If you live in Missouri and are age 65 or older – or if you soon will be turning age 65 – you may want to learn about your Medicare health coverage options, even if you’re not yet ready to retire.
The Centers for Medicare & Medicaid Services (CMS) reported the following information on Medicare trends in Missouri for the 2021 plan year:
- A total of 1,247,001 residents of Missouri are enrolled in Medicare.
- The average Medicare Advantage monthly premium slightly decreased in Missouri compared to last year — from $9.80 in 2020 to $9.59 in 2021.
- There are 122 Medicare Advantage plans available in Missouri for 2021, compared to 97 plans in 2020.
- All Missouri residents with Medicare have access to buy a Medicare Advantage plan, including plans with $0 premiums.
- There are 12 different Medigap plans offered in Missouri for 2021.
Medicare is a federal program that helps pay the costs of health care for seniors and people of any age who have certain disabilities or health conditions. Let’s learn about the different parts of Medicare.
Together, Part A and Part B make up what’s known as original Medicare. You get original Medicare directly from the federal government. While original Medicare helps pay for a lot of health services, it only pays a portion.
- Medicare Part A is specifically for inpatient services you receive in a hospital, skilled nursing facility or hospice care, as well as some limited home health services. Most people don’t pay a premium for Part A. This is because it’s funded through a payroll tax you or your spouse likely paid during your working years.
- Medicare Part B is for outpatient services and medical supplies you may receive when you see a regular doctor or specialist. You typically do pay a premium for Part B.
You still have to pay significant out-of-pocket costs when you seek care. Plus, original Medicare doesn’t cover prescription drugs, dental, hearing, or vision care.
Medicare Advantage in Missouri
Medicare Advantage (Part C) plans offer an “all-in-one” alternative to getting original Medicare plus supplemental coverage. These plans are available from private insurers as a full replacement.
Medicare Advantage plans include all the same coverage as original Medicare and then some, usually including prescription drug benefits. They frequently also include dental, vision, and hearing benefits, as well as health and wellness programs.
The following companies offer Medicare Advantage plans in Missouri:
- Aetna Medicare
- Anthem Blue Cross and Blue Shield
- Anthem HealthKeepers
- Essence Healthcare
- Healthy Blue
- Lasso Healthcare
- WellFirst Health
It’s important to note that plan options vary by county. What’s available to you depends on the ZIP code where you live in Missouri.
Medicare supplement plans in Missouri
You can help pay for costs original Medicare doesn’t cover by purchasing a Medicare supplement plan. These are also called Medigap plans.
In Missouri, many insurance companies offer Medigap plans. As of 2021, some of the companies offering Medigap plans throughout the state include:
To be eligible for Medicare in Missouri, you must be:
- age 65 or older
- any age and have a qualifying disability
- any age and have end stage renal disease (ESRD)
- any age and have amyotrophic lateral sclerosis (ALS)
When can I enroll in Medicare Missouri plans?
Your initial Medicare enrollment period begins three months before you turn 65 years old and continues for 3 months after. It usually makes sense to enroll in at least Part A at this time since most people qualify for it without a premium.
If you choose to continue working and are eligible to continue your employer-sponsored group health plan coverage, you may want to weigh your options when deciding whether to enroll in Part B or other Medicare coverage. If you choose to wait, you may qualify for a special enrollment period later.
Medicare enrollment periods
In addition to your initial enrollment period, you may enroll in various parts of Medicare during these periods, too:
- Late enrollment. From January 1 through March 31, you may enroll in a Medicare plan or Medicare Advantage plan.
- Medicare Part D enrollment. From April 1 through June 30, you may enroll in a Part D plan.
- Medicare open enrollment. From October 15 through December 7, you may enroll in, drop out of, or change your part C or Part D plan.
- Special enrollment. Under special circumstances, you may qualify for a special enrollment period of 8 months.
Tips for enrolling in Medicare plans in Missouri
When shopping for Medicare plans in Missouri, keep these considerations in mind:
- What costs can you expect to pay? How much are the premiums? How much can you expect to pay when you see a doctor or fill a prescription?
- Are there requirements for choosing doctors? Does the plan require you to choose a primary care physician and get referrals for specialty care?
- How wide is the provider network? Does it include physicians and facilities that are convenient to you? If you already have relationships with providers, are they part of the plan network?
- What if you still work? If you choose to continue working, how do your Medicare options compare to coverage offered through your employer?
- What if you’re married? Does your spouse qualify for Medicare coverage as well? If one of you is younger than age 65, you may need to consider other options.
Check out these resources to learn more about enrolling in Medicare in Missouri:
- More than 1.2 million Missouri residents are enrolled in Medicare.
- There are several private insurance companies offering various types of Medicare Advantage and Medigap plans throughout the state.
- Overall, monthly premium costs have decreased for 2021 Medicare Advantage plans in Missouri.
- There are also several Medigap plan options if you live in Missouri and are looking for additional coverage.