Missouri Medicare Supplement Plans (Medigap)
Missouri Medicare Supplement Plans were created to work alongside with the Original Medicare policies. These supplemental policies are provided by private insurance carriers in your area and are Medicare approved. The policies were constructed to provide protection against the out of pocket costs not covered by Traditional Medicare.
These policies include coverage for deductibles, copayments and coinsurance. These Medicare Supplement policies are broken down into individual parts and plans which are explained here.
Missouri Medicare Plans Explained
- Part A Medicare: Traditional Medicare covering hospitalization, inpatient procedures and diagnostic testing.
- Medicare Part B: Traditional Medicare covering doctor’s office visits, outpatient procedures and diagnostic testing.
- Medicare Advantage: This plan replaces Traditional Medicare. It covers the same benefits as Parts A and B but with certain limitations
- Medicare Part D: There is no prescription drug coverage with Traditional Medicare. A Part D Plan will provide coverage for most medications with little or no out of pocket cost.
- Missouri Medicare Supplement Plans: Supplement Plans are offered by private insurance carriers. These plans assist with the OOP costs associated with deductibles, copays and coinsurance that the Traditional Medicare benefits don’t cover.
To ensure for the best health care coverage and lowest OOP expenses you should use a combination of Traditional Medicare, a Medicare Supplement Plan and a Medicare Part D prescription drug plan.
What Benefits Does Medicare Cover in Missouri
Whether it’s Part A hospitalization coverage or Part B outpatient services, Original Medicare covers at only 80%. While 80% seems like a lot, the beneficiary will be required to pay the remaining 20%. This can quickly escalate especially if you have health issues that require medication, procedures and follow up care with your physician.
Missouri Medicare Supplement Plans can help with these OOP expenses. Depending on your healthcare needs, Missouri residents can choose from the 10 different policies offered as Supplement Plans. We can assist if you fill out the form or call us today.
Requirements for Missouri Medicare Supplement Plans
To qualify for any of the Medicare Supplement plans you need to have already turned 65 and be enrolled in Medicare Part B. You must obtain Part B coverage as soon as you become eligible or during your Open Enrollment Period (OEP). Failing to do so will result in a Part B penalty.
As of 2018 the Part B monthly premium is $134.00. The Part B penalty adds an extra 10% to your premium for each full 12-month period you went without the insurance.
Medicare Eligibility in Missouri for the Disabled Under 65
Individuals who are disabled and receive Social Security Disability benefits, or certain Railroad Retirement Benefits, automatically qualify for Medicare Parts A and B after 24 months.
Federal law doesn’t require insurance carriers to offer Medicare Supplement plans however, some state laws do. Missouri is one of those states that allows for any of the 10 individual plans offered by the private insurance agencies. If you live in Missouri, are disabled and under the age 65, call us for more information.
The best time to sign up for Missouri Medicare Supplement Plans is during the Open Enrollment Period. The 1st day of the month after turning 65 and having been enrolled in Medicare Part B is when an enrollee becomes eligible. You then have an additional 6 months to apply.
This is when you’re granted the Guaranteed Issue (GI) right. Missouri is unique as it has something called a Policy Anniversary Rule in which you have 30 days before and 30 days after your GI to change your Supplement policy.
If you fail to enroll during the OEP you can be denied coverage due to a pre-existing health condition. If you are approved for any of the Supplement Plans you may be subject to the underwriting process which can result in higher monthly premiums.
Enrolling during your OEP gives the beneficiary the GI which prevents coverage denial or a higher OOP premium cost.
Medicare Supplement Plan Premiums in Missouri
Each individual state’s private insurance carriers determine their insurance premiums. Your age, sex and location are some of the determining factors considered. For example, premium prices for a gentleman living in Kansas City will differ from a woman living in St. Louis. Additionally, there are 3 different pricing methods used and they are:
- Community rated: everyone pays the same premium amount, regardless of age.
- Issue-age-rated: the premium amount is determined based on the age you are when you purchase the insurance.
- Attained-age-rated: similar to Issue-age-rating however, your premium price will increase as you age.
To determine which method the carriers in your area use, contact us today for more information.
