Missouri Medicare- Answers to Your Enrollment and Plan Questions

If you’re a Missouri resident looking for information on enrolling in Medicare or trying to find a Missouri Medicare Advantage plan or Missouri Medigap plan, you’ve probably realized how confusing it is to navigate. At 417 Insurance and Investments in Springfield, MO, it’s our job to make the process simple!

We meet with Medicare eligible people, helping them choose plans that allow them to keep their doctors and cover their prescription drugs. Our services don’t cost our clients anything. We’re a bridge between Missouri residents and the Medicare insurance companies.

We get lots of questions about how Medicare in Missouri works. We realized how many people have these same questions that haven’t yet made it to our office, so this is our comprehensive frequently asked Medicare questions list. We hope to answer your questions about enrollment at 65 years old, how to choose a plan in Missouri, the difference between Missouri Medicare plans, and a lot more!

When should I sign up for Medicare in Missouri?

Residents of Missouri and all other states usually qualify for Medicare beginning in their 65th birthday month. Your timeframe for first-time enrollment is called your Initial Enrollment Period, or IEP. It spans from 3 months before your 65th birthday month to 3 months after your 65th birthday month.

During this time you can meet with us– a Medicare agent near you in Springfield, Missouri- to go over your plan options, complete paperwork, and be done with the process at no cost to you.

If you’re still working and have insurance through your employer, your enrollment may look a little different. This article will tell you more.

How do I sign up for Medicare in Missouri?

When you sign up for social security, you’ll have the option to enroll in Part A and Part B. If you want a Medicare Advantage Plan or Medigap/Supplement plan (from a private insurer) it’s best to work with an agency who has access to comparing all the plans at once. We can take our clients’ doctors, prescriptions, and budget and match them to the right plan for their situation, all in about 30 minutes.

Our article on enrolling in Medicare covers every step of the process for Medicare beneficiaries, and covers situations like if you’re waiting to receive social security benefits.

Can you help me understand the basics of Medicare if I live in Missouri?

Medicare in Missouri and elsewhere is made up of different parts:

Part A is hospital insurance. It can cover nursing home stays, skilled care centers, and some other long term care, as well as general hospital stays. There is no premium for Part A in most situations.

Part B is provider coverage. It pays out when you see a doctor or other health professional. You must pay a premium each month that is set by the government. In 2020, the monthly Medicare premium is $144.60. If you are a high earner, you will have to pay a surcharge.

Part A and Part B make up what is known as “Original Medicare”

Part D is prescription drug coverage. You must buy this coverage from a private insurance company or face penalties later on. The cost of your Part D plan is determined by the plan you choose. Some high earners may have to pay extra.

Part C is also known as Medicare Advantage. It’s a private health insurance plan that can provide both hospital and provider coverage instead of Part A and Part B. Some Advantage plans in Missouri offer Part D drug coverage as well. You can browse and compare each private plan on your own, or you can work with a Medicare agent in Missouri to get help at no cost to you. Each Medicare Advantage plan has its own premium set by the insurance company.

Supplemental Plans (also known as Medigap) are also private plans, but you stay enrolled in Part A and Part B as well. Medigap simply covers some of your out of pocket costs after Part A, Part B, and sometimes Part D pay out. The monthly premium for Medigap plans in Missouri differs with each plan. At 417 Insurance and Investments we handle Medigap plans as well. We can also help you compare Medigap and Medicare Advantage.

Is Medicare the same as Medicaid?

No, Medicare and Medicaid aren’t the same. Medicre is a program for people over 65 and some disabled people, providing them with healthcare. It is administered by the federal government. Medicaid in Missouri is called MO HealthNet and it provides healthcare for people with low income.

Some people will qualify for both Medicare and Medicaid. If you do, you may qualify for a Dual Special Needs Plan that can make dual enrollment easier and get you certain extra benefits.

What companies offer Missouri Medicare plans?

You can get Part A and Part B (Original Medicare) directly through Medicare when you sign up. You’ll need a separate Part D (prescription drug) plan if you want to avoid penalties later. You can purchase a Part D plan through a private insurer.

Many people choose to enroll in a Medigap (Supplemental) plan to get added benefits on top of their Original Medicare plan. 

Other enrollees choose a Medicare Advantage plan that covers Part A, Part B, Part D, and usually some additional benefits. 

To get a full list of your options, you can contact us for your free consultation or see your options online.

Who qualifies for Medicare in Missouri?

There are two ways to be eligible for Medicare in Missouri:

1. Age- If you’re 65 years and older and you or your spouse have paid into Medicare for 10 years through employment you have eligibility in Missouri. You also must be a US citizen or a legal resident for 5+ years.

2. Disability- If you have received Social Security Disability benefits for a total of two years, you will qualify for Medicaid. Those with End Stage Renal Disease or ALS qualify as well, without this 2 year waiting period.

What is the maximum income to qualify for Medicare in Missouri?

The good news is that you can enroll in Medicare at any income! In fact, if you’re over 65 without employer insurance and don’t enroll in Part B or Part D, you’ll face penalties later on.

However, if you are a “high income earner” you’ll pay extra on top of the base premium. This is known as the IRMAA (Income Related Monthly Adjustment Amount) surcharge. Your income is based on your tax return from 2 years ago. In 2020, the surcharge starts when you earn $87,000/year if you’re single and $174,000/year if you’re married. You can see all of the income limits, and get more information about IRMAA in this article.

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If we didn’t answer your question above, feel free to give us a call! Angela (yep, a real person!) will answer when you call and has the resources to get you an answer, no matter how complicated.

Fill Out Your Basic Info to See Your Medicare Plan Options

Adam works with Medicare clients to answer questions, assist with enrollment, and run plan comparisons to find the right one for your needs.

He’s also an expert in Dual Enrollment for those on both Medicare and Medicaid.

Not sure whether to choose a Medicare Advantage or Medicare Supplement Plan?

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