Medicare in Missouri
Key Takeaways
Applying for Medicare in Missouri when you approach age 65 is easy, but understanding the coverages offered and the costs involved is important.
If you choose not to enroll in Medicare at age 65, make sure you have a plan for dealing with late-enrollment penalties or issues with getting certain coverages in the future.
Medicare Advantage in Missouri could help you save money whether you sign up now or later.
From St. Louis on the eastern border, through the Gateway Arch, and westward to Kansas City on the far side, Missouri is known as the “Show-Me” state.
When it comes to the complicated world of Medicare, Missourians can benefit from having someone who can 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.
How do I apply for Medicare in Missouri?
- You can enroll online with the Social Security Administration. [i]
- 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. [i]
You have the option of enrolling in Part A of Original Medicare (which covers a portion of your hospital-related expenses), Part B (which covers an amount of your other medical expenses) or both.
If you enroll in both Parts A and B, you have the option to add Part D to cover a portion of your prescription expenses. 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 ones 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 the three months after your 65th birthday.
- If you are automatically enrolled, then you will be enrolled in both Parts A and B. Most people, 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 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. [i]
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 in Missouri 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 if you pass on 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 at a special price.
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 Plans of Medicare?
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 bundles the hospital and medical coverage offered by Parts A and B of Original Medicare in MO, as well as the drug coverage and supplemental coverage that can be added to Original Medicare.
- Medicare Advantage also offers additional coverage options not provided by Original Medicare like dental and vision coverage and a monthly stipend for purchasing over-the-counter supplies.
- Medicare Advantage and Original Medicare have different coverage areas and various costs. While Original Medicare can be used nationwide, Medicare Advantage is usually limited to a network of providers in your area. Still, that distinction allows Medicare Advantage in Missouri to often offer more affordable options.
Who has the Best Medicare Advantage Plan?
While there’s only one Original Medicare plan, Medicare Advantage in Missouri 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.
Medicare in Missouri by the Numbers
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.
Medicare
Missouri
1,192,886 Beneficiaries with Part A & Part B
526,191 Medicare Advantage Beneficiaries
44.11% Meducare 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% Meducare Advantage Participation Rate, Previous Year
See more +
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.
Missouri Medicare Resources & Contacts
Beneficiaries spend an average of $9,993.63 each year on Medicare in Missouri. To be certain you are not leaving anything on the table, let us help. A GoHealth licensed insurance agent can assess your coverage or explain which Missouri-based resources, like these, may be able to help:
Nationwide Resources
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.
Medicare guide
Before 65 Guide
Understanding health insurance before age 65, especially when considering early retirement
Medicare guide
Medicare Plans Guide
Costs, coverage and enrollment details for each Medicare plan
Medicare guide
Medicare Beneficiary Guide
For those currently enrolled in Medicare
Medicare guide
Low Income and Medicare Guide
For individuals with a qualifying income status
Medicare guide
A Caregiver’s Guide
For individuals with a qualifying income status
