Introduction to Medicare Advantage in Missouri (Medicare Part C)

Medicare Part C, also sometimes known as “Medicare Replacement”, are alternate names for what most seniors know as Medicare Advantage. These comprehensive insurance plans are one of many ways in which senior citizens can protect themselves from the costly gaps in their Original Medicare coverage. The word “replacement” is probably the most accurate description, seeing as how a Medicare Advantage policy will effectively replace your Medicare benefits.

Federal Regulations for Medicare Advantage

Thankfully, replacing Original Medicare with a Medicare Advantage policy will not leave you with inferior coverage. There are protective laws in place which will guarantee your basic Medicare coverage (Medicare Parts A and B) no matter what Medicare Advantage policy you get. In general, most policies are sold with additional benefits, such as those which provide coverage for the costly gaps in Original Medicare, as well as additional benefits which will be discussed below.

Medicare Advantage Enrollment In Missouri

Missouri seniors are middle-of-the-road when it comes to Medicare Advantage. Around 26% of Medicare-qualified retirees have replaced their federal benefits with an Advantage plan. Of those, different people prefer many different types of Medicare policies. You can get an idea of the breakdown in this chart:

Plan Type Enrollment Percentage
HMO Plans 59%
Local PPO Plans 13%
Special Needs Plans 11%
Regional PPO Plans 9%
Private Fee-For-Service Plans 5%
Other (Cost Plans, MSA’s, etc.) 3%

Plan Coverage & Cost

Your health and specific location will play a significant role in what you eventually pay for a Medicare Advantage policy. Based on our data, we have a list of estimated rates which seniors near you might be paying for their policies:

Most Popular Medicare Advantage Plans in Missouri

Medicare Advantage plans are highly customizable. This gives you a great variety of choice if you decide to shop around for one. By far, though, the biggest difference from one plan to another are the provider networks associated with each type. Exclusive networks will cost less, but give you less access to medical care. More inclusive networks will naturally cost more, but give you more freedom when it comes to choosing your doctors and facilities.

Helpful Medicare Advantage Tips & Tricks

Doctor/Provider Network Restrictions

Original Medicare is accepted nearly everywhere – Medicare Advantage, however, is not. Your insurance company will determine which doctors and hospitals are allowed into your provider network. They will also set restrictions on how and where you can get your medical care. Lastly, even if your preferred doctor or facility is in your provider network now, that doesn’t mean you will have access to them for the life of your policy. Your provider can change the rules of your provider network at any time.

Doctor/Providers List

Drug, Vision and Dental Coverage

You have the option to add all sorts of additional benefits (often referred to as “ancillary coverage”) to your Medicare Advantage policy. Plans which include prescription drug coverage are called MAPD plans. You may also have the option to add vision care, or dental benefits to your policy. Just remember that adding more coverage will raise the price, but you’ll get the convenience of having all of your medical benefits managed under a single, simple policy.

Enrollment Options & Best Time To Enroll

When applying for Medicare Advantage, enrolling at the right time is key. If you can get in during the Initial Enrollment Period, you should have a fairly easy time getting covered. The longer you wait, however, the more difficult things can become. Enrolling outside of the IEP may require you to answer health questions before your provider will decide to accept you. And if you have a serious pre-existing condition, such as End Stage Renal Disease, you many have a harder time still. But your local licensed insurance agent or your state department of insurance can help you find coverage under extenuating circumstances. For more info, be sure to take a look at our Medicare Advantage Enrollment Options page.

  • Initial Enrollment Period: Within your first 6 months of Medicare enrollment, you can enroll in a Medicare Advantage policy.
  • Annual Enrollment Period (AEP): From October 15th through December 7th each year, you are free to change or cancel your Medicare Advantage and part D drug plan.
  • Special Enrollment Period (SEP): Any sort of special circumstance in which you may need to change or get new coverage outside of a regular enrollment period, such as moving out of your service area, losing your employer/plan coverage, or your provider ceasing coverage in your area.

What Medicare Advantage Plan Is Best For Me?

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