Medicare in Springfield, Missouri

If you live in Springfield, Missouri, or its surroundings and you are looking to learn more – or possibly even enroll – in Medicare, we are here to help you! We know everything you need to know about Medicare in Springfield and can guide you through Medicare’s eligibility rules and give you cost estimates of different plans. Ultimately, we are here to help you make the best choice regarding your healthcare future.

Original Medicare in Missouri

Original Medicare in Missouri is the same healthcare program established by the federal government in 1965, and it has the same rules in every state. Original Medicare in Missouri provides healthcare coverage to eligible beneficiaries older than 65 for both inpatient and outpatient services at medical facilities nationwide. It consists of two parts – Medicare Part A and Medicare Part B.

Inpatient services are covered under Medicare Part A. Most individuals receive premium-free Part A. The only requirement is that the individual (or their spouse) must have paid Medicare taxes through an employer for ten years. Outpatient services are covered under Medicare Part B. This applies to doctor visits and many preventive services. Part B does have a monthly premium that is based on an individual’s income.

To be eligible for Original Medicare in Missouri you need to meet some requirements. Firstly, you need to be a U.S. citizen or permanent resident for at least 5 years in a row. You need to be 65 years old or older, receiving Social Security disability benefits for at least 24 months, or be diagnosed with End-Stage Renal Disease or ALS.

Medicare Supplement Plans in Missouri

Across the U.S., there are ten different Medicare Supplement Plans, also known as “Medigap” plans. These Medigap plans are standardized, which means that no matter where you live, the benefits of the plans are the same. However, costs for the plans do differ depending on a range of factors related to your personal health situation and where you live. In general, the three most popular Medigap plans are Plan F, Plan G, and Plan N.

However, the best Medicare Supplement Plan for you depends on your own personal health and financial situation. Some folks may need more comprehensive coverage, so they choose Plan G, while others choose Plan N because its costs are a bit lower. People may switch to Plan F, though enrollment in this plan has slowed due to the phasing out of this plan. You should come into Medicare planning with an open mind and consider how choosing a Medicare Supplement plan will affect you in the long term.

Medicare Advantage Plans in Springfield, Missouri

Besides Medigap plans, another popular healthcare option Medicare beneficiaries choose is a Medicare Advantage plan. In Missouri alone, over 35% of enrollees have a Medicare Advantage plan. While there are no five-star Medicare Advantage plans in Missouri, the Humana prescription plan is rated at 4.5 stars, though it is only available in some areas.

It’s worth noting that just because a policy has five stars doesn’t necessarily mean the policy is the most suitable choice for you. Some plans are new and, therefore, not yet rated, and these plans could be the best for your situation.

Medicare Advantage plans generally have lower monthly premiums than other plan options, but their copays can still hurt your pocket. In Missouri, monthly premiums for Advantage plans range from $0 a month to as much as $175 a month, depending on your location.

Further, Medicare Advantage plans are tied to networks, so if you enroll in an Advantage plan, you will have to agree to use that plan’s network of providers. Most Medicare Advantage plans also cover prescription drugs. If that is the case, you do not need to enroll in a standalone Medicare Part D drug plan. Lastly, Medicare Advantage plans in Missouri will typically cover all of your Part A, B, and D benefits. However, to access any of these services, you will still have to pay your copayments.

Medicare Part D in Missouri

While some Medicare Advantage plans will also offer Medicare Part D as well, no Medigap plans will cover Part D. Medicare Part D plans cover certain prescription drugs, and Part D is a nice way to round off your healthcare costs. You can either have a stand-alone Part D plan or you can take it in a bundle with Medicare Advantage.

Depending on which policy you choose, Medicare Part D will cost between $15 and $120 each month. Sometimes a plan with lower premiums sounds more attractive, but it may actually benefit you to pay more money upfront in the long run. By working with an agent, you’ll be able to more easily identify which policy is right for you.

The last thing to note about Part D is that you may incur a Part D late enrollment penalty if you delay your enrollment.

Common questions about Medicare in Missouri

What is the Medigap Anniversary Rule in Missouri?

Because you live in Missouri, you are eligible for one really cool Medigap benefit that is only available in three states nationwide. This benefit is called the Anniversary Rule. The Anniversary Rule allows Medigap enrollees to switch policies within 60 days of their policy anniversary. During this window, you can only change from your plan to another plan of the same letter. So, for example, you cannot switch from Plan A to Plan G. However, you can switch supplement carriers, which allows you to compare premiums every single year to ensure you are getting the lowest rates. Plan changes are easy and can be done over the phone with your agent. Comparing policies on an annual basis allows you to save money.

If I Live in Springfield, When Should I Enroll in Medigap?

In Springfield, as with everywhere, the best time to enroll in a Medigap plan is during your Medigap Open Enrollment Period. Your Open Enrollment window will start when you turn 65 or upon the effective date for your Medicare Part B. During this period, you can apply for any Medicare supplement that is available in your area. Insurance companies cannot turn you down for any reason during your Open Enrollment window.

Medigap Eligibility in Springfield If You Are Under 65

While federal law does not require carriers to offer Medigap plans to those under the age of 65 but on disability, state law requires companies to offer at least one policy. Premiums for these policies are usually higher than premiums for people 65 and older. State law does require that insurance companies charge all disabled beneficiaries the same premium rates. If you are on Medicare Disability, you may also want to look into a Medicare Advantage plan.

Can I have a Medigap plan and a Medicare Advantage plan at the same time?

No. It is against the law to have both a Medigap plan and a Medicare Advantage plan at the same time. This is an important factor to keep in mind when considering which plan to enroll in. Choosing one plan over the other can have long-term consequences, so having an agent to assist in this decision can be highly beneficial.

Applying for Medicare in Springfield, Missouri

We know that applying to Medicare can be tricky. There is a maze of rules, and violating the rules can have consequences on your healthcare and your pocketbook. If you live in the Springfield area, consider giving one of our agents a chance to help you navigate these tricky waters. We’ll help you ensure that you wind up picking the best possible plan for your situation.

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