage plans had an average premium of $10 per month in 2019.

There were 16 available plans in Kentucky that feature $0 monthly premiums.

• Average monthly premium cost in 2019 (weighted): $10
• Average in-network out-of-pocket spending limit: $4,478
• Average deductible in 2019 (weighted): $15.05¹

It's important to note that Medicare Advantage plan costs can vary from one region of Kentucky to another.

Some of the average costs and enrollment numbers for 2019 Kentucky Medicare Advantage plans are listed by county below in this guide.

A licensed insurance agent can help you compare Medicare Advantage plan costs in your area.

Or call 1-800-557-6059 1-800-557-6059 TTY Users: 711 24/7 to speak with a licensed insurance agent.

Medicare Eligibility & Enrollment

Enrolling in a Medicare Advantage plan in Kentucky requires that you first enroll in Medicare Part A and Part B, also known together as Original Medicare.

You may be able to sign up for Medicare at age 65 if:

• You are a U.S. citizen or permanent legal resident who has lived in the U.S. for five continuous years.
  
  
• You or your spouse worked long enough to qualify for Social Security or Railroad Retirement benefits.
  
  
• You or your spouse are government employees or retirees who paid Medicare payroll taxes.

You may also be eligible for Medicare benefits under 65 if:

• You have been receiving Social Security disability benefits or certain Railroad Retirement Board disability benefits for at least 24 months.
  
  
• You have ALS (amyotrophic lateral sclerosis, or Lou Gehrig's disease).
  
  
• You have End-Stage Renal Disease (ESRD), and you or your spouse have paid Social Security taxes for a certain length of time.

If you have ESRD, you may be able to enroll in a Kentucky Medicare Special Needs Plan (SNP) that is specifically designed to help meet your health care needs.

How to sign up for a Medicare Advantage Plan in Kentucky

The first time you may be able to enroll in a Kentucky Medicare Part C plan is during your Medicare Initial Enrollment Period (IEP), when you first become eligible for Medicare.

Your Medicare IEP begins three months before your 65th birthday, includes the month of your birthday and extends for three additional months thereafter.

You may also be able to sign up for a Medicare Advantage plan during the following enrollment periods:

Medicare Advantage Open Enrollment Period: January 1 – March 31

During the Medicare Advantage Open Enrollment Period, you may switch Medicare Advantage plans or drop your Medicare Advantage plan and return to Original Medicare.

If you return to Original Medicare during this period, you'll be able to join a Medicare standalone prescription drug plan (Medicare Part D).

Medicare Annual Enrollment Period (AEP): October 15 – December 7

Medicare AEP lasts from October 15 to December 7 every year. During this period, you may enroll in a Medicare Advantage plan or switch from one Medicare Advantage plan to another.

If you have a Medicare Advantage plan, you can disenroll from your plan during AEP and return to Original Medicare.

During AEP, you may also join, switch or drop a Medicare Part D plan. 

Medicare Special Enrollment Periods (SEP)

You may potentially be granted a Medicare Special Enrollment Period (SEP) for qualifying circumstances, though the requirements are specific and can affect your enrollment eligibility in different ways.

A licensed insurance agent can help you find out if you qualify for a Medicare Special Enrollment Period.

Or call 1-800-557-6059 1-800-557-6059 TTY Users: 711 24/7 to speak with a licensed insurance agent.

Top-rated Medicare Advantage Plans in Kentucky 2019

Each year, the Centers for Medicare & Medicaid Services (CMS) uses a system of one to five stars to rate all Medicare Advantage plans in the U.S.²

Poor-performing plans are given 1 star, while higher-performing plans are given 5 stars. The ratings are based on information taken from plan member surveys and regular Medicare monitoring activities.

In order for a Medicare Advantage plan to be considered a top-rated plan, it must have four or more stars out of five stars.

There are 27 top-rated 2019 Medicare Advantage plans in Kentucky that are rated four stars or higher, which is 67.5 percent of all MA plans available in Kentucky in 2019.

