St. Louis is one of the largest cities in Missouri, with 2,221,000 residents. Out of that, 647,751 are Medicare beneficiaries, and they have plenty of St. Louis, Missouri, Medicare plans from which to choose. St Louis is known for the famous Gateway Arch, commissioned by President Eisenhower in 1954.
Medicare plans in St. Louis, Missouri
Today we will talk about the average Medicare Advantage plan options and affordable Medicare Supplement plans. Next, we’ll review the cheapest Medicare Part D and Special needs plans.
In conclusion, we’ll answer some frequently asked questions and discuss how to get help with supplemental Medicare plan options in St Louis.
The data below is based on a 65-year-old non-smoking female.
Medicare Advantage plans
There are 278,328 Medicare beneficiaries enrolled in Missouri Medicare Part C plans. Medicare Advantage enrollees make up about 55% of the Medicare population. In St. Louis, Medicare members have 41 Medicare Advantage options.
Wellfirst is a relatively new local Medicare Advantage company. Their HMO-POS has a low maximum out-of-pocket. Since they are new, they have not been assigned a star rating from the Centers for Medicare & Medicaid Services.
UnitedHealthcare is the Medicare giant. They are simply the largest company when it comes to Medicare plans. Shown below is their PPO with a 4-Star rating and reasonable maximum out-of-pocket.
Aetna has great Medicare Advantage options. They usually include a unique dental opportunity that allows for more flexibility for dentists.
The average cost of Medicare Advantage plans in St. Louis, Missouri
| PLAN | PREMIUM | MOOP | Plan Type | Star Rating |
| Wellfirst Health | $0 | $2,500 | HMO-POS | N/A |
| UnitedHealthcare | $0 | $3,900 | LOCAL PPO | 4 |
| Aetna | $0 | $5,000 | LOCAL PPO | 4 |
| Humana | $0 | $3,900 | REGIONAL PPO | 3 |
| Anthem BCBS | $0 | $3,900 | LOCAL PPO | 4 |
Medicare Supplement plans
Missouri Medicare Supplements, known as Medigap plans, are standardized by the federal government. These plans have the same benefits, regardless of your carrier or where you live.
They combine with Original Medicare to cover your cost-share responsibility. Because they’re’ additional coverage to Medicare, you can see any doctor nationwide that accepts Medicare without needing a referral.
There are ten choices when it comes to Medigap coverage. The vast majority of beneficiaries choose between the top three Medicare Supplement options.
Plan F – This is the full coverage option. Except for the monthly premium, you pay zero dollars out of pocket. There is also a high deductible option called the Plan HDF.
Plan G – This option provides almost identical coverage to Plan F. There is only one difference. You’re responsible for paying the small annual Medicare Part B deductible. Like Plan F, there is also a high deductible option for Plan G. The designation is HDG.
Plan N – This plan is the most bang for the buck. With affordable premiums and small copays when you go for a doctor or emergency room visit, many seniors gravitate to this option.
The average cost of Medicare Supplement plans in St. Louis, Missouri
| LETTER PLAN | LOWEST PREMIUM | HIGHEST PREMIUM |
| PLAN A | $94.01 | $304.58 |
| PLAN B | $150.35 | $288.94 |
| PLAN C | $177.89 | $284.87 |
| PLAN D | $164.44 | $240.00 |
| PLAN F | $178.92 | $350.13 |
| PLAN HDF | $42.00 | $67.65 |
| PLAN G | $146.75 | $307.58 |
| PLAN HDG | $42.00 | $66.92 |
| PLAN K | $62.25 | $107.54 |
| PLAN L | $105.50 | $243.07 |
| PLAN M | $132.96 | $283.10 |
| PLAN N | $120.97 | $240.16 |
Medicare Part D prescription drug plans
Prescription drug coverage in Missouri isn’t’ required. However, if you decide you don’t want to pay for prescription coverage now, you’ll be charged a penalty later in your life if you decide you need a drug plan. Private insurance companies such as Wellcare and Cigna provide Medicare Part D plans. These plans follow a standard model.
Regardless of which company or plan you choose, they must give coverage at least as good as the standard model. These plans consist of four coverage phases.
- Deductible
- Initial Coverage
- Coverage Gap
- Catastrophic Coverage
As you pick up your prescriptions, you’ll move through the phases. Most Medicare beneficiaries don’t get past the initial coverage phase. The Coverage Gap phase is also referred to as the Donut hole.
SilverScript by Aetna has the cheapest premium coming in under seven dollars. CVS owns Aetna, so you can imagine how they can offer drug coverage for such a low cost. The SilverScript brand is tried and true and is considered one of the top plans.
Centene-owned Wellcare is the second-lowest premium drug plan. Wellcare has been trending to the top regarding Medicare options for several years.
Humana comes in third. Humana is also an excellent choice regarding your Medicare drug coverage.
The average cost of Medicare Part D plans in St. Louis, Missouri
| PLAN | PREMIUM | DEDUCTIBLE | STAR RATING |
| Aetna | $6.80 | $480 | 3 |
| Wellcare | $12.90 | $480 | 3 |
| Humana | $22.70 | $480 | 4 |
| Clear Spring | $28.70 | $480 | 2 |
| UnitedHealthcare | $29.40 | $310 | 4 |
Special Needs Plans
Medicare Advantage plans include special needs options, and these Special Needs Plans, or SNPs, help Medicare beneficiaries with specific challenges. SNP plans include Dual Eligible, Chronic Health, and Institutionalized Special Needs Plans.
Dual Eligible plans assist low-income Medicare beneficiaries that also qualify for Medicaid. These plans will usually include low to no cost for medical services and devices—lower prices on prescription drugs and additional benefits catered to people on Medicaid.
Chronic Plans assist people with chronic health conditions such as diabetes, COPD, or heart disease. These plans can lower the cost of treatment and drugs for the condition the program is designed for.
Institutionalized Plans are for people that are living in an institution. These plans focus on additional care that institutionalized beneficiaries would need.
There is no shortage of Dual SNP plans in St. Louis.
Wellcare’s’ D-SNP HMO has the lowest maximum out-of-pocket. Wellcare in many areas offers dental implants and utility assistance for low-income beneficiaries.
UnitedHealthcare has a unique offering in its SNP dual offerings. They have a D-SNP PPO plan, while Most D-SNP plans are HMO-style plans, giving their clients more access to care.
Humana always has solid D-SNP plans. With excellent customer service, they go the extra mile for their clients.
The average cost of Medicare Special Needs plans in St. Louis, Missouri
| PLAN | PREMIUM | MOOP | Plan Type | Eligibility |
| Wellcare | $0 | $3,450 | HMO | Dual |
| UnitedHealthcare | $0 | $7,550 | LOCAL PPO | Dual |
| Humana | $0 | $3,450 | HMO | Dual |
| Aetna | $0 | $7,550 | HMO | Dual |
| Essence | $0 | $7,550 | HMO | Dual |
How to sign up for Medicare plans in St. Louis, Missouri
There are many options, with 41 Medicare Advantage plans and 10 Medigap options. The bad news is that it can make things more complicated. We’re here to help every step of the way, no matter what you need.
We can help educate you on Missouri Medicare and your options. Help determine which plans work best with your doctors and prescriptions. We can even help you enroll and start the program. Simply fill out our online request form, or give us a call.
