Medicare annual enrollment is now open!
Learning Center / Medicare / Medicare and Medicare Advantage in Missouri

In this article


Medicare and Medicare Advantage in Missouri

February 9, 2022

Medicare and Medicare Advantage in Missouri

Medicare is a federal program that provides medical coverage for individuals who are 65 and over. In Missouri, over 1.2 million residents receive healthcare benefits from various Medicare plans.

One reason why Medicare is a popular choice among beneficiaries is the benefits the insurance offers. A plan usually covers X-rays, pain management, various surgeries, flu shots, and many more services. Some individuals may have insurance through an employer, but Medicare helps when a worker's policy fails to meet the minimum coverage requirements.

You might find yourself becoming eligible for Medicare in Missouri and are interested in purchasing a plan. The Medicare system is not always straightforward and you might find yourself with a lot of questions.

Below are some of the most common questions people have about Medicare. These answers will help you get started and learn more about your options. Of course, if you still have questions you can reach out for more information.

Who Can Qualify for Medicare in Missouri?

Like other government programs, Medicare has specific enrollment criteria. You may qualify for Medicare if you are a citizen of the United States. Additionally, permanent legal residents who have lived in the country for at least five years are eligible. Of course, there are other criteria for Medicare as well. You would need to meet a specific age requirement to sign up.

People who have qualifying disabilities can sign up as well. However, you need to be on Social Security Disability Insurance for a minimum of two years. A person can enroll if they have end-stage renal disease or Lou Gehrig's disease.

You can apply for Medicare if you are a permanent legal resident and meet the age requirement. Once you find yourself eligible for coverage, you can choose your plan. You can discover your local options when you look into signing up.

At What Age Can You Get Medicare in Missouri?

Medicare is available for people who are at least 65 years of age. You may be able to sign up three months before your 65th birthday; contact a representative to see if you are able to apply for coverage early or need to wait.

Some individuals can get a Medicare insurance plan well before they turn 65. While most applicants are at least 65, an estimated 17% of beneficiaries of any age have coverage for disability reasons. Younger Missouri residents can apply for Medicare if they meet the disability requirements or have specific medical conditions.

If you have been on Social Security Disability Insurance for a while, you can look into some of the plans regardless of your age. It is helpful to speak to someone for more information about when you can apply for Medicare.

How Much Does Medicare Cost in Missouri?

The cost of Medicare can vary from person to person, depending on the plan options and other factors. The state does regulate how much money insurers can charge you. Under Original Medicare, Part A deals with coverage for inpatient care at facilities like hospitals and Part B covers outpatient care.

You do not have to pay a premium for Part A if you are over 65 and have paid Medicare taxes for at least 10 years. Part B does require you to pay a standard premium of $148.50. You could get A and B in a bundle for a single monthly premium. However, you would still need to pay out-of-pocket costs. You could sign up for Medicare Advantage plans, which come at a different price.

Like Part A of Original Medicare, there are Medicare Advantage plans that offer free premiums. Every resident in Missouri has access to low-cost plans. It is necessary to talk to an agent to learn more about what your rates could be. There are nine Medicare plans under Part D, and they help cover the costs of prescription medication and insulin.

Many people in Missouri have access to Part D policies with low premiums. The lowest premium is $7.20 a month. People can apply to Medicare savings programs to help pay for insurance costs.

What Is Medicare Advantage in Missouri?

When you glance at an overview of Medicare, you will see different kinds of coverage like Medigap. However, you may be interested in signing up for a policy under Medicare Advantage, also called Part C. Medicare Advantage is a private version of Medicare, and these plans provide additional benefits. For instance, the program covers vision and hearing services. If you need medical transportation or in-home safety devices, a few plans offer these benefits.

Around 32% of people in Missouri have enrolled for Medicare Advantage insurance. In total, 122 plans are available in Missouri. Additionally, there are caps for out-of-pocket expenses of many of the basic medical services. A person using this type of insurance plan has a limited provider network, but the costs may be cheaper. Several policies provide "giveback" rebates to decrease the amount deducted from a Social Security check.

If you are looking to join a Medicare Advantage program, enrollment starts every fall. The period runs from October 15 to December 17. A person can switch from Original Medicare to an Advantage program during that time as well. There is another enrollment period, and it goes from January 1 to March 31. If you already have a Medicare Advantage plan, you can switch to a different one. You have plenty of time to look into what type of insurance policy works best for you.

What is the Best Medicare Advantage Plan in Missouri?

Residents of Missouri have many plans to choose from, and some may suit you better than others. It’s important to examine different options and see which ones may work depending on your medical needs and any current healthcare providers.

You might notice that healthcare plans belong in one of several categories. A common type is Health Maintenance Organization (HMO). With HMO, you get additional coverage, but you need to receive care from in-network providers. Multiple plans are a part of a preferred provider organization (PPO). PPO plans are a popular choice as well, and you would have more options of providers. While staying in the network is cheaper, you can choose a doctor outside of it as well.

Another category is special needs plans (SNP). Only people with specific diseases can apply to this type of coverage, and the plans tailor their benefits to meet each person's needs. A Private-Fee-For-Service (PFFS) plan determines how much it will pay doctors and how much you have to spend. Other types of Medicare plans are medical savings account and HMO Point of Service. HMO and PPO plans appear to be the best types of plans. Look for the best options for you.

Contact Us to Learn More About Medicare in Missouri

Healthcare can be costly, but Medicare can offer health and financial security for qualifying individuals. Insurance can give you access to basic medical services and improve your overall quality of life. The list of benefits is long, so you can get the care that you need. However, you would need to be aware of the ins and outs of Medicare and the types of available plans.

We can help you learn more about what Medicare options are right for you. Compare plans in your area and learn how to enroll. If you have specific questions, contact one of our licensed insurance agents. We can provide answers and offer Medicare advice. Do not hesitate to get the coverage and answers you need.

© 2021-2023, LLC

Privacy Policy  |  Terms and Conditions

GENERAL DISCLAIMERS is a commercial site designed for the solicitation of insurance from selected health insurance carriers and, LLC is a licensed insurance agency. It is not a government agency. It is also not an insurer, or a medical provider., LLC is a licensed representative of Medicare Advantage (HMO, PPO, PFFS, and PDP) organizations that have a Medicare contract. Enrollment depends on the plan’s contract renewal.
We do not offer every plan available in your area. Currently we represent nine carrier plan organizations nationally. Please contact, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
Alternatively, you may be referred, via a link, to a selected partner website, which is independently owned and operated and may have different privacy and terms of use policies from us.
If you provide your contact information to us, an insurance agent/producer or insurance company may contact you. If you do not speak English, language assistance service, free of charge, is available to you; contact the toll-free number listed above. This site is not maintained by or affiliated with the federal government's Health Insurance Marketplace website or any state government health insurance marketplace.
The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. To learn more about a plan's nondiscrimination policy, please click here.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.