Company vs company · Monroe County, KY · 2027 plan year
Anthem Blue Cross and Blue Shield vs Wellcare Medicare Advantage plans
Medicare.gov compares Medicare Advantage plans with each other. This page also shows Original Medicare, so you can see the full trade-off: premiums, copays, the yearly limit, extra benefits, and the rules about doctors and approvals.
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In most states, including Kentucky, you cannot count on getting Medigap later
You can buy any Medigap plan with no health questions in the 6 months that start when you are 65 or older and have Part B. After that, a Medigap company in Kentucky can ask about your health. It can say no, or it can charge you more. So if you join a Medicare Advantage plan now, you may not be able to get Medigap later. Kentucky’s birthday rule helps only people who already have Medigap, not people who leave Medicare Advantage.
One exception is the trial right. If you joined Medicare Advantage when you first got Medicare at 65, or you left a Medigap plan to try Medicare Advantage for the first time, you can switch back within 12 months. Then you can buy a Medigap plan with no health questions.
Read about Medigap rights on Medicare.govYour yearly cost, side by side
Move the controls to match your year. Totals include premiums, the Part B premium, copays, and drug costs.
Want to check your exact drugs? Medicare.gov lets you enter each drug and shows what each plan charges for it. Enter your drugs on Medicare.gov
We have no Medigap Plan G price for a 65-year-old woman in Monroe County. Enter the monthly price from your quote, or check Medigap prices for ZIP 42167 on Medicare.gov.
Original Medicare
We have no Medigap Plan G price for a 65-year-old woman here, so we cannot show this total yet. Enter your quote above to see it. Check Medigap prices on Medicare.gov
Anthem Medicare Advantage (HMO-POS)
HMO-POS from Anthem Blue Cross and Blue Shield
$6,395 a year
- Premiums
- $2,514
- Medical costs
- $1,785
- Drugs
- $2,096
Most you can pay in a bad year, before drugs: $9,664.
Wellcare Giveback (HMO-POS)
HMO-POS from Wellcare
$6,217 a year
- Premiums
- $1,734
- Medical costs
- $2,308
- Drugs
- $2,175
Most you can pay in a bad year, before drugs: $11,584.
With these settings, Wellcare Giveback (HMO-POS) costs about $178 less a year than Anthem Medicare Advantage (HMO-POS).
These are estimates, not quotes. Check every number with Medicare (Medicare.gov or 1-800-MEDICARE) and with the plan before you choose. What you pay depends on your doctors and hospitals, your drugs and pharmacy, and the care you use. Drug costs use typical prices for generic and brand-name drugs. Original Medicare amounts are 2027 projections from the 2026 Medicare Trustees Report. CMS sets the final amounts in November.
Text us about this comparisonWhat you pay each time you get care
In-network costs for one visit or one stay. The Original Medicare amounts follow your Medigap choice above: Plan G.
