Table of Contents

Medicare Plans by State

STATE -Select-
  • Alabama
  • Arizona
  • Arkansas
  • California
  • Colorado
  • Connecticut
  • Delaware
  • Florida
  • Georgia
  • Hawaii
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana
  • Maine
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Mississippi
  • Missouri
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York
  • North Carolina
  • North Dakota
  • Ohio
  • Oklahoma
  • Oregon
  • Pennsylvania
  • Rhode Island
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Vermont
  • Virginia
  • Washington
  • West Virginia
  • Wisconsin
  • Wyoming
Page Reviewed / Updated – December 23, 2023

Medicare is government health insurance for seniors who are at least 65, some younger individuals with disabilities and people with end-stage renal disease. It’s comprised of several parts. Part A covers inpatient hospital care. Most people don’t pay a premium for Part A, although those who didn’t accrue enough credits via payroll taxes can pay a monthly fee for coverage. Part B covers outpatient medical care, such as physician appointments, and is subject to a monthly premium. Part D covers prescription drugs, and attracts an additional premium each month. Medicare Advantage combines most Medicare benefits under a single plan with one monthly premium.

Medicare Advantage Plans, also known as Medicare Part C, are managed by private insurance companies. However, plans must include certain basic elements and providers are regulated by the Centers for Medicare and Medicaid Services. Part C insurance must offer the same benefits as Original Medicare Parts A and B, except for hospice care. Although not mandatory, most providers also offer prescription drug cover. Plans often contain extra services not included in regular Medicare, such as dental, vision and hearing care, senior wellness education and nutrition programs.

Unlike Original Medicare, Medicaid Advantage enrollees must generally obtain health care services from an approved network of providers, as set by their insurer. As Part C providers can set their own deductible and copay amounts, seniors should compare policies before signing up. Insurers also limit annual out-of-pocket costs. This means seniors always know the maximum amount they may be liable to pay for health care each year, which may enhance their peace of mind.

As of July 2023, Missouri is home to around 1,299,000 Medicare-eligible individuals. Of these, almost 666,000, or 51%, are enrolled for Part C. Since 2022, the number of people who qualify for Medicare in Missouri has risen 2.16%. Previously, only 47% of roughly 1,271,000 potential beneficiaries joined Medicare Advantage. The situation in Missouri reflects the rising popularity of Part C policies across the country. Nationally, 51% of all Medicare-qualified people opt for private coverage through Medicare Advantage.

This guide offers an in-depth look at Medicare Advantage, delves into the coverage provided by Advantage Plans in Missouri, outlines the eligibility criteria for seniors and provides clear guidance on when and where to enroll.

The Top 10 Medicare Advantage Plans in Missouri

Many Medicare Advantage providers operate in Missouri, with most insurers offering a variety of plans to suit diverse budgets and requirements. The table below lists the 13 most popular Part C insurers in Missouri. Enrollment numbers combine the total enrollees for every plan offered by the different providers, and price ranges take into account the cost of differing policies. Further details are available from Medicare.gov, and all data is up-to-date in July 2023.

Name

Enrollment

Medicare Star Rating

Monthly Cost Range

Plan Types

UnitedHealthcare

191107

3

$0 – $92

PPO, HMO

Humana

121594

2.5

$0 – $131

PPO, HMO, PFFS

Aetna Medicare

74771

3.5

$0 – $57

PPO, HMO

Anthem HealthKeepers

44226

4

$0 – $0

HMO

Blue Medicare Advantage

19872

4

$0 – $0

PPO, HMO

Kaiser Permanente

18563

4

$0 – $0

HMO

Anthem Blue Cross and Blue Shield

13046

3

$0 – $39

PPO

Highmark Inc.

