Medicare in Kentucky runs on federal rules, with free SHIP counseling through CHFS/DAIL and a Medicaid-administered savings program that can cut your premiums to zero. This guide covers what Medicare costs in Kentucky for 2026, how each part works, and how to get help paying.,

In This Guide

About these numbers: Premiums and deductibles below come from CMS for calendar year 2026, effective January 1. Medicare costs change every year. For the most current figures, contact Medicare at 1-800-633-4227 (1-800-MEDICARE) or Kentucky SHIP through CHFS/DAIL.

Original Medicare in Kentucky: Parts A and B

Original Medicare is administered directly by the federal government. The mechanics and costs are the same in Kentucky as in every other state.

Part A (Hospital Insurance)

Part A covers inpatient hospital stays, limited skilled nursing facility care, hospice, and some home health care.

Cost Amount
Monthly premium $0 for most people (40+ quarters of work history)
Hospital deductible $1,736 per benefit period
Hospital coinsurance, days 61-90 $434 per day
Lifetime reserve days $868 per day
SNF coinsurance, days 21-100 $217 per day

The hospital deductible rose $60 from 2025, to $1,736 per benefit period. A benefit period starts when you're admitted and ends 60 days after discharge. Get readmitted after that and the deductible resets.

Part B (Medical Insurance)

Part B covers doctor visits, outpatient care, preventive services, durable medical equipment, and mental health care. It does not cover routine dental, vision, or hearing.

Delay Part B past your enrollment window without creditable coverage and you owe a permanent late penalty of 10% for every 12 months you could have had it.

Medicare Advantage in Kentucky (Part C)

Medicare Advantage plans are sold by private insurers as an alternative to Original Medicare. They cover everything Parts A and B do, except hospice, which Original Medicare keeps covering. Most bundle in Part D drug coverage and may include dental, vision, and hearing benefits.

Plan availability varies significantly across Kentucky. Louisville and Lexington metro areas generally offer a wider choice of plans. Rural Kentucky, particularly in the Appalachian counties of Eastern Kentucky, tends to have fewer options. Plan networks, premiums, and drug formularies differ by county and change annually.

How These Plans Work

Use the Medicare Plan Finder at medicare.gov to compare plans by ZIP code. Enter your doctors and prescriptions to see what each plan covers and your estimated annual cost. Kentucky SHIP counselors can walk through those results with you at no charge.

Medicare Part D: Prescription Drugs

Part D covers outpatient prescription drugs. You can get it as a standalone plan paired with Original Medicare, or bundled into a Medicare Advantage plan.

The Inflation Reduction Act eliminated the old coverage gap, so the donut hole no longer exists. Part D now moves through three phases:

  1. Deductible: you pay full price until you meet your plan's deductible (up to $615 in 2026).
  2. Initial coverage: you pay copays or coinsurance while your plan and drug manufacturers cover the rest.
  3. Catastrophic: once your out-of-pocket spending reaches $2,100, you pay $0 for covered drugs for the rest of the year.

The $2,100 cap is the most important number in Part D for 2026. It was $2,000 in 2025 and adjusts annually. The average standalone Part D premium is about $40 to $50 a month, though plan premiums vary widely. Every plan also offers the Medicare Prescription Payment Plan, which lets you spread out-of-pocket drug costs into capped monthly payments across the year instead of paying in full at the pharmacy. People who qualify for Extra Help often pay far less, sometimes $0.

Not sure which Part D plan fits your prescriptions? Chat with Brevy's care navigator at brevy.com.

Medigap in Kentucky

Medigap policies are sold by private insurers and fill the cost-sharing gaps in Original Medicare, including deductibles, coinsurance, and copays. They work only with Original Medicare, never with Medicare Advantage.

Kentucky offers the full set of federally standardized plans, labeled A through N, regulated by the Kentucky Department of Insurance. Plans C and F are closed to anyone who became Medicare-eligible on or after January 1, 2020. Plan G is the most popular choice for people newly eligible today: it covers the Part A deductible, Part A and Part B coinsurance, and skilled nursing facility coinsurance, leaving only the $283 Part B deductible as your responsibility.,

Your strongest entry point is the federal Medigap Open Enrollment Period, the six months beginning when you turn 65 and enroll in Part B. During that window, an insurer must sell you any plan at the standard rate regardless of your health history. Outside that window, Kentucky insurers may use medical underwriting, meaning they can review your health, charge more, or decline you.

