Medicare in Kansas

In Sunflower State, just 17 percent of Medicare beneficiaries chose Advantage plans

  • By
  • Contributor
  • November 14, 2018

Medicare in Kansas: Key takeaways

Total Medicare enrollment in Kansas

In August 2018 there were 520,736 Medicare beneficiaries in Kansas. That’s almost 18 percent of the state’s population, which is about the same as the percentage of the overall US population enrolled in Medicare.

As of 2015, the states with the highest percentage of beneficiaries were West Virginia and Maine with about 23 percent each. Those with the lowest percentage were Alaska (11 percent) and Utah (12 percent). In raw numbers, Alaska has the fewest recipients at 96,152 (and is the only state with fewer than 100,000 Medicare beneficiaries) and California (which has about an eighth of the country’s population within its borders) has the most at 6.1 million (15 percent of its population). This doesn’t count the US Territories, which mostly have low total enrollment in Medicare (Northern Mariana Islands had just 2,358 Medicare enrollees in 2018; but Puerto Rico had 739,058).

Read about Medicare’s open enrollment period and other important enrollment deadlines.

Kansas protections for Medicare beneficiaries

Kansas is one of 30 states where Medicare beneficiaries under the age of 65 (ie, those who are eligible for Medicare due to a disability, rather than age) have guaranteed access to a Medigap plan. Federal regulations grant a six-month enrollment window for Medigap when a person first turns 65 and is enrolled in both Medicare Part A and Part B, but there’s no federal requirement for a similar guaranteed-issue enrollment period when a person becomes eligible for Medicare as a result of a disability. Kansas regulations, however, ensure that disabled Medicare beneficiaries have the same access to Medigap as people who are enrolling when they turn 65.

The Kansas Insurance Department has a tool that shoppers can use to see estimated prices for the various Medigap plans available in their area.

Breakdown of the aged vs. disabled

Individuals who qualify by virtue of their age alone make up 85 percent of Kansas Medicare recipients. The balance — 15 percent — are on Medicare as the result of a disability. Kentucky has the highest percent of Medicare recipients listed as disabled (28 percent), followed by Alabama, Mississippi, West Virginia and Arkansas. Hawaii has the smallest percentage at 12 percent, followed by North and South Dakota at 14 percent each.

Medicare spending per recipient and statewide

As of 2015, Medicare paid about $9,162 per enrollee in Kansas. That’s according to a standardized spending report from CMS, which eliminates spending differences that stem from strictly geographic differences in costs (eg, higher labor costs or overhead expenses in higher cost-of-living areas). The report only considers spending in Original Medicare, as opposed to Medicare Advantage.

Louisiana had the highest per-capita Medicare spending, at $11,016, while Hawaii had the lowest, at $6,004.

Medicare spent a total of $4.8 billion for Kansas residents in 2014. Kansas was one of 20 states with total Medicare spending under $6 billion that year. With the largest and smallest numbers of recipients, itʼs no surprise that California accounts for $64.8 billion of overall Medicare spending while Alaska cost the Medicare system only $741 million in 2014. Total Medicare spending for all states and the District of Columbia was $581 billion in 2014.

Medicare Advantage in Kansas

Medicare Advantage offers health benefits for Medicare beneficiaries through private plans instead of through Original — or traditional — Medicare (the federal government’s fee-for-service program). These plans are one option for consumers who desire additional benefits beyond what Original Medicare offers, but are not considered a wise option by some consumers who are concerned that government spends more per enrollee on the private plans than it does on Original Medicare.

Medicare Advantage plans are available with no premium other than the cost of Part B (although nationwide, the average Medicare Advantage plan has a premium of $28/month in 2019), but they also have provider networks that are more limited than Original Medicare, and total out-of-pocket costs can be considerably higher than enrollees would pay if they had Original Medicare plus a Part D plan plus Medigap (out-of-pocket spending, not including prescription drugs, is capped at no more than $6,700 under a Medicare Advantage plan, but depending on which Medigap plan they choose, Original Medicare enrollees can have $0 in out-of-pocket spending, not counting their prescription drug costs).

88,695 Kansas Medicare beneficiaries — 17 percent of the state’s total Medicare population — had coverage under Medicare Advantage plans as of August 2018. Nationwide, nearly 36 percent of Medicare beneficiaries were enrolled in a Medicare Advantage program that year.

Minnesota is the only state where more than half (56 percent) of Medicare eligibles enrolled in a Medicare Advantage plan. Alaska, with only 655 Advantage enrollees in 2017, has just 1 percent of its Medicare population enrolled in Medicare Advantage plans. Only two other states have Medicare Advantage enrollment (as a percentage of the state’s Medicare enrollees) in the single digits: Wyoming with 3 percent, and Vermont with 8 percent.

Stand-alone Medicare Prescription Drug plans

Kansas had 296,278 Medicare beneficiaries – about 57 percent of the state’s total – enrolled in stand-alone prescription drug plans as of August 2018. The state has 26 plans in 2019, with premiums ranging from about $16 to $100 per month.

Medicare prescription drug coverage — called Medicare Part D — was the result of legislation passed in 2003 and signed into law by President George W. Bush in 2006. It is a bit of a controversial program because it was an unfunded liability — meaning that the vast majority of costs fell on taxpayers — and the law also barred Medicare from negotiating lower drug prices with drug makers. But by the end of its first decade, Medicare Part D was providing coverage for almost three quarters of all eligible Medicare beneficiaries, including those who have Part D coverage as part of their Medicare Advantage plan.

For those under 65 in Kansas

Are you under 65 years of age? If you’re disabled, you may be eligible for Medicare. But if not, we have information on Kansas health insurance and the Kansas health insurance marketplace at our health insurance site.

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 Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.