Assisted living facilities primarily help residents with non-medical needs. Although minor and infrequent medical services, such as first-aid for a wound, can sometimes be met on-site by nurses. These communities may sometimes also be called ALFs, residential care facilities, retirement homes, or long-term care facilities.
The financial options available to help pay for senior care is dependent on, among other things, the type of care that is required. If you are just beginning the research process on how to pay for long-term care, it is helpful to have an idea about the type of care you or your loved one currently requires, as well as to anticipate future needs. In addition, it is important to be familiar with the associated eldercare terminology.
Can using home care technology help your family save money caring for an aging loved one? The answer is most certainly “Yes”. Our goal is not to provide a comprehensive list, but rather to make sense of those that are available on the market today and can reduce the care hours required by elderly persons. As such, they can reduce a family’s out-of-pocket care costs or reduce the hours they spend providing care themselves.
Medicare Advantage (Part C), a privately offered alternative to Original Medicare (Parts A and B), has grown in popularity over the years. Despite the growing popularity of Medicare Advantage, some seniors face obstacles that prevent them from truly understanding how it works and who it benefits. Common mistakes about Medicare Advantage include misunderstanding its differences from Original Medicare, getting it confused with other forms of private Medicare insurance (like Medigap or Part D), or not understanding how to look up or evaluate plans.
Seniors 65 and older or individuals with certain qualifying disabilities under age 65 are eligible for Medicare coverage. Original Medicare provides fee-for-service coverage in two parts: Part A for hospitalization, skilled nursing, hospice and home health care and Part B for medical insurance coverage for outpatient care, some home health care, preventative services and durable medical equipment. An alternative to this coverage is a Medicare Advantage Plan, sometimes referred to as Medicare Part C. Medicare Advantage offers Part A and B benefits but often includes additional services, such as vision, prescription medication and dental coverage.
Unlike Original Medicare plans, which are managed by the federal government, Medicare Advantage Plans are sold by private insurance companies that have been approved by Medicare and must follow the regulations imposed by the Centers for Medicare and Medicaid Services. Medicare Advantage Plans must offer the same coverage as Original Medicare, but often, Medicare Advantage Plans only cover in-network physicians, while Original Medicare beneficiaries can see any providers who accept Medicare benefits.
Based on CMS data, in Kansas, more than 574,000 out of the state’s 2,937,150 residents qualify for Medicare Advantage Plans, marking a 2.55% increase from 2022. This percentage is slightly below the national rate of 2.66%. However, only slightly over 179,000 of those eligible actually have Medicare Advantage coverage, resulting in a 31% enrollment rate. Nationally, approximately 48% of eligible individuals are enrolled, indicating a lower state enrollment. Meanwhile, In 2023, Kansas witnessed a significant 13.66% surge in enrollment, surpassing the national increase of 9.75%. This suggests that a larger portion of eligible seniors in Kansas are choosing Medicare Advantage, supported by a 10.84% rise in in-state enrollment.
This guide provides comprehensive information about available Medicare Advantage Plans in Kansas. It delves into the finest plans the state offers, provides a detailed explanation of their operation and outlines the scope of coverage they provide.
The Top 10 Medicare Advantage Plans in Kansas
In Kansas, Medicare beneficiaries can choose from several Medicare Advantage Plans from various providers across the state. The below table notes the top 11 Medicare Advantage Plans based on total enrollment numbers. Because each provider may have several plans, numbers for those plans are combined. The table also notes the Medicare star rating, plan types and a range of average costs. The information provided is as recent as July of 2023. Beneficiaries should check Medicare.gov for more information.
Name
Enrollment
Medicare Star Rating
Monthly Cost Range
Plan Types
Humana
84207
3
$0 – $92
PPO, HMO, PFFS
Aetna Medicare
31803
3.5
$0 – $0
PPO, HMO
MVP HEALTH CARE
10133
4
$0 – $0
PPO
Healthfirst Medicare Plan
9327
4.5
$0 – $29
HMO
Highmark Blue Cross Blue Shield of Western New Yo
2440
3
$0 – $13
HMO
Blue Medicare Advantage
1530
4
$0 – $0
HMO
UnitedHealthcare
790
4
$0 – $197
PPO, HMO
Highmark Inc.
733
4
$0 – $131
PFFS
Ascension Complete
504
N/A
$0 – $0
PPO
Independent Health
447
3
$0 – $0
HMO
How Medicare Advantage Plans Work in Kansas
The two most popular types of Medicare Advantage plans are from health maintenance organizations (HMOs) or preferred provider organizations (PPOs), but Kansas has other types of plans available as well. Each plan type has specific parameters covering networks, drug coverage, primary care providers and other coverage-related details. Before enrolling, beneficiaries should compare their options and ensure they know how each MA plan works to make an informed decision regarding their health coverage. The descriptions below cover the most common plans to provide essential information and help with this decision.
What Medicare Advantage Plans Cover in Kansas
Medicare Advantage plans in Kansas must include the same coverage as Original Medicare. Hence, beneficiaries get the same Medicare Part A hospital insurance and Medicare Part B medical insurance coverage, except hospice care which remains covered under Original Medicare. Many MA plans also bundle Medicare Part D and various additional benefits to make them an all-in-one solution. Extra benefits may include hearing aids, dental and vision care, rides to medical appointments and wellness programs.
Coverage Available With Medicare Parts A & B?
Coverage Available With Medicare Advantage?
