missouri-medicare-plans

Missouri Medicare Plans

The St. Louis Arch in Missouri will always be considered a gateway to the west. There are the live country shows in Branson, a major theme park called Silver Dollar City, is also the boyhood home of Mark Twain. With the Lake of the Ozarks showing off its beauty, its hard to believe such historic and special places exist in one area. It is no wonder that so many people have chosen Missouri as the state for their retirement. With so many Medicare beneficiaries in Missouri, it is important to understand that state-specific rules and timelines regarding Medicare enrollment, in order to make sure you make the most informed decision!

What are Medicare Options in Missouri?

Missouri, like many states, offers the standard Medicare Supplement plans, also known as Medigap plans. If you are a resident, you can choose from the following plans: A, B, C, D, F, G, H, K, L, M, N, high-deductible Plan F, and high-deductible Plan G. You’re able to enroll during the year, but if you want your coverage to be guaranteed, you want to enroll during your open enrollment period in Missouri.

What are the Most Popular Medicare Supplement Plans in Missouri?

  • Medicare Supplement Plan F
  • Medicare Supplement Plan G
  • Medicare Supplement Plan N

When is the Open Enrollment Period in Missouri?

As a Medicare beneficiary, you can enroll in any Medicare Supplement within your first six months of your Part B effective date. This is considered your open enrollment period. medicare-open-enrollmentDuring this time, insurance carriers are required to approve your MediGap application, and are prohibited from declining the coverage you need because you have a pre-existing condition. You can still apply outside of this window, but you will be required to go through medical underwriting, and could be denied coverage based on your health history.

Can I Change Medicare Supplement Plans in Missouri?

Missouri Anniversary Rule

Missouri is one of few states that gives Medicare Supplement plan enrollees the ability to change their MediGap plans once per year with no medical underwriting. This is known as the Missouri Anniversary Rule.

 

The Missouri Anniversary Rule begins 30 days before your policy issue anniversary date and ends 30 days after your policy issue anniversary date. This gives you a total of sixty days around your Medicare Supplement enrollment anniversary to change your MediGap plan. Like all good things, however, there are a few rules to remember. The first rule is that you must already be enrolled in a Medicare Supplement plan to take advantage of the Anniversary Rule. This means that people with no additional coverage or Medicare Advantage plans do not qualify. The second rule is that you must change your plan to one of equal or lesser coverage. Essentially you can change from one Plan G to another Plan G, or down to a Plan N, but you cannot use this rule to change from a Plan N to a Plan G.

 

Changing MediGap Plans without Missouri Anniversary Rule

Outside of using the Missouri Anniversary Rule, changing Medicare Supplement plans in Missouri follows the same guidelines as most other states. Once you are more than 6 months past your Medicare Part B effective date, you must go through medical underwriting in order to be approved to enroll into or change your Medicare Supplement plan. This means that insurance carriers are given the ability to assess your health history, prescriptions, height and weight, as well as other health-related
factors to determine if you will be approved or denied coverage. During medical underwriting, insurance carriers have the ability to deny a Medicare Supplement plan application based on pre-existing conditions, so it is important to enroll in a MediGap plan during your open-enrollment period to guarantee your acceptance.

Medigap Plan F in Missouri

Medicare Supplement Plan F has been a very popular plan with Medicare beneficiaries over time. The reason for the popularity of Plan F, is that it covers the gaps left by Medicare with no deductibles or copayments. This means that Medicare Part A and B costs are covered with no additional out-of-pocket. However, if you became Medicare eligible after January 1st 2020, you are not eligible to enroll in MediGap Plan F. Luckily, there are other great Medicare Supplement plan options available.

Medigap Plan G in Missouri

Medicare Supplement Plan G is a very comprehensive Medicare Supplement plan with very little out-of-pocket expense. Once you have met your Part B annual deductible, MediGap Plan G becomes a full coverage plan, covering all of the gaps left by Original Medicare, with no additional out-of-pocket expenses. Plan G is typically a very cost-efficient plan with an affordable monthly premium to ensure gold-standard coverage.

Plan G can be a very good choice in Missouri. It's a great plan but we may also be able to find better value. Give us a call and we will look through all options.
Keith Armbrecht
Medicare on Video

Medigap Plan N in Missouri

Medicare Supplement Plan N is also a great, comprehensive MediGap plan available in Missouri. This plan has slightly more out-of-pocket cost than MediGap Plan G, but also comes with a lower monthly premium. As with Plan G, you are still responsible for the Medicare part B annual deductible. Once you have met this deductible, your Original Medicare coverage kicks in, but you still have some cost-share. With MediGap Plan N, you will pay copayments up to $20 for office visits, and up to $50 for ER visits that do not result in an inpatient admission. Plan N also has the possibility of an excess charges if you use a doctor or healthcare provider that does not accept Medicare Assignment. Excess charges can be up to 15% of the Medicare-approved payment. If the monthly premium difference between Plan G and Plan N is large enough, Plan N is often times a very attractive option for your Medicare Supplement plan.

What is the Cost of a Medicare Supplement Plan in Missouri?

Monthly premiums for Medicare Supplement plans are based on three main factors- age, gender, and location. There are other things that may impact your premium such as tobacco use. The premium amounts will vary based on these factors, so it is important to receive a quote based on your specific demographic information.

Medicare Plans in Missouri for Those Under 65

When it comes to Medicare in Missouri, insurance carriers are required to offer at least one plan to those enrolled in Medicare under age 65. These plans typically have much higher premiums that those offered to Medicare beneficiaries 65 and older. There are also Medicare Advantage Policies that you can look into.

Once you reach 65, more Medicare supplement plans will open up for enrollment in Missouri without any health questions. This period guarantees acceptance.

Medicare Advantage in Missouri

Missouri also offers options for Medicare Advantage plans. In these plans you must live in your plan’s service area and enroll during an appropriate election period.  Medicare Advantage plans do not required medical underwriting if enrolling during an election period, but are also significantly different plans than Medicare Supplement plans.

Medicare and Medicaid in Missouri

It is possible to qualify for both Medicare and Medicaid in the state of Missouri. These two programs, however, are separate and have different qualifications you must meet in order to receive benefits. To qualify for Medicaid, you must meet Missouri’s state income requirements. To qualify for Medicare, you must be either over the age of 65, or under 65 but receiving Social Security Disability Insurance for a minimum of 24 months before applying for Medicare. 

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