Medicare Advantage Plans in Kansas

Medicare Advantage plans are an alternative to Original Medicare, offered by Medicare-approved private insurance companies. These plans include Part A (hospital) and Part B (medical) coverage, and most also include Part D (prescription drug coverage). Many plans go beyond basic services, offering benefits such as dental, vision, hearing, fitness programs, and more.

Medicare Eligibility

To enroll in a Medicare Advantage plan, you must first sign up for Original Medicare (Parts A and B). Most people qualify for Medicare enrollment at age 65. However, some qualify earlier due to disability, ALS, or ESRD.

Enrollment opportunities include:

• Initial Enrollment Period (IEP)
• General Enrollment Period (GEP)
• Special Enrollment Periods (SEP)

Late enrollment or lack of eligibility for premium-free Part A may result in penalties.

What Types of Medicare Advantage Plans Are Available in Kansas?

Kansas residents can choose from the following plan types:

• Health Maintenance Organizations (HMOs): Require you to use in-network providers. Referrals are usually required to see specialists.
• Preferred Provider Organizations (PPOs): Let you see out-of-network providers at a higher cost. Generally, no referrals are needed.
• Private Fee-for-Service (PFFS) Plans: Allow you to visit any provider who agrees to the plan’s terms. Some have networks.
• Special Needs Plans (SNPs):
  • C-SNPs: For individuals with chronic conditions like diabetes, heart disease, or cancer.
  • I-SNPs: Designed for those in institutions or requiring nursing-level care.
  • Dual Eligible Special Needs Plans (D-SNPs): Tailored for individuals who qualify for both Medicare and Medicaid. These often offer enhanced benefits such as dental, care coordination, and prescription drug coverage at low or no cost.
• Medical Savings Accounts (MSAs): Combine a high-deductible Medicare plan with a savings account funded by your insurer for healthcare expenses.

What Are Your Prescription Drug Options with Medicare Advantage?

Most Medicare Advantage plans in Kansas include Part D drug coverage. However, some plans—like MSAs or certain PFFS plans—do not.

If your plan lacks drug coverage, you may:

• Enroll in a standalone Part D plan (if allowed by your MA plan type).
• Face a late enrollment penalty if you go without creditable drug coverage.

How Do You Choose a Medicare Advantage Plan?

Before enrolling, review this guide on Medicare Advantage costs to understand your financial obligations:

• Premiums: Many MA plans in Kansas offer $0 premiums.
• Deductibles, Coinsurance & Copays: You may pay $0–$20 for primary care and $0–$50 for specialists, with up to 20% coinsurance for other services.
• Out-of-Pocket Maximums: Plans cap your annual expenses—typically between $3,000 and $7,550 in-network.
• Extra Benefits: Some plans include dental, vision, telehealth, fitness, and transportation services.

When and How Do You Enroll in a Medicare Advantage Plan?

You can enroll in Medicare during specific enrollment periods:

• Initial Enrollment: Starts 3 months before and ends 3 months after your 65th birthday month.
• Annual Open Enrollment (Oct 15–Dec 7): Change, drop, or join an MA plan.
• General Enrollment (Jan 1–Mar 31): For those enrolling in Medicare Part B for the first time.
• Medicare Advantage Open Enrollment (Jan 1–Mar 31): Switch or disenroll from your MA plan.
• Special Enrollment Periods: Triggered by:
  • Moving out of your plan’s service area
  • Losing employer coverage
  • Qualifying health conditions
  • Plan discontinuation

What If You Want to Change Your Medicare Advantage Plan?

You can switch plans during:

• Annual Open Enrollment (Oct 15–Dec 7)
• Medicare Advantage Open Enrollment (Jan 1–Mar 31)

What Are Medicare Resources in Kansas?

• Senior Health Insurance Counseling for Kansas (SHICK): Offers free Medicare counseling. Learn more.
• Kansas Senior Medicare Patrol (SMP): Educates beneficiaries about avoiding healthcare fraud.
• Kansas Insurance Department: Handles Medicare-related complaints.
• Kansas Medical Assistance Program (KMAP): Medicaid assistance for low-income residents. Call 1-800-792-4884 or visit the website for eligibility details.

Learn more about the differences between Medicare and Medicaid.

Understanding Medicare Advantage Star Ratings

The CMS star ratings system is how the Centers for Medicare & Medicaid Services (CMS) rates Medicare Advantage (MA) plans using a 5-star quality scale. These ratings help consumers compare the performance of different plans based on a standardized set of measures.

CMS Star Ratings Overview

• 1 star: Poor performance
• 2 stars: Below average
• 3 stars: Average
• 4 stars: Above average
• 5 stars: Excellent

These ratings are updated annually and reflect data collected from Medicare Advantage (Part C) and Medicare Advantage Prescription Drug Plans (Part D).

Other Medicare Plan Options to Help with Out-of-Pocket Costs

Medicare Supplement Plans, also known as Medigap, help pay for expenses not covered by Original Medicare such as coinsurance, copayments, and deductibles.

• You must be enrolled in Parts A and B.
• The best time to enroll is during your 6-month Medigap Open Enrollment Period after signing up for Part B.
• After that, insurers may require medical underwriting.
• Medigap does not include drug coverage—you’ll need a separate Part D plan.

There are 10 standardized plans. Medicare Supplement Plan G had the highest enrollment in 2023 and, along with Plan N, is among the fastest-growing. Plan F is not available to new Medicare enrollees as of 2020.

Learn more about Medicare Supplement plans in Kansas.

Next Steps

If a Medicare Advantage plan in Kansas fits your needs, compare available options in your ZIP code. Review the provider network, out-of-pocket costs, and extra benefits. Once you’re eligible, be ready to enroll during the proper time.