Kansas Medicare Supplement Plans (Medigap)
Kansas Medicare Supplement plans were created to work with Medicare to add additional benefits to your Traditional Medicare coverage.
These benefits were created to provide coverage for what isn’t covered by Traditional Medicare. This includes out of pocket expenses such as, deductibles, copayments and coinsurance.
Medigap policies are the same as Medicare Supplement plans. These policies are sold by private insurance companies. Kansas Medicare Options are explained into parts and plans.
Kansas Medicare Benefits
Having more coverage than Original Medicare can protect you from unexpected healthcare costs.
Medigap or Medicare Supplement plans can cover the 20% Traditional Medicare does not cover.
These plans will allow you to see any doctor who accepts Medicare assignment.
Medigap policies do not include prescription drugs, you will need to purchase a Part D, Prescription drug plan.
These plans have a formulary (list of covered drugs), you will want to check with the plan to be sure all your medications are covered.
Part C is also known as a Medicare Advantage plan, these plans are typically low-cost plans because they receive a portion of your Part B premium to take responsibility of your Health Coverage.
Medicare will not be responsible for your healthcare claims if you are enrolled in a Medicare Advantage plan. Part C replaces Part A and Part B, and there are limitations.
A Medicare Supplement with a Part D plan will get you the most comprehensive healthcare coverage.
What Benefits does Medicare Cover is Kansas
Medicare does cover a variety of services, they do not cover them fully. The Medicare beneficiary is responsible for 20% of the healthcare expenses. The beneficiary may be responsible for additional out of pocket costs, that is why a Medigap plan is needed, to help cover the “gap” Medicare doesn’t.
- Hospital Care
- Skilled nursing facility care
- Nursing home care (only if custodial care isn’t the only care you need)
- Home health services
Part B (Medical Insurance)
- Medically Necessary Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.
- Preventive Services are also covered to prevent illness or detect it at an early stage, when treatment is most likely to work best.
- You pay nothing for most preventive services if you get the services from a health care professional who accepts Medicare Assignment.
- You will pay a deductible and coinsurance for your Part A and Part B services. If you choose to buy a Medicare Supplement Insurance policy, your policy may pay some of these costs.
Requirements for Kansas Medicare Supplement Plans
To enroll in a Medigap policy you must be at least 65 years old and enrolled in Medicare Part B. You need to enroll in your Medicare Part B as soon as you are eligible to avoid the Part B Late Enrollment Penalty. Kansas Medigap plans are only available to Kansas residents.
Medicare Eligibility in Kansas for the Disabled, Under 65
You automatically get Part A and Part B after you get disability benefits from Social Security or certain disability benefits from the Railroad Retirement Benefits for 24 months.
The Federal law does not require insurance providers to offer Medicare Supplement Insurance for people who are disabled and under age 65, but some state laws do.
Kansas state requires that insurance providers offer at least one type of Medicare Supplement plan to individuals under 65 who receive Medicare Benefits.
There are Medicare Supplement plans available to those on disability in Kansas, call the number above for more information on the plans available to you.
How to Sign up for Medicare Supplement Insurance in Kansas
Your Open Enrollment Period (OEP) begins the 1st day of the month you’re at least 65 years old AND your Medicare Part B has become effective.
For example, if your birthday was August 31st and your Medicare Part B effective date was October 5th, then your OEP begins November 1st.
Thankfully you can enroll in a Medigap plan anytime, even if you missed your OEP. Your OEP is in effect for 6 months and during this time you are granted Guaranteed Issue (GI).
Guaranteed Issue Right
Having the opportunity to use your Guaranteed Issue right is one you should not pass up. This means the insurance company can’t refuse Medigap coverage.
In addition, they must cover all your pre-existing health conditions and can’t charge you more for a Medigap policy because of past or present health problems.
You can qualify for a GI in Kansas if you Voluntarily leave your group plan that is primary to Medicare. If Medicare is primary, you may not qualify for GI.
