What are your Medicare Advantage Plan options in Kansas?
Updated: December 19, 2022 Contributing Expert: Kelly BlackwellCertified Senior Advisor ®
Jump to section:Medicare Advantage Plans offer a few key differences that distinguish them from Parts A and B of the Original Medicare system managed by the federal government. While Part A pays for inpatient care at a hospital and Part B covers services and supplies used to treat or prevent medical conditions, Medicare Advantage Plans come with a few added benefits. Plans are required to offer the same level of care as Original Medicare and may include additional health care benefits, such as prescription drug coverage, routine hearing, vision, and dental exams, and fitness club memberships:
Designed to be an all-in-one solution, Medicare Advantage Plans are offered by Medicare-approved private insurance companies. There are several types of Medicare Advantage Plans available, depending on your insurance provider and location. Learn the differences between these plans and how they affect your coverage so that you can make the right choice for your medical situation.
Compare ratings of some of Kansas’s Medicare Advantage Plan providers:
Compare 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 |
Blue Cross Blue Shield | 4.5 stars | A | A+ | Not rated |
Humana | 4 stars | A- | A+ | 2nd out of 9 |
UnitedHealthcare | 3.5 stars | A- | A- | 4th out of 9 |
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.
There are four types of plans available in Kansas’s Medicare Advantage program: Health maintenance organization (HMO), preferred provider organization (PPO), private fee-for-service (PFFS), and special needs plan (SNP). Each offers a different level of flexibility in your network of care providers and varies in price. All Medicare Advantage Plans provide the same coverage as Original Medicare, but additional benefits may come with an increased premium.
HMOs typically require that you receive all services from in network providers:
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.
PFFS plans don’t require a primary care physician or referrals for specialists:
SNPs are only for people with specific conditions and characteristics, and include care coordination and targeted benefits tailored to meet your specific needs:
If you want to enroll in a Kansas Medicare Advantage Plan, you need to be enrolled in Medicare Part A and Part B, and you cannot be enrolled in Medigap. Enrollment is available to seniors 65 and older and those with a qualifying disability.
Your disability typically qualifies if you’ve received at least 24 Social Security or Railroad Retirement Board (RRB) Disability Insurance payments. You can also enroll in Medicare Advantage Plans if you have End-Stage Renal Disease (ESRD) or amyotrophic lateral sclerosis (ALS).
There are three periods when you can enroll:
Medicare provides special enrollment periods for unusual life circumstances, such as losing your job (and health coverage) and moving out of the area your insurance carrier services.
Consider these factors as you compare Medicare Advantage Plans available in your area:
How to compare Medicare Advantage Plans in Kansas | ||
Monthly premium | This is in addition to your Part B monthly premium. so it affects your monthly cash flow. You pay whether or not you access your benefits. You should have access to at least one zero premium plan with drug coverage in your area. | |
Provider network | Check to make sure your doctors, hospitals, and pharmacies are in network to keep costs as low as possible. | |
Out-of-pocket max | This is the most you’ll spend ― not including your premium, deductible, and drug costs ― for Medicare-covered services as long as you follow the plan’s rules for in and out of network coverage. | |
Deductibles, coinsurance & copays | Also known as cost-sharing, these expenses apply when you access your benefits. Check to see what your plan charges for doctor’s visits, services, treatments, and prescription drugs. | |
Drug coverage/formulary | See if your drugs are on the plan’s formulary and how much they cost each time you fill a prescription. You may want to talk with your doctor about a generic or alternative version of a drug you need. | |
Additional benefits | Consider which additional benefits are important to you. Most plans require you to use network providers and may charge extra premiums for more comprehensive coverage. |
If you’re feeling confused by the multitude of plan options available, getting in touch with trained, unbiased counselors can be a good first step. Kansas is home to organizations that can help you make an informed decision.
Kansas Medicare Advantage Resources | ||
Kansas Association of Area Agencies on Aging | Website| 785-267-1336 | The Kansas Association of Area Agencies on Aging (i4a) aims to help older adults and people with disabilities maintain independence and receive community services. |
Kansas Department for Aging and Disability Services | Website| 785-296-4986 | The Kansas Department for Aging and Disability Services (KDADS) offers services to older adults including home- and community-based services and more. |
Kansas Senior Medicare Patrol | Website | 800-432-4040 | The Kansas Senior Medicare Patrol helps you prevent, detect, and report healthcare fraud. The organization offers counseling and education. |
Kansas State Health Insurance Program (SHIP) | Website | 800-432-4040 | The State of Kansas SHIP program offers free counseling with a goal of educating you to make the best decisions for you related to Medicare and Medicare Advantage plans. |
As a health care professional since 1987, Kelly Blackwell has walked alongside and cared for seniors as they journey through the season of their fourth quarter of life. Blackwell holds a Bachelor of Science in nursing from the University of Northern Colorado, a Master of Science in health care administration from Grand Canyon University, an interprofessional graduate certificate in palliative care from the University of Colorado Anschutz Medical Campus and holds a Certified Senior Advisor ® credential from the Society of Certified Senior Advisors.
Blackwell contributes to the University of Colorado-Anschutz blog and has been published in “The Human Touch” distributed by the University of Colorado Center for Bioethics and Humanities. She cowrote “Dying Is” for Pathways Hospice.
A registered nurse, Blackwell understands health insurance choices influence quality of life and are driven by values, goals, and beliefs. She’s passionate about engaging with, educating, and empowering seniors as they navigate the health care system. She’s equipped to lend an experienced, compassionate voice to beneficiaries seeking information about Medicare Advantage Plans.
As a CSA ® , Blackwell has access to valuable resources for Medicare beneficiaries. Her work as a bedside nurse and clinical manager has given her the opportunity to see how Medicare rules, regulations, and benefits work when patients need them. With a passion to learn and to make a difference in the lives of seniors, Blackwell supports seniors through Medicare and fourth-quarter life decisions.
Certified Senior Advisor (CSA) ®As a health care professional since 1987, Kelly Blackwell has walked alongside and cared for seniors as they journey through the season of their fourth quarter of life. Blackwell holds a Bachelor of Science in nursing from the University of Northern Colorado, a Master of Science in health care administration from Grand Canyon University, an interprofessional graduate certificate in palliative care from the University of Colorado Anschutz Medical Campus and holds a Certified Senior Advisor ® credential from the Society of Certified Senior Advisors.
Blackwell contributes to the University of Colorado-Anschutz blog and has been published in “The Human Touch” distributed by the University of Colorado Center for Bioethics and Humanities. She cowrote “Dying Is” for Pathways Hospice.
A registered nurse, Blackwell understands health insurance choices influence quality of life and are driven by values, goals, and beliefs. She’s passionate about engaging with, educating, and empowering seniors as they navigate the health care system. She’s equipped to lend an experienced, compassionate voice to beneficiaries seeking information about Medicare Advantage Plans.
As a CSA ® , Blackwell has access to valuable resources for Medicare beneficiaries. Her work as a bedside nurse and clinical manager has given her the opportunity to see how Medicare rules, regulations, and benefits work when patients need them. With a passion to learn and to make a difference in the lives of seniors, Blackwell supports seniors through Medicare and fourth-quarter life decisions.