Medicare offers federally backed health insurance for Americans once they turn age 65 or meet specific disability or health requirements. When enrolling, recipients must decide between Original Medicare, administered by the federal government, or Medicare Advantage, which is run through private health insurance companies with federal backing. Medicare Advantage is sometimes referred to as Medicare Part C or MA.
Medicare Advantage plans are offered in every state including Kansas and may offer more comprehensive coverage. MA plans often include some extras that aren’t offered by Original Medicare. In Kansas, all residents have multiple Medicare Advantage options available to them (how many varies by county), so it’s important to review what each one offers and compare it to Original Medicare.
Read this article to learn everything you need to know about Medicare Advantage Plans in Kansas.
Medicare Advantage Plans in Kansas
Compare ratings of insurance companies offering Medicare Advantage Plans in Kansas:
| Insurance company | Medicare rating | A.M. Best rating | BBB rating | J.D. Power ranking |
|---|---|---|---|---|
| Aetna | 4 stars | A | A+ | 6th out of 9 |
| Cigna | 4 stars | A- | Not rated | 8th out of 9 |
| Humana | 4 stars | A- | A+ | 2nd out of 9 |
| UnitedHealthcare | 3.5 stars | A- | A- | 4th out of 9 |
What You Should Know About Medicare Advantage Plans in Kansas
- In 2023, there are 90 Medicare Advantage plans available in Kansas, compared to 88 plans in 2022.
- 100% of Medicare beneficiaries have access to a zero premium Medicare Advantage plan in 2023.
- The average Medicare Advantage monthly premium in 2022 is $6.17, a decrease from 2022.
- Through the CMS Innovation Center’s Value-Based Insurance Design (VBID) Model, 20 plans will offer Medicare Advantage enrollees eliminated Part D cost-sharing; rewards and incentives programs related to healthy behaviors; and customized, innovative benefits that address social determinants of health, such as food insecurity and social isolation, for certain underserved and/or chronically ill enrollees.
Is Medicare Advantage Right for You?
You have choices in Medicare coverage. While you can opt to stick with Original Medicare, a Medicare Advantage Plan – also known as Part C – may be a better alternative for you.
| Original Medicare | Medicare Advantage Plans |
|---|---|
| Original Medicare covers your Part A hospital insurance and Part B medical insurance. | Medicare Advantage Plans combine Part A, Part B, and additional benefits. |
| You can add Part D prescription drug coverage. | Prescription drug coverage is usually included. |
| You’re able to use any medical provider in the U.S. that accepts Medicare. | You’ll usually need to use doctors in your plan’s network. |
| You can buy supplemental coverage to manage out-of-pocket costs, including your coinsurance. | Your Medicare Advantage Plan may have lower out-of-pocket costs than Original Medicare. |
| Vision, hearing, dental, and other benefits aren’t covered. | Your plan may offer additional benefits, including vision, hearing, and dental. |
Note:
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What’s covered with a Medicare Advantage Plan?
Medicare Advantage Plans cover benefits from Original Medicare Part A (hospital insurance), Part B (medical insurance), usually Part D (prescription drug coverage), and sometimes additional benefits that Original Medicare doesn’t cover. Each Medicare Advantage Plan insurer sets the rules about how you receive and pay for these benefits.
| Hospital and skilled nursing facility inpatient care | Home health care | Prescription drug coverage (if included in your plan) |
|---|---|---|
Medically necessary outpatient services, such as:
| Preventive services, such as:
| Additional benefits (depending on your plan), such as:
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How to Compare Medicare Advantage Plans in Kansas
With 90 Medicare Advantage Plans available in Kansas, you likely have a few options in your area. To help you choose the best plan for you, consider what is most important to you before selecting a plan. There are several factors to keep in mind:
- Monthly premium: This is how much you pay for coverage monthly, regardless of the care you receive. You may need to pay your plan’s premium in addition to the Medicare Part B premium, although some plans have $0 premiums or help pay for your Part B premium.