Primary doctor visit
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
Anthem Medicare Advantage (HMO-POS)
$0
Anthem Medicare Advantage (Regional PPO)
$0
Wellcare Simple (HMO-POS)
$0
Wellcare Giveback (HMO-POS)
$0
Specialist visit
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
Anthem Medicare Advantage (HMO-POS)
$45
Prior authorizationAnthem Medicare Advantage (Regional PPO)
$40
Prior authorizationWellcare Simple (HMO-POS)
$35
Prior authorizationWellcare Giveback (HMO-POS)
$55
Prior authorization
Lab tests
Original Medicare + Medigap Plan G
$0
most Medicare-covered tests
Anthem Medicare Advantage (HMO-POS)
$0
Prior authorizationAnthem Medicare Advantage (Regional PPO)
$0-$10
Prior authorizationWellcare Simple (HMO-POS)
$0-$50
Prior authorizationWellcare Giveback (HMO-POS)
$0-$50
Prior authorization
MRI or CT scan
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
Anthem Medicare Advantage (HMO-POS)
$50-$490
Prior authorizationAnthem Medicare Advantage (Regional PPO)
$50-$345
Prior authorizationWellcare Simple (HMO-POS)
$0-$500
Prior authorizationWellcare Giveback (HMO-POS)
$0-$500
Prior authorization
Emergency room
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
Anthem Medicare Advantage (HMO-POS)
$130
Anthem Medicare Advantage (Regional PPO)
$115
Wellcare Simple (HMO-POS)
$130
Wellcare Giveback (HMO-POS)
$115
Urgent care
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
Anthem Medicare Advantage (HMO-POS)
$30
Anthem Medicare Advantage (Regional PPO)
$35
Wellcare Simple (HMO-POS)
$40
Wellcare Giveback (HMO-POS)
$30
Outpatient surgery
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
Anthem Medicare Advantage (HMO-POS)
$0-$300
Prior authorizationAnthem Medicare Advantage (Regional PPO)
$0-$295
Prior authorizationWellcare Simple (HMO-POS)
$475
Prior authorizationWellcare Giveback (HMO-POS)
$475
Prior authorization
Ground ambulance
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
Anthem Medicare Advantage (HMO-POS)
$260
Prior authorizationAnthem Medicare Advantage (Regional PPO)
$350
Prior authorizationWellcare Simple (HMO-POS)
$350
Prior authorizationWellcare Giveback (HMO-POS)
$350
Prior authorization
Hospital stay, 5 days
Original Medicare + Medigap Plan G
$0
Plan G pays the $1,788 Part A deductible
Anthem Medicare Advantage (HMO-POS)
$2,450
for a 5-day stay
Prior authorizationAnthem Medicare Advantage (Regional PPO)
$1,725
for a 5-day stay
Prior authorizationWellcare Simple (HMO-POS)
$2,625
for a 5-day stay
Prior authorizationWellcare Giveback (HMO-POS)
$2,340
for a 5-day stay
Prior authorization
See every cost in one table
| What you pay in network | Original Medicare + Medigap Plan G | Anthem Medicare Advantage (HMO-POS) | Anthem Medicare Advantage (Regional PPO) | Wellcare Simple (HMO-POS) | Wellcare Giveback (HMO-POS) |
|---|---|---|---|---|---|
| Monthly premium | Part B $209.50 + Medigap Plan G at the price of your quote + drug plan $26.30 | $0 + Part B $209.50 | $123 + Part B $209.50 | $0 + Part B $209.50 | $0 (pays back $65 a month of your Part B premium) + Part B $209.50 |
| Yearly limit on what you pay | You pay the $292 Part B deductible. Plan G pays the rest. | $7,150 in network | $9,250 in network; $13,900 in and out of network | $7,000 in network | $9,850 in network |
| Medical deductible | $292 Part B. Plan G pays the $1,788 Part A deductible. | $0 | $500 | $0 | $350 |
| Primary doctor visit | $0, after the $292 yearly Part B deductible | $0 copay | $0 copay | $0 copay | $0 copay |
| Specialist visit | $0, after the $292 yearly Part B deductible | $45 copayPrior authorization | $40 copayPrior authorization | $35 copayPrior authorization | $55 copayPrior authorization |
| Lab tests | $0, most Medicare-covered tests | $0 copayPrior authorization | $0-$10 copayPrior authorization | $0-$50 copayPrior authorization | $0-$50 copayPrior authorization |
