Medicare Advantage Plans in Missouri
Learn about Medicare options and how to choose the best Missouri Medicare Advantage plan for your needs
Missouri Medicare Advantage plans provide Medicare enrollees with an alternative to Original Medicare. Most Medicare Advantage plans include prescription coverage. They also usually come with dental, vision, and hearing benefits, which are not included with Original Medicare. These additional benefits, among others we’ll share later on in this piece, are a huge draw for Medicare beneficiaries. In 2024, 56% of Missouri Medicare beneficiaries are enrolled in a Medicare Advantage plan. That said, these plans also have disadvantages!
In this guide, we’ll give you a thorough breakdown of the Medicare Advantage plans in Missouri. We’ll cover how many plans you can choose from, what the general pros and cons are, and some details about top-rated Missouri Medicare Advantage plans.
Key Takeaways:
56% of Medicare beneficiaries in Missouri are enrolled in a Medicare Advantage plan.
There are a total of 102 Medicare Advantage plans in Missouri in 2024.
Many people enroll in Medicare Advantage plans because of extra benefits like dental, vision, and hearing coverage.
Prior authorization and provider networks can cause major headaches among Medicare Advantage enrollees.
When choosing the best Missouri Medicare Advantage plan, you need to consider your personal preferences and needs, including doctors, prescriptions, and extra benefits.
Quick facts about Medicare Advantage plans in Missouri
Many Missouri residents choose Medicare Advantage over Original Medicare. Below, you’ll get a snapshot of what the Missouri Medicare Advantage market looks like. Keep in mind that plan availability and enrollment rates vary between counties.
There are over 1.2 million people on Medicare in Missouri.
56% of Medicare beneficiaries in Missouri are enrolled in a Medicare Advantage plan.
Medicare Advantage enrollment varies by county and ranges from 13% in Atchison County to 75% in Franklin County.
There are a total of 102 Medicare Advantage plans in Missouri in 2024, but plan availability varies between counties.
St. Charles County and St. Louis County have the highest number of plans available, with 44.
Harrison County, MO, has the fewest Medicare Advantage plans, with 11.
Overview of Medicare Advantage
Medicare Advantage plans, which are also called Medicare Part C plans, offer an alternative to Original Medicare. Just over 50% of Medicare beneficiaries nationwide are enrolled in Medicare Advantage plans. While it’s slightly more common to be on Medicare Advantage than Original Medicare, it’s important to understand both the pros and cons of Medicare Advantage before choosing to enroll.
Pros of Medicare Advantage
Medicare Advantage plans have two key benefits that Original Medicare does not: an out-of-pocket limit and extra benefits that Original Medicare doesn’t provide.
Maximum out-of-pocket amount
With every insurance plan, you’ll have coinsurance, which is the portion of costs your health insurance plan does not cover. In other words, the portion of the costs you’re responsible for paying out of pocket. Original Medicare has a standard 20% coinsurance, and there’s no out-of-pocket limit. This means you’re responsible for 20% of your healthcare costs, regardless of how much care you receive in a year. Medicare Advantage plans have varying coinsurance amounts, but they also come with maximum out-of-pocket spending amounts. These maximum amounts put a limit on the amount you may owe for healthcare costs each year.
Extra benefits
One of the biggest reasons people sign up for Medicare Advantage plans is for the extra benefits. Most Medicare Advantage plans come bundled with prescription drug coverage. They also usually provide some benefits to cover dental, vision, and hearing care. Medicare Advantage plans may also offer a number of other benefits, including a Part B premium rebate, fitness programs or gym memberships, over-the-counter benefit cards, and transportation services for doctor appointments. These benefits are incredibly attractive to Medicare enrollees, who are often looking to save money or get more value from their Medicare plans.
Cons of Medicare Advantage
While more people nationwide are choosing Medicare Advantage, just under 50% of the population chooses Original Medicare. Many people are also leaving their Medicare Advantage plans after seeing or experiencing one of the common Medicare Advantage nightmares. One of the biggest issues people face with Medicare Advantage plans is limited access to care due to the two following features.
Provider networks
Medicare Advantage plans use local provider networks to keep their costs low. While provider networks are a common practice in health insurance, they do limit beneficiaries’ access to timely care. In some cases, you may not be able to see your preferred doctor. In other cases, if you need to find a new provider, you may have a difficult time finding someone who is in your plan’s network and accepting new patients.
Prior authorization requirements
Prior authorization requirements can take some time. If your prior authorization is denied, you’ll need to appeal and will either experience even greater delays to treatment or not receive coverage. While prior authorization requirements are a common practice in health insurance, Medicare Advantage plans are notorious for frequent requirements and denials.
When to enroll in Medicare Advantage
Most people will enroll in a Medicare Advantage plan either when they first get Original Medicare or during the Medicare Open Enrollment Period. The Medicare Open Enrollment Period occurs every year from October 15 - December 7, and is a good opportunity to enroll in Medicare Advantage or switch between Medicare Advantage plans. You are also able to switch from Medicare Advantage back to Original Medicare during this time.
Top-rated Medicare Advantage plans in Missouri
Every year, Medicare Advantage plans receive a star rating from 1-5. A 1-star rating is the worst rating and a 5-star rating is the best. Below, you’ll find information about insurance carriers who offer highly rated 4.5-star or 5-star plans in Missouri.
Insurance carriers who offer 5-star plans:
Essence Healthcare
Medica
Insurance carriers who offer 4.5-star plans:
Humana
Medica
Aetna
How to choose the best Missouri Medicare Advantage plan
Everyone wants to be on the best Missouri Medicare Advantage plan, but it’s not so easy. There’s not one plan that’s “best” for everyone. Instead, you’ll need to make note of your top needs and priorities, then compare the plans available in your county to find the best one for you. The following three questions will help guide you as you compare your options.
1. Do you have doctors who you prefer to see?
As we mentioned above, Medicare Advantage plans use provider networks. If you have doctors who you prefer to see, you’ll want to compare plans that have those doctors in their networks.
2. Do you take prescriptions?
Most (not all) Medicare Advantage plans include prescription drug coverage. If you want prescription coverage bundled with your plan, make sure that the plans you’re looking at cover your prescriptions. You should also look at the price you’ll pay for prescriptions because copays and coinsurance vary between plans.
3. Are there extra benefits you’re excited about?
One of the key reasons people choose to enroll in Medicare Advantage is to get some of the extra benefits, like the OTC card or Part B give-back benefit. If you’re interested in these benefits, make a note of those that are most important to you. Once you’ve narrowed plan options down to those that cover your doctors and prescriptions, you can compare the different benefits to find the best one for your situation.
With up to 44 Medicare Advantage plans to compare in Missouri, things can feel a little overwhelming. Especially if you have multiple doctors and prescriptions, you want to make sure they get covered! That’s why we’re here to help. We can help you quickly compare plans and enroll in one that gets you the most savings. Give us a call at (855) 900-2427 or schedule a time to talk to get Medicare checked off your list today!