Medicare in Missouri
Key Takeaways
- Applying for Medicare in Missouri when you approach age 65 is easy, but it’s important to understand the coverage offered and the costs involved.
- If you choose not to enroll in Medicare at age 65, make sure you have a plan for dealing with late-enrollment penalties.
- Medicare AdvantageMedicare Advantage (Medicare Part C) is health insurance for Americans aged 65 and older that blends Medicare benefits with private health insurance. This typically includes a bundle of Original Medicare (Parts A and B) and Medicare Prescription Drug Plan (Part D). in Missouri could help you save money whether you sign up now or later.
When it comes to the complicated world of Medicare, Missourians can benefit from having someone to show them the way. GoHealth is here to help.
Who Qualifies for Medicare in Missouri?
Any U.S. citizen age 65 or older that calls Missouri home is eligible to enroll in the federal healthcare insurance program known as Medicare. Some people under 65 also may qualify for Medicare in MO.
- Residents who have received 24 months of Social Security Disability Insurance payments or Railroad Board benefits payments are eligible.
- Residents with End Stage Renal Disease or Lou Gehrig’s disease (also known as ALS) are eligible.
Start your Medicare PlanFit CheckUp today.
How Do I Apply for Medicare in Missouri?
- You can enroll online with the Social Security Administration.
- You can enroll via phone by calling 1-800-772-1213 (TTY: 1-800-325-0778).
- You can enroll by visiting a local Social Security office.
If you enroll in both Parts A and B, you have the option to add Part D to cover a portion of your prescription costs. You may also choose to add Medigap, which is supplemental coverage that helps fill in the gaps in terms of out-of-pocket expenses like copays and coinsurance.
Enrolling in Parts A and B also opens the window for you to replace Original Medicare with Medicare Advantage. Medicare Advantage in Missouri bundles your coverage options while offering additional services like dental and vision coverage.
Do I Automatically Get Medicare When I Turn 65?
If you start receiving Social Security benefits before your 65th birthday, you will automatically be enrolled into Original Medicare in Missouri at age 65. If not, you can enroll during the seven-month Initial Enrollment Period that includes the month of your 65th birthday as well as the three months before and after.
- If you are automatically enrolled, then you will be enrolled in both Parts A and B. Regardless of any other insurance they may carry, most people have Part A at age 65 because it provides hospital coverage without a monthly premium if they have worked at least 10 years.
- Some people still have employer-sponsored insurance at 65 and wait on Part B because it has a monthly premium. If you are automatically enrolled, you should receive a welcome packet leading up to your 65th birthday and fill out CMS Form 1763 or contact the Social Security Administration if you don’t want to enroll in Part B.
Find the Medicare Advantage plan that meets your needs.
What Is the Cost of Medicare When You Turn 65?
Passing on Part B at age 65 because you’re still using an insurance option at work usually creates a Special Enrollment Period that allows you to add Part B later without a penalty. But in most other situations, the cost of Medicare will increase if you don’t enroll at age 65 because of late-enrollment penalties that last a lifetime.
You may have to pay more later if you don’t enroll in Part B or Part D at age 65, and adding Medigap after your Initial Enrollment Period can be more expensive as well — not to mention potentially trickier. Generally speaking, it’s best to get your Medigap plan within the first six months after you enroll in Original Medicare. During this period, you won’t be asked medical questions that could impact your ability to secure a specific plan.
If you don’t get supplemental coverage in Medigap around age 65, Medicare Advantage in Missouri could fill your supplemental insurance needs. A GoHealth licensed agent can help you understand your options.
What Are the Different Medicare Plans?
Medicare Advantage beneficiaries can’t carry a Medigap plan, but they don’t need one because Medicare Advantage plans offer their version of supplemental coverage to fill in the gaps.
That’s an example of how Medicare Advantage plans bundle services, a fundamental difference between Medicare plans in Missouri.
- Medicare Advantage usually bundles the hospital and medical coverage offered by Parts A and B of Original Medicare in MO with drug coverage and supplemental benefits.
- Medicare Advantage offers additional coverage options not provided by Original Medicare like dental and vision and a monthly stipend for purchasing over-the-counter supplies.
- Medicare Advantage and Original Medicare have different coverage areas and costs. While Original Medicare can be used nationwide, Medicare Advantage is usually limited to a network of providers in your area. Still, that distinction often allows Medicare Advantage in Missouri to offer more affordable options.
