Medicare Supplement Insurance, more commonly known as Medigap , helps beneficiaries pay a variety of their out-of-pocket costs under Original Medicare. Private insurance companies provide the policies under guidelines set by Medicare. This page describes Medicare Supplement Insurance plans in Kentucky and who qualifies.
What is Kentucky Medigap?
If you have Original Medicare, you can join a Medigap plan to help pay some of your out-of-pocket costs. Unlike Medicare Advantage, there is no yearly out-of-pocket maximum with Original Medicare. Without a Medigap plan, you could owe significant medical bills, especially if you have a chronic condition or require a lengthy hospital stay.
Original Medicare includes Part A, hospital insurance, and Part B, medical insurance. It does not provide prescription drug coverage, which means you cannot use a Medigap plan to cover the cost of medications.
Medicare Supplement plans are standardized, meaning every Plan A (or B, D, etc.) provides the same benefits no matter which insurance company offers it. There are 10 standard Supplement plans (A, B, C, D, F, G, K, L, M, and N), but not every Medigap insurer offers every plan. In addition, some insurance companies sell high-deductible versions of one or more plans.
Please note that Medigap is not standalone insurance like Medicare Advantage, TRICARE, or Medicaid. These plans supplement your Medicare coverage; they do not replace it.
Who qualifies for Medicare Supplement Insurance in Kentucky?
Kentuckians who are age 65 or older and enrolled in Original Medicare qualify for Medicare Supplement Insurance.
If you have Medicare Parts A and B but qualify due to a disability (in other words, you aren't yet 65), Medigap insurers do not have to offer you coverage. Once you turn 65, though, you get the same guaranteed issue rights that other over-65 Medicare beneficiaries receive.
What does Medigap cover?
Medigap plans cover a variety of services provided by Original Medicare. Which services depends on which Supplement plan you choose. The following table details the benefits under each Medigap plan:
Since Kentucky Medicare Supplement plans only pay for services included with Medicare Parts A and B, coverage doesn't include prescriptions. Those benefits are available with a standalone Medicare Part D plan. Alternatively, you can join a Medicare Advantage Prescription Drug plan (MA-PD). However, if you choose an Advantage plan, you can't also have Medigap.
Medigap Plan C and Medigap Plan F in Kentucky
There are two Supplement plans that cover the Medicare Part B deductible: Medigap Plan C and Medigap Plan F. As of January 1, 2020, however, this coverage is no longer available to new Medicare beneficiaries.
Medigap Plan D and Medigap Plan G provide the same benefits as C and F, respectively, minus the Part B deductible. As a bonus, most beneficiaries find they pay less out-of-pocket with Plans D and G, thanks to lower monthly premiums.
When is the best time to join a Kentucky Medicare Supplement plan?
The best time to join a Kentucky Supplement plan is during your Medigap Open Enrollment Period (OEP). This begins the day you are both age 65 or older AND enrolled in Medicare Parts A and B.
Your Medigap OEP lasts for 6 months and is one of the few times you have a guaranteed issue right. This means that Medigap insurers cannot deny you coverage or charge you a higher premium, even if you have preexisting medical conditions.
If you do not have guaranteed issue rights, your Medigap application goes through medical underwriting. This is the process insurance companies use to decide whether to offer you a policy and at what rate. Medical underwriting involves answering a series of health-related questions, including age, medical history, and tobacco use.
How to choose a Medigap plan in Kentucky
The first step in choosing a Kentucky Medigap plan is deciding how much coverage you need. Medical underwriting makes it more difficult to get approved for a Supplement plan if you wait until you're sick to apply. That's why we recommend choosing the most robust coverage you can afford during your Medigap OEP.
Pricing is the next consideration. Although benefits are standardized, premiums are not, and each Medigap insurer sets its own rates. Kentucky allows providers to use either of the following pricing methods:
- Attained-age rated: Premiums start out low but rise as you age. These policies are usually the most expensive option over time.
- Issue-age rated: Premiums are based on your age at the time you join the plan, not your age throughout the life of the policy. They may rise over time due to inflation, though.
Our Find a Plan tool makes it easy to compare Medigap plans in Kentucky. Simply enter your location information to review Medicare plan options in your area.
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