Medicare Advantage Plans in Missouri

Medicare Advantage is a private insurance product that offers all the coverage of Original Medicare, plus additional services like fitness programs and prescription drug coverage. Available Medicare Advantage plans and the cost of each vary across Missouri.

Medicare Advantage is available to anyone who qualifies for Original Medicare and is required to cover at least what Original Medicare — made up of Medicare Parts A and B — covers. In 2023, there are 126 Medicare Advantage plans offered in Missouri. . However, not every plan is available in every part of the state. Availability depends on the insurance company offering the plan and where you live.

Medicare Part A covers services you receive in the hospital or nursing home, also known as inpatient care. Medicare Part B covers outpatient care. This can include wellness visits, examinations in your doctor’s office or therapy sessions.

While Medicare Parts A and B cover these general areas of care, Medicare Part D provides prescription drug coverage. Part D is an optional add-on if you have Original Medicare. Many Medicare Advantage plans include Part D coverage as well as other services not offered by Original Medicare, among them:

• Dental care
• Hearing aids
• Vision coverage
• Transportation and meals
• Fitness classes

The Centers for Medicare & Medicaid Services (CMS) sets rules on who is eligible and what is covered by both Original Medicare and Medicare Advantage, but states like Missouri also can play a role in the details of Medicare Advantage plans.

The cost of Medicare Advantage in Missouri varies based on where you live and what coverage you want to have included. You can find plans in your area by entering your zip code at Medicare.gov, or you contact a GoHealth licensed insurance agent to help you find the right plan for your needs.

The average cost of a Medicare Advantage plan in Missouri 2023 is $7.67 per month. Some people may also qualify for a $0 per-month premium; in Missouri, 100% of people who are eligible for Medicare have access to at least one $0 premium plan.

Your costs will also depend on rules set by your individual plan. Many Medicare Advantage plans require you to receive care within a particular network of providers to receive the maximum coverage for your healthcare services.

The federal government sets Medicare Advantage eligibility since Medicare is a federal public health insurance program.

Medicare is available to:

• People who are 65 and older.
• People who qualify for Social Security Disability Insurance and have received at least 24 monthly payments, regardless of age.
• People with end-stage renal disease, regardless of age.
• People with amyotrophic lateral sclerosis, regardless of age.

In addition to specific eligibility rules, Medicare also has set periods for when you can enroll. Your first chance to sign up, called your Initial Enrollment Period, is a seven-month period that includes the month you turn 65, plus three months before and after.

If you are interested in enrolling in a Medicare Advantage plan, it may be best to consider this option when you first enroll in Medicare. Whether you opt to enroll in Original Medicare and add a Part D prescription plan, or choose a Medicare Advantage plan with prescription coverage, it’s usually a good idea to start prescription drug coverage immediately.

If you wait to sign up for a Part D plan, a late enrollment penalty will be added to your Medicare premium for the rest of your life, and this penalty is based on how long you were eligible for a prescription plan but chose not to enroll.

To avoid penalties and get the most from Medicare benefits, here are important dates to remember for Medicare Advantage enrollment:

• October 15 to December 7: During the Medicare Open Enrollment Period (also called the Annual Enrollment Period), you can switch to, drop or change Medicare Advantage plans, or go back to Original Medicare and Part D.
• January 1 to March 31: Called the Medicare Advantage Open Enrollment Period, this time is for Medicare Advantage beneficiaries who want to change Part C plans or go back to Original Medicare.

Special enrollment periods are also available based on certain circumstances, like a new disability, changes to your eligibility or a move to an area where your current plan isn’t offered.

Whether or not you include prescription drug coverage in your Medicare Advantage plan is up to you. Most Medicare Advantage plans in Missouri offer drug coverage.

Without a Part D plan added to your Medicare Advantage coverage, you should expect to pay the entire cost of your outpatient prescription medications. You may add Part D coverage to your plan at any time, but if you don’t sign up when you are first eligible, you will have to pay a penalty for the rest of your life. This penalty will be added to your regular monthly premium.