Orlando Harmon
Medicare is a federal health insurance program for people aged 65 and over. Those under 65 may be eligible if they have a disability, End-Stage Renal Disease (ESRD), or ALS (Lou Gehrig's Disease). Signing up for Medicare can be done online, by phone, or by contacting your local Social Security Office. This process depends on your specific situation, including your age, health status, and whether you are already enrolled in Part A. Medicare Part A covers hospitalization, home or skilled nursing, and hospice, while Part B covers medical insurance.
| Characteristics | Values |
|---|---|
| Who is eligible for Medicare in Kentucky? | Americans who are 65 and older or younger with disabilities or renal disease |
| What are the different parts of Medicare? | Part A (Hospital Insurance), Part B (Medical Insurance), Part C (Medicare Advantage) and Part D (Prescription Drug Plan) |
| How to apply for Medicare in Kentucky? | Online, by phone, or at the Social Security Office |
| When to apply for Medicare? | Initial Enrollment Period, which starts three months before the month of your 65th birthday |
| What is Medigap? | Supplemental coverage that helps fill in the gaps in out-of-pocket costs like copays and coinsurance |
| What is the "birthday rule"? | Starting in 2024, Kentucky will allow Medicare beneficiaries under 65 to have access to guaranteed-issue Medigap plans |
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What You'll Learn
Medicare Part A and Part B
Your first opportunity to enrol in Medicare in Kentucky begins three months before your 65th birthday and continues for three months after. This is known as your Initial Enrollment Period. During this time, it is advisable to enrol in Part A, as you likely won't need to pay a premium for it. However, if you or your spouse continues working, you may opt to delay enrolling in Part B. In this case, you will qualify for a special enrolment period later on.
Once enrolled in Original Medicare, you have the option to add Part D to cover prescription drug expenses and reduce out-of-pocket costs. You may also choose to add Medigap (Medicare supplement plans) to fill in any coverage gaps. Medigap plans are available from private insurance companies and help cover out-of-pocket costs like copays and coinsurance. In Kentucky, all 10 standard Medigap plans are available, and they must be added within six months of your Original Medicare coverage beginning to ensure eligibility without additional medical questions.
Medicare Advantage (Part C) is an alternative to Original Medicare, offering the same coverages as Parts A and B, but with additional benefits such as dental, vision, and prescription drug coverage. In Kentucky, you can purchase a Medicare Advantage plan from various private insurance companies. These plans often feature a maximum out-of-pocket annual cost and may offer allowances for utilities, groceries, and over-the-counter health items.
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Applying online
Applying for Medicare in Kentucky can be done online through the Social Security Administration. This is the easiest and fastest way to apply and receive any financial help you may need.
To apply online, you will first need to create a secure 'my Social Security' account. You can then use this account to sign up for Medicare or apply for benefits.
If you are already receiving Social Security benefits before turning 65, you may be automatically enrolled in Original Medicare, which includes Part A (hospital insurance) and Part B (medical insurance). If you are not yet receiving Social Security benefits, you will need to apply during your Initial Enrollment Period, which starts three months before your 65th birthday and ends three months after. You may have to pay a penalty if you miss this enrollment period.
If you are under 65, you may still be eligible for Medicare if you have a disability, End-Stage Renal Disease (ESRD), or ALS (Lou Gehrig's Disease). In these cases, you can apply online for Medicare only.
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Medicare card
Medicare is a federal program that provides medical insurance for Americans aged 65 and above, or younger people with disabilities or renal disease. It is comprised of four parts: Part A, B, C, and D.
Part A, also known as hospital insurance, covers inpatient hospital care, skilled nursing home facility care, home health, and hospice care. Part B, or medical insurance, helps pay for doctor's services and supplies that hospital insurance does not cover. Part C, or Medicare Advantage, involves plans through healthcare provider organizations. Part D helps pay for medical prescriptions.
