Originally from Los Angeles, California, Adrian Coto is a writer living in Brooklyn, New York. A graduate of the NYU Creative Writing MFA program, he's worked as a legal assistant, a law school administrator, and now as a copywriter and editor.
John Leach is an insurance content editor who has worked in print and online. He has years of experience in car and home insurance and strives to make these topics easy to understand for everyone. He has a linguistics degree from UC Santa Barbara.
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Medicare Advantage offers some of the most comprehensive plans available. But with so many plan options in the Missouri Medicare world, how can you find the best plan for you?
Original Medicare (the combination of Medicare Part A and Medicare Part B ) provides a basic but essential healthcare foundation for Medicare beneficiaries. But what if you need more than the bare essentials, like Medicare prescription drug coverage or preventive services?
If that’s the case, then Medicare Advantage (or Medicare Part C ) might be for you. These health insurance plans come from private insurance companies and can offer much more expansive Medicare coverage and benefits, in addition to Original Medicare essentials.
Eager to get your search started? Check out Insurify’s plan-comparison tool! With its easy-to-use format and side-by-side comparisons, you’ll have all the tools you need to find a plan that works for you.
Top Medicare Advantage Insurance Plans in Missouri
Before we cover the best-rated plan, we want to make sure you know the most important part of finding the right plan. That’s you. Your needs, your preferences, and your budget are the most important factors in determining the best plan. Be sure to get clear on what you need from your Medicare plan before you start comparing options.
5. Aetna Medicare Gold Advantage Value Prime (HMO) - Score: 76.30 (Tie)
7. AARP Medicare Advantage Plan 1 (HMO-POS) - Score: 75.76
8. Humana Gold Plus H0028-014 (HMO) - Score: 75.05
The top Medicare Advantage plans for Missouri were determined using factors that include each plan’s star rating, monthly premiums, co-payments, deductibles, and out-of-pocket maximums, as well as insurer benefits such as coverage for dental, vision, hearing, and many others.
#1 Essence Advantage Select
Insurify Composite Score: 78.38 (Tie)
Monthly Premium: $0
Plan Deductible: $0
Out-of-Pocket Maximum: $2,900
Service Area Counties: St. Louis, St. Charles, Jefferson, St. Louis City, St. Louis, and more.
This plan ties for the number one spot mostly because of the low-cost care it offers Medicare beneficiaries. That includes $0 copays for Tier 1 and Tier 2 drugs from preferred retailers. Plus, $0 copays for preventive and primary care office visits, some diagnostic services, preventive dental, and routine vision.
The main drawback is that this plan doesn’t offer coverage for hearing aids, though hearing exams have a low $20 copay. On a final note, your actual plan costs may change depending on your county.
#1 Aetna Medicare Gold Advantage Prime
Insurify Composite Score: 78.38 (Tie)
Monthly Premium: $0
Plan Deductible: $0
Out-of-Pocket Maximum: $3,450
Service Area Counties: Crawford, Franklin, Jefferson, St. Charles, Warren, St. Louis, St. Louis City
Tied for first, this plan has a services area that’s fairly limited compared to others, though the premium, plan deductible, and prescription drug deductible are $0. This plan offers great co-pay rates for vision, dental, hearing, and mental health services and also offers low coinsurance for diabetic supplies. This plan’s CMS rating is 4.5 stars out of 5.
#3 AARP Medicare Advantage
Insurify Composite Score: 76.53 (Tie)
Monthly Premium: $0
Plan Deductible: $0
Out-of-Pocket Maximum: $2,900
Service Area Counties: Washington, Warren, Gasconade, Franklin, Crawford, Jefferson, Ste. Genevieve, St. Charles, St. Francois, St. Louis, and more.
In addition to having a monthly premium and plan deductible of $0, this plan also has a prescription drug deductible of $0. It also has benefits coverage that includes dental, vision, hearing, and mental health services. The generally low co-pays and great nursing facility coverage net this plan a CMS score of 4.5 stars out of 5.
On a final note, your actual plan costs may change depending on your county.
#3 Essence Advantage
Insurify Composite Score: 76.53 (Tie)
Monthly Premium: $0
Plan Deductible: $0
Out-of-Pocket Maximum: $3200
Service Area Counties: St. Louis, Jefferson, St. Charles, St. Louis, St. Louis City, and more.
This plan offers the ideal $0 copay for Tier 1 and Tier 2 prescriptions from preferred retailers. And you’ll get $0 copays for preventive and primary care office visits, lab services, hearing aids, preventive dental, and routine vision. Plus, plenty of low-cost copays, including mental health services.
On a final note, your actual plan costs may change depending on your county.
#5 CoxHealth MedicarePlus
Insurify Composite Score: 76.30 (Tie)
Monthly Premium: $0
Plan Deductible: $0
Out-of-Pocket Maximum: $3,200
Service Area Counties: Barry, Greene, Christian, Webster, Lawrence, Taney, Stone
Here’s yet another plan with low, low costs, on a list of low-cost plans. We can’t stress enough that Missouri offers some of the lowest-cost plans on the market across the country.
This plan offers $0 to $18 copays for Tier 1 and Tier 2 drugs, with the cheapest copays for drugs ordered through the mail. You’ll also get $0 copays from preventive office visits, $5 for primary care, and $35 for specialists. Plus low-cost coverage for hearing, preventive dental, and routine vision care.
#5 Aetna Medicare Gold Advantage Value Prime
Insurify Composite Score: 76.30 (Tie)
Monthly Premium: $0
Plan Deductible: $0
Out-of-Pocket Maximum: $3,450
Service Area Counties: Callaway, Gasconade, Lincoln
If you’re in need of low-cost prescriptions, you should definitely check out this plan. You’ll get $0 copays for Tier 1 and Tier 2 drugs from preferred retailers. Plus $0 copays for preventive and primary care office visits, some diagnostic services, hearing aids, preventive dental, comprehensive dental, and routine vision!
This plan’s monthly premium comes to an annual cost of $288, though both the plan deductible and prescription drug deductible are $0. Though it does have vision, hearing, preventive dental, and a handful of other benefits, its comprehensive dental coverage has a coinsurance of 50 percent, which can be pricey. With generally low prescription drug co-pays, this plan has a CMS rating at 4.5 stars out of 5.
#8 Humana Gold Plus
Insurify Composite Score: 75.05
Monthly Premium: $0
Plan Deductible: $0
Out-of-Pocket Maximum: $2,900
Service Area Counties: Franklin, St. Charles, St. Francois, St. Louis, Washington, St. Louis City, St. Louis, Jefferson, Warren, and more.
While this plan is last on this list, it does tie for the number one position of having the lowest out-of-pocket limit. It also has one of the largest healthcare networks in the state.
This plan offers $5 to $30 copays for Tier 1 and Tier 2 drugs from preferred providers. Plus, you’ll find $0 copays for primary care and preventive care office visits, some diagnostic services, preventive dental, and routine vision care.
How Much Does Medicare Advantage Cost in Missouri?
The total overall cost for health plans can vary from person to person and from plan to plan. While you can expect some costs to come from the usual suspects of monthly premiums, deductibles, co-pays, and coinsurance, there are a handful of other factors at play that you should consider:
The plan options that you select can directly impact the overall cost of the entire plan.
A plan’s service area can limit whether or not you actually have access to a particular plan.
A plan’s network can also affect the overall cost, as such networks can vary in their size and the costs of the services they provide.
In terms of annual costs, Medicare Advantage plan premiums run an average of $621.12 per year, meaning a monthly premium could cost you an average of $51.76 on average. Additionally, prescription drug deductibles currently rest at an average of $249.92
Medicare Advantage Plan Types
While there are a good number of individual plans to choose from in Missouri, there are a handful of plan types that can help you narrow down your search based on your preferences.
Health Maintenance Organization ( HMO ): HMO plans provide coverage for doctors, hospitals, and other healthcare providers in your plan’s network. Any visits to someone outside your provider network will generally not receive coverage (unless those visits are for emergency or urgent care). For specialist services, you will need a doctor’s referral.
Preferred Provider Organization ( PPO ): A PPO plan is more flexible than an HMO, allowing you to visit doctors or other healthcare providers out of your network (albeit at a higher cost). For in-network providers, you can expect to pay less in coinsurance and co-payments.
Private Fee-for-Service ( PFFS ): PFFS plans generally have few limits on which medical service providers you can visit. However, these plans also reserve the right to decide how much they will cover for doctor visits, hospital visits, and other medical services.
Special Needs Plan ( SNP ): SNP insurance policies restrict eligibility to individuals who live in an institution (such as a nursing home ) or suffer from a chronic health condition (such as HIV/AIDS, end-stage renal disease, or diabetes). Dual Special Needs Plans (D- SNPs ) exist for individuals who qualify for both Medicare and Medicaid.
Medicare Advantage Prescription Drug Plan (MA-PD): MA-PD plans roll health and prescription drug coverage into one plan. This type of plan serves as an alternative to the Medicare Part D plans you would have to enroll in if you had Original Medicare and needed prescription drug coverage. It is crucial that you check a plan’s formulary before enrolling so that you can ensure the plan covers any medications you need.
Medical Savings Account ( MSA ): MSA plans essentially create a savings account that receives funds from the insurance provider. Though these typically have a high deductible, you can use the savings fund to pay for some healthcare expenses.
Interested in what plan types are available to you? Take advantage of Insurify’s plan-comparison tool! It provides a wealth of detailed information on countless Medicare Advantage plans.
FAQ: Missouri Medicare Advantage
You can enroll in a Medicare Advantage plan during your Initial Enrollment Period, which begins three months before your 65th birth month and ends three months after. Of course, you will first have to enroll in Original Medicare to obtain your Medicare number. If you suffer from pre-existing conditions, such as end-stage renal disease (ESRD), you can also qualify to enroll.
Alternatively, you can enroll in a Medicare Advantage plan during the Open Enrollment Period, which runs from October 15 to December 7 of each year. During this time, you can make any number of enrollment changes, including switching from Original Medicare to Medicare Advantage or switching between MA plans.
While Medicare Advantage does provide extra benefits and coverage, there are a few drawbacks to consider when making your decision.
One previously mentioned downside is a plan’s service area, which can exclude large chunks of a given state. It won’t do you much good to find a great plan if it doesn’t include your county of residence. Also, the variation in costs from premiums, co-pays, coinsurance, and deductibles can see you paying more for coverage.
With this in mind, it might seem attractive to go with the standardized cost and coverage that comes with Original Medicare. But you would be missing out on a wide swath of Medicare benefits.
The short answer is yes. You can enroll in both Medicare Advantage and Medicaid. However, you will have to meet the eligibility requirements for both programs. To find more information on these requirements, visit www.medicare.gov, or call 1 (800) 633-4227. TTY users can call 1 (877) 486-2048.
Conclusion: The Best Thing to Do Is Compare!
While all of this information may point you in the right direction, it’s important to consider two very important factors: your own specific medical needs and your financial limitations. Take stock of the type of doctors or medications you need. At the same time, consider any budgetary constraints you might have. Considering both of these components, you’ll be able to find a plan that works for you.
If you need a good source of information on the many Medicare Advantage plans, check out Insurify’s plan-comparison tool! It’s easy to use, provides detailed information, and can be an invaluable tool in finding the plan that’s perfect for your medical needs and your wallet.
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Written by
Adrian Coto
Insurance Writer
Originally from Los Angeles, California, Adrian Coto is a writer living in Brooklyn, New York. A graduate of the NYU Creative Writing MFA program, he's worked as a legal assistant, a law school administrator, and now as a copywriter and editor.
John Leach is an insurance content editor who has worked in print and online. He has years of experience in car and home insurance and strives to make these topics easy to understand for everyone. He has a linguistics degree from UC Santa Barbara.