| MRI or CT scan | $0, after the $292 yearly Part B deductible | $50-$490 copayPrior authorization | $50-$345 copayPrior authorization | $0-$500 copayPrior authorization | $0-$500 copayPrior authorization |
| X-rays | $0, after the $292 yearly Part B deductible | $50-$130 copayPrior authorization | $90-$110 copayPrior authorization | $50 copayPrior authorization | $50 copayPrior authorization |
| Emergency room | $0, after the $292 yearly Part B deductible | $130 copay | $115 copay | $130 copay | $115 copay |
| Urgent care | $0, after the $292 yearly Part B deductible | $30 copay | $35 copay | $40 copay | $30 copay |
| Outpatient hospital | $0, after the $292 yearly Part B deductible | $0-$490 copayPrior authorization | $0-$345 copayPrior authorization | $0-$500 copayPrior authorization | $0-$500 copayPrior authorization |
| Surgery center | $0, after the $292 yearly Part B deductible | $0-$300 copayPrior authorization | $0-$295 copayPrior authorization | $475 copayPrior authorization | $475 copayPrior authorization |
| Ground ambulance | $0, after the $292 yearly Part B deductible | $260 copayPrior authorization | $350 copayPrior authorization | $350 copayPrior authorization | $350 copayPrior authorization |
| Hospital stay | $0, Plan G pays the $1,788 Part A deductible | $490 per day for days 1-5; $0 per day for days 6-90Prior authorization | $345 per day for days 1-7; $0 per day for days 8-90Prior authorization | $525 per day for days 1-5; $0 per day for days 6-90Prior authorization | $585 per day for days 1-4; $0 per day for days 5-90Prior authorization |
| Skilled nursing facility | $0, Plan G pays days 21-100 | $0 per day for days 1-20; $221 per day for days 21-100Prior authorization | $0 per day for days 1-20; $221 per day for days 21-100Prior authorization | $0 per day for days 1-20; $221 per day for days 21-60; $0 per day for days 61-100Prior authorization | $0 per day for days 1-20; $221 per day for days 21-70; $0 per day for days 71-100Prior authorization |
| Mental health visit | $0, after the $292 yearly Part B deductible | $45 copayPrior authorization | $40 copayPrior authorization | $40 copayPrior authorization | $40 copayPrior authorization |
| Physical therapy | $0, after the $292 yearly Part B deductible | $45 copayPrior authorization | $35 copayPrior authorization | $40 copayPrior authorization | $50 copayPrior authorization |
| Home health care | $0, Medicare-covered home health | $0 copayPrior authorization | $0 copayPrior authorization | $0 copayPrior authorization | $0 copayPrior authorization |
| Medical equipment | $0, after the $292 yearly Part B deductible | 20% coinsurancePrior authorization | 20% coinsurancePrior authorization | 20% coinsurancePrior authorization | 20% coinsurancePrior authorization |
| Part B drugs | $0 after the $292 Part B deductible | 0%-20% coinsurancePrior authorization | 0%-20% coinsurancePrior authorization | 0%-20% coinsurancePrior authorization | 0%-20% coinsurancePrior authorization |
| Drug deductible (Part D) | $687 with Humana Value Rx Plan (PDP) | $595 | $45 | $700 | $700 |
| Drug tiers (one month, retail) | Preferred Generic: $0 copayGeneric: $0 copayPreferred Brand: 20% coinsuranceNon-Preferred Drug: 31% coinsuranceSpecialty Tier: 26% coinsurance | Preferred Generic: $0 copayGeneric: $0 copayPreferred Brand: 25% coinsuranceNon-Preferred Drug: 25% coinsuranceSpecialty Tier: 27% coinsurance | Preferred Generic: $0 copayGeneric: $5 copayPreferred Brand: 25% coinsuranceNon-Preferred Drug: 29% coinsuranceSpecialty Tier: 32% coinsurance | Generic: $0 copayPreferred Brand: 25% coinsuranceNon-Preferred Drug: 47% coinsuranceInjectable Drugs: 1% coinsuranceSpecialty Tier: 25% coinsuranceSelect Care Drugs: $0 copay | Generic: $0 copayPreferred Brand: 25% coinsuranceNon-Preferred Drug: 38% coinsuranceInjectable Drugs: 1% coinsuranceSpecialty Tier: 25% coinsuranceSelect Care Drugs: $0 copay |
Not sure which of these costs apply to you?
