The Sunflower State has five carriers offering Marketplace plans for 2021. Most residents who enroll in coverage qualify for subsidies.
Overview of Kansas Health Insurance and the Affordable Care Act (ACA)
Kansas is one of the few states that has not adopted Medicaid expansion under the ACA (Obamacare).1 The ACA gave states the option to extend eligibility to childless adults earning up to 138% of the federal poverty level. This figure amounts to $17,609 for a single Kansan in 2020.2
About 46,000 Kansans are in the Medicaid coverage gap who would otherwise qualify. Despite this, Kansas still has a relatively low uninsured rate. According to the latest Kaiser Family Foundation report, 9% of the state’s 2.8 million population are uninsured.
Close to one third of Sunflower State residents are enrolled in government-funded programs, such as Medicaid and Medicare. A small percentage buy plans through the Health Insurance Marketplace. Many low-income Kansans qualify for help with Marketplace premiums.
Buying Kansas Health Insurance for Individuals, Families, and Self-Employed Professionals
More than half of Kansans get private health insurance through an employer. Those without access to job-based coverage can buy private plans through the Marketplace. Plans sold in the individual Marketplace are available to singles, families, and self-employed entrepreneurs with no employees.
You can buy any Marketplace plan that’s available in your area. In most cases, you can find bronze, silver, and gold plans. These metal plans pay from 60% to 80% of your covered medical costs. There are also platinum plans that pay 90% of covered expenses, but these are rarely sold.
An alternative to metal plans is catastrophic health insurance. This type of coverage is designed for people under 30 who typically have fewer healthcare needs. However, older adults who qualify for a hardship exemption can also enroll. Catastrophic plans count as qualified coverage under the Affordable Care Act (Act). They have the same protections as metal plans.
ACA-regulated plans provide guaranteed coverage regardless of health or preexisting condition. Policies include 10 essential health benefits, such as maternity and mental health care, free preventive services, and prescription drug coverage. For metal plans, any children enrolled also get dental and prescription drug coverage.
Kansas Health Insurance Marketplace Enrollment
Kansans use the federal Marketplace via healthcare.gov to enroll in Obamacare. Nearly 86,000 residents signed up during the 2020 Open Enrollment Period. Enrollment for 2021 plans run from November 1, 2020 to December 15, 2020. Coverage begins on January 1, 2021.
If you miss signing up, you can still enroll in a 2021 plan if you have a qualifying life event. Examples include losing coverage or getting married. If not, you have to wait for the next Open Enrollment Period.
Health Insurance Companies in Kansas
Five Kansas health insurance companies offer Marketplace plans for 2021. All companies offer bronze, silver, and gold plans.
- Blue Cross Blue Shield of Kansas
- Medica Insurance Company (includes catastrophic health insurance)
- Oscar Insurance Company (includes catastrophic health insurance)
- Ambetter from Sunflower Health Plan
- Cigna Health and Life Insurance Company
Health Insurance Costs in Kansas
Health insurance premiums in Kansas are cheaper in 2020 than it was in 2019. Below are the average monthly rates for Marketplace plans from 2019 to 2020:
- Average lowest-cost bronze premium: $398 in 2019; $372 in 2020
- Average lowest-cost silver premium: $517 in 2019; $496 in 2020
- Average lowest-cost gold premium: $505 in 2019; $497 in 2020
Financial Help With Marketplace Premiums for Low-Income Kansans
An adult earning from $12,769 to $51,040 can qualify for premium tax credits (subsidies) from the federal government. This amount represents 100% to 400% of the federal poverty level (FPL) in 2020. The FPL increases by $4,480 for each additional person in the household.
Check a 2020 subsidy chart and calculator to see which subsidies you might qualify for.
Medicaid for Low-Income Kansas Residents
- Children up to age 19
- Parents and caregivers with children up to 19
- Pregnant women
- People 65 and older
- Individuals who are blind or have disabilities
Eligible groups must meet residency, citizenship, and income requirements to enroll. For instance, a family of four with dependent children can earn from $676 to $816 per month as of 2019.
Kansas Children’s Health Insurance Program
KanCare also operates a Children’s Health Insurance Program. It’s open to dependents under 19 whose families earn too much to qualify for Medicaid. About 57,000 children enrolled as of November 2019.5
The income limit to qualify is 255% of the FPL or $4,178 a month for a family of three. Families that make more than 166% of the FPL must pay a monthly premium ranging from $20 to $50.
Kansas Medicare Coverage for Seniors and People With Disabilities
More than a half-million Kansans have Medicare.6 Most who qualify are usually 65 or older. But younger adults with disabilities are also eligible. Nearly 85% of all Kansas beneficiaries have Original Medicare from the federal government. The rest are enrolled in private Medicare Advantage plans. Both options provide Part A hospital and Part B medical insurance. But Medicare Advantage (known as Part C) offers extra benefits, such as Part D prescription drug coverage.
Part C plans are restricted to local and regional network providers whereas Original Medicare is accepted nationwide at participating providers. However, Original Medicare has coverage gaps, such as limited drug coverage. Because of this, many Kansas (about 297,000) buy a separate Part D drug plan to get comprehensive benefits.7
Others also enroll in Medicare Supplement (called Medigap) to help pay covered Part A and B costs. For example, there’s 20% coinsurance for Part B. Most Medigap plans pay 100% of this cost. Kansas, like most states, offers 10 standard plans that cover some to all of your covered out-of-pocket expenses.
Short-Term Health Insurance in Kansas
Short-term medical policies in Kansas offer initial coverage for up to 364 days. Policies can be renewed for a maximum of 36 months. You might consider short-term health insurance if you have a temporary coverage gap. For instance, if you lost coverage through a parent’s health plan or you’re in between jobs.
Keep in mind that short-term plans aren’t the same as comprehensive health insurance under the Affordable Care Act (ACA). The ACA provides protections such as coverage for preexisting conditions and mandatory essential health benefits. But short-term plans aren’t required to follow ACA laws.
Short-term health policies typically have many limitations and exclusions. So make sure you understand what’s covered before you enroll. It’s also a good idea to compare costs (such as premiums and deductibles) with ACA coverage to decide which works best for you.