Original Medicare doesn't cover 100% of the costs for covered services. People with Original Medicare insurance are responsible for paying for the gap between what healthcare services cost and what Medicare pays.
There are no out-of-pocket maximums and it covers only 80% of your medical services. If you don’t have a lot of medical expenses in a year, this doesn’t matter too much. If your healthcare services cost $40,000, however, this would leave you owing about $8,000 in one year. For this reason, if you’re one of the nearly 71% of Kentucky residents enrolled in Original Medicare, you might be considering a Medicare Supplement plan, to help keep your out-of-pocket costs low.
Medicare Supplement (also called Medigap) plans are offered by private insurance carriers as an additional coverage option that you can stack on top of Original Medicare. These policies aim to supplement, or fill the gaps left by, Original Medicare. While they’re offered by private insurance carriers, the federal government standardizes them. That means that all Medicare Supplement plans of the same type must provide the same coverage.
Beneficiaries in Kentucky have ten types of Medigap plans to choose from. While the most popular plans in the state are Medigap Plan G and Plan N, it’s important to choose a plan based on your needs and priorities. In this post, we’ll discuss the different Medicare Supplement plan options available in Kentucky and how to choose the best one for you.
Medigap plans are standardized across the country, so most states offer the same ten plans.
Every plan of the same type provides identical coverage, but your monthly premium varies based on personal and policy factors.
There are three pricing structures insurance carriers use to price their plans: community rated, issue-age rated, or attained-age-rated.
Take a look at our Kentucky Medicare Guide for information on how to enroll, compare coverage options, and save money on your Medicare.
Because Medigap plans are standardized, most states (including Kentucky) offer the same ten plans. All plans are named with a letter A through N.
Each letter plan has its own level of coverage. Plans labeled with the same letter have identical coverage, regardless of which insurance carrier sells it. For example, all Medigap Plan Ds will provide identical coverage across all insurance providers and across all states.
Our Medigap comparison chart is a helpful tool that outlines the differences between each plan.
*Note that Plans F and C are unavailable for Medicare beneficiaries who turn 65 after January 1, 2020.
More than 50,000 Medicare recipients in Kentucky are enrolled in a Plan G. Beneficiaries often choose Plan G because it’s the most comprehensive Medigap plan, covering coinsurance and copays that Original Medicare doesn’t cover. Plan G also pays Part B excess charges and 80% of foreign health expenses. It also generally has a reasonable monthly premium, making it both a high coverage and affordable option.
While Plan G is the most popular Medigap plan in Kentucky, it might not be the best one for you. Before enrolling in a plan, you should consider a variety of factors such as your current and future medical needs, budget, and lifestyle. One of our licensed Medicare Advisors can help you use your priorities to find the right plan for your needs.
Medigap premiums in Kentucky range from $34 a month for a high-deductible Plan G to $648 for the highest-cost Plan D. Medicare’s plan comparison tool lists all of the plans available in Kentucky along with their premiums. You can also contact us at 855-900-2427 to get more information about Medicare Supplement plans in Kentucky.
So if all Medigap plans of the same type have the same coverage, what’s different about them? The main difference between plans is the cost of your monthly premium. Your individual premium depends on both who you are and your plan’s pricing structures.
These are the factors that may affect the cost of your premium:
Your age
Your gender
Where you live
Whether or not you smoke
When you enroll
Whether or not you live with someone who is also eligible for Medicare
Economic factors like inflation
Your policy’s pricing structure
Men, tobacco users, and older adults tend to pay higher premiums due to having more healthcare needs—although age isn’t always a factor. You may also pay a higher premium if you enroll outside of your Medigap Open Enrollment Period because you’ll likely need to go through medical underwriting.
Insurance companies can use different pricing structures to set and change their premiums. Your Medigap plan can either be community-rated, issue-age-rated, or attained-age-rated.
Community-rated plans do not use age to determine your monthly premium so everyone pays the same price. Premiums are the same for everyone in the same geographic area. These policies tend to be the most cost-effective in the long term because your monthly premium is the same regardless of your age or gender.
Issue-age-rated monthly premiums are based on your age at the time you enroll in the plan. These plan premiums are lower the younger you are when you sign up. Unlike attained-age-rated plans, these plans do not get more expensive as you get older.
Attained-age-rated plans use your current age to determine your monthly premium. Premiums are low when you first enroll (the younger you are, the cheaper they are) but will increase as you get older.
Choosing the best healthcare plan can feel overwhelming, but luckily, you don’t need to do it alone! Working with a licensed Chapter Medicare Advisor can help you choose the best Medicare coverage for your needs. Our advice is always free and our advisors always have your best interest at heart—give us a call at 855-900-2427 or schedule a chat to get started.