Kentucky also has a Medigap birthday rule (KRS 304.14-525, effective January 1, 2024): once a year, within 60 days after your birthday, a current policyholder can move the same plan letter to a different insurer with no medical underwriting. It is a plan-for-plan replacement (for example, Plan G to Plan G), not a way to change benefit levels. The same law also created a new six-month open enrollment period for people under age 65 who are newly eligible for Medicare.

Medigap or Medicare Advantage?

You cannot hold both. Choose Medigap and you stay on Original Medicare with the freedom to see any provider who accepts Medicare nationwide, at a higher monthly premium. Choose Medicare Advantage and you trade some of that flexibility for a plan network and potentially lower upfront cost. For a comparison, see our guide to Original Medicare vs. Medicare Advantage.

Help Paying for Medicare in Kentucky

Two programs can substantially reduce Medicare costs for people with limited income and resources.

Medicare Savings Programs

Kentucky administers the Medicare Savings Programs through Kentucky CHFS Medicaid, using the standard federal income tiers and resource limits.

Federal name Individual Couple What it pays
QMB Up to about $1,350 Up to about $1,824 Part A and B premiums, deductibles, coinsurance
SLMB Up to about $1,616 Up to about $2,184 Part B premium
QI Up to about $1,816 Up to about $2,455 Part B premium

The income figures in the table above use the standard federal Medicare Savings Program tiers that Kentucky applies. QMB is the most valuable: it covers your Part B premium plus all deductibles and coinsurance, and federal law bars providers from billing a QMB enrollee for that cost-sharing. For all three programs the 2026 resource limit is $9,950 for one person and $14,910 for a couple. The income figures are tied to the Federal Poverty Level and update each April.

To apply, contact your local Department for Community Based Services (DCBS) office or apply through kynect, Kentucky's online benefits portal. Enrolling in any MSP automatically qualifies you for Extra Help with Part D.

Extra Help for Part D

Extra Help, also called the Low-Income Subsidy, pays Part D premiums, deductibles, and copays for people with limited income and resources. Since 2024, the partial-subsidy tier was eliminated, so everyone who qualifies now receives the full subsidy.

  • Income limit (2026): up to about $1,995 a month for an individual, $2,705 for a couple
  • Resource limits: $16,590 for an individual, $33,100 for a married couple
  • If you qualify for QMB, SLMB, or QI, you're enrolled in Extra Help automatically

Apply through Social Security or call 1-800-772-1213.

Medicare Enrollment Periods

These deadlines are federal and apply the same way in Kentucky as everywhere else.

Period Dates What you can do
Initial Enrollment 7 months around your 65th birthday Sign up for Parts A, B, and D; pick Medicare Advantage or Medigap
Annual Open Enrollment Oct 15 - Dec 7 Switch Medicare Advantage plans, move between Medicare Advantage and Original Medicare, change Part D
Medicare Advantage Open Enrollment Jan 1 - Mar 31 Switch Medicare Advantage plans or drop Medicare Advantage for Original Medicare (if already enrolled in Medicare Advantage)
General Enrollment Jan 1 - Mar 31 Sign up for Part B if you missed your Initial Enrollment Period
Special Enrollment (working past 65) Anytime during employer coverage, then 8 months after it ends Enroll without penalty if you delayed due to current employer group coverage

The General Enrollment Period and the working-past-65 Special Enrollment Period in the table above are set by federal rule and run the same way in Kentucky as everywhere else., Changes made during Annual Open Enrollment take effect January 1. If you're already receiving Social Security before 65, you're enrolled in Parts A and B automatically. Otherwise you sign up through the Social Security Administration.

If you missed your Initial Enrollment Period and don't qualify for a Special Enrollment Period, use the General Enrollment Period (January 1 through March 31). Coverage starts the first day of the month after you sign up. A late-enrollment penalty may still apply.,

Free Medicare Help: Kentucky SHIP

You don't have to sort through these options alone. Kentucky runs a State Health Insurance Assistance Program (SHIP), administered by the Kentucky Cabinet for Health and Family Services (CHFS) through the Department for Aging and Independent Living (DAIL). SHIP counselors are trained volunteers who give free, unbiased Medicare help and don't sell insurance.

A Kentucky SHIP counselor can help you:

  • Understand what Parts A, B, C, and D cover and what each costs
  • Compare Medicare Advantage and Medigap plan options
  • Apply for the Medicare Savings Programs and Extra Help
  • Work through billing problems, claim denials, and appeals

To reach local help, visit the SHIP page at chfs.ky.gov/agencies/dail/pages/ship.aspx for a directory of local counselors.