Who Has the Best Medicare Advantage Plan?
While there’s only one Original Medicare plan, Medicare Advantage offers multiple plan options that could fit your specific situation and improve your coverage effectiveness. A GoHealth licensed insurance agent, just a phone call away, specializes in guiding you through the strengths of various plans, helping you make an educated decision.
Find the Medicare Advantage plan that meets your needs.
Thousands of older adults enroll in Medicare every day across the United States. The latest CMS data shows that 1,192,886 people are enrolled in Medicare Part A and B in Missouri. The total number of beneficiaries enrolled in Medicare Advantage increased from 480,479 to 526,191 year over year. Medicare Advantage participation in Missouri went from 41.10% to 44.11% year over year. If you’d like to dive deeper into how Medicare in Missouri breaks down across the state, we provide a glance at who is using Medicare and how.
1,192,886 Beneficiaries with Part A & Part B
526,191 Medicare Advantage Beneficiaries
44.11% Medicare Advantage Participation Rate
54.44% Female
45.56% Male
89.63% Non-Hispanic White
6.47% African American
1.10% Hispanic
2.80% Other/Unknown
16.08% Eligible for Medicaid
1.02 Average HCC Score
$10,379.12 Actual Per Capita Costs
18.47% Hospital Readmission Rate
28.87% % of Beneficiaries with an Emergency Department Visit
480,479 Medicare Advantage Beneficiaries, Previous Year
Increased Medicare Advantage, Year over year
41.10% Medicare Advantage Participation Rate, Previous Year
Table reflects the latest Beneficiary Demographics Data: Medicare Geographic Variation – by National, State & County
Average HCC Score: The Hierarchical Condition Category score gauges a population’s overall health. The score is based on a value of 1.0. Populations with an HCC score of less than 1.0 are considered relatively healthy. The score can be used to estimate health costs.
CLAIM - Medicare Counseling
https://www.missouriship.org/
What should I know about CLAIM?
The state’s official State Health Insurance Assistance Program (SHIP) provides free counseling for all things Medicare in Missouri.
Missouri Department of Insurance
Phone lines open M-F, 8 a.m. to 5 p.m.
https://insurance.mo.gov/consumers/complaints/index.php
What should I know about the Missouri Department of Insurance?
The department’s Division of Consumer Affairs responds to insurance-related complaints.
MO Healthnet
Phone lines open M-F, 6 a.m. to 6:30 p.m., Saturday 8 a.m. to 5 p.m.
https://mydss.mo.gov/healthcare
What should I know about the MO Healthnet?
It is the official state Medicaid program, with representatives available to answer questions and help Missourians apply.
Missouri Veterans Commission
https://mvc.dps.mo.gov/index.php
What should I know about the Missouri Veterans Commission?
The commission helps veterans and their families understand and even apply for health-related benefits.
Nationwide Resources
Speak with a GoHealth insurance agent that is licensed in Missouri about your Medicare questions.
Mon – Fri, 8 a.m. – 6 p.m. CT
Centers for Medicare and Medicaid Services
You can reach the Social Security Administration by phone for general questions. Not all questions can be answered over the phone.
Also, SSA.gov provides online resources for the following: Review information, apply for benefits, or manage your account online
1-800-722-1213
TTY 1-800-325-0778
Speak to SSA Representative, Monday – Friday, 8 AM – 7 PM ET
Medicare Learning Guides
Healthcare is personal. So is choosing insurance. If you are new to Medicare, a beneficiary researching options, or a caregiver, we have tailored Medicare Guides for you.
Before 65 Guide
Understanding health insurance before age 65, especially when considering early retirement
Medicare Plans Guide
Costs, coverage and enrollment details for each Medicare plan
Medicare Beneficiary Guide
For those currently enrolled in Medicare
Low Income and Medicare Guide
For individuals with a qualifying income status
A Caregiver's Guide
For individuals with a qualifying income status
Sources
- Apply for Benefits. SSA.gov.
- Social Security Office Locator. SSA.gov.
- CMS-1763. CMS.gov.
This website is operated by GoHealth, LLC., a licensed health insurance company. The website and its contents are for informational and educational purposes; helping people understand Medicare in a simple way. The purpose of this website is the solicitation of insurance. Contact will be made by a licensed insurance agent/producer or insurance company. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. Our mission is to help every American get better health insurance and save money.
Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.