Medicare Plans in Missouri
Missouri offers a variety of Medicare plans, but sorting through them all to find the right coverage can be exhausting. We don’t think it should be! We’ve done the research to help you sort through the many Medicare plans in Missouri and find the coverage that fits your needs.
Who’s eligible for a Medicare Plans in Missouri?
Medicare is a federally sponsored program that provides healthcare services to those who qualify, by either age or disability/illness. Individuals generally become eligible for Medicare plans in Maryland once they reach 65 years of age. Persons under the age of 65 may also qualify if they have been receiving Social Security Disability Insurance (SSDI) for two years or have been diagnosed with Amyotrophic Lateral Sclerosis (ALS) or End Stage Renal Disease (ESRD).
To qualify, you must be a citizen or permanent resident, having lived in the US for the past five years. In addition, you or your spouse must have worked and paid Medicare taxes for at least 10 years.
If you are unsure about your eligibility or will be turning 65 in the next six months, we’re here to help. Talk to a licensed insurance agent now by calling the number above.
What are the Medicare Plans in Missouri?
Orginial Medicare Part A & Part B
Original Medicare is the federal component of Medicare and contains the first two parts of Medicare.
Part A (Hospital Insurance) provides coverage for inpatient services. It covers things like hospital care, skilled nursing facility care, hospice care, and nursing home care.
Part B (Medical Insurance) provides coverage for outpatient medical services and supplies. It covers things like mental health care, ambulance services, and durable medical equipment (e.g. walkers and blood sugar monitors). Part B also covers some services that prevent or detect illnesses early, like flu shots, cardiovascular screenings, and diabetes screenings.
Original Medicare doesn’t cover everything. Services generally not covered by Original Medicare include:
- Long term care (custodial care)
- Most outpatient prescription drugs
- Hearing aids
- Eye exams and eyeglasses
- Most dental care and dentures
- Routine foot care
- Cosmetic surgery
That’s why there is such a wide variety of additional Medicare plans available to help expand your coverage.
Medicare Advantage Plans (Part C)
Medicare Advantage plans are provided by Medicare-approved private insurance companies and work as an alternative to Original Medicare (Parts A and B). These plans must provide the same coverage as Original Medicare (with the exception of hospice care, which remains covered by Part A). They can also provide additional benefits, such as dental, vision, and prescription drug coverage. Medicare Advantage plans with prescription drug coverage are called Medicare Advantage Prescription Drug (MAPD) plans.
To enroll in a Medicare Advantage plan, you must first be enrolled in both parts of Original Medicare. Premiums for these plans can start at $0, increasing with the level of coverage selected. You’ll need to continue paying your Part B premium in addition to your Part C premium.
Medicare Prescription Drug Plans (Part D)
Prescription Drug coverage is generally not covered by Original Medicare or Medigap Plans. Stand-alone Prescription Drug plans, offered by Medicare-approved private insurance companies, work alongside Original Medicare (Parts A and B) to add prescription drug coverage. With these plans, a tier system is used to grade medications, and copays/coinsurance for each medication are set in accordance with their tiers. Drugs graded in the lowest tiers have the lowest copays/coinsurance, and vice versa. Each plan provides a drug formulary for you to see which tier(s) your medications fall into. This allows you to compare plans and select one with the best overall value for your specific prescription needs.
Medicare Supplement Plans (Medigap)
Medicare Supplement plans add an additional layer of coverage to your Original Medicare by filling in coverage gaps. Medigap plans are provided by Medicare-approved private insurance companies and work alongside your Original Medicare to help reduce your out-of-pocket costs by paying certain healthcare costs, like copayments, coinsurance, and deductibles.
When Can I Enroll In A Plan?
Medicare Advantage and Medicare Prescription Drug Plans
You are first eligible to sign up for Medicare plans in Missouri during your Initial Enrollment Period (IEP). Your IEP starts three months before your 65th birthday month and continues for an additional three months. This means you have a total of seven months to enroll.
Following this period, you will be able to make changes to your Medicare Advantage or Medicare Prescription Drug coverage during the Annual Election Period (AEP). This period occurs once per year, from October 15th to December 7th.
Medicare Initial Enrollment Period
7-Month Initial Enrollment Period | Begins 3 months before the month you turn 65
*Signing up for Parts A and B during months 5,6, and 7 may result in delayed coverage.
KEY FACT: The General Enrollment Period provides you an opportunity to enroll in Original Medicare if you missed your IEP. This period occurs every year from January 1st to March 31st. Then, you’ll have an opportunity to select a Medicare Advantage Plan from April 1st through June 30th.
Additional Medicare Resources in Missouri
The Missouri State Health Insurance Assistance Program (CLAIM) is a non-profit organization that provides free, unbiased information and support for Medicare beneficiaries and their caregivers.
The Medicare Cost Savings Program is available to provide financial assistance to qualifying Medicare beneficiaries in Missouri.
Sources: Medicare.gov; missouriclaim.org; mydss.mo.gov