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Kentucky Medicare Advantage: The Best & Worst Plans
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More than 25 percent of Medicare beneficiaries in the Bluegrass State have Medicare Advantage. These plans are popular because they bundle your Part A and B Medicare coverage, usually with additional benefits like prescription, dental, vision, or hearing.
Medicare Advantage plans, also called Medicare Part C, are one way to get Medicare health insurance coverage. To enroll in a Medicare Advantage (MA) plan, you must first get Medicare Part A and Part B.
There are several types of MA plans, and they operate differently. Some include Medicare Part D, or prescription drug plans, and other benefits like hearing, vision, and dental.
These plans are sold by Medicare-approved private insurance companies, but prices and availability of plans vary by county. You’ll likely have several plan options in your service area, so it’s important to shop around and compare prices. Always read plan details carefully.
Ready to shop plans now? Use the Insurify Medicare comparison tool to find the right Medicare plan for you. Start with your ZIP code to compare Medicare Advantage, Medigap, and prescription drug plans. Try it today!
What Are the Best Medicare Advantage Plans in Kentucky?
There is no objectively “best” Medicare plan—the best plan for you is the one that most meets your needs at the lowest total out-of-pocket cost. We can help you in your consideration of whether an MA plan is right for you. We also have objective, licensed insurance agents who can help you free of charge at 1 (844) 965-1378 (TTY 711), Monday–Friday from 8 a.m. to 8 p.m. ET.
To help people compare the performance of different plans, the federal Medicare program uses a five-star rating system (with five being the highest score). Plans are evaluated in five areas: staying healthy, managing chronic conditions, plan responsiveness, member complaints and discontinuation, and customer service. Plans also receive an overall rating.
The Kentucky MA plans below all have 4 to 4.5 overall stars.
The Best Medicare Advantage Plans In Kentucky
1. Humana Community
2. AARP Medicare Advantage Choice
3. AARP Medicare Advantage Plan 1
4. AARP Medicare Advantage Plan 2
5. AARP Medicare Advantage Plan 3
6. AARP Medicare Advantage Plan 6
7. AARP Medicare Advantage Walgreens
8. Aetna Medicare Premier 2
Note that prescription coverage with all of these plans has three phases:
1. The initial coverage phase starts after you’ve paid your deductible (if applicable) and lasts up to the initial coverage limit of $4,130.
The gap coverage phase, or the “gap,” starts when the total drug costs paid by you and the plan reach $4,130 and lasts until you meet the prescription out-of-pocket threshold of $6,350.
The catastrophic coverage phase starts when your annual out-of-pocket prescription costs exceed $6,350.
The prescription coverage information below applies primarily to the initial coverage phase and to the drugs included on the plan’s formulary. Be sure to read prescription coverage details carefully.
Remember that there’s no single “best” Medicare plan. The best plan for you is the one that gets you the health coverage you need for the least total cost.
Humana Community H1036-236 (HMO)—4.5 stars
Monthly Premium: $0
Annual Deductible: $0
Annual Out-of-Pocket Max (not including prescription drugs): $4,900
Beneficiaries of this plan enjoy $0 co-pays for primary care and $20 for specialists, including outpatient mental health visits and hearing exams. Hearing aids are covered with a co-pay of $499–$799. Prescriptions in Tier 1 have no co-pay at preferred retailers.
Preventive dental care is included with no cost-sharing, as are eye exams, eyeglasses, and contacts. Comprehensive dental services are either not covered or require 50 to 70 percent coinsurance, so be sure to read the plan details carefully.
Annual Out-of-Pocket Max (not including prescription drugs): $5,500 in-network/$10,000 in and out of network
This plan is available in Franklin, Knott, Anderson, Bell, Fayette, Floyd, Grant, Harlan, Jessamine, Knox, Leslie, Letcher, Madison, Pendleton, Perry, Pike, Whitley, and Woodford counties. As a PPO plan, it offers different cost-sharing levels for in-network and out-of-network providers. You’ll have $10 co-pays for in-network primary care visits and $30–$60 for out-of-network.
For specialist visits, those co-pays bump up to $45 and $60, respectively. Hearing exams will cost you nothing, and hearing aids will run you between $375 and $2,075. One perk of this plan is that preventive dental care is offered with no cost-sharing regardless of what provider you see. Comprehensive dental coverage is a bit complicated, though, with coinsurance rates between 0 and 50 percent. And routine eye exams, glasses, and contacts from in-network providers are fully covered. AARP MA Plans are offered through UnitedHealthcare.
AARP Medicare Advantage Plan 1 H5253-067 (HMO)—4 stars
Monthly Premium: $26
Annual Prescription Drug Deductible: $150
Annual Out-of-Pocket Max (not including prescription drugs): $4,500
Residents of Knox, Woodford, Letcher, Madison, Perry, Franklin, Pike, Anderson, Jessamine, Fayette, Bell, Knott, Floyd, Leslie, Whitley, and Harlan counties have access to this plan. There’s no co-pay for primary care visits and $35 co-pays for specialists. Preventive dental care is fully covered, while comprehensive dental services require between 0 and 50 percent coinsurance.
