Medicare in Missouri - Compare Plan Options
If you are a Missouri resident who is 65 years old or has a qualifying disability, you are eligible to receive medical insurance from Medicare – a federal program. Nearly 1.3 million people in Missouri are covered by Medicare.
Medicare Plans in Missouri
Different Medicare plans in Missouri provide varying levels of coverage based on your personal health needs and lifestyle. If you have multiple health conditions or a disability, Original Medicare may not cover all your expenses, resulting in higher out-of-pocket costs. Medicare Advantage could be a good option for more comprehensive coverage. However, a Medigap plan can help fill the remaining gaps if you want maximum coverage.
Here are the five types of Medicare plans in Missouri:
Original Medicare (Parts A & B)
In Missouri, Original Medicare is the foundation of the Medicare program, combining Part A (hospital insurance) and Part B (medical insurance). Part A is generally available at no cost for individuals who have contributed to Medicare through ten years of work and tax payments. However, Part B requires a monthly premium that varies based on income. While Original Medicare provides comprehensive coverage for various healthcare services, it does not include certain aspects like prescription drug coverage.
Medicare Advantage (Part C)
In Missouri, private insurers approved by Medicare offer Medicare Advantage (MA) plans beyond Original Medicare coverage. These plans may include prescription drug, vision, dental, and hearing coverage, providing more comprehensive healthcare. Additionally, MA plans often have lower out-of-pocket costs compared to Original Medicare. With many Medicare Advantage options in Missouri, choosing a plan that suits your healthcare needs is essential.
Medicare Supplement Insurance (Medigap)
In Missouri, private insurers offer Medigap plans that serve as valuable supplements to Original Medicare, bridging the gaps in coverage. These policies provide coverage for deductibles, co-payments, and coinsurances. With ten standardized Medicare Supplement plans, categorized from A to N, they adhere to government standards, ensuring consistent and reliable benefits. Among these plans, Medigap Plan G is the preferred choice for many. Medigap policies require an additional monthly premium. You can compare Medigap quotes to determine the average monthly cost.
Medicare Prescription Drug Plans (Part D)
Prescription drug coverage is not included in Original Medicare in Missouri. However, you can obtain it through a standalone Medicare prescription drug plan offered by approved private insurers. Selecting a plan covering your medications is crucial, as each plan has a formulary and a list of prescription drugs. It’s important to keep in mind that formulary changes may occur annually.
Special Needs Plans (SNPs)
Medicare Advantage plans, known as Special Needs Plans (SNPs), offer valuable options for individuals with specific chronic conditions or needing specialized care, including those with both Medicare and Medicaid. In Missouri, three types of SNPs are available: Chronic Condition SNPs, Dual Eligible SNPs, and Institutional SNPs. Note that the availability of SNPs may vary across different areas of Missouri, and eligibility criteria for SNP plans may differ for each individual.
Medicare Eligibility in Missouri
Individuals aged 65 and older, those with disabilities who are younger, and people diagnosed with End-Stage Renal Disease (ESRD) are eligible for Medicare benefits in Missouri.
You must meet the Social Security Administration (SSA) national standards to qualify for Medicare in Missouri. If you are a U.S. citizen or permanent resident who has worked in jobs requiring Medicare taxes for a minimum of ten years, you can apply for Medicare benefits once you turn 65. It is important to note that before applying for Medicare, you must have resided in the United States for five consecutive years.
Individuals younger than 65 may be eligible if they have received Social Security disability benefits for at least 24 months or have ESRD. Individuals with ESRD must also meet residency requirements to be eligible.
In addition to meeting specific eligibility requirements, applicants must apply for Medicare coverage before their 65th birthday or within three months after their disability begins to avoid late enrollment penalties. Applicants can use the Social Security website or visit a local office for assistance and advice.
With regard to cost, if you are not eligible for automatic qualification for Part A, you might have to pay as much as $506 per month (as of 2023). The Part B standard premium is $164.90 monthly (as of 2023), but your premium could be higher if you have a higher income.
How Do I Apply for Medicare in Missouri?
Applying for Medicare in Missouri is an easy process. You can apply online or by phone.
If you apply online, you must visit the Social Security Administration website and complete an application. The website includes a helpful tutorial that walks you through the process step-by-step. Once your application has been submitted, completing the process typically takes less than 10 minutes.
If you prefer to apply over the phone, call 1-800-772-1213 (TTY users should call 1-800-325-0778).
As you can see, each plan type has unique features and benefits. Although choosing the right plan may seem overwhelming, take the time to do some research, ask questions, and determine which plan aligns with your healthcare needs and budget.
Missouri Medicare Resources
Missouri residents should explore their available Medicare options. Resources like Area Agencies on Aging (AAAs), local public health agencies, and nonprofit groups provide valuable programs and information to seniors.