Key Kentucky Medicare Contacts

Kentucky SHIP (State Health Insurance Assistance Program) Free, unbiased one-on-one Medicare counseling from trained volunteers who do not sell insurance; find your local counselor through the directory. Kentucky Cabinet for Health and Family Services, DAIL
Kentucky Department for Community Based Services (DCBS) Applications for the Medicare Savings Programs (QMB, SLMB, QI) that help pay your Medicare premiums and cost-sharing, administered by Kentucky Medicaid (DMS). Apply through kynect
Social Security Extra Help (the Part D Low-Income Subsidy) applications, plus automatic Part A and Part B enrollment questions. 1-800-772-1213 Apply for Extra Help
Medicare Compare Medicare Advantage, Part D, and Medigap plans by ZIP code and get answers to general Medicare questions (1-800-MEDICARE). 1-800-633-4227 Medicare Plan Finder
Your next step Contact Kentucky SHIP through the Cabinet for Health and Family Services for a free appointment with a trained counselor who can compare your Medicare Advantage, Part D, and Medigap options and screen you for the Medicare Savings Programs and Extra Help, without ever selling you anything.

Frequently Asked Questions

What does Medicare cost in Kentucky in 2026?

Most people pay $0 for Part A. The standard Part B premium is $202.90 a month with a $283 annual deductible. Part D premiums vary by plan (the 2026 average runs about $40 to $50), and many Medicare Advantage plans in Kentucky charge no extra premium. Your total depends on which plan you choose and how much care you use.

Does Kentucky have a birthday rule for Medigap?

Yes. Since January 1, 2024 (KRS 304.14-525), Kentucky has a birthday rule: once a year, within 60 days after your birthday, a current policyholder can move the same plan letter to a different insurer with no medical underwriting. It is a plan-for-plan replacement only, not a way to change benefits. See our Kentucky Medigap birthday rule guide for details.

How do I apply for the Medicare Savings Program in Kentucky?

Contact your local Department for Community Based Services (DCBS) office or apply through kynect, Kentucky's online benefits portal. The program is administered by Kentucky CHFS Medicaid, and the income limits use the standard federal tiers (QMB, SLMB, QI). The 2026 resource limit is $9,950 for an individual and $14,910 for a couple.

What is Kentucky SHIP and who runs it?

SHIP in Kentucky is the State Health Insurance Assistance Program, operated by the Kentucky Cabinet for Health and Family Services through the Department for Aging and Independent Living (DAIL). Counselors are trained volunteers who provide free, one-on-one Medicare counseling and do not sell insurance. Visit chfs.ky.gov/agencies/dail/pages/ship.aspx for local contact information.

Are there fewer Medicare Advantage options in rural Kentucky?

Yes. Louisville and Lexington metros generally offer a wider selection of Medicare Advantage plans. Rural Kentucky, particularly in Eastern Kentucky's Appalachian counties, tends to have fewer plan options. Use the Medicare Plan Finder at medicare.gov to see exactly which plans are available at your address.

Learn More

MedicareMedicare Plans by State: What Varies and What Doesn'tOriginal Medicare is the same in all 50 states. Medicare Advantage, Part D, and Medigap rules are not. See what changes by state, then open your state guide. MedicareMedicare: The National GuideWhat is Medicare? A plain guide to Parts A, B, C, and D, who qualifies, 2026 costs, when to enroll, and what it doesn't cover, with help-paying options. MedicareOriginal Medicare vs. Medicare AdvantageCompare original Medicare vs Medicare Advantage on cost, networks, the $9,250 cap, and switching back. A neutral 2026 side-by-side to help you choose. MedicareHow Medigap WorksMedigap (Medicare Supplement) explained: how the standardized A-N plans work, Plan G vs Plan N, closed C and F plans, and the 6-month guaranteed-issue window. MedicareMedicare Part D Drug CoverageMedicare Part D in 2026: a $2,100 out-of-pocket cap, no donut hole, three benefit phases, the $615 deductible, premiums, the late penalty, and Extra Help. MedicareMedicare Enrollment PeriodsWhen to sign up for Medicare without a lifelong penalty: the 7-month Initial Enrollment Period, working past 65, the GEP, and what each late penalty costs.

Find personalized help comparing your Medicare plan options in Kentucky at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

BC

Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.