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Medicare Advisor, insurance and healthcare consultant

Tammy Burns is an experienced health insurance advisor. She is ACA-certified for health insurance and other ancillary, life, and annuity products.

Kansans have a wide range of options when it’s time to choose health insurance. Depending on your circumstances, you can join your employer’s plan, enroll in Medicaid or Medicare, or purchase a plan from an insurer. This guide has detailed information about all your Kansas health insurance options.

What to know about insurance in Kansas

  • Health Insurance Marketplace: Any individual or family can buy health coverage in Kansas through the Health Insurance Marketplace, except incarcerated people and undocumented immigrants. You must purchase your plan through the marketplace to access cost-sharing reductions or an Advanced Premium Tax Credit.
  • Open Enrollment: The open enrollment period runs from November 1 through December 15 each year. If you miss the open enrollment period, you may not be able to sign up for insurance until the next year.
  • Special Enrollment: Special enrollment periods allow you to sign up for insurance outside of the enrollment dates if you experience a qualifying circumstance such as getting married, losing a job, or having a child.
  • Advanced Premium Tax Credit: If you don’t qualify for an Advanced Premium Tax Credit or cost-sharing reductions, or if you don’t wish to take the credit, you can purchase a plan directly from an insurer.
  • Types of Plans: In Kansas, almost 55% of residents have employer-sponsored health insurance. Another 5% have non-group insurance, while 15% are enrolled in Medicare and 14% in Medicaid. Around 9% of Kansans are uninsured.

How do I enroll in Kansas’ health insurance marketplace?

Like many states, Kansas uses the federal website HealthCare.gov to enroll its residents in health insurance. To see available plans, you must create an account at HealthCare.gov by providing your name and contact information, setting a password, and choosing security questions.

Next, HealthCare.gov will ask questions about your income and family situation, such as whether you’re married, if you have dependents, and what your household income is. This information is used to check if you’re eligible for Medicaid or various cost-saving programs. You’ll also need to provide the full name, date of birth, and Social Security number of everyone in your family that needs coverage.

After you enter this information, you’ll be able to see a list of the plans and programs you’re eligible for. The site allows you to compare them side-by-side and shows the monthly premiums, deductibles, and coinsurance requirements. After you pick a plan, you can complete the enrollment process. In Kansas, there are a number of people who can help you make decisions about your health insurance, including Navigators, who are trained to help you understand the marketplace and the policies available.

The following companies offer individual health insurance plans to Kansas residents:

  • Ambetter from Sunflower Health Plan
  • Blue Cross and Blue Shield of Kansas
  • Blue Cross and Blue Shield of Kansas City
  • Cigna Health and Life Insurance Company
  • Medica Insurance Company
  • Oscar Insurance Company

How do I enroll in Kansas individual and family insurance?

The process to enroll through the Health Insurance Marketplace is the same, whether you’re purchasing health insurance just for yourself or for your family. However, you will need to consider each person’s health needs if you are choosing insurance for your whole family.

Insurance for individuals in Kansas

As an individual, you have more flexibility when looking for coverage. For example, if you’re generally healthy, you may choose a low-premium plan that has a higher deductible, knowing you don’t need to pay towards the deductible until you receive medical care. If you have regular medical expenses, you may choose a higher premium and save money through lower deductibles and copays.

You should also take time to research the types of plans available.

  • Exclusive Provider Organizations (EPOs) only cover care if you use in-network healthcare providers.
  • Health Maintenance Organizations (HMOs) also limit coverage to in-network providers and may ask you to get a referral before seeing a specialist.
  • Point of Service (POS) and Preferred Provider Organizations (PPO) allow you to see out-of-network providers if you pay a higher percentage of the cost, though POS requires referrals and PPOs don’t. In general, the more flexibility you have to see out-of-network providers, the higher the cost of the plan.

Insurance for families in Kansas

When choosing a health insurance plan to cover your family, you must consider the medical needs of everyone that will be covered. If your spouse has epilepsy or one of your children has asthma, you need to take this into account when looking at the costs and how easy it is to access the care your family needs.

The balance between the monthly premium and costs, like the annual deductible and copayments, is an important consideration. If you need regular care or prescription medicine on an ongoing basis, it may make more sense to pay a higher monthly premium, knowing it will be easier to manage the deductible and copays.

