The Best Medicare Supplement (Medigap) Plans in Missouri
- Missouri seniors can get help covering Medicare-related expenses through Medicare Supplement (Medigap) insurance. Choose the best policy with the help of our review of Missouri Medigap plans.
For Missouri seniors who need help covering the out-of-pocket costs that remain after Medicare reimbursement, a Medicare supplement plan (Medigap) may be the answer. Designed to work alongside Medicare Part A and B, Medigap insurance pays for up to 100% of expenses such as deductibles or the copays for hospital or outpatient care. Currently, more than 327,000 Missouri seniors, which is about 37% of the state’s Original Medicare enrollees, receive supplemental medical coverage through these plans.
Whether you’re planning on purchasing a Medigap plan to help manage your medical expenses, or you're just doing preliminary research, there are several things you should know about this supplemental insurance. The information in this article is designed to help you learn the basics of these plans so you can make an informed decision.
You can find Medicare Supplement plans where you live by comparing plans from several different insurance companies online.
What Are the Best Missouri Medicare Supplement Plans?
Medicare supplement policies are sold through private insurers throughout Missouri, and there are 10 types of plans available, each identified by a single letter. Because Medigap is regulated by the federal government, every plan type has standard benefits regardless of the issuer. In other words, although coverage packages differ among uniquely lettered plans, Plan A offers identical benefits no matter who you buy it from.
Benefits available through Medigap may include full or partial coverage of:
- Hospice copays
- Pints of blood needed for transfusions
- Part A and/or B coinsurance and deductibles
- Residential skilled nursing coinsurance
- Medical care expenses incurred while traveling abroad
- Part-B-covered services that exceed Medicare-approved amounts
- Up to 365 days of in-hospital care after Part A benefits are exhausted
Plans vary in the benefits offered and the amount of coverage provided and may include additional restrictions, limitations or deductibles. Some plans also maintain annual spending caps to limit a policyholder’s out-of-pocket expenses. A more detailed comparison of Medigap benefits under each plan type is available in the chart that’s provided below.
Do All Sellers Offer the Same Plans?
No. Each Missouri insurance company that sells Medigap may offer a different selection of plans. Federal guidelines mandate that all Medigap sellers must offer Plans A, C and F, but they’re not required to offer all 10 plans.
What Are the Most Popular Medigap Plans?
Plans F, G and N are the most popular Medigap plan types. They often have lower premiums, especially if area insurers offer high-deductible options for Plans F and G, making them more affordable for seniors to purchase. None of these three plans limit annual out-of-pocket spending.
Unfortunately, because Medigap plans that cover the Part B deductible aren’t available to recent Medicare enrollees, Plan F isn’t available to all purchasers. Federal guidelines limit enrollment in this plan to seniors who became eligible for Part B prior to January 1, 2020.
How Do I Enroll in a Missouri Medigap Plan?
Although seniors may apply for Medicare supplement insurance any time after they turn 65 and enroll in Medicare Part B, the best time to purchase a plan is during Medigap’s open enrollment period. This six-month span begins on the first day of the month you turn 65, which is when most seniors are initially eligible to participate in Medicare.
During the open enrollment period, all Part B enrollees, regardless of their health, are guaranteed Medigap coverage. For these six months, federal law forbids Medigap providers from using medical underwriting practices to assess the insurability of an applicant. Insurers may not deny an applicant coverage, and seniors won’t have to worry about being charged more for a plan due to health issues.
What Happens If I Have a Pre-Existing Condition?
Even if you have a pre-existing condition, you’re guaranteed coverage through Medigap during the open enrollment period. However, insurers may require a waiting period before you can be reimbursed for services and supplies related to your condition. Any relevant services rendered during this waiting period won't be covered under your policy.
Does Retirement Affect the Medigap Enrollment Period?
For some seniors, retirement may affect the timing of their Medigap enrollment periods. If you’re still employed at age 65 and are receiving health benefits through an employer or union, you’re entitled to delay enrollment in Medicare Part B until you retire. Because your eligibility to enroll in Medigap relies on your participation in a Part B plan, your open enrollment period for Medigap is also delayed.
Your Medigap open enrollment period opens after you’ve retired and joined a Part B plan. You’ll still have six months to purchase a policy, and during this time, Medigap sellers may not deny you coverage or charge you more for a policy due to your health.
What Happens After the Open Enrollment Period Ends?
You may still be able to purchase Medicare supplement insurance after open enrollment ends. However, coverage is no longer guaranteed. Insurance companies are allowed to use medical underwriting criteria to assess risk, and applicants may be denied coverage in certain circumstances. If you purchase a Medigap plan after your open enrollment period ends, you may also have to pay substantially more for a policy, depending on your health.
What Is a Guaranteed Issue Right?
In certain situations, seniors may enroll in a Medigap plan of their choice after open enrollment ends, without risk of being denied or assessed higher premiums. These federal protections are referred to as guaranteed issue rights, and they may occur in the following common circumstances:
- A Medicare Advantage plan enrollee loses their coverage when a plan is discontinued or changes its service area.
- A Medicare Advantage plan enrollee changes their residence and no longer lives within the coverage area of their MA plan.
- A Medicare beneficiary exercises a trial right to a Medicare Advantage plan but switches back to Original Medicare during the first year of coverage.
- A Medigap policyholder loses their supplemental coverage when their issuing company goes bankrupt.
- A Medigap policyholder relinquishes their supplemental coverage after being misled by the insurer.
- A Medicare SELECT policyholder loses their coverage after moving out of the plan’s service area.
- An employee over the age of 65 loses supplemental coverage offered through an employer or union.
Medicare Advantage members who've lost their coverage must revert to an Original Medicare plan before being eligible to purchase a Medigap policy. Other guaranteed issue rights may also apply. If you think you qualify for guaranteed Medigap coverage through these federal protections, make sure to gather any supporting documentation.