- Plan network: You may need to use doctors and providers who are within a plan’s network. Before choosing a Medicare Advantage Plan, think about the doctors and facilities (including pharmacies) you prefer to use, then check if the plan offers coverage at those locations. Some plans may provide out-of-network coverage, but this usually comes at a higher cost.
- Deductible: Your deductible is the amount you must pay before your insurance plan starts helping cover the costs. Medicare Advantage Plans set their deductibles, and these may change only once per year on January 1.
- Copayments and coinsurance: Copayments or coinsurance are how much you pay for each service or doctor’s visit, such as $20 per doctor visit. Each Medicare Advantage Plan sets its copayment or coinsurance amount that can differ from what you would pay through Original Medicare.
- Out-of-pocket maximum: Each Medicare Advantage Plan sets a yearly limit on the maximum amount you’d be responsible for paying for services covered by Medicare. Once you reach this limit, you won’t have to pay anything for the services you receive covered by Part A and Part B in that year.
- Additional coverage: Most Medicare Advantage Plans also provide prescription drug coverage and often include additional benefits that Original Medicare won’t cover, such as vision, dental, and hearing. Plans may provide even more benefits, like discounted gym membership or transportation to doctor’s visits. Medicare Advantage Plans can also tailor their benefits to the specific needs of particular chronically ill beneficiaries.
About Medicare Advantage Plans in Kansas
With only 22% of Kansas residents choosing a Medicare Advantage Plan, Plan C isn’t as popular in the state as it is elsewhere in the country. This may be because there are fewer plans available in Kansas than in many other states, but these plans are still an option worth exploring.
| Number of Medicare Advantage Plans available | Medicare Advantage Plan types available | Medicare Advantage Plans rated 3.5 or higher by NCQA |
|---|---|---|
| 90 |
|
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Types of Medicare Advantage Plans in Kansas
In Kansas, the most common Medicare Advantage plans available are HMOs or PPOs, although there are also a few SNPs and regional PFFS plans available. Seniors eligible for Medicare may choose from plans provided by multiple private insurers, although the choices available vary by county.
Types of Medicare Advantage Plans
| HMOs | HMOs typically require that you receive all services from in network providers:
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| PPOs | PPOs include a preferred network of providers, but you have the option of choosing doctors or hospitals from outside of the network for a higher cost.
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| PFFS Plans | PFFS plans don’t require a primary care physician or referrals for specialists:
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| SNPs | SNPs are only for people with specific conditions and characteristics, and include care coordination and targeted benefits tailored to meet your specific needs:
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Enrollment and Eligibility for Medicare Advantage Plans in Kansas
You’re eligible for Medicare when you turn 65 or if you’re younger and have a qualifying disability. A qualifying disability means at least one of the following applies:
- You’ve received Social Security Disability Insurance or Railroad Board Disability Annuity for 24 months
- You have Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease
- You have End-Stage Renal Disease
When you become eligible for Medicare, you are also eligible for Medicare Advantage Plans. There are specific times of the year when you can enroll for the first time in a Medicare Advantage Plan: during your Initial Enrollment Period and the Open Enrollment Period.
- Your IEP begins three months before the month you turn 65 and extends for three months after the month you turn 65. During this period, you can enroll in a Medicare Advantage Plan. If you join before the month you turn 65, your coverage will begin the first day of the month you turn 65. If you enroll in the three months after turning 65, your coverage will begin the first day of the month after you enroll.
- If you miss your IEP, you can sign up for Medicare during the General Enrollment Period from January 1 to March 31.
- After you enroll in Medicare, you can enroll in or make changes to your Medicare Advantage Plan coverage during the Medicare OEP from October 15 and December 7 of each year. During this time, you can change from Original Medicare to Medicare Advantage, switch to a different Medicare Advantage Plan, or change from Medicare Advantage back to Original Medicare.