Hearing exams have no co-pay, but hearing aids cost between $375 and $2,075. Routine eye exams, glasses, and contacts are fully covered. With this plan, you’ll get your best prices for Tier 1 and 2 prescription drugs by getting 90-day supplies by mail from preferred retailers.
AARP Medicare Advantage Plan 2 H5253-100 (HMO)—4 stars
Monthly Premium: $26
Annual Prescription Drug Deductible: $150
Annual Out-of-Pocket Max (not including prescription drugs): $4,500
This plan is essentially the same as the AARP Medicare Advantage Plan 1 listed above, but it’s available in Bullitt, Larue, Meade, Oldham, Hardin, Spencer, Shelby, Henry, Nelson, Taylor, Marion, and Jefferson counties.
AARP Medicare Advantage Plan 3 H5253-051 (HMO)—4 stars
Monthly Premium: $110
Annual Deductible: $0
Annual Out-of-Pocket Max (not including prescription drugs): $3,400
Only residents of Campbell, Kenton, Pendleton, Boone, and Grant counties have access to this plan, which offers a lower out-of-pocket maximum in exchange for a higher monthly premium. Its other benefits are comparable to the plans immediately above. Primary care visits have a $5 co-pay, and specialists are $25. Tier 1 drugs have a $0 co-pay (though Tier 6 specialty care drugs are not covered at all).
Preventive dental is fully covered, but comprehensive requires up to 50 percent cost-sharing. Routine vision exams, glasses, and contacts are fully covered. Hearing exams are fully covered, and hearing aids cost between $375 and $2,075. Podiatry care with this plan is slightly cheaper than most, with a $25 co-pay rather than the typical $35.
AARP Medicare Advantage Plan 6 H5253-052 (HMO)—4 stars
Monthly Premium: $0
Annual Prescription Drug Deductible: $195
Annual Out-of-Pocket Max (not including prescription drugs): $4,900
This plan has rather limited availability: Boone, Grant, Campbell, Kenton, and Pendleton counties. You’ll get the best price on prescriptions (sometimes $0) with 90-day supplies from preferred retailers. Hospital stays are slightly more expensive with this plan than others, at $350 per day for the first five days (compared to other plans at $275 or less for the first four or five days), but beyond day five, inpatient care is fully covered.
At $45, specialist visits are also just slightly more expensive, while primary care visits are the typical $5 co-pay. With the standard plan, preventive dental care is fully covered; some comprehensive dental services are also fully covered, but others aren’t covered at all. Enrollees may purchase optional supplemental benefits that expand dental coverage. Vision and hearing benefits are the same as with the plans above.
Annual Out-of-Pocket Max (not including prescription drugs): $5,100 in-network/$10,000 in and out of network
With this plan, available in just Kenton, Campbell, and Boone counties, you’ll pay the lowest price at in-network providers. It also has a two-tiered out-of-pocket max for in-network and out-of-network services. Specialist visit co-payments are on the higher side, at $50, while primary care visits require no cost-sharing. This plan has a slightly lower star rating for its prescription plan than the other plans listed here.
As with many plans, you’ll get your best costs with 90-day prescription supplies through preferred retailers. With the standard plan, preventive dental is fully covered, regardless of what healthcare provider you visit, but not all comprehensive services covered. Optional supplemental dental benefits can be purchased. Note that hearing aids are not covered under this plan.
Aetna Medicare Premier 2 H5521-020 (PPO)—4 stars
Monthly Premium: $124
Annual Deductible: $0
Annual Out-of-Pocket Max (not including prescription drugs): $4,800 in-network/$11,300 in and out of network
This plan is also limited to Boone, Kenton, and Campbell counties. A big perk of this plan is that hearing aids are fully covered, regardless of the healthcare provider you visit. Another appealing benefit is that vision care and eyewear, including upgrades, are almost entirely covered. The plan’s prescription coverage has just over three stars, though.
You trade a $0 prescription drug deductible for co-pays on all prescriptions, but it’s not exorbitant, especially for Tier 1 and 2 drugs. Inpatient hospital stays cost slightly less than with some other plans, and primary care and specialist visits have typical co-pays of $5 and $40, respectively.
Mental health visit co-pays ($40) are also slightly higher than average. This plan’s dental coverage isn’t the most robust: fluoride treatments aren’t covered, and comprehensive dental services require 50 to 70 percent co-payment or aren’t covered at all.
Ready for Medicare to work for you? Use the Insurify Medicare comparison tool to explore Medicare Advantage plans. Start with your ZIP code, and you’ll be comparing options in less than two minutes. Try it today!
How Much Does Medicare Advantage Cost in Kentucky?
Because they’re sold by private insurance companies, the costs of MA plans vary, and your total out-of-pocket costs for healthcare will depend on what medical services you use.