You should also consider the type of plan when deciding on family health insurance. An HMO is good if you’re happy with the in-network providers, but if you have to see a specialist regularly, a PPO means you can make an appointment without a referral. Before settling on a plan, make sure there’s a wide range of doctors and specialties available in-network, but remember that all types of plans cover emergency treatment, even if the provider is out of the network.

How much does health insurance cost in Kansas?

Health insurance plans are classified into four tiers: bronze, silver, gold, and platinum. These tiers show how costs are split between you and your insurer. Although plans with the lowest monthly premium may be attractive, it’s important to understand how all your insurance costs interact to ensure you pick the right plan for your circumstances.

Average premiums in Kansas  2018 2019 2020 2021
Most affordable bronze plan $371 $398 $372 $373
Most affordable silver plan $503 $517 $496 $470
Most affordable gold plan $489 $505 $497 $501

  • Bronze plans have the lowest premiums, but in exchange, there are higher out-of-pocket expenses. People with bronze plans pay 40% of their medical costs when they need care. In addition, deductibles are often very high. This makes bronze plans a good choice for people in good health who want insurance in case of an emergency. In Kansas, the most affordable bronze plan in 2021 is $373 a month.
  • People with silver plans pay 30% of costs when they need care, and deductibles are generally lower than bronze plans. One of the biggest benefits of silver plans is the cost-sharing reduction, or CSR, and the tax credit. These benefits lower the amount you have to pay. To take advantage of these savings, you must enroll through the Health Insurance Marketplace on a silver plan, making it a good choice for those who qualify. The most affordable silver plan in Kansas in 2021 is $470 per month.
  • Gold plans have a high monthly premium but the lowest costs when you need care. Deductibles are usually low, and people with gold plans only pay 20% of the cost of care, so they’re a great choice for those who need a lot of medical care. Platinum plans are very similar, with low deductibles and enrollees only required to pay 10% of medical costs. The most affordable 2021 gold plan in Kansas is $501.

What kind of low-income health insurance is available in Kansas?

Kansas provides most of its low-income health insurance through the Medicaid program, also called KanCare. The program is jointly funded by Kansas and the federal government and provides health insurance to around 431,000 adults and children in the state. The MediKan program is available to certain Kansans who aren’t eligible for other programs.

Medicaid in Kansas

People aged 65 or over, disabled, pregnant, or blind may be eligible for KanCare. It’s also available to people with certain medical conditions, children, and the parents or guardians of children under 19.

Rules differ based on your circumstances, but all applicants must meet residency and citizenship requirements and certain income requirements. The income limit is based on the size of your household. Single people can earn up to $17,131 per year, before taxes, with this figure rising to $23,169 for households of two and $29,207 for households of three. This figure may be higher for pregnant women and children. In addition, people who are eligible for the Aged, Blind, and Disabled program or receiving long-term care support must also have assets lower than the limit.

KanCare covers prescription drugs, mental health services, and medical services. In addition, most beneficiaries are covered for inpatient hospital, hearing, dental, and eye-wear. KanCare has a range of Home and Community-Based Services that provide long-term care for those with a medical need, including the elderly, people with physical or developmental disabilities, and those with brain injuries. KanCare also covers nursing home care for people with a medical need.

Kansans can apply for KanCare through the Medical Consumer Self-Service Portal or by mailing in an application. Applications can be requested by calling 1-800-792-4884.

MediKan in Kansas

MediKan is a short-term health insurance option that provides services for people with a physical or mental disability. You can only receive MediKan for 12 months, and it’s only available if you don’t qualify for any other state or federal programs. People applying for MediKan must also apply for Social Security disability benefits. For further information about MediKan, or to apply, call 1-800-792-4884.

What are Kansas’ Medicare options for seniors and people with disabilities?

Medicare is a federal program that provides health insurance to older adults and people with certain disabilities. There are several options for people eligible for the program.

  • Original Medicare is also known as Part A and Part B. Medicare Part A provides hospital insurance, while Part B helps pay for non-hospital care, including preventative care and outpatient services. Medicare Part D can be added to Original Medicare to cover prescription drugs and help reduce out-of-pocket expenses.
  • Medicare Part C is an alternative to original medicare. Also known as Medicare Advantage, it’s provided by private health insurance companies. Medicare Advantage plans must cover everything that’s covered by Part A and Part B but can also cover extra services, such as dental care, gym memberships, and prescription drugs.