Medicare Advantage Open Enrollment occurs between January 1 and March 31 of each year. This period is only for beneficiaries already in a Medicare Advantage Plan, and you can change plans or switch to Original Medicare. You cannot switch from Original Medicare to Medicare Advantage during Medicare Advantage Open Enrollment.
There are exceptions to these enrollment periods called Special Enrollment Periods. Certain events or circ*mstances may make you eligible to change your Medicare Advantage Plan outside of the open enrollment periods, such as if you move outside of your existing plan’s service area or to a location with new plan options you didn’t have before. If you think you may qualify for a Special Enrollment Period, call 1-800-MEDICARE and explain your situation.
Medicare Enrollment Periods
| Enrollment period | When it happens | Medicare plans you can choose | What you can do |
|---|---|---|---|
| Initial Enrollment Period | Three months before you turn 65, the month you turn 65, and three months after | Medicare Part A, Part B, Part D, Medigap, or Medicare Advantage Plan | Sign up for Medicare Part A and Part B. Complete your Part B enrollment to avoid a late enrollment penalty. |
| General Enrollment Period | January 1 – March 31 | Medicare Part A, Part B, Part D, Medigap, or Medicare Advantage Plan. If you enroll in Medicare during this period, your MAP enrollment is April through June. | Sign up for Medicare if you missed your IEP |
| Open Enrollment Period | October 15 – December 7 | Medicare Part A, Part B, Part D, Medigap, or Medicare Advantage Plan | Join, switch, or drop a plan |
| Medicare Advantage Open Enrollment Period | January 1 – March 31 | Medicare Part A, Part B, Part D, Medigap, or Medicare Advantage Plan | If you’re enrolled in a Medicare Advantage Plan, you can change your plan or switch to Original Medicare |
| Special Enrollment Period | When you have a qualifying event | Medicare Part A, Part B, Part D, Medigap, or Medicare Advantage Plan | Make changes to your plan |
Kansas Medicare Advantage Plans With Prescription Drug Coverage
Most Medicare Advantage HMO and PPO plans and all SNP plans provide prescription drug coverage like you would get from Medicare Part D. Some PFFS plans may provide prescription drug coverage, but not all do. Evaluate a plan’s prescription drug coverage when deciding which Kansas Medicare Advantage Plan to use.
Prescription drug coverage may vary by cost, coverage, and convenience among Medicare Advantage Plans. Your monthly premium may include a premium for the drug coverage in the plan. There is usually a copayment or coinsurance amount that you have to pay for each prescription after you reach your annual deductible.
Some plans use different cost tiers with different costs for different drugs. For instance, you may pay less for generic drugs than brand-name drugs or less for brand-name drugs within different tiers. If your plan uses tiers, the formulary will list all covered drugs and their tiers. Verify your preferred or local pharmacies are included in the plan’s network.
Getting Help with Medicare Advantage Plans
Kansas-wide Medicare Advantage Resources
| Resource | Contact | How they help |
|---|---|---|
| Kansas Department for Aging and Disability Services – Medicare Frequently Asked Questions | (785) 296-4986 | The Kansas Department for Aging and Disability Services educates the public and assists consumers on topics related to Medicare and health insurance so they can make informed decisions |
| Kansas Insurance Department – Medicare Supplement Shopper’s Guide | N/A | A PDF guide to Medicare Supplement Insurance |
Federal Medicare Advantage Resources
| Resource | Contact | How they help |
|---|---|---|
| American Hospital Association – Medicare Advantage | 1-800-424-4301 | The AHA provides education for health care leaders and is a source of information on health care issues and trends. |
| CMS.gov – Medicare Advantage Applications | N/A | This page provides important information on the application process for Part C Medicare Advantage plans. |
| Medicare.gov – Medicare Advantage Plans | 1-800-633-4227 | This government website provides information on the Medicare Advantage program. |
Tammy Burns
Insurance and healthcare consultant
Tammy Burns is an experienced health insurance advisor. She earned her nursing degree in 1990 from Jacksonville State University, obtained her insurance billing and coding certification in 1995, and holds a health and life insurance license in Alabama, Georgia, Iowa, Mississippi, and Tennessee. Burns is Affordable Care Act (ACA)-certified for health insurance and other ancillary, life, and annuity products. She maintains an active nursing license and practices private-duty nursing.
