Kentucky preferred provider organization plans give beneficiaries access to a network of medical providers who offer discounted coverage. The provider organization can offer discounted coverage rates due to the government funding that subsidizes the costs of the plan.
Beneficiaries of PPO plans will receive discounted care so long as they visit the providers within the plan’s provider area. If you must receive out-of-network coverage, you will have to pay higher premiums and out-of-pocket medical costs.
A Kentucky Health Maintenance Organization plan is an affordable way for Medicare beneficiaries to take care of their health. These plans are attractive to people who are in good health who do not need regular access to out-of-network care.
When compared to PPO plans, HMOs are more limited. When someone joins an HMO, they will have to select a primary care physician (PCP). Anytime you need to see a specialist for a health concern, you will have to visit your PCP and get a referral.
Additionally, anyone with an HMO will not receive coverage outside of the plan’s coverage area.
Kentucky private-fee-for-service plans provide coverage funded by private health insurance companies. PFFS plans are also known as Medicare Part C. These plans can be the most difficult to sort through because the companies that fund the plans set their own coverage terms.
To simplify your process of looking for a PFFS plan, call one of our expert health insurance agents to help you find a plan with specific benefits.
These plans are available to beneficiaries who need extra support and who meet specific requirements. SNPs, provide coverage for people with chronic conditions, nursing home residents, and people with dual Medicare and Medicaid eligibility.
Medicare beneficiaries in Kentucky who require extra medical care may qualify for a special needs plan (SNP). Potential subscribers must meet certain requirements in order to join an SNP. First, the potential beneficiary must be receiving financial aid from either social security or the Railroad Retirement Board. Second, they must also have a chronic condition that requires frequent medical attention and support.
SNPs, unlike other Medicare Advantage plans can be joined by people under the age of 65. You must also be enrolled in Original Medicare when you apply for an SNP.
Chronic conditions that may qualify you for a Kentucky SNP include:
- Chronic heart failure
- Chronic and disabling mental health conditions (dementia, Alzheimer’s, etc)
- Diabetes mellitus
- End-stage renal disease
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