Preventive Screenings
Yes
Yes
Hospital Care
Yes
Yes
Durable Medical Equipment
Yes
Yes
Prescription Drugs
No
Yes**
Vision Care
No
Yes*
Dental Care
No
Yes*
Hearing Aids
No
Yes*
*Select plans offer this coverage
** Most plans offer this coverage
Eligibility for Medicare Advantage in Kansas
Because Medicare Advantage is an alternative to Original Medicare, beneficiaries must follow the same eligibility rules. Therefore, recipients must be aged 65 or older or have a qualifying disability to be eligible for Medicare Advantage in Kansas. Applicants also can qualify if they’ve been diagnosed with Lou Gehrig’s disease or end-stage renal disease, a medical condition that causes the kidneys to quit working permanently.
All applicants must have Medicare Parts A and B and be U.S. citizens or qualified noncitizens. To sign up for specific Medicare Advantage plans, the applicant must reside in an area serviced by the desired plan. Some plans like Special Needs Plans have additional eligibility requirements. Approved beneficiaries can only join or switch to an MA plan during one of the approved enrollment periods listed below.
Initial Coverage Election Period: This is the initial 7-month period, coinciding with one’s 65th birthday, during which everyone is eligible to enroll in a Medicare Advantage plan.
Annual Election Period (AEP): Also referred to as the Open Enrollment Period, this the time of year when anyone over 65 can enroll in Medicare Advantage for the first time or change to a new plan.
Medicare Advantage Open Enrollment Period: During this period, those who are already enrolled in Medicare Advantage can switch to a different plan or switch back to Original Medicare.
Start Date
End Date
Initial Coverage Election Period
3 Months Before One’s 65th Birth Month
3 Months After One’s 65th Birth Month
Annual Election Period (AEP)
October 15th
December 7th
Medicare Advantage Open Enrollment Period
January 1st
March 31st
Additionally, Medicare Advantage plan participants can change their plan outside of these enrollment periods under certain qualifying circumstances, such as moving to a new state.
How to Find & Choose a Medicare Advantage Plan in Kansas
Navigating the many intricacies of Medicare Advantage plan types, insurers, and the specific plan options available by region can be a difficult and time-consuming task. Below are several resources we’ve created to help you through the process.
First is a downloadable PDF that you can use as a guide to help you compare plans as you research. Finally, we have listed a number of organizations that you can contact with experts that will help you determine whether Medicare Advantage is right for you and what plans you should consider.
Free for seniors living within the state, the Senior Health Insurance Counseling for Kansas (SHICK) program connects individuals with trained volunteers within the community who can provide answers to questions about Medicare and other insurance-related issues. There are volunteers located throughout many communities who educate and help seniors choose which insurance plan best suits their needs, including choosing how much insurance is needed, the type of coverage they should have and understanding the cost of premiums. This one-on-one counseling is available free of charge both on the phone or in-person. The organization also provides information through public forums, presentations and through printed materials.
To locate the nearest SHICK program, or to speak to someone about what services are available, call 1-800-860-5260. You can also search for the nearest county office at the Kansas Commission on Aging website.
The Kansas Department of Health and Environment helps seniors determine their eligibility for Medicare and other programs and protects the rights of each consumer. The organization website also includes policy memos concerning long-term care, VA benefits and any eligibility changes as they are updated.
The Kansas Department of Health and Environment is located in Topeka and can be reached by phone at (785) 296-1500, or through email at [email protected].
Seniors in Kansas who are enrolled in Medicare and have limited incomes may receive help with out-of-pocket insurance costs through a Kansas Medicare Savings Program. These programs may help with insurance premiums, deductibles and copayments. Available savings programs include the Qualified Medicare Beneficiary (QMB), Low Income Medicare Beneficiary (LMB) and Expanded Low-Income Medicare Beneficiary (ELMB), which can all lower the cost of Medicare premiums and cost-sharing expenses. To qualify, seniors must be 65 and older and currently receiving Medicare.
To learn about eligibility, seniors should contact the KanCare Clearinghouse in Topeka at 1-800-792-4884. They can also download an application online and fax it to 1-844-264-6285.
The Kansas Senior Medicare Patrol helps prevent Medicare abuse and fraud throughout the state and educates recipients on how to protect against identity theft and health care fraud. The program trains volunteers, helps seniors file reports and provides publications and information about fraud warnings. The program is free to all seniors who are applying for or currently enrolled in Medicare.
To learn more about Medicare fraud in Kansas or to sign up as a volunteer, contact the Kansas Department for Aging and Disability Services at 1-800-432-3535.
Local Medicare Advantage Resources
Aging and Disability Resource Center
The Kansas Aging and Disability Resource Centers (ADRCs) help individuals of all ages, including seniors, plan for their future and long-term health needs. The organization provides counseling and a list of resources about Medicare and other insurance-related issues, including prescription drug coverage. Through local community offices, the resource centers can also guide seniors through their options and connect them with the available support services.
The KCMPA is the only accountable care organization in the state of Kansas that participates in the Medicare Shared Savings Program (MSSP). This organization is comprised of 12 primary care practices in Kansas and Missouri that helps keep medical costs low for seniors with limited incomes.
To learn more about which physicians participate in the MSSP, contact the organization at 1-816-673-9061.
Kansas Area Agency on Aging
The Kansas Area Agencies on Aging (AAAs) provide seniors with information and options counseling on Medicare. This assistance is available for free to seniors of all income levels and includes information about the best type of insurance to pay for nursing home care, caregivers and assisted living.
There are 11 AAAs located throughout the state serving specific counties. To find the nearest agency, call 1-913-573-5000 or send an email to [email protected].