Burns’ background as a nurse, insurance biller and coder, and insurance consultant includes infectious disease, oncology, gynecology, phlebotomy, post operative, family medicine, geriatrics, home health, hospice, human resources, management, billing, coding, claims, fixed annuities, group and individual health and life products, and Medicare. She’s always been driven by a desire to help people, spending more than 25 years as a practicing nurse in hospitals, private doctors’ offices, home health, and hospice. As a nurse, Burns supported patients filing insurance claims with Medicare, Medicaid, and private insurance companies as well as responding to billing questions from confused patients.
Seeing firsthand how unsuspecting patients are frequently confused by an overly complex system they don’t understand led Burns to become an insurance agent and health care consultant, now helping people understand the medical system. Since becoming an insurance agent in 2013, she has worked with some of the largest and most reputable insurance carriers and agencies in the nation, and she has built a large and loyal clientele by way of her commitment to transparency and personalized service.
Tammy Burns
Insurance and healthcare consultant
Tammy Burns is an experienced health insurance advisor. She earned her nursing degree in 1990 from Jacksonville State University, obtained her insurance billing and coding certification in 1995, and holds a health and life insurance license in Alabama, Georgia, Iowa, Mississippi, and Tennessee. Burns is Affordable Care Act (ACA)-certified for health insurance and other ancillary, life, and annuity products. She maintains an active nursing license and practices private-duty nursing.
Burns’ background as a nurse, insurance biller and coder, and insurance consultant includes infectious disease, oncology, gynecology, phlebotomy, post operative, family medicine, geriatrics, home health, hospice, human resources, management, billing, coding, claims, fixed annuities, group and individual health and life products, and Medicare. She’s always been driven by a desire to help people, spending more than 25 years as a practicing nurse in hospitals, private doctors’ offices, home health, and hospice. As a nurse, Burns supported patients filing insurance claims with Medicare, Medicaid, and private insurance companies as well as responding to billing questions from confused patients.
Seeing firsthand how unsuspecting patients are frequently confused by an overly complex system they don’t understand led Burns to become an insurance agent and health care consultant, now helping people understand the medical system. Since becoming an insurance agent in 2013, she has worked with some of the largest and most reputable insurance carriers and agencies in the nation, and she has built a large and loyal clientele by way of her commitment to transparency and personalized service.
Sources
- CMS.gov Medicare Advantage and Other Health Plan Enrollment | Last accessed March 2024
- HHS.gov | What is Medicare Part C? | Last accessed March 2024
- KFF.org | Medicare Advantage in 2022: Enrollment Update and Key Trends | Last accessed March 2024
- KFF.org | Medicare Advantage 2021 Spotlight: First Look | Last accessed March 2024
- KFF.org | State Health Facts | Last accessed March 2024
- KFF.org | Medicare Part D: A First Look at Medicare Prescription Drug Plans in 2021 | Last accessed March 2024
- Medicare | Health Maintenance Organizations (HMO) | Last accessed March 2024
- Medicare | How do Medicare Advantage Plans Work? | Last accessed March 2024
- Medicare | Avoid Late Enrollment Penalties | Last accessed March 2024
- Medicare | Preferred Provider Organizations (PPO) | Last accessed March 2024
- Medicare | Special Circ*mstances (Special Enrollment Periods) | Last accessed March 2024
- Medicare | Special Needs Plans (SNP) | Last accessed March 2024
- Medicare | Understanding Medicare Advantage and Medicare Drug Plan Enrollment Periods | Last accessed March 2024
- NCQA Health Insurance Plan Ratings | Ratings in Alabama | Last accessed March 2024