No matter which Medicare plan you choose, it can still be difficult to afford healthcare costs like premiums, copays, and deductibles. Medicare Supplement Insurance Plans, or Medigap, cover many of these expenses.

Eligibility

To be eligible for Medicare, you must be aged 65 or older, have a disability and be receiving disability benefits, or have end-stage renal disease. If you’ve worked in Medicare-covered employment for at least 10 years, you don’t need to pay a premium for Part A, however, there are costs for Part B and D and Medicare Advantage.

Enrollment

Most people automatically receive an enrollment package three months prior to becoming eligible. During your initial enrollment period, you can choose to sign up for Original Medicare or Medicare Advantage. If you’re still working when you turn 65, you don’t receive this package but can still sign up if you meet the requirements. If you choose to keep employer-sponsored healthcare, you can sign up during a special enrollment period when you finish working. Medicare also has an Open Enrollment Period from October 15 to December 7 that allows you to make changes to your plan.

Medicare Resources

Kansas’ State Health Insurance Assistance Program is known as Senior Health Insurance Counseling for Kansas (SHICK). It has trained counselors available throughout the state to answer questions about Medicare and health insurance. If you have questions about Medicare or need help enrolling, you can talk to a SHICK counselor by calling 1-800-860-520.

Are there short-term health insurance plan options in Kansas?

Insurance providers in Kansas can sell short-term, limited-duration insurance (STLDI) policies, also known as short-term insurance plans, to people looking for temporary health insurance. This can be a good option if you need to cover a gap in your insurance. For example, if you’ve left your job and lost employer-provided insurance, an STLDI will cover you while you wait for your next job to start. It can also be used while you wait to be eligible for Medicare or if you miss the open enrollment period for the Health Insurance Marketplace. In Kansas, short-term plans can only be provided for terms of 6 or 12 months initially. They can be renewed once for a total of up to 24 months.

Kansas Insurance FAQs

Does Kansas require health insurance?

There are no state laws in Kansas that require residents to purchase health insurance. The Affordable Care Act still has the individual mandate, which states that you and dependent children must have minimum essential coverage; however, the penalty for not complying with this requirement is currently $0, meaning the mandate isn’t enforced.

Do I have to use the Health Insurance Marketplace in Kansas?

Kansans can choose to buy a health insurance plan outside of the marketplace. Options include buying a plan directly from an insurance company or through a broker. All plans must offer essential health benefits. However, premium tax credits and cost-sharing reductions are only available if you apply and enroll through the marketplace.

What types of alternative health insurance plans (like cost sharing plans) are available in Kansas?

Alternative health insurance plans, such as cost sharing plans, are available to consumers in Kansas. These sorts of plans are distinct from the cost-sharing reductions available through the Health Insurance Marketplace. These plans are not strictly insurance plans. Instead, they allow members to pool their funds to pay for health services.

Do I need health insurance if I have HSA/FSA?

It’s your choice whether to buy health insurance. When deciding, remember that flexible savings accounts and health savings accounts don’t give you the same benefits as insurance. Unless you can save enough to cover significant medical expenses, it’s best to get health insurance in addition to your HSA or FSA.

Do I need short-term disability coverage in Kansas if I have health insurance?

Short-term disability coverage isn’t the same as health insurance. Health insurance pays for medical expenses, while short-term disability covers the cost of housing, food, utilities, and other expenses while you can’t work. If you’re concerned about covering day-to-day expenses in the case of an accident, it’s best to get both types of insurance.

Do I need long-term disability coverage in Kansas if I have health insurance?

Like short-term disability, long-term disability coverage is intended to replace your income if you’re out of work for a significant period of time due to illness or injury. It’s not intended to cover significant medical expenses in addition to paying for your mortgage, food, and other expenses. Even with health insurance, you should still look into LTD insurance to ensure you can continue to pay your bills in this situation.

What does Medikan cover?

Medikan is a state-funded short-term insurance plan that provides coverage to certain people with disabilities who have applied for Social Security benefits.

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