Text us what you have now. We will help you read this comparison and check it with Medicare.gov.
A higher drug plan premium is not, by itself, a reason to switch
With Original Medicare, you buy a separate drug plan. In Kentucky, 8 drug plans are for sale for 2027, from $5.30 to $225.90 a month. Half of them cost $74.35 a month or less.
- Every 2027 drug plan limits what you pay for covered drugs to $2,400 a year. The drug coverage in Medicare Advantage plans has the same limit.
- The premium is one part of your yearly cost. The calculator above adds premiums, medical costs, and drug costs, so you can see the whole year.
- A Medicare Advantage plan can cost less in a light year. But you also take on its network and prior authorization rules, and you may not be able to get Medigap later.
- If your income is limited, Extra Help can pay most of your drug plan premium and drug costs. Check Extra Help at SSA.gov
The two companies in Monroe County
Anthem Blue Cross and Blue Shield
- 6 plans for 2027 (not counting special needs plans)
- 2 with a $0 premium; 1 pay back part of your Part B premium
- Yearly limits from $4,450 to $9,250
- Star ratings 3 to 4.5
- Anthem Medicare Advantage (HMO-POS) · $0 a month · limit $7,150
- Anthem Medicare Advantage (Regional PPO) · $123 a month · limit $9,250
- Anthem Medicare Advantage 3 (PPO) · $70 a month · limit $5,900
- Anthem Medicare Advantage (PPO) · $41 a month · limit $9,250
- Anthem Veteran (PPO) · $0 a month · limit $9,250
- Anthem Medicare Advantage 2 (HMO-POS) · $35 a month · limit $4,450
Wellcare
- 3 plans for 2027 (not counting special needs plans)
- 3 with a $0 premium; 1 pay back part of your Part B premium
- Yearly limits from $7,000 to $9,850
- Star ratings 3 to 3
- Wellcare Simple (HMO-POS) · $0 a month · limit $7,000
- Wellcare Giveback (HMO-POS) · $0 a month · limit $9,850
- Wellcare Simple Open (PPO) · $0 a month · limit $7,500
Doctors, referrals, and prior authorization
Cost is one side. The other side is how you get care. These rules come from the CMS plan files. Prior authorization means the plan must approve a service before you get it.
Original Medicare
- Any doctor or hospital in the U.S. that takes Medicare
- No referrals
- Prior authorization only for a short list of services
Anthem Medicare Advantage (HMO-POS)
HMO-POS
- You use the plan network. Some care outside the network is covered at a higher cost.
- No referral needed to see a specialist.
Prior authorization for 23 services
Specialist visits, Diagnostic tests, MRI or CT, Radiation therapy, Outpatient hospital, Observation stay, Surgery center, Ambulance, Mental health visits, Psychiatrist visits, Physical therapy, Occupational therapy, Home health, Partial hospitalization, Cardiac rehab, Pulmonary rehab, Medical equipment, Prosthetics, Diabetic supplies, Substance use care, Hospital stay, Skilled nursing, Part B drugs
Anthem Medicare Advantage (Regional PPO)
Regional PPO
- The plan has a network. You can go outside it, but you pay more.
- No referral needed to see a specialist.
Prior authorization for 23 services
Specialist visits, Diagnostic tests, MRI or CT, Radiation therapy, Outpatient hospital, Observation stay, Surgery center, Ambulance, Mental health visits, Psychiatrist visits, Physical therapy, Occupational therapy, Home health, Partial hospitalization, Cardiac rehab, Pulmonary rehab, Medical equipment, Prosthetics, Diabetic supplies, Substance use care, Hospital stay, Skilled nursing, Part B drugs
Wellcare Simple (HMO-POS)
HMO-POS
- You use the plan network. Some care outside the network is covered at a higher cost.
- You need a referral to see a specialist.