If you are receiving Social Security benefits before turning 65, you may be automatically enrolled in Original Medicare (Parts A and B). If not, you have to apply during your Initial Enrollment Period, which starts three months before your 65th birthday. You can apply for Medicare online, by phone, or at the Social Security Office. You will receive your Medicare card about two weeks after signing up.
It is important to note that you should guard your Medicare card and not give out your personal information to people you don't know to protect yourself from Medicare fraud.
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Medicare Advantage and drug plans
Medicare Advantage (also known as Part C) is health insurance for Americans aged 65 and older. It combines the benefits of Original Medicare (Part A and Part B) with private health insurance. In Kentucky, Medicare Advantage replaces Original Medicare but offers the same Part A and B benefits and coverages.
Medicare Advantage plans in Kentucky include doctor and hospital coverage, as well as additional benefits in one convenient plan. Some plans offer prescription drug coverage (Part D), dental, vision, and hearing benefits. These plans are popular because you get medical, hospital, and additional benefits all in one plan. Most plans have a $0 monthly premium and a maximum out-of-pocket annual cost.
Medicare Advantage Special Needs Plans (SNPs) are available in Kentucky for people living with disabilities and/or certain medical conditions. These plans combine Original Medicare Part A and Part B with valuable benefits. For example, C-SNPs offer care for people with diabetes, heart conditions, lung disease, or kidney disease.
To enroll in Medicare Advantage in Kentucky, you can apply online with the Social Security Administration or over the phone at 1-800-772-1213 (TTY: 1-800-325-0778). You can also visit a local Social Security office. If you are receiving Social Security benefits before you turn 65, you may be automatically enrolled in Original Medicare. If not, you must apply during your Initial Enrollment Period, which starts three months before your 65th birthday.
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Cancelling Medicare coverage
To cancel your Medicare coverage, you can submit CMS Form 1763 to your local Social Security office. Before you do so, it is important to consider the risks of cancelling your coverage. For example, if you have employer-sponsored coverage or Medicaid, you may want to keep Part A coverage, as it is often required for paying for some medical expenses that these other forms of insurance won't cover.
If you have employer-sponsored coverage, you may wish to decline Part B and Part D coverage so that you don't have to pay their premiums. However, your private coverage must meet certain standards, or you may have to pay monthly penalties if you choose to sign up for Parts B and D later. Before declining Part B, ask your employer-sponsored coverage provider if you would have to pay monthly penalties if you were to sign up in the future. Similarly, before declining Part D, ask if your private insurance is considered creditable coverage by Part D. If it isn't, you would have to pay monthly penalties for Part D if you were to sign up later.
If you are enrolled in Medicare Part D, you may be able to save money by finding a cheaper plan that meets your needs. You can use the Medicare Plan Finder to find the right Part D plan for you. If you have Original Medicare with Parts A, B, and D, you can choose to get a private Medicare supplement (sometimes called a Medigap plan) to cover some of the expenses that Medicare Parts A, B, and D won't cover. For example, a Medicare supplement could cover things like your co-insurance payments for Part B.
If you are enrolled in Medicare Part D and cannot afford the monthly premium, deductible, copayments, or co-insurance, you may qualify for the Low Income Subsidy (LIS), also called "Extra Help." With the LIS, you don't have to pay a Part D premium or deductible, and there may be lower copayments. To qualify for the LIS, you must also get Medicaid coverage or be in a Medicare Savings Program, or your countable income must be less than $23,475 per year and your resources less than $16,100 if you are single (the limits are higher for larger households).
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Frequently asked questions
You can apply for Medicare online at Social Security. You will need to create a secure my Social Security account to sign up for Medicare or apply for benefits.
If you are 65 or older, you can apply for Medicare. If you are under 65, you may still be eligible if you have a disability, End-Stage Renal Disease (ESRD), or ALS (Lou Gehrig's Disease).
Medicare Part A is insurance for hospitalization, home or skilled nursing, and hospice. You get Part A automatically if you are receiving benefits from Social Security or the Railroad Retirement Board. Medicare Part B is medical insurance, and you need to sign up for it.
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