8344

3.5

$0 – $56

PPO

Cox HealthPlans

3926

N/A

$0 – $0

HMO

Cigna

1926

3

$0 – $0

PPO, HMO

How Medicare Advantage Plans Work in Missouri

Medicare Advantage plans aren’t one type fits all. That’s why there are several types available. The Health Maintenance Organization (HMO) plans are generally the most commonly available plan type. Preferred Provider Organizations (PPOs) are usually the next most common. Both plan types are similar, but HMOs require members to stay within a provider network, while PPOs typically provide coverage in and out of a provider network. Private Fee-for-Service (PFFS) plans and Special Needs Plans (SNP) are generally available on a very limited basis. All plan types may differ in drug coverage, primary care providers and specialist accessibility.

Medicare Advantage Plan Types Graphic

What Medicare Advantage Plans Cover in Missouri

Medicare Advantage plans provide all the same benefits as Original Medicare, including Parts A and B coverage. Most MA plans also include prescription drug benefits, which Original Medicare doesn’t cover. Many MA plans also offer numerous additional benefits beneficiaries won’t find in Original Medicare. These perks might include coverage for hearing care and allowances for hearing aids, routine vision and dental care, over-the-counter medications and home health care. Some plans may cover nonemergency medical transportation and services that promote health and wellness, such as gym memberships, wellness programs such as SilverSneakers and limited home modifications.



Coverage Available With Medicare Parts A & B?

Coverage Available With Medicare Advantage?

Preventive Screenings

Yes

Yes

Hospital Care

Yes

Yes

Durable Medical Equipment

Yes

Yes

Prescription Drugs

No

Yes**

Vision Care

No

Yes*

Dental Care

No

Yes*

Hearing Aids

No

Yes*

*Select plans offer this coverage

** Most plans offer this coverage

Eligibility for Medicare Advantage in Missouri

Medicare Advantage eligibility begins with the same parameters as Original Medicare. Thus, applicants must be aged 65 or older or have a disability that qualifies them to join the program at a younger age. Applicants who’ve been receiving Social Security Disability Insurance payments for at least 24 months or are diagnosed with Lou Gehrig’s disease (ALS) or end-stage renal disease qualify. They must also be U.S. citizens or authorized noncitizens. 

Besides the general Medicare requirements, there are two primary Medicare Advantage eligibility requirements. Applicants must enroll in Original Medicare Parts A and B, and they must live within the service area of an MA insurance provider accepting new members during their application period. The beneficiary also can’t have Medicare Supplement Insurance, also called Medigap, and an MA plan. 

Continued eligibility can cause an MA plan to be inadvertently compromised. Some MA plans don’t allow beneficiaries to sign up for separate Part D prescription drug plans, even if the MA plan doesn’t include prescription coverage. Signing up for Part D when the MA plan doesn’t allow it typically results in the program switching the beneficiary back to Original Medicare. Enrollment periods are below: 

  • Initial Coverage Election Period: This is the initial 7-month period, coinciding with one’s 65th birthday, during which everyone is eligible to enroll in a Medicare Advantage plan.
  • Annual Election Period (AEP): Also referred to as the Open Enrollment Period, this the time of year when anyone over 65 can enroll in Medicare Advantage for the first time or change to a new plan.
  • Medicare Advantage Open Enrollment Period: During this period, those who are already enrolled in Medicare Advantage can switch to a different plan or switch back to Original Medicare.

Start Date

End Date

Initial Coverage Election
Period

3 Months Before One’s
65th Birth Month

3 Months After One’s
65th Birth Month

Annual Election Period
(AEP)

October 15th

December 7th

Medicare Advantage Open
Enrollment Period

January 1st

March 31st

Additionally, Medicare Advantage plan participants can change their plan outside of these enrollment periods under certain qualifying circumstances, such as moving to a new state.

How to Find & Choose a Medicare Advantage Plan in Missouri

Navigating the many intricacies of Medicare Advantage plan types, insurers, and the specific plan options available by region can be a difficult and time-consuming task. Below are several resources we’ve created to help you through the process.

First is a downloadable PDF that you can use as a guide to help you compare plans as you research. Finally, we have listed a number of organizations that you can contact with experts that will help you determine whether Medicare Advantage is right for you and what plans you should consider.