With MA plans, Medicare beneficiaries are still responsible for a monthly premium as well as the monthly Medicare Part B premium.
One popular aspect of Advantage plans, though, is that they offer a cap on what you’re responsible for paying for medical and hospital services each year.
When thinking about your total out-of-pocket costs, think of your monthly premium, deductibles, cost of healthcare visits (based on how often you need to go), and your cost for medications under that plan.
If you need help affording your healthcare, contact the Kentucky State Health Insurance Assistance Program (SHIP) at 1 (877) 293-7447 (option #2), or call 1 (502) 564-6930 and ask for a SHIP counselor.
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What Do Advantage Plans Cover?
All MA insurance plans include the same Part A (hospital) and Part B (medical) coverage stipulated by the Centers for Medicare & Medicaid Services. All MA plans are also required to cover preventive care with no cost-sharing, at least at in-network providers.
Most plans also include prescription drug coverage, the details of which vary by plan, and not all medications are covered by each plan. If you are considering an MA plan, be sure to review the formulary, or list of covered drugs, to check if your current medications are on it and how much they’ll cost.
Some Advantage plans offer additional coverage like vision, dental, hearing, and wellness program benefits.
Advantage plans are not the same as Medicare Supplement plans, also called Medigap. You cannot use an Advantage plan and Medicare Supplement Insurance at the same time.
What Types of Medicare Advantage Plans Are Available in Kentucky?
Several types of plans are available:
Health maintenance organization (HMO) plans cover services only through a limited network of healthcare providers, hospitals, laboratories, etc. With these plans, you will have one primary care provider from whom you’ll usually need a referral to see specialists.
Preferred provider organization (PPO) plans have a network of “preferred” providers and facilities that have negotiated with the plan to provide services to its members. Your out-of-pocket costs will be lowest if you stay within that network. Any services you get outside of the preferred network will have higher cost-sharing or might not be covered at all.
Private fee-for-service (PFFS) plans let you go to the doctor or facility of your choice and then submit the claim to the insurer. But not all medical providers will accept this plan, and providers can choose whether to accept the terms at every visit.
Special needs plans (SNP) are designed to meet the needs of people with specific diseases (like end-stage renal disease) or other characteristics. The benefits, provider network, and drug formularies are tailored accordingly. For information about eligibility, you need to contact Medicare at 1 (800) MEDICARE (633-4227) or medicare.gov. TTY users can call 1 (877) 486-2048.
Medical savings accounts (MSA) aren’t common. They combine a high-deductible health plan with a bank account that Medicare deposits money into. You can use the money to pay for your healthcare services during the year, but note that the Medicare deposit is usually less than the deductible.
FAQ: Kentucky Medicare Advantage
This program helps Medicare beneficiaries with prescription drug costs. You apply through the Social Security Administration here, or you can call:
If you have Medicare and Supplemental Security Income (SSI) or Medicare and Medicaid, you automatically receive Extra Help.
Yes. Sometimes, an insurance company decides not to renew their contract with Medicare, which means some or all of their plans may be discontinued in certain areas. When this happens, the insurer is required to notify enrollees who will be affected and inform them of other plan options in the service area.
When considering an MA plan, consider your full out-of-pocket costs with each plan, and compare prices to save money.
There are several different enrollment periods:
Initial Enrollment Period: This is the seven-month period that begins three months before the month you turn 65, includes the month you turn 65, and ends three months after. If you are under age 65 and receive Social Security disability, you qualify for Medicare in the 25th month after you begin receiving your Social Security benefits. In this case, your Initial Enrollment Period is the seven-month period surrounding that month.
Annual Election Period: From October 15 through December 7, you can enroll in an MA or Part D plan or disenroll from one of these plans.
Annual Open Enrollment Period: From January 1 to March 31, you can switch from MA back to Original Medicare, in which case you can also enroll in a stand-alone Part D plan.
Special Election Periods may be available following certain life events, such as moving, qualifying for Extra Help, or moving into an institution such as a nursing home.
Conclusion: Comparing Plans Ensures You Get The Best Plan
A $0 monthly premium is eye-catching, but it doesn’t always save you money in the long run. If you’re trying to calculate how much you’ll spend with a certain plan, consider not just the premium and deductible but how much cost-sharing you’ll be responsible for. That amount will vary by plan, so to find the best option for you, be sure to shop around.
Ready for Medicare to work for you? Use the Insurify Medicare comparison tool to explore Kentucky Medicare plans. Start with your ZIP code, and you’ll be comparing plans in less than two minutes. Try it today!
We also have objective, licensed insurance agents who can help you free of charge. Give us a call at all 1 (844) 965-1378 (TTY 711), Monday–Friday from 8 a.m to 8 p.m. ET.
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Mallory ProfetaInsurance Writer
Mal Profeta is a writer, editor, educator, and public health advocate. They serve as the communications director of an NIH-funded clinical and translational science research center that focuses on addressing health disparities in Appalachia. A former Fulbright recipient, they hold a bachelor's degree from Transylvania University and a master's from New York University.
