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Plan vs plan · Hardin County, KY · 2027 plan year

Anthem Medicare Advantage (HMO-POS) vs Wellcare Simple (HMO-POS)

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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Anthem Medicare Advantage (HMO-POS)

Plan premium
$0 a month
Yearly limit, in network
$7,150
2027 star rating
3.5 of 5
Prior authorization needed for
23 services

Wellcare Simple (HMO-POS)

Plan premium
$0 a month
Yearly limit, in network
$7,000
2027 star rating
3 of 5
Prior authorization needed for
20 services

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.gov

Your yearly cost, side by side

Move the controls to match your year. Totals include premiums, the Part B premium, copays, and drug costs.

How much care do you expect?

Ongoing specialist care

Medigap plan with Original Medicare

Plan G pays almost everything after the $292 yearly Part B deductible.

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 Hardin County. Enter the monthly price from your quote, or check Medigap prices for ZIP 42701 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 Simple (HMO-POS)

HMO-POS from Wellcare

$6,574 a year

Premiums
$2,514
Medical costs
$1,885
Drugs
$2,175

Most you can pay in a bad year, before drugs: $9,514.

With these settings, Anthem Medicare Advantage (HMO-POS) costs about $179 less a year than Wellcare Simple (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.

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What 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

  • Wellcare Simple (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 authorization

  • Wellcare Simple (HMO-POS)

    $35

    Prior authorization

Lab tests

  • Original Medicare + Medigap Plan G

    $0

    most Medicare-covered tests

  • Anthem Medicare Advantage (HMO-POS)

    $0

    Prior authorization

  • Wellcare Simple (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 authorization

  • Wellcare Simple (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

  • Wellcare Simple (HMO-POS)

    $130

Urgent care

  • Original Medicare + Medigap Plan G

    $0

    after the $292 yearly Part B deductible

  • Anthem Medicare Advantage (HMO-POS)

    $30

  • Wellcare Simple (HMO-POS)

    $40

Outpatient surgery

  • Original Medicare + Medigap Plan G

    $0

    after the $292 yearly Part B deductible

  • Anthem Medicare Advantage (HMO-POS)

    $0-$300

    Prior authorization

  • Wellcare Simple (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 authorization

  • Wellcare Simple (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 authorization

  • Wellcare Simple (HMO-POS)

    $2,625

    for a 5-day stay

    Prior authorization
See every cost in one table
What you pay in networkOriginal Medicare + Medigap Plan GAnthem Medicare Advantage (HMO-POS)Wellcare Simple (HMO-POS)
Monthly premiumPart B $209.50 + Medigap Plan G at the price of your quote + drug plan $26.30$0 + Part B $209.50$0 + Part B $209.50
Yearly limit on what you payYou pay the $292 Part B deductible. Plan G pays the rest.$7,150 in network$7,000 in network
Medical deductible$292 Part B. Plan G pays the $1,788 Part A deductible.$0$0
Primary doctor visit$0, after the $292 yearly Part B deductible$0 copay$0 copay
Specialist visit$0, after the $292 yearly Part B deductible$45 copayPrior authorization$35 copayPrior authorization
Lab tests$0, most Medicare-covered tests$0 copayPrior authorization$0-$50 copayPrior authorization
MRI or CT scan$0, after the $292 yearly Part B deductible$50-$490 copayPrior authorization$0-$500 copayPrior authorization
X-rays$0, after the $292 yearly Part B deductible$50-$130 copayPrior authorization$50 copayPrior authorization
Emergency room$0, after the $292 yearly Part B deductible$130 copay$130 copay
Urgent care$0, after the $292 yearly Part B deductible$30 copay$40 copay
Outpatient hospital$0, after the $292 yearly Part B deductible$0-$490 copayPrior authorization$0-$500 copayPrior authorization
Surgery center$0, after the $292 yearly Part B deductible$0-$300 copayPrior authorization$475 copayPrior authorization
Ground ambulance$0, after the $292 yearly Part B deductible$260 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$525 per day for days 1-5; $0 per day for days 6-90Prior 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 21-60; $0 per day for days 61-100Prior authorization
Mental health visit$0, after the $292 yearly Part B deductible$45 copayPrior authorization$40 copayPrior authorization
Physical therapy$0, after the $292 yearly Part B deductible$45 copayPrior authorization$40 copayPrior authorization
Home health care$0, Medicare-covered home health$0 copayPrior authorization$0 copayPrior authorization
Medical equipment$0, after the $292 yearly Part B deductible20% coinsurancePrior authorization20% coinsurancePrior authorization
Part B drugs$0 after the $292 Part B deductible0%-20% coinsurancePrior authorization0%-20% coinsurancePrior authorization
Drug deductible (Part D)$687 with Humana Value Rx Plan (PDP)$595$700
Drug tiers (one month, retail)Preferred Generic: $0 copayGeneric: $0 copayPreferred Brand: 20% coinsuranceNon-Preferred Drug: 31% coinsuranceSpecialty Tier: 26% coinsurancePreferred Generic: $0 copayGeneric: $0 copayPreferred Brand: 25% coinsuranceNon-Preferred Drug: 25% coinsuranceSpecialty Tier: 27% coinsuranceGeneric: $0 copayPreferred Brand: 25% coinsuranceNon-Preferred Drug: 47% coinsuranceInjectable Drugs: 1% coinsuranceSpecialty Tier: 25% coinsuranceSelect Care Drugs: $0 copay

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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

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

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

Extra benefits

Extra benefitOriginal MedicareAnthem Medicare Advantage (HMO-POS)Wellcare Simple (HMO-POS)
DentalNoComprehensive, up to $1,000 a yearComprehensive, up to $1,500 a year
Eye examNoYesYes
Glasses or contactsNoYes, $200 allowanceYes, $300 allowance
Hearing aidsNoYes, up to $2,000Yes, up to $350
Over-the-counter allowanceNoNo$360 a year
Fitness benefitNoNoYes
Rides to careNoNoNo
Meals after a hospital stayNoYesNo
Emergency care abroadPlan G and Plan N pay 80% after a $250 deductibleYesYes
Part B premium givebackNoNoNo

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

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

More 2027 plans in Hardin County

County guide: 2027 plans in Hardin 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 Hardin County, KY. So the Original Medicare total needs your own Medigap quote. You can look up prices for ZIP 42701 on Medicare.gov. Totals use typical Medicare-allowed amounts for each service and typical drug prices.

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.

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