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Medicare in Missouri
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Finding 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.

What Is Medicare and What Does It Cover?

Medicare is a government-sponsored health insurance program that covers a variety of health care expenses. It’s available to people 65 or older, as well as certain people under the age of 65 with a qualifying disability or illness. Medicare doesn’t cover everything, and it isn’t intended to pay 100% of medical expenses. Medicare beneficiaries generally pay a portion of their medical expenses through coinsurance, copayments, and deductibles.

To find out what’s covered, first we’ll look at the four parts of Medicare:

Original Medicare (Parts A and 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
  • Acupuncture

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 available through Medicare-approved private insurance companies. Medicare Advantage plans work as an alternative way to get the coverage provided by Original Medicare (Parts A and B). These plans offer the same coverage as Original Medicare but can also include additional benefits, like dental and vision coverage. Some plans, called Medicare Advantage Prescription Drug (MAPD) plans, also provide prescription drug coverage.

In order to enroll in a Medicare Advantage plan, you must first be enrolled in both parts of Original Medicare. Part C premiums can start at $0 and increase depending on the level of coverage provided. In addition to your Part C premium, you will have to continue paying your Part B premium. Missouri offers a wide selection of Medicare Advantage plans with varying degrees of coverage.

To learn more about Medicare Advantage plans, click here.

Medicare Prescription Drug Plans (Part D)

Prescription drugs are not covered by Original Medicare (Parts A and B) or Medigap plans. Stand-alone Medicare Prescription Drug plans work together with your Original Medicare to cover prescribed medications. These plans, offered by Medicare-approved private insurance companies, assign medications into tiers. Each tier has an associated copay/coinsurance; the higher the tier, the higher the copay/coinsurance. These plans provide a drug formulary, so you can check the drug tier of your medications before picking a plan. This allows you to find the plan that will best fit your prescription needs. Medicare Part D plans can help offset the costs of prescription drugs, making treatment more affordable.

To learn more about Medicare Prescription Drug plans, click here.

Medicare Supplement Plans (Medigap)

As mentioned earlier, Medicare beneficiaries still pay a portion of their medical bills through coinsurance, copayments, and deductibles. That’s where Medicare Supplement plans come in. Medigap plans are designed to fill the gaps in Original Medicare (Parts A and B) coverage. These plans are offered by Medicare-approved private insurance companies and help to cover certain costs, like coinsurance, deductibles, and copays.

To learn more about Medicare Supplement plans, click here.

Am I Eligible for Medicare Plans in Missouri?

To qualify for Medicare, you must be eligible for Social Security benefits. Most people become eligible for Medicare when they turn 65 years of age.

If you’re 65 or older, you may be eligible for Medicare if you’re a citizen or permanent resident, having lived in the US for the past 5 years. You or your spouse must also have had a job that contributed to Medicare through Social Security deductions for at least 10 years.

If you’re under the age of 65, you may also qualify if you have been receiving Social Security Disability Insurance (SSDI) for 24 months. You may also qualify if you have Amyotrophic Lateral Sclerosis (ALS) or End-Stage Renal Disease (ESRD).

We can help if you’re unsure about your eligibility for Medicare plans in Missouri or will be turning 65 within the next six months. You can view plans available in your area online by using the form below or give us a call to talk with a licensed insurance agent.

When Can I Enroll in A Medicare Plan?

Medicare Advantage and Medicare Prescription Drug Plans

Your Initial Enrollment Period (IEP) is your first opportunity to enroll in Medicare. This IEP is a seven-month period that starts three months before your 65th birthday month.

You can then enroll in a Medicare Advantage or Medicare Prescription Drug plan during the Annual Election Period (AEP). This period occurs from October 15th to December 7th each year.

Medicare Initial Enrollment Period

Key Fact: Every year, the General Enrollment Period offers another opportunity to enroll in Original Medicare. This period occurs annually from January 1st to March 31st. Immediately following this period you can select a Medicare Advantage Plan from April 1st to June 30th each year.

Medicare Supplement Plans

Once you are 65 or older and enrolled in Medicare Part B, you will get an opportunity to enroll in a Medigap plan. Your Medigap Open Enrollment Period begins the same month as your Part B coverage and continues through the next six months.

Important Note: If you enroll during this period, you’re guaranteed the Medigap plan of your choice, regardless of any pre-existing conditions. But if you miss this window, carriers may charge you a higher premium or deny you coverage altogether.

Special Enrollment Periods

If you have experienced a qualifying life event, such as transitioning into or out of a care facility or moving outside of your plan’s coverage area, you may be eligible for a Special Enrollment Period. Special Enrollment Periods enable you to make changes to your coverage outside of the usual enrollment periods. Our licensed insurance agents can help you determine if you qualify for a Special Enrollment Period.

How Do I Select a Medicare Plan?

MedicareMatchup provides a convenient way to compare Medicare plans in Missouri. We work with trusted partners to find the right plan for your budget and medical needs. You can call us to speak with a licensed insurance agent or use the form below to compare Medicare plans online.

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

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Disclaimers: Outside of the Medicare Annual Enrollment Period, members can enroll in a plan only if they meet certain criteria. A licensed insurance agent can help you determine whether you are eligible. Plan availability varies by region and state. Callers will be directed to a licensed insurance agent with a third-party partner of Medicarematchup.com who can provide more information about Medicare Advantage plans offered by one or several Medicare-contracted carrier(s). Enrollment in any plan depends on contract renewal. Medicare has neither reviewed nor endorsed the information contained in this advertisement. Not connected with, or endorsed by, the U.S. government or the federal Medicare program. This information is not a complete description of benefits. For a complete listing of Medicare plans, please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day, 7 days a week, or consult www.medicare.gov.