Kentucky Health Insurance: 2021 Coverage Guide

Fran
Fran Majidi
September 16, 2020

People in Kentucky have a better-than-average healthcare system in their state, but it’s still important to understand the differences between health plans. If you’re buying an individual or family plan, you should compare rates carefully with SmartFinancial. It’s important to enroll in a health plan during open enrollment or you may have to wait another year. The only time you can buy health insurance outside the open enrollment period is if you have a qualifying event.

When Is Open Enrollment in Kentucky?

November 1, 2020 - December 15, 2020. Coverage begins January 2021.

How to Get Health Insurance in Kentucky

Start by taking a look at how many times you visited the doctor last year. How much did you spend in out-of-pocket expenses like visits, copays, deductibles, etcetera. Now, create a projection of your medical needs for next year based on what you see. This will help you determine which tier plan will be most economical for you.

After you wrap your head around your medical expenses, compare health insurance companies and health insurance quotes. After you submit a form to SmartFinancial, you’ll see what’s available in your area. You’ll also be able to ask an agent some important questions you may have.

What Types of Health Insurance Are Available in Kentucky?

HMOs, EPOs, PPOs and POS plans are available in Kentucky. You can also buy short-term health insurance or the cheapest, a catastrophic plan, which only covers emergencies. Most people choose between HMO and PPO plans. Most people in Kentucky buy the silver tier option, which covers 70% of medical costs. There is a cheaper plan, the bronze tier, which only covers 60% of costs. If you frequently visit doctors or medical practitioners, you may want to consider the gold plan, which covers 80% of costs. If you have a chronic condition, a platinum plan, which covers 90% of costs may cost more each month but may save you money overall because you’ll have very little to pay out-of-pocket.

Does Health Insurance Cover Pre-existing Conditions?

According to the Affordable Care Act, it is illegal for marketplace health plans to deny you health insurance coverage because you have pre-existing conditions.

Compare Health Insurance Plans in Kentucky

Do I Qualify for a Special Enrollment Period?

Common reasons people qualify for a special enrollment period:

  • You may have lost a job, changed jobs or even started your own business. Even if you willingly quit a job, you qualify for the special enrollment period.
  • You qualify for the special enrollment period when you turn 26 because you can no longer be on a parent’s plan.
  • If you have a health plan that will be invalid after a move, you can buy a new plan that covers your new location.
  • When you extend healthcare with Cobra, there is an end date. You may buy a new plan when Cobra expires.
  • If you lose coverage after a divorce, you can buy a new health plan.
  • When you get married you can add a spouse to a plan or buy a new one together.
  • Birth or adoption of a child qualifies you for the special enrollment date for that child.
  • Death of spouse or partner qualifies you for the special enrollment date to buy a new plan if you lost shared coverage with that partner or spouse.
  • If a spouse or partner loses coverage for a qualifying reason, and if you lose your coverage along with that person, you can buy a new health plan together or separately.

Is Health Insurance Required in Kentucky?

No, only California, Massachusetts, New Jersey, Vermont, Rhode Island, and DC still require health insurance. Otherwise, there is a tax penalty. Even though it’s not required in every state, buying health insurance is necessary to avoid medical bankruptcy.

How Much Is Health Insurance in Kentucky?

The average cost of health insurance in Kansas for a 40 year old is about $455 a month. Health insurance is less expensive, the younger you are. Tobacco use increases health insurance rates.

How to Save on Health Insurance in Kentucky

The best way to save on health insurance in Kansas is to compare rates based on the tier system. Beforehand, you’ll want to estimate your medical costs

Medicare in Kentucky

Medicare is health insurance coverage for Americans ages 65 years and older. The government also allows younger people with disabilities to enroll in the program. Individuals with End-Stage Renal Disease (a permanent kidney failure treated with dialysis or a transplant) can also sign up as can some individuals with severe mental health issues. Others who qualify for Medicare disability coverage are individuals with Amyotrophic Lateral Sclerosis (also called Lou Gehrig’s Disease). Most beneficiaries will receive Original Medicare (Parts A and B). Some people buy Medicare Advantage, which includes Part A and B as well as offering vision, dental and prescription drug coverage.

