Medicare in Kansas

Original Medicare is available throughout the United States. And in most parts of the country, Medicare Advantage plans are available as an alternative, for people who prefer private health insurance. Medicare Advantage plans are available in all 105 counties⁷ in Kansas as of 2023.³

Seventeen percent of Kansas Medicare beneficiaries selected private Medicare Advantage plans as of 2018,² which was much lower than the 35% of all Medicare beneficiaries nationwide who had Medicare Advantage enrollment at that point.⁸ The remaining 83% of the state’s Medicare beneficiaries had opted instead for coverage under Original Medicare.

Total Medicare coverage enrollment has been growing nationwide, but Medicare Advantage enrollment has been growing even faster.⁹ As of mid-2023, nearly 32% of Medicare beneficiaries in Kansas (180,598 people) were enrolled in private plans obtained through Medicare Advantage insurers¹ (this does not count people with Original Medicare who supplement their coverage with private Medigap or Medicare Part D prescription drug coverage). For reference, Medicare Advantage enrollment had climbed to over 48% nationwide by that point.⁶

Medicare Advantage offers all of the benefits of Original Medicare (hospital inpatient care plus outpatient services), plus additional benefits like a cap on out-of-pocket costs, and in most cases, integrated Medicare Part D prescription drug coverage (the cap on out-of-pocket costs does not apply to the Medicare Part D prescription drug coverage, however).

Many Medicare Advantage plans also provide additional benefits and programs, such as dental and vision coverage, a 24-hour nurse hotline, and fitness. And many Medicare Advantage plans have no monthly premiums other than the cost of Medicare Part B.¹⁰ But there are tradeoffs and limitations: Medicare Advantage plans have more limited networks than Original Medicare, and total out-of-pocket costs under a Medicare Advantage plan are typically higher than they would be with Original Medicare combined with Medigap and a stand-alone Medicare Part D prescription drug plan.¹⁰

Depending on the county in which they live, residents in Kansas can select from between five and 41 Medicare Advantage plans for 2023.³

During the Medicare Annual Election Period each fall (October 15 to December 7), Medicare beneficiaries can switch between Medicare Advantage and Original Medicare, and can also make changes to their Medicare Part D prescription drug coverage (but in most cases, there is not an opportunity to make a change to Medigap coverage without medical underwriting and/or a penalty). There is also a Medicare Advantage Annual Enrollment Period (January 1 to March 31) during which people who are already enrolled in Medicare Advantage plans can switch to a different Medicare Advantage plan or drop their Medicare Advantage plan and enroll in Original Medicare instead.

Medigap plans are used to supplement Original Medicare, covering some or all of the out-of-pocket costs (for coinsurance and deductibles) that people would otherwise incur if they only had Original Medicare on its own. More than half of all Medicare beneficiaries have supplemental healthcare coverage from an employer’s plan or Medicaid.¹¹ But optional private Medigap plans are available to Original Medicare beneficiaries who don’t have supplemental coverage from another source.

249,918 Kansas residents were enrolled in Medigap plans as of 2021.¹² That amounted to about 45% of the state’s Medicare population in 2021¹² (Medicare Advantage enrollment is lower than the national average in Kansas and Original Medicare enrollment is higher;¹⁶ this results in a higher-than-average percentage of the Medicare population enrolled in Medigap plans, which can only be used to supplement Original Medicare coverage).

The Kansas Insurance Department publishes a Medigap buyer’s guide, available here. There are 54 insurers offering Medigap plans in Kansas.¹³ Almost all of them use attained-age rating for setting monthly premiums, although a few use issue-age rating (here’s how they both work).

Medigap plans are standardized under federal rules, and people are granted a six-month window, when they turn 65 and enroll in Original Medicare, during which coverage is guaranteed issue for Medigap plans. Federal rules do not, however, guarantee access to a Medigap plan if you’re under 65 and eligible for Medicare as a result of a disability.

But Kansas is among the majority of the states with rules to ensure at least some access to Medigap plans for enrollees under the age of 65. And the consumer protections in Kanas are among the nation’s strongest. In Kansas, all Medicare beneficiaries — including those who gain eligibility due to a disability and those who become eligible when they turn 65 — have the same guaranteed issue access to Medigap coverage (see page 4 of the Kansas Medigap buyer’s guide).

Starting when a person is enrolled in Medicare Part B (regardless of their age), they have a six-month window during which coverage is guaranteed issue for all available Medigap plans. As long as the person enrolls during their six-month open enrollment window, insurers are required to charge younger, disabled beneficiaries the same premiums that apply to a 65-year-old. This is a stronger consumer protection than most states have; in the majority of the states where Medigap plans are guaranteed-issue for people under age 65, the insurers are allowed to charge higher prices for that population.

As is the case in every state, Kansas residents who are enrolled in Medicare prior to age 65 still have a guaranteed-issue Medigap open enrollment period when they turn 65, regardless of whether they already had Medigap coverage prior to turning 65. But since Kansas does not allow Medigap insurers to charge higher rates for younger enrollees, this is not as important as it is in other states where disabled beneficiaries pay much higher premiums and can then switch to a lower-cost plan when they turn 65.

Original Medicare does not cover outpatient prescription drugs. But Medicare beneficiaries can get prescription drug coverage through Medicaid or an employer-sponsored plan (offered by a current or former employer). For people who don’t have access to either of those, a Medicare Part D prescription drug plan is available to provide prescription drug coverage to Medicare beneficiaries. Medicare Part D prescription drug coverage can be obtained as a stand-alone prescription drug plan or integrated with a Medicare Advantage plan (89% of Medicare Advantage plans provide Medicare Part D prescription drug coverage).³

As of mid-2023, there were 273,387 Kansas Medicare beneficiaries with coverage under stand-alone Medicare Part D prescription drug plans.¹ Another 166,408 Kansas Medicare beneficiaries had Medicare Part D prescription drug coverage integrated with a Medicare Advantage plan at that point.¹ Although overall Medicare enrollment in Kansas has been increasing, Medicare Advantage enrollment has been increasing faster — in keeping with nationwide trends.⁹

For 2023 coverage, there are 23 stand-alone Medicare Part D prescription drug plans available in Kansas, with monthly premiums starting at $2.80 per month.¹⁴

Medicare Part D prescription drug enrollment is available during the Medicare Annual Enrollment Period each fall, from October 15 to December 7. You can change your plan multiple times during that period; the last plan change you make will take effect January 1 of the coming year.

Many Medicare beneficiaries receive financial assistance through Medicaid with the cost of Medicare premiums, prescription drug expenses, and services not covered by Medicare – such as long-term care.

Our guide to financial assistance for Medicare beneficiaries in Kansas includes overviews of these benefits, including Extra Help, long-term care coverage, and eligibility guidelines.

Need help with your Medicare application in Kansas? Got questions about Medicare eligibility in Kansas? You can contact SHICK — Senior Health Insurance Counseling for Kansas — with questions related to Medicare in Kansas.

The Kansas Insurance Department’s website provides a comprehensive Medigap resource for people filing for Medicare benefits in Kansas and wishing to supplement the coverage with a Medigap plan. The page includes a general information guide to Medigap plans as well as a rate comparison tool.

Medicare.gov, maintained by CMS (the Centers for Medicare & Medicaid Services) provides information about every aspect of Medicare, and includes a healthcare provider finder tool as well as a plan finder tool that can help you determine which insurers for Medigap, Medicare Part D, and Medicare Advantage are offered by private insurance companies approved by Medicare.

The Medicare Rights Center provides Medicare-related assistance throughout the United States. They maintain a website and a call center where consumers can get answers to a wide range of questions about Medicare.