The Most Popular Medicare Supplement Plans in Missouri
The individual insurance carriers across the country each have 10 different Supplement Plans. Regardless of which state you live in the plan benefits are the same with each of the individual carriers. Premium cost is the only thing that will vary. Of the 10 Medicare Supplement Plans, the most popular of the 3 letter plans are Plans F, G and N.
- Plan F: The most popular of the 10 plans as it offers the best coverage. It covers Medicare Part A and B deductibles at 100%. It also covers the 20% of hospital and outpatient costs not covered by Traditional Medicare. Part B coinsurance and copayments as well as foreign travel coverage is included in this coverage. It basically provides complete coverage leaving the beneficiary with no OOP costs.
- Plan F High Deductible: This plan provides the same exact same coverage as Plan F however, not until the beneficiary meets the $2, 240.00 deductible. The reason this plan is popular is that the monthly premiums are significantly cheaper than Plan F.
- Plan G: This plan is comparable to Supplement Plan F. The difference with Plan G is that it doesn’t cover the $183.00 Medicare Part B deductible. This is a popular plan as it still provides great benefits at a more affordable price.
- Plan N: While the plan rates are lower there is less overall coverage. Additionally, ER and office visits will require a copay which the beneficiary will be responsible to pay. There is no excess charge coverage which in Missouri physicians are allowed to implement.
Medicare Advantage Plans in Missouri
Medicare Advantage plans are also offered by private insurance carriers and replaces your Original Medicare Part A and Part B.There are restrictions with Advantage Plans such as treatment with only in network providers and certain coverage limitations.
Also, you are unable to combine a Medicare Advantage Plan with a medicare Supplement Plan. While the premiums aren’t often as high as the various Medicare Supplement Plans your OOP costs will be. Overtime you end up saving more money by opting for a Supplement Plan.
Missouri Prescription Drug Plans for Medicare
None of the Medicare Supplement Plans or Traditional Medicare offer prescription drug coverage. By purchasing a Missouri Medicare Part D Plan it will ensure coverage on most medication written by your healthcare provider.Not only will this plan save you money, like Part B, there is a late enrollment penalty.
Once your IEP has expired, the Part D penalty is added to your premium. Depending on how long you go without drug coverage will determine the added expense.
Most people opt for a combination of plans including Traditional Medicare, a Medicare Supplement Plan and a Prescription Drug Plan for the most comprehensive coverage.
With Traditional Medicare only providing 80% coverage, this leaves the possibility for high OOP costs. Factor in no prescription medication coverage and you’re looking at hundreds to thousands of dollars that you will be financially responsible for.
By obtaining a Medicare Supplement Plan, that 20% leftover from Medicare Part’s A and B will be covered at 100%. To get hep with the various plan options or compare rates, click here or call today. Our licensed insurance agents will be happy to assist.
Missouri Medicare Resources
To assist with some of the OOP expenses associated with medicare there are Medicare Savings Programs. You can visit Centers for Medicare and Medicaid or your state’s individual health insurance assistance program available on the SHIP Center. Both are good options when it comes to needing extra financial assistance as most seniors are on a fixed income.
Missouri State Facts
- In 2015, 19% of Missouri residents received benefits from Medicare. The total number of Medicare beneficiaries in the state was over 1.1 million.
- In 2013, 19% of eligible beneficiaries in Missouri where disabled. The other 81% became eligible due to attaining the age of 65.
- In 2013, Over 8,000 recipients receiving Medicare benefits were diagnosed with end-stage renal disease. (ESRD)
- Do Missouri teachers get Medicare? Teachers become eligible for Medicare in Missouri at the age of 65.
- Does Missouri require you to sign up for Medicare? Seniors who receive Social Security benefits are automatically enlisted in Medicare Part A and Medicare Part B. You can forfeit your Medicare coverage if you are currently employed and offered health insurance or if you have purchased individual marketplace coverage. If you currently are not receiving SS benefits or have private health insurance you will want to enroll in Medicare once eligible to avoid any of the penalty fees.
- Where can I compare Medicare in Kansas City, MO? You can compare Missouri Medicare Supplement Plans by calling or filling out the online forms. Our licensed insurance agents will help you compare prices and can assist with any questions you may have.