Medicare in Missouri

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  • Ready to enroll in Medicare? Make sure you know what to look into when making plan choices. Begin your research into Medicare in Missouri here.

What Missouri Medicare Plans Are Available? 

Missourians qualify for Medicare Part A, Part B, Medicare Advantage, Medicare Part D and private Medigap plans that are referred to as Medicare Supplement plans. Much of your coverage is already paid for by the government, but you are still responsible for a portion of your premiums and copayments. Knowing what you will be responsible for can help you make needed financial plans for your health care. Your Medicare options are the following. 

  • Medicare Part A: Considered a part of traditional Medicare, Part A covers costs if you need to visit the hospital or require home health care, nursing or hospice care.  
  • Medicare Part B: Also a part of traditional Medicare, Part B covers your preventative care. This would include your routine medical appointments, transportation services, medical devices, supplies and any tests that your doctor requires for medical diagnoses.  
  • Medicare Advantage: In 2006, Congress approved a new law that allows Medicare beneficiaries to opt into insurance plans provided by private companies in place of traditional benefits. The law requires these Medicare Advantage plans to provide all of the coverage traditional Medicare provides. The key difference is that you may choose a plan that includes services not covered by Part A or Part B, such as drug coverage, vision or dental. 
  • Medicare Part D: This is the traditional Medicare prescription drug plan. You may opt in to Part D regardless of whether you choose Medicare Advantage. One reason for doing so is if your Medicare Advantage plan does not offer prescription drug coverage. 
  • Medicare Supplement plans: The purpose of these plans is to cover the cost of medical care that you are responsible for beyond your Medicare plan’s portion of payment for services. For example, after you have satisfied your deductible for the year, you may be required to pay 20% of the cost of medical treatment. A Medicare Supplement plan (also referred to as a Medigap plan) covers the difference. 

A majority of people in Missouri have selected traditional Medicare coverage in 2020. About 756,000 people enrolled in Medicare Part A and B while around 486,000 chose a Medicare Advantage Plan. Whether a plan is best for you will depend on factors such as your health conditions, what type of coverage is more important to you and your ability to afford health care. If you believe you will struggle with your copays, you may want to consider a Medigap policy. 

Who Is Eligible for Missouri Medicare? 

If you have recently turned 65 or are coming up on your birthday, you are probably eligible to receive Medicare coverage. Most people are automatically enrolled in traditional Medicare as long as they begin collecting Social Security 4 months before their birthday. If you did not contribute to Social Security for at least ten years during your life or have not started receiving your Social Security benefits, you will need to enroll manually. Failure to enroll soon enough could result in costly penalties, so make sure to do it during your initial enrollment period. 

Medicare Part A is free so long as you met the requirements for automatic enrollment. Part B may cost up to $150 monthly and you can expect premiums to fluctuate over time. You do not need to send a payment for your Part B premium, however, as it will be deducted from your pension or Social Security checks month to month. 

Medicare Advantage plans allow you to choose the terms of your coverage, and while each plan will vary in cost, a portion of it is covered by the government. You could theoretically pay very little or nothing for a Medicare Advantage plan, but if you opt for additional coverage, you will need to pay a higher premium. Medicare Part D may also vary in cost depending on the level of prescription coverage you seek.  

As long as you enroll in Medicare during your initial enrollment period, you will not be penalized. This period begins 3 months prior to your birthday and you have another 3 months afterward to enroll. Should you miss this deadline, general enrollment is available from the beginning of the year until the end of March.  

If you missed your initial enrollment due to service overseas, being on your employer’s health plan past the age of 65 or because you or a family member suffers from a disability, you may enroll during a special enrollment period and receive coverage without penalty. You will want to act quickly if you are considering enrolling in a Medicare Supplement plan. These plans are offered by private insurers, but you may not be denied coverage or charged more due to your health or age so long as you apply within 6 months of your birthday. 

How Do I Enroll in Medicare in Missouri? 

Enrolling in Medicare is a simple and straightforward process. You can visit Medicare.gov to check the status of your enrollment, select a different plan or apply for enrollment. Simply follow the directions on the website and you can complete this process from the comfort of home. Medicare Supplement plans are not administered through Medicare, so you will need to work through a private insurer to enroll for Medigap coverage. 

Contact Information for Missouri Medicare, Medicaid and Insurance Help 

If you would like further assistance with your Medicare enrollment or have questions regarding aid and assistance, you can visit any of the following resources. 

CLAIM, State Health Insurance Assistance Program 

Missouri Medicaid Eligibility and Enrollment 

Missouri CLAIM 

The Missouri Rx (MoRx) Plan 

Missouri Department of Insurance