Medicare Advantage is a private insurance product that expands on the essential services offered as part of Original Medicare (Parts A and B) .
Medicare Advantage plans must offer the same services as Medicare Parts A and B, but additional covered services can vary.
The cost of your Medicare Advantage plan in Missouri will depend on the services you choose and where you live.
Medicare Advantage offers coverage that matches Original Medicare and may also include a range of additional services. For the more than 1.25 million Missourians enrolled in Medicare, these plans from private insurers may provide options that allow them to live healthier lives with greater peace of mind.
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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 2024, there are 134 Medicare Advantage plans offered in Missouri. However, 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 cost of Medicare Advantage in Missouri varies based on where you live and what coverage you want. You can find plans in your area by entering your zip code at Medicare.gov, or contact a GoHealth licensed insurance agent to help you find the right plan for your needs.
In 2024, the average monthly premium for a Medicare Advantage plan in Missouri is $10.31. 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 see providers in their network to receive the maximum coverage for your healthcare services.
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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.
Most Medicare Advantage plans include Part D prescription drug coverage. There are also 21 standalone Part D plans available in Missouri as of 2024.
Without a Part D plan, 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.
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