Medicare Plan Options

Original Medicare provides reliable essential health coverage that may be a good fit if you have limited care needs. However, if you’re managing a chronic condition, taking regular prescription medications, or want benefits beyond basic hospital and medical coverage, there are options for more robust coverage. You can add prescription drug coverage or Medicare Supplement Insurance for an additional monthly premium, which can save you a lot of money long-term. Missouri’s Medicare Advantage program is also available as an alternative for getting your Medicare benefits along with coverage for other health-related expenses.

Original Medicare

Original Medicare is the national health insurance program administered by the federal government for those aged 65 and over and younger people with qualifying disabilities. Its coverage is split into two parts: Part A, or hospital insurance, and Part B, or medical insurance. If you or your spouse paid Medicare taxes for a certain period of time or you meet other qualifying criteria, you don’t have to pay anything for Part A coverage. Everyone pays a monthly premium for Part B coverage, though programs are available to cut down on your out-of-pocket expenses if you meet the income qualifications.

Medicare Advantage Plans

Medicare Advantage Plans, or Part C, are a popular option among Missouri seniors who want benefits not provided by Original Medicare. With Part C, you get all the benefits included in Original Medicare Parts A and Part B. Depending on the policy you choose, you may also get additional benefits. Most plans include prescription drug coverage, and many include health-related services such as assisted living or home care; vision, hearing, and dental; and enrollment in or discounts for fitness or wellness programs.

Medicare Prescription Drug Coverage Plans

Original Medicare doesn’t automatically cover prescription drugs, so it’s a good idea to make sure you enroll in a prescription drug coverage plan when you initially sign up for Medicare, even if you aren’t on medications at the time. If you wait, you’ll be subject to late enrollment fees for as long as you have your policy. This coverage, also called Part D, pays for the most common prescriptions that your doctor may prescribe. There are multiple plans to choose from, each with its own monthly premium, list of covered drugs, and tiered pricing.

Medicare Supplement Insurance Plans

Medicare Supplement Insurance, also called Medigap, reduces the out-of-pocket expenses you pay when using your Part A coverage. Medigap plans are offered by private insurance companies for an additional monthly premium and reduce costs such as copays, deductibles, and coinsurance. Multiple plans are available with varying price points and coverages, and all plans are standardized, making it easy to cross-compare them.

Medicare in Missouri by the Numbers

People enrolled in Original Medicare   Average plan cost  Annual state spending per beneficiary  Spending per beneficiary compared to the national average 
743,621 Plan A: $0 to $471 per month*
 
Plan B: $148.50 per month**
$10,205 1.00%

*Most people pay no premium, but this can vary depending on how long they paid Medicare taxes.
**This is the average number, but it can vary based on income.

Medicare Resources in Missouri

If you’re researching Medicare policies or signing up for a plan, several statewide agencies can help. These agencies provide free information and assistance with signing up for Medicare and affiliated programs, helping you get the health care services you need at a price that you can afford.

Missouri Department of Insurance

The Missouri Department of Insurance protects you as you purchase and use your Medicare policy. Through this department, you can get more information about Medicare and Medigap, the statewide prescription drug assistance program, and long-term care insurance. The department can also connect you with counselors who can provide one-on-one assistance with insurance-related questions and issues.

Contact Information: Website | (573) 751-4126

CLAIM

CLAIM is the statewide senior health insurance information program. It offers free, unbiased options counseling through volunteer counselors who are trained to answer any questions you have about your Medicare benefits, options for reducing your out-of-pocket costs, and your best options for prescription drug coverage. You can get help from CLAIM in one of three ways, including calling the toll-free number, filling out and submitting an online form, or visiting a CLAIM event in your local community.

Contact Information: Website | (800) 390-3330

Area Agencies on Aging

Missouri has 10 Area Agencies on Aging, each of which serves a designated area of the state. Through your local AAA, you can connect with CLAIM representatives for one-on-one health insurance options counseling. These counselors can help you sign up for Original Medicare or switch back from a Medicare Advantage plan during open enrollment and special enrollment periods. They can also help you understand and settle your medical bills and resolve denied claims or billing errors.

Contact Information: Website | (573) 526-4542

Missouri Senior Medicare Patrol

Missouri SMP is a program that helps you recognize, prevent and report Medicare and health care fraud, errors, or abuse. This agency organizes events throughout the state where you can learn about common scam tactics. Its counselors can also help you detect fraud by reviewing your billing statements for mistakes and charges for services that you didn’t get or weren’t ordered by your doctor. You can also call the SMP if you suspect you were a target of Medicare fraud or if you notice discrepancies in billing statements.

Contact Information: Website | (660) 747-5447 or (888) 515-6565

Legal Aid of Western Missouri is one of the state’s nonprofit agencies that provide free civil legal services and representation to qualifying individuals. This firm serves the most populous region of the state through a variety of services, including economic development, assistance with accessing public benefits, and veterans’ issues. Through this agency, you can get help with hearings and appeals related to denial or loss of Medicare coverage.

Contact Information: Website | (800) 990-2907

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