Medicare in Kansas

Medicare is the federal health insurance program for seniors aged 65 and over, disabled adults and people with end-stage renal disease (ESRD). In 2023, 574,000 people in Kansas are enrolled in at least one part of the program, which represents 20% of the total population. Kansas spends around $4.4 billion on Medicare costs, which amounts to about $7,655 per beneficiary.

Original Medicare is the preferred option for many Kansas seniors. About 69% of Medicare-eligible older adults in the state choose some combination of Medicare Parts A, B and D. Part A is the inpatient hospital benefit, which seniors with a qualifying work history get for free at age 65. Married or widowed enrollees can use their spouses’ work history if they don’t have the required 40 work credits of their own to get premium-free coverage. Medicare Part B is an optional program that pays up to 80% of the cost for outpatient services, such as office visits, transportation and supplies. Part D is the Medicare drug benefit for prescriptions filled at a pharmacy.

About 31% of seniors in Kansas choose to access their Medicare benefits through Medicare Advantage, which is an increasingly popular alternative to Original Medicare. Sometimes called Part C, Medicare Advantage enrollment grew by 10.84% in Kansas from 2022-23, beating out the 6.9% national growth during the same period. Part C plans are issued by private insurance companies and combine all the coverage of Parts A and B, plus a few extras such as dental and vision care, into a single plan that’s available as an HMO, PPO, PFFS or SNP.

This guide contains information about Medicare options for Kansas seniors, including pricing and plan details. It goes over several resources that can help seniors and families planning for their health care needs, as well as helpful information to assist seniors trying to make the right choices when enrolling in Medicare in Kansas.

Options for Medicare Coverage in Kansas

Older adults in Kansas have many options for Medicare coverage. Original Medicare is a good fit for some, but those who need a different choice can select one of the state’s many Medicare Advantage plans. With these varied options, seniors can easily customize a plan that fits their needs and budget, or they can add additional coverage to Original Medicare.

Original Medicare (Parts A & B)

Original Medicare splits coverage between the inpatient plan (Part A), outpatient services (Part B) and prescription drug coverage (Part D). As of 2023, most seniors pay $0 a month to get Part A coverage, with a $1,600 deductible that applies for each inpatient stay in the hospital, nursing home or other inpatient facility. Part B comes with a $164.90 monthly premium and a $244 annual deductible. After these costs are met, both A and B pay 80% of additional costs for authorized care. Part D provides varying levels of support for prescription drugs.

Who Should Consider Original Medicare

Original Medicare may be a good option for those who:

• Travel frequently within the United States
• Don’t need extra benefits such as home-delivered meals and coverage for over-the-counter medication
• Want to choose their own prescription drug coverage

Medicare Advantage (Part C)

Medicare Advantage Plans are issued by private insurance companies in each state. These plans may be organized as HMOs, PPOs, PFFS plans or special needs plans (SNPs). Costs vary for each plan, with some in Kansas offering $0 premiums and others offering very low deductibles. This flexibility makes Medicare Advantage Plans potentially very attractive to new enrollees. Unlike Original Medicare, Part C participants don’t need and aren’t eligible to enroll in a Medigap supplemental plan. Low-income participants can still get additional coverage via Medicaid, however.

Who Should Consider Medicare Advantage

Medicare Advantage works well for many seniors, including those who:

• Could qualify for low premiums due to good overall health
• Need control over their out-of-pocket costs
• Like the idea of a managed plan

• Need coverage not provided by Original Medicare

The Top 10 Medicare Advantage Plans in Kansas

Kansas has many different Medicare Advantage plans. The table below lists the top options based on the number of people enrolled while also providing information about associated costs and coverage as of August 2023. More information on Medicare Advantage is available on the Medicare Advantage Plans in Kansas page.

Medicare Prescription Drug Coverage (Part D)

Original Medicare doesn’t pay for most prescription drugs through Part A or B coverage. Instead, seniors purchase separate prescription drug policies, also called Part D coverage. Medicare contracts with private health insurance companies to provide this coverage. There are multiple plans to choose from with varying monthly premiums, which beneficiaries pay in addition to their Original Medicare premiums. While seniors don’t have to purchase prescription drug coverage when they’re first eligible for Medicare, not obtaining this coverage at this time may result in late enrollment penalties they pay for as long as they have Medicare if they enroll later.

Each prescription drug plan has its own formulary, or list of covered drugs. Formularies are typically split up into tiers. The tier a medication is in determines how much the insurance company pays and how much the beneficiary pays for it. Lower-level tiers are usually made up of generic and low-cost brand name drugs, while higher tiers are composed of more expensive brand name and specialty drugs. In most cases, the lower the tier, the lower the policyholder’s cost-sharing responsibility.

Who Should Consider Medicare Prescription Drug Coverage

Seniors who may benefit from prescription drug coverage include those who:

• Currently take prescription medication or expect to in the future
• Want to avoid late enrollment penalties
• Want to reduce out-of-pocket prescription drug expenses

Medicare Supplement Insurance (Medigap)

While Original Medicare provides coverage for many medical costs, seniors may still have significant out-of-pocket expenses. These may include copays, coinsurance and deductibles. Seniors may be able to reduce their cost-sharing obligations by purchasing a Medigap plan. These plans can only be used with Original Medicare. It’s illegal for private insurance companies to sell Medigap plans to those with Medicare Advantage plans.

For more information on Medigap plans, seniors can refer to the Best Medicare Supplement Companies of 2023 page.

Who Should Consider Medicare Supplement Insurance

Good candidates for Medigap may be those who:

• Have ongoing health issues and expenses
• Travel overseas often
• Want to access an expanded network of health care providers
• Expect to need health services not covered by Original Medicare

Medicare Resources in Kansas

Medicare beneficiaries and those who believe they can receive Medicare coverage in Kansas have several resources they can tap to help them get the most out of their coverage or choose the right coverage option. These organizations offer free resources and education for older adults who can benefit from Medicare programs.