Choose a Medicare Advantage Plan



State-Wide Medicare Advantage Resources

CLAIM

 Community Leaders Assisting the Insured of Missouri, or CLAIM, is Missouri’s State Health Insurance Assistance Program (SHIP). CLAIM has over 450 partners and trained and certified volunteer Medicare counselors who provide confidential Medicare benefits counseling services. Counselors answer questions, educate seniors about their Medicare options, help them apply for and enroll in Medicare plans, file claims, organize health care bills and make appeals. Additionally, counselors can help seniors apply for available programs that may help pay for Medicare Parts B and D. The CLAIM website also has pages explaining the state’s Medicare options, supplements and related programs.

Contact Info

To contact CLAIM, seniors can call 800-390-3330, visit the CLAIM website to fill out an online form, or visit the office at 4215 Philips Farm Road, Suite 101-A in Columbia.

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Missouri SMP

The Missouri SMP, or Senior Medicare Patrol program, works to protect Missouri Medicare and Medicaid participants from health care fraud. Program volunteers provide Medicare beneficiaries with one-on-one counseling services, education and outreach designed to empower seniors to recognize, prevent and report any type of health care abuse, mistakes or fraud. Volunteers can help seniors recognize errors on their medical bills and protect themselves from Medicare-related identity theft.

Contact Info

Seniors can call the SMP hotline at 888-515-6565, call the program’s main line at 660-747-5447 or email [email protected]. They can also mail an inquiry to 106 W. Young, P.O. Box 1078, Warrensburg, MO 64093.

Email
Missouri Department of Health and Senior Services 

The Missouri Department of Health and Senior Services website has a page with a list of links to various Medicaid and Medicare resources. Seniors can visit this site to find answers to frequently asked questions about open Medicare enrollment, learn about Medicare Advantage and Medicare supplemental Medigap policies, get updates on the latest Medicare news and more. 

Contact Info

Seniors can visit the Medicare/Medicaid page of the Missouri DHSS here, call the department at 573-751-6400 or email [email protected].

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Missouri Department of Insurance

The Missouri Department of Insurance is a state agency dedicated to helping residents understand their insurance options, consumer rights and the laws regulating insurance. Seniors can visit the website to find information about Medicare and Medigap policies, long-term care insurance and other senior resources within the state. Insurance consumers can visit the site to learn how to file complaints and appeal an insurance company’s denial of a claim. The website also has an insurance shopping tool to help consumers identify their needs and compare plans and costs.

Contact Info

To reach the Missouri Department of Insurance, seniors can call 573-751-4126, visit the office in person at 301 W. High St., Room 530 in Jefferson City or mail questions and inquiries to P.O. Box 690, Jefferson City, MO 65102-0690.

Local Medicare Advantage Resources

Area Agencies on Aging

Area Agencies on Aging, such as Senior Age, are located throughout Missouri, and most have care coordinators available to help seniors enroll in Medicare plans and understand their benefits. Seniors unable to visit an office in person may be able to receive a home visit from a care coordinator to assess and discuss their needs. Missouri AAAs may also provide general benefits counseling, “New to Medicare” classes and comprehensive information about Medicare enrollment and related resources on their website.

Contact Info

A map of the coverage areas for Missouri’s 10 Area Agencies on Aging can be found on the Missouri Department of Health and Human Services website. The map lists the contact information for each agency, including its physical and web address and telephone number. 

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VOYCE

VOYCE is an advocacy and resource nonprofit serving 21 counties in and around St. Louis. The organization’s mission is to help seniors and their loved ones receive high quality, long-term care. The website’s list of resources includes the national site to help Medicare recipients compare nursing homes, and it has a Medicare page linking to resources explaining recent Medicare changes, how to complete enrollment forms and more. Other services VOYCE offers include a helpline that connects callers to a licensed long-term care expert who can provide advice about Medicare and other financing options.

Contact Info

Individuals can contact VOYCE by calling 314-919-2403 or 866-918-8222. Seniors can also email VOYCE through its online inquiry form, or visit the office Monday through Friday at 680 Craig Road, Suite 245 in St. Louis.

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