Prior authorization for 20 services
Specialist visits, Diagnostic tests, MRI or CT, Radiation therapy, Outpatient hospital, Surgery center, Ambulance, Mental health visits, Psychiatrist visits, Physical therapy, Occupational therapy, Home health, Partial hospitalization, Medical equipment, Prosthetics, Diabetic supplies, Substance use care, Hospital stay, Skilled nursing, Part B drugs
Wellcare Giveback (HMO-POS)
HMO-POS
- You use the plan network. Some care outside the network is covered at a higher cost.
- You need a referral to see a specialist.
Prior authorization for 20 services
Specialist visits, Diagnostic tests, MRI or CT, Radiation therapy, Outpatient hospital, Surgery center, Ambulance, Mental health visits, Psychiatrist visits, Physical therapy, Occupational therapy, Home health, Partial hospitalization, Medical equipment, Prosthetics, Diabetic supplies, Substance use care, Hospital stay, Skilled nursing, Part B drugs
Extra benefits
| Extra benefit | Original Medicare | Anthem Medicare Advantage (HMO-POS) | Anthem Medicare Advantage (Regional PPO) | Wellcare Simple (HMO-POS) | Wellcare Giveback (HMO-POS) |
|---|---|---|---|---|---|
| Dental | No | Comprehensive, up to $1,000 a year | Preventive only | Comprehensive, up to $1,500 a year | Comprehensive, up to $1,000 a year |
| Eye exam | No | Yes | Yes | Yes | Yes |
| Glasses or contacts | No | Yes, $200 allowance | No | Yes, $300 allowance | Yes, $100 allowance |
| Hearing aids | No | Yes, up to $2,000 | Yes, up to $2,000 | Yes, up to $350 | No |
| Over-the-counter allowance | No | No | $140 a year | $360 a year | No |
| Fitness benefit | No | No | No | Yes | Yes |
| Rides to care | No | No | No | No | No |
| Meals after a hospital stay | No | Yes | No | No | No |
| Emergency care abroad | Plan G and Plan N pay 80% after a $250 deductible | Yes | Yes | Yes | Yes |
| Part B premium giveback | No | No | No | No | $65 a month |
What changed for 2027
Anthem Medicare Advantage (HMO-POS)
Renewal Plan · 2026 plan H9525-013-1
- In-network out-of-pocket maximum up from $6,300 to $7,150
- Drug deductible up from $230 to $595
- Diagnostic radiology (MRI, CT): $50-$450 copay to $50-$490 copay
- Outpatient hospital: $0-$450 copay to $0-$490 copay
- Inpatient hospital: $450 per day for days 1-5; $0 per day for days 6-90 to $490 per day for days 1-5; $0 per day for days 6-90
- Skilled nursing facility: $0 per day for days 1-20; $218 per day for days 21-100 to $0 per day for days 1-20; $221 per day for days 21-100
- Dental maximum down from $1,500 to $1,000
- Eyewear allowance down from $300 to $200
Anthem Medicare Advantage (Regional PPO)
Renewal Plan · 2026 plan R5941-016-0
- Monthly premium up from $97 to $123
- Skilled nursing facility: $0 per day for days 1-20; $218 per day for days 21-100 to $0 per day for days 1-20; $221 per day for days 21-100
Wellcare Simple (HMO-POS)
Consolidated Renewal Plan · 2026 plan H9730-009-0
- Drug deductible up from $615 to $700
- Emergency care: $115 copay to $130 copay
- Diagnostic radiology (MRI, CT): $0-$450 copay to $0-$500 copay
- Outpatient hospital: $0-$450 copay to $0-$500 copay
- Ground ambulance: $300 copay to $350 copay
- Inpatient hospital: $375 per day for days 1-7; $0 per day for days 8-90 to $525 per day for days 1-5; $0 per day for days 6-90
- Skilled nursing facility: $0 per day for days 1-20; $218 per day for days 21-60; $0 per day for days 61-100 to $0 per day for days 1-20; $221 per day for days 21-60; $0 per day for days 61-100
- Dental maximum down from $3,000 to $1,500
