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Kentucky Medicare

Medicare covers services (like lab tests, surgeries, and doctor visits) and supplies (like wheelchairs and walkers) considered Health care services or supplies needed to prevent, diagnose, or treat an illness, injury, condition, disease, or its symptoms and that meet accepted standards of medicine.

There are several plans and options:

  • Part A and Part B are part of the original Medicare. If you are staying with original Medicare you may want to look into a Medicare Supplement (Medigap) plan.
  • Medicare Part C – Medicare Advantage plan
  • Medicare Part D – prescription drug Coverage

Two plans that may cover prescriptions are Medicare Part B and Medicare Part D.

If you’re in a Medicare Advantage Plan or other Medicare plan, you may have different rules, but your plan must give you at least the same coverage as Original Medicare. Some services may only be covered in certain settings or for patients with certain conditions.

  • For information about Part B, refer to Medicare.gov’s Part B page.
  • For information about Part D, or drug coverage, refer to Medicare.gov’s Part D page.
  • FAQ for KY Medicaid Members regarding Medicare

Medicare Part B and Part D drugs will not be covered by the Kentucky Department for Medicaid Services. These claims will deny with NCPDP Error Code 41 and the supplemental message of “Submit bill to other processor or primary payer” with the additional message “Bill Medicare Part D; Other payer not cost avoided.

 

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