At a glance: Medicare health insurance in Kansas
- More than half a million Kansas residents are enrolled in Medicare
- Only 16 percent of Kansas Medicare beneficiaries select Medicare Advantage plans
- Residents in Kansas can select from between 3 and 40 Medicare Advantage plans for 2020, depending on where they live
- 62 insurers offer Medigap plans in Kansas; Disabled beneficiaries under age 65 have the same access and premiums as those who age onto Medicare at 65.
- About 56 percent of Kansas Medicare beneficiaries have stand-alone Part D prescription coverage
- Per-enrollee Medicare spending in Kansas is just slightly lower than the national average
Medicare enrollment in Kansas
533,235 Kansas residents were enrolled in Medicare as of July 2019. That’s a little more than 18 percent of the state’s total population, which is similar to the share of the total United States population enrolled in Medicare.
85 percent of Medicare beneficiaries in Kansas are eligible due to their age (ie, being at least 65), while the other 15 percent are eligible due to a disability. Nationwide, 84 percent of Medicare beneficiaries are eligible due to age, while 16 percent are eligible due to disability.
Medicare Advantage in Kansas
16 percent of Kansas Medicare beneficiaries selected private Medicare Advantage plans in 2018, which was much lower than the 34 percent of all Medicare beneficiaries nationwide who were enrolled in Medicare Advantage at that point. The remaining 84 percent of the state’s Medicare beneficiaries had opted instead for coverage under Original Medicare.
Medicare Advantage offers all of the benefits of Original Medicare, plus additional benefits like a cap on out-of-pocket costs, and in most cases, integrated Part D prescription drug coverage (the cap on out-of-pocket costs does not apply to the Part D coverage, however). Many Medicare Advantage plans also offer things like dental and vision coverage, and some Advantage plans have no premiums other than the cost of Part B. But there are tradeoffs: Medicare Advantage plans have more limited networks than Original Medicare, and total out-of-pocket costs under an Advantage plan are typically higher than they would be with Original Medicare combined with Medigap and a stand-alone Part D plan.
Depending on the county in which they live, residents in Kansas can select from between three and 40 Medicare Advantage plans in 2020. As of 2019, there’s a Medicare Advantage open 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 in Kansas
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.
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.
Medicare Part D in Kansas
Original Medicare does not cover outpatient prescription drugs. But Medicare beneficiaries can get prescription coverage via a Medicare Advantage plan, an employer-sponsored plan (offered by a current or former employer), or a stand-alone Part D plan.
As of July 2019, there were 299,079 Kansas Medicare beneficiaries with coverage under stand-alone Part D prescription drug plans. That’s about 56 percent of the state’s total Medicare beneficiaries, as opposed to about 42 percent of all Medicare beneficiaries nationwide enrolled in stand-alone Part D plans.
Medicare Advantage enrollment is lower than average in Kansas, and that typically results in higher than average enrollment in stand-alone Part D plans. Most Medicare Advantage plans include integrated Part D coverage, but when most enrollees have Original Medicare, the need for stand-alone Part D coverage is greater.
For 2020 coverage, there are 28 stand-alone Part D plans available in Kansas, with premiums ranging from $13 to $75 per month.
Medicare spending in Kansas
In 2016, Original Medicare spent an average of $9,438 per beneficiary in Kansas. The data were standardized to eliminate differences in payment rates from one area to another, but it was only based on Original Medicare spending, so it did not include costs for Medicare Advantage enrollees.
The national average that year was $9,533 per enrollee, so Medicare spending in Kansas was only slightly below the national average. Average per-beneficiary spending in Original Medicare was highest in Louisiana ($11,399) and lowest in Hawaii ($6,441).
You can read more about Medicare in Kansas in our state Medicare guide. You can also contact SHICK — Senior Health Insurance Counseling for Kansas — with questions related to Medicare coverage in Kansas.
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.