- Yearly OTC allowance down from $852 to $360
- Hearing aid allowance down from $750 to $350
- Overall star rating down from 3.5 to 3
Wellcare Giveback (HMO-POS)
Renewal Plan · 2026 plan H9730-007-0
- In-network out-of-pocket maximum up from $9,000 to $9,850
- Drug deductible up from $615 to $700
- Part B giveback down from $84 to $65
- Specialist visit: $40 copay to $55 copay
- Diagnostic radiology (MRI, CT): $0-$450 copay to $0-$500 copay
- Outpatient hospital: $0-$450 copay to $0-$500 copay
- Inpatient hospital: $475 per day for days 1-5; $0 per day for days 6-90 to $585 per day for days 1-4; $0 per day for days 5-90
- Skilled nursing facility: $0 per day for days 1-20; $218 per day for days 21-70; $0 per day for days 71-100 to $0 per day for days 1-20; $221 per day for days 21-70; $0 per day for days 71-100
- Hearing aids removed
- OTC allowance removed
- Overall star rating down from 3.5 to 3
More 2027 plans in Monroe County
- Humana Essentials Plus Giveback (PPO), H7617-049 (page for Jefferson County, KY)
- HumanaChoice H5216-317 (PPO) (page for Jefferson County, KY)
- Humana USAA Honor Giveback (PPO), H5216-225 (page for Jefferson County, KY)
- HumanaChoice H5216-188 (PPO) (page for Jefferson County, KY)
- DEVOTED CHOICE GIVEBACK 002 KY (PPO), H5718-002 (page for Jefferson County, KY)
- Humana Value Choice (PPO), H7617-050 (page for Jefferson County, KY)
- AARP Medicare Advantage from UHC KY-1 (HMO-POS), H5253-099 (page for Jefferson County, KY)
- Humana USAA Honor Giveback (PPO), H5216-442 (page for Jefferson County, KY)
County guide: 2027 plans in Monroe CountyState guide: Kentucky
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Sources and method
Plan data comes from the CMS 2027 Plan Benefit Package and landscape files. The data is from 2026-10-10. We checked a sample of plans field by field against Medicare.gov. Original Medicare amounts are the 2027 projections in the 2026 Medicare Trustees Report (Tables V.E1 and V.E2). CMS sets the final amounts in November. We do not have a Medigap price for Monroe County, KY. So the Original Medicare total needs your own Medigap quote. You can look up prices for ZIP 42167 on Medicare.gov. Totals use typical Medicare-allowed amounts for each service and typical drug prices.
- Anthem Medicare Advantage (HMO-POS) on Medicare.gov · plan website · drug list
- Anthem Medicare Advantage (Regional PPO) on Medicare.gov · plan website · drug list · doctor directory
- Wellcare Simple (HMO-POS) on Medicare.gov · plan website · drug list · doctor directory
- Wellcare Giveback (HMO-POS) on Medicare.gov · plan website · drug list · doctor directory
- Medigap prices for ZIP 42167 on Medicare.gov
- CMS Plan Benefit Package files, 2027
- CMS 2027 landscape files (premiums and limits)
- CMS 2027 plan crosswalk
- CMS 2027 Star Ratings
- 2026 Medicare Trustees Report: projected 2027 Part A and Part B amounts (Tables V.E1 and V.E2)
- CMS 2026 Part A and Part B amounts
- Medicare.gov: Medigap guaranteed issue rights
These are estimates, not quotes, and they are for education only. Check every number with Medicare and with the plan before you choose. What you pay depends on your doctors and hospitals, your drugs and pharmacy, and the care you use. Plans can change their benefits, premiums, drug lists, and networks each year.
Pinnie is not an insurance agent or broker and does not sell Medicare plans. Pinnie is not connected with or endorsed by the U.S. government or the federal Medicare program. For all your options, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.