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Medicare Advantage Plans in Missouri


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About Medicare Advantage plans in Missouri

If you’re a Medicare beneficiary in Missouri, you may be wondering about your Medicare coverage options. Medicare Advantage plans, also known as Medicare Part C, are another way to get your Medicare Part A and Part B benefits. These plans are offered by private insurance companies that contract with Medicare and provide at least the same level of coverage found under Original Medicare, Part A and Part B. However, instead of getting your Medicare benefits through the federal program, you’ll get your benefits administered through your Medicare Advantage plan.

One benefit of Medicare Advantage plans is that some plans may also offer additional coverage beyond Original Medicare. This may include benefits like routine vision or dental, hearing, wellness programs, and prescription drugs.

There are several types of Medicare Advantage plans available, although not every type may be offered in every location. Your Medicare Advantage plan options may include:

  • Health Maintenance Organization (HMO): HMOs come with a provider network of doctors and hospitals that you must use to be covered by the plan. If you go outside of the network for care, you may not be covered (except in medical emergencies). HMOs require members to have a primary care doctor who will manage most of their care. For specialist care, you’ll need to get a referral from your primary care physician first.
  • Preferred Provider Organization (PPO): PPOs also have provider networks, and your cost sharing is usually lower if you use in-network doctors and hospitals. However, you also have the option to use non-network providers and pay higher copayments. You don’t need to have a primary care doctor with this kind of plan, and you don’t need referrals for specialist care.
  • Medicare Savings Account (MSA): This type of plan combines a high-deductible Medicare health plan with a medical savings account. Every year, your plan deposits money into a savings account, which you can use to pay for covered Medicare services before reaching the deductible.
  • Special Needs Plans (SNP): Special Needs plans limit enrollment to people who have certain chronic conditions, live in an institution, or have both Medicaid and Medicare. If you fall into one of these three groups and there is a Special Needs Plan for your eligibility group in your service area, you may be eligible to enroll. These types of plans cater their benefits to help members with their unique needs, which may include special provider networks or coordination services to fit your situation.
  • Private Fee-for-Service (PFFS): If you travel frequently, you may enjoy the convenience of a PFFS plan, which doesn’t usually have provider networks. You can use any doctor or hospital that will accept the plan’s terms and conditions each time you need care; the provider can choose to contract with the plan on a case-by-case basis.

Medicare Advantage plans in Missouri with prescription drug coverage

One key difference with Medicare Advantage plans is that, unlike Original Medicare, you can get prescription drug coverage (Medicare Part D) wrapped into your plan. In other words, if you enroll in a Medicare Advantage Prescription Drug plan in Missouri, you would get all of your Medicare Part A, Part B, and Part D coverage included under a single plan. In contrast, Original Medicare beneficiaries must enroll in a stand-alone Medicare Prescription Drug Plan if they want prescription drug benefits.

Keep in mind that Medicare Advantage Prescription Drug plans may vary in costs and covered prescription medications. To check if a specific Medicare Advantage plan covers your prescription drugs, check the plan’s formulary, which is a list of the medications covered by the plan. The formulary may change at any time. You will receive notice from your plan when necessary.

Compare Medicare Advantage plans in Missouri

If you are shopping for a Medicare Advantage plan in Missouri, it is important to consider all available plan options. Your county of residence will determine the availability and cost of plan options in that area. Please note that a Medicare Advantage plan with the same benefits and coverage may have different monthly premiums from one county to another. Also note that some Medicare Advantage plans in Missouri may have premiums as low as $0, but beneficiaries are still responsible for paying their Medicare Part B premiums and any cost sharing required by the plan (such as copayments and deductibles).

If you take prescription drugs, you might want to consider enrolling in a Medicare Advantage Prescription Drug plan in Missouri. Keep in mind that Medicare Advantage plans offer additional benefits not found in Medicare Part A or Part B, so consider both your medical and prescription medication needs when choosing a Medicare Advantage plan option that fits your situation.

You can start comparing Medicare Advantage plan options in Missouri in your area today. Simply enter your zip code in the plan finder tool on this page to receive a customized list of Medicare plan options available to you. You may also enter your current prescription drugs to get a more detailed list of Medicare plan options that cover your medications. For personalized assistance with a licensed insurance agent, contact eHealth to discuss your Medicare needs.

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