If you're looking for more well-rounded coverage, you might want to consider a Medicare Advantage (MA) plan. Millions of Medicare beneficiaries have made the switch, with over one-half now enrolled in an Advantage plan. This page explains Medicare Advantage plans in Kansas, how the program works, and how to compare your options.
What is Medicare Advantage?
Also known as Medicare Part C, Medicare Advantage plans must provide same benefits as Original Medicare. This includes Part A, hospital insurance, and Part B, medical insurance. Prescription drug coverage is not included with Original Medicare. For that, you need Medicare Part D.
Advantage plans are not limited to the coverage provided by Original Medicare. In fact, around 90 percent offer additional benefits, such as prescription drug coverage and routine vision and dental care.
You are still responsible for paying the Medicare Part B premium, even if you join an Advantage plan.
Kansas Medicare Advantage plans with prescription drug coverage
Medicare Advantage Prescription Drug plans (MA-PD) combine your Parts A, B, and D benefits into a single policy. Most MA plans include prescription drug coverage. If yours does not, you can join a standalone Medicare Part D plan.
Who is eligible for Medicare Advantage in Kansas?
If you have Medicare Parts A and B, you are eligible for Medicare Advantage in Kansas.
You become eligible for Medicare once you turn 65. Or, you may also qualify if you collect Railroad Retirement Board (RRB) or Social Security disability benefits for 24 months.
When can you sign up for a Medicare Advantage Plan in Kansas?
Medicare Advantage sign-up periods are:
- Initial Enrollment Period (IEP): Begins 3 months before your Medicare eligibility month and lasts for 7 full months. So, if your birthday or 25th month of disability is in June, your IEP begins March 1 and ends on September 30.
- General Enrollment Period: From January 1 through March 31, anyone who did not sign up for Medicare Part A and/or Part B can do so. Then, from April 1 through June 30, you may join an Advantage plan.
- Medicare Annual Enrollment Period (AEP): From October 15 through December 7, you may make any changes needed to your Medicare coverage, including joining an Advantage plan.
- Medicare Advantage Open Enrollment Period (OEP): If you already have a Part C plan, you may participate in OEP from January 1 through March 31. Options are limited to switching to a new Advantage plan or returning to Original Medicare. You may also join a Part D plan during OEP if making that change causes you to lose your prescription drug coverage.
- Special Enrollment Periods (SEP): There are dozens of special circumstances that may qualify you for an SEP. The full list is on Medicare.gov.
Types of Medicare Advantage plans in Kansas
There are four main types of Medicare Advantage plans in Kansas.
- Health maintenance organizations: HMO plans use a provider network and require members to choose a primary care doctor who provides referrals to specialists.
- Preferred provider organizations: PPO plans also use a provider network, but they allow members to receive out-of-network services for a higher copay. You don't need a primary care doctor or referrals to see a specialist if you have a PPO plan.
- Private fee-for-service: PFFS plans determine how much the plan and its members will pay for covered services. Some PFFS plans have a provider network that accepts the plan's terms (i.e. how much it pays). You pay more for out-of-network services.
- Special needs plans: SNPs limit membership to people who have certain chronic illnesses, qualify for both Medicare or Medicaid, or who live in a nursing home or require at-home care.
How to choose a Medicare Advantage plan in Kansas
When comparing Medicare Advantage plans in Kansas, look at the following metrics:
- Coverage (including drug formulary for an MA-PD plan)
Our Find a Plan tool makes it easy to compare Medicare Advantage plans in Kansas. Just enter your location information and estimated coverage start date to review Medicare plans in your area.
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