If you do not have health insurance for 63 days prior to signing up for a Medicare Supplement, the supplemental policies may require that you wait six months after your Medigap policy date before they will cover your pre-existing conditions.
Although that seems unfair, you should remember, your Traditional Medicare must pay its portion of you pre-existing condition medical costs while you are waiting for the Medicare Supplement policy to pay its portion.
To avoid this waiting period, you will need to offer proof of “creditable coverage”. Creditable coverage is any other health insurance policy you had before applying for your Medigap coverage.
If you can show you had at least six months of continuous coverage, your Medigap insurance company will not enforce the waiting period before they will pay for medical costs that result from pre-existing conditions.
You cannot have a lapse in the coverage for more than 63 days, you must verify that your prior insurance coverage is considered “creditable coverage” and you must enroll in a Medicare supplement plan as soon as you’re eligible for one.
You should never cancel coverage until you have confirmed that your new policy has been approved and issued.
Once the Open Enrollment Passes
Once your Medigap Open Enrollment Period passes, you may not be able to enroll in a Medicare Supplement plan as easily if you’re doing so for the first time.
If you’re already enrolled in a Medigap plan, you may not be able to switch plans with guaranteed issue (except in certain situations).
Without guaranteed-issue rights, you may be subject to medical underwriting and charged higher premiums based on your health status. Insurance companies can also deny you coverage if you have health problems.
It’s usually more difficult to find Medicare Supplement coverage after your Medigap Open Enrollment Period has passed if you have disabilities or pre-existing conditions; even if you can find a Medigap plan that will accept you, your premium costs may be higher.
Kansas Medicare Supplement Plans Premiums
The cost of a Medigap policy is determined by the insurance company and not the state. The price is determined based off many different factors including; age, sex, and location. A plan in Overland Park will not cost the same as a Plan in Wichita.
Each carrier uses 1 of these 3 rating methods:
- Community Rated
- Issue Age Rated
- Attained Age Rated
The Top Rated Medicare Supplement Plans in Kansas
It does not matter the company you go with for your Medigap coverage. The only difference between the plans is the cost the carrier chooses to charge. A Plan F is a Plan F, no matter the company, it is the same coverage. The top letter plans are F, G and N.
Plan F is the most Popular choice of all Medicare recipients, it leaves beneficiaries with minimal out-of-pocket expenses. This plan offers the broadest coverage, keep in mind you still need to pay your Medicare Part B monthly premium.
Plan F covers:
- Part A Coinsurance and hospital costs-up to an additional 365 days after Medicare benefits are used up
- Part B Coinsurance or Copayment
- Skilled Nursing Facility Coinsurance
- Medicare Part A and B deductible
- Part B excess charges
- Foreign Travel Emergency (up to plan limits)
If Medicare Plan F is too expensive for your budget, another great option is Plan G.
This plan is at times significantly cheaper than Plan F and depending on your area you can save a good amount of money on your premiums.
The only difference in the two plans is that with plan G you will be responsible for your Part B deductible.
You will also still need to pay your Part B premium.
This plan tends to be cheaper than Plan F, here are the differences in the two plans:
- Plan F pays the 20% of Part B Medical expenses that aren’t covered by Traditional Medicare, without requiring a copay. With Plan N, you may be responsible for a copayment.
- This plan does not cover Part B excess charges.
- Plan N does not cover the Part B deductible of $183 for 2018.
Kansas Medicare Advantage Plans
Also know as Part C, Medicare Advantage plans are usually low-cost plans that can require you to stay in the plans service area. These plans have a list of covered doctors that can change at any time.
When you enroll in a Medicare Advantage plan, Medicare is no longer responsible for your healthcare claims. Medicare Advantage plans are offered by private insurance companies.
Medicare pays a fixed amount for your care each month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare.
Each plan can charge different out-of-pocket costs. These plans are not standardized by the government and the rules can change each year.