Medicare Advantage plans are rated in the following five categories:

• Preventive care and health maintenance (screenings, tests, vaccines, etc.)
• Management of chronic conditions
• Member experiences and ratings of the plan
• Member complaints, problems receiving services and member retention
• Customer service

List of Medicare Advantage Plans Available in Kentucky in 2019

You can view a list of plans offered in your area of Kentucky by using our plan comparison tool.

Or call 1-800-557-6059 1-800-557-6059 TTY Users: 711 24/7 to speak with a licensed insurance agent.

Private insurance companies offer Medicare Advantage plans in Kentucky

A number of different insurance carriers may offer Medicare Advantage plans in Kentucky. The availability of plans where you live can vary depending on the county in which you reside.

Private insurance companies offer Medicare Advantage plans that may be unique to the plan area they serve.

A licensed insurance agent can help you compare Medicare Advantage plans that are sold by insurance companies in your area.

You can also refer to the following information sources to help you compare your plan options:

• The Medicare Star Ratings can give you an idea of a plan’s overall quality.
  
  
• Agencies like A.M. Best, Moody’s and Standard & Poor’s can provide information about an insurance company’s credit rating and financial standing.
  
  
• Websites such as the Better Business Bureau and Consumer Reports can teach you about a company’s reputation among its customers.
  
  
• You can read through Medicare Advantage plan reviews and testimonials from customers.

Kentucky Medicare Advantage plans by county

The chart below provides some more information about 2019 Kentucky Medicare Advantage plans by county.¹

• Boone County had the highest number of top-rated plans in 2019, with 9 plans receiving Star Ratings of 4 stars or higher.
  
  
• The largest number of Medicare Advantage beneficiaries in 2019 were in Jefferson County, where 100 percent of MA enrollees were part of a $0 premium plan.

KY Medicare Advantage enrollees by plan type

The chart below illustrates the percentage of 2019 Kentucky Medicare Advantage enrollees that are enrolled in each primary type of Medicare Advantage plan.¹

The major types of Medicare Advantage plans include:

• HMO
  Most Health Maintenance Organization (HMO) plans require you to visit health care providers who are in the plan network. An HMO plan will also typically require you to get a referral from a primary care doctor before you can see a specialist.
  
  
• PPO
  If you have a Preferred Provider Organization (PPO) plan, you may be able to visit providers outside of your plan's network, though you will typically pay higher out-of-pocket costs when you do so.
  
  PPO plans typically do not require you to get a referral before you can see a specialist.
  
  
• PFFS
  Private Fee-For-Service (PFFS) plans determine how much they pay and how much you are responsible for paying at the time that you receive care services.
  
  With most PFFS plans, you can typically visit any health care provider who accepts Medicare and who also accepts your plan's terms.
  
  
• SNP
  A Special Needs Plan (SNP) is a type of Medicare Advantage plan limited to people with certain chronic conditions and other specific characteristics.
  
  Typically, you must visit health care providers and hospitals within your SNP network, except for in cases when you need emergency or urgent care. All SNPs provide prescription drug coverage.

Not all of these types of plans may be available in your area. A licensed insurance agent can help you compare the types of 2019 Kentucky Medicare Advantage plans that are available where you live.

Local health insurance resources in Kentucky

• Kentucky’s State Health Insurance Assistance Program offers assistance, information and counseling to Kentucky’s seniors and disabled individuals, as well as their families and their caregivers.
  
  This free program may be contacted at 877-293-7447 (option 2) with any questions regarding Medicare, Medicare Advantage or other health insurance benefits.      
  
  
• You can also explore more information about the insurance industry in Kentucky by visiting the state’s Department of Insurance website.
  
  
• Kentucky Prescription Drug Assistance Programs
  The state of Kentucky has a number of programs designed to help with the cost of prescription drugs. There are programs for both Medicare beneficiaries and non-Medicare beneficiaries alike that can cover the cost of premiums and cost-sharing or even lower the cost of the drugs themselves.