With Original Medicare, there is no annual out-of-pocket