Part C plans may require you to obtain referrals for specialists. Medigap policies cannot work with Medicare Advantage plans.
If you have End stage renal disease (ESRD) you typically can’t enroll in a Medicare Advantage plan. You can enroll in a Medicare Advantage Special Needs Plan if the plan specifically serves individuals with ESRD.
Kansas Medicare Part D Prescription Plans
Plans do not usually cover for cosmetic issues, weight loss or sexual dysfunction. Each plan has a formulary (a list of covered drugs), that is broken down into tiers based on their cost.
Stand-alone Part D Plans compliment your Medigap policy and Original Medicare, giving you the most comprehensive coverage.
Part D Coverage Phases:
- The Deductible Phase is the amount the enrolled pays prior to coverage kicking in.
- In the Initial Coverage phase your plan pays 75% of your prescription drug costs and the enrollee pay 25% up to the plan limit
- The Coverage Gap is also known as the donut hole. The plan will pay 49% for generic drugs and 10% for brand name drugs. For brand drugs, the manufacturer discounts their costs by 50%. This discount is counted as an enrollee out of pocket cost expenditure. Helping you get out of the donut hole faster. The beneficiary pays 51% of the cost for generic drugs and 40% of the cost of brand name drugs
- Once you reach the Catastrophic Coverage phase you have reached the annual out of pocket threshold, the plan pays for 95% of your drug costs.
Part D Penalty
If you do not enroll in a Medicare Part D Prescription Drug plan when you are eligible you may be responsible for a Part D Penalty.
If you are eligible for Medicare because you are turning 65, your initial enrollment period begins three months before, three months after and the month of your 65th birthday.
The Part D penalty is based on the number of months you were without PDP coverage. Therefor, for each month of no coverage, you will pay an additional premium of 1 percent of the current “national base beneficiary premium”. For 2018, the beneficiary premium is $35.02.
This is not a one-time penalty. You’ll be penalized every month for as long as you have Medicare Part D coverage.
How to Apply for Kansas Medicare Supplement Plans
When you call one of our licensed agents or fill out our form you can find out what benefits you may be eligible to receive. Furthermore, we can help with all your Medicare options including Medigap, Medicare Advantage and Part D plans. You can compare rates and get the remaining 20% not covered by your Medicare, covered.
Kansas Medicare Resources
Beneficiaries will have options to help pay for their Medicare costs. Medicare Savings Programs may pay Medicare Part A and Medicare Part B deductibles, coinsurance, and copayments if you meet certain conditions.
If you qualify for QMB, SLMB, OR QI program, you automatically qualify to get extra help paying for your Medicare prescription drug coverage. Another Medicare resource is Kansas is the Senior Health Insurance Counseling for Kansas (SHICK)
Kansas Health Facts
Statistics showed that in 2013, 15% of Medicare beneficiaries within the state where disabled. Of that 15%, less than 1% were diagnosed with end-stage renal disease.
Statistics also showed that in 2015 the entire number of beneficiaries who received Medicare in the state equaled almost 500,000. That’s 17% of the total number of residents residing in the state of Kansas.
Kansas Medicare FAQs:
- How often are there excess Medicare charges in Kansas? Kansas does not prohibit excess charges. It is important to keep track of all doctors who accept Medicare and accept the assigned rate. You can look at Medicare.gov database to see which doctors accept the Medicare assignment or if they charge excess charges. To make life easier, you can buy a Medicare Supplement policy that pays for excess Part B excess charges. Medicare Plan F and G both provide coverage for Part B excess charges.
- What Medicare Part D plans area available in Kansas? There is an abundance of Part D plans throughout Kansas. Each county can be and usually is different. To better understand which plan is right for you, call an agent at the number above.
- Where can I find a Medicare agent licensed in Overland Park, KS? We have Insurance Agents Licensed in the entire state of Kansas., you can call us or fill out a contact form.