How Many People Are on Medicare in Kentucky?

Roughly 21 percent of the people of Kentucky are on Medicare.

How Much Is Medicare in Kentucky?

If you do not qualify for Medicare, you can buy it for $458 a month for Part A in 2020 and a standard monthly premium for Medicare Part B was $144.60 for 2020, or even higher depending on income.

Original Medicare vs Medicare Advantage: What’s the Difference?

Medicare is a government subsidized health plan that is available to qualified Americans age 65 and older. Medicare Advantage is sold through private health insurance companies, but these policies are also regulated by the government. Medicare Advantage plans offer the same benefits as Medicare Parts A and B. Medicare Advantage plans also offer more coverage for dental, vision, hearing and prescription drugs. Medicare Advantage plans have a maximum out-of-pocket limit. For 2020, it was $6,700 but many plans set their maximums at a much lower cost. That is why it’s important to compare companies. People who opt for original Medicare can buy Medicare Supplements to help with out-of-pocket costs. You cannot buy both Medicare Advantage and Medicare Supplements. If you enroll in a Medicare Advantage Plan during open enrollment, you will automatically be disenrolled from original Medicare.

How to Get Medicare Coverage in Kentucky

If you receive social security payments, you may automatically enroll in Medicare, but you may have to sign up if you do not receive payments. The easiest way to enroll in Medicare is by working with a trusted insurance agent to get the coverages you want. Just enter your zip code and answer a few simple questions.

Types of Medicare Plans Available

Original Medicare, Medicare Advantage, Medicare Cost Plans (only offered in certain areas), Demonstration/Pilot Programs (also called Research Studies; only offered in certain areas) and Programs of All-Inclusive Care for the Elderly (PACE).

How Do I Qualify for Medicare?

To qualify for Medicare you must be a citizen of the U.S. or have been a legal resident for at least five years. If you are age 65 or older and you/your spouse have worked for at least 10 years (40 quarters) or you have a disability, Amyotrophic Lateral Sclerosis (ALS) or end-stage renal disease (ESRD), you most likely qualify for Medicare.

How Can I Save on Medicare in Kentucky?

You can save on Medicare by signing up for Part B as soon as you’re eligible. People who enroll late must pay a penalty every year. If you’re interested in buying Medicare Advantage, you can shop and compare Medicare plans for the best value.

Kentucky State Health System Ranking

  • Kentucky: Overall State Ranking: 39 of 51
  • Kentucky: Overall Performance: Better than Average
  • Kentucky: Access & Affordability: 28
  • Kentucky: Prevention & Treatment: 24
  • Kentucky: Avoidable Hospital Use & Cost: 45
  • Kentucky: Healthy Lives: 48
  • Kentucky: Health Care Disparities: 35
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Kentucky Health Insurance Coverage

The people of Kentucky have different kinds of health insurance while some Kentucky residents are not insured at all. See the breakdown below:

  • Private coverage: 46%
  • Medicaid: 27%
  • Medicare: 21%
  • Uninsured: 6%

Kentucky Health Insurance Companies

  • Human Health Plan, Inc. (Kentucky)
  • United Healthcare Services, Inc. (Kentucky)
  • UnitedHealthcare Insurance Company (Kentucky)
  • Aetna Health Inc. (Pennsylvania) - Ohio
  • Aetna Life Insurance Company (Kentucky)
  • Anthem Health Plans Kentucky (Anthem Blue Cross and Blue Shield in Kentucky)
  • Humana Health Plan, Inc. (Kentucky)
  • Cigna Health and Life Insurance Company - Kentucky
  • Connecticut General Life Insurance Company - Kentucky
  • Baptist Health Plan, Inc.
  • Compass Rose Health Plan

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