If you’re an Original Medicare beneficiary in Missouri, and you’re concerned about Medicare-related costs, you can get help paying for those expenses by enrolling in a Medicare Supplement (or Medigap) plan. There are various Medicare Supplement plans available in Missouri, depending on the zip code in which you live, so it’s a good idea to understand the difference between the many Medigap plans and find out what each one offers.
Keep in mind that if you’re enrolled in Medicare Part C, Medicare Supplement coverage can’t be used to pay for costs you may have with your Medicare Advantage plan.
How Medigap plans work in Missouri
Medigap plans in Missouri are designed to help Medicare beneficiaries pay for costs associated with Original Medicare, Part A and Part B, including copayments, coinsurance, and deductibles. Some plans may help with other costs that Original Medicare doesn’t cover, such as emergency health coverage when you’re traveling out of the country or Part B excess charges (the extra 15% extra amount that non-participating providers may charge you for Medicare-covered services).
There are 10 standardized Medicare Supplement plans available in 47 states, including Missouri, each of which is identified by one of 10 letters (A, B, C, D, F, G, K, L, M, and N), with plans of the same letter offering the same benefits. Massachusetts, Minnesota, and Wisconsin offer their own versions of standardized Medigap plans.
Like the rest of the country, you must already be enrolled in Original Medicare, Part A and Part B, to be eligible for a Medigap plan in Missouri. In Missouri, your Medigap Open Enrollment Period starts the first day you are both age 65 and older and enrolled in Medicare Part B, and lasts for six months. This is typically the best time to enroll in a Medicare Supplement plan. During your Medigap Open Enrollment Period, you can enroll in any Medigap plan available in your area, with any insurance company, without being denied coverage because of pre-existing conditions or required to undergo medical underwriting. Note that while insurance companies can’t reject you because of your health status during this period, they are allowed to require a waiting period of up to six months before covering your pre-existing conditions. Outside of your Medigap Open Enrollment Period, you may not have these special Medigap protections (known as “guaranteed-issue rights). If you decide to enroll in Medigap in Missouri at a later date, you may be denied coverage or charged more for your insurance plan.
Since Medigap in Missouri is supposed to supplement Original Medicare rather than replace it, you have to remain enrolled in Original Medicare for your hospital and medical coverage and to stay eligible for Medicare Supplement coverage. This means you’ll need to continue paying your Medicare Part B premium in order to keep your health insurance coverage, in addition to any premium that your Medigap plan may require. If you need prescription drug coverage, you may want to think about enrolling in a stand-alone Medicare Part D Prescription Drug Plan, since Medigap does not offer any such coverage and Original Medicare’s prescription drug coverage is limited.
Types of Medigap plans in Missouri
Take a look at the graph below in order to familiarize yourself with the 10 types of standardized Medicare Supplement plans available in Missouri. In this chart, X indicates that the service (or item) is 100% covered; a percentage indicates what percent of the service/item is covered; and a blank cell indicates it is not covered.
|Medicare Supplement Plans|
|Medicare Supplement Benefits||A||B||C||D||F*||G||K||L||M||N|
|Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are exhausted||X||X||X||X||X||X||X||X||X||X|
|Medicare Part B copayment or coinsurance||X||X||X||X||X||X||50%||75%||X||X***|
|First three pints of blood||X||X||X||X||X||X||50%||75%||X||X|
|Medicare Part A hospice care coinsurance or copayment||X||X||X||X||X||X||50%||75%||X||X|
|Skilled nursing facility care coinsurance||X||X||X||X||50%||75%||X||X|
|Medicare Part A deductible||X||X||X||X||X||50%||75%||50%||X|
|Medicare Part B deductible||X||X|
|Medicare Part B excess charges||X||X|
|Foreign travel emergency coverage (up to plan limits)||80%||80%||80%||80%||80%||80%|
|Out-of-pocket limits apply.**|
*Medicare Supplement Plan F offers a high-deductible version in which beneficiaries pay a certain deductible amount before the plan begins coverage. This amount may change from year to year.
**Once you reach the out-of-pocket limits (including the Part B deductible), both Medicare Supplement Plans K and L pay 100% of covered services in the above chart for the remainder of the calendar year.
***Medicare Supplement Plan N pays 100% of the Medicare Part B coinsurance, except for a copayment of up to $20 on doctor visits and up to $50 on emergency room visits that don’t result in an inpatient admission.
Choosing a Medigap plan in Missouri
Medicare Supplement plans in Missouri with the same letter designation don’t vary in coverage or benefits, as explained above. However, each insurance company that offers Medicare Supplement plans can set its own monthly premium costs. This means that residents of Clayton, in St. Louis County, may pay more or less than residents of Jefferson City in Cole County for an identical Medicare Supplement plan. Keeping these cost differences in mind, it may be a good idea to compare all Medicare Supplement plans available in your area in order to choose the Medigap plan in Missouri that best suits your personal health and budget needs.
To get help choosing a Medigap plan in Missouri that fits your individual requirements, you can contact a licensed insurance agent by dialing the phone number on this page. Or, if you’re ready to browse plan options now, enter your zip code into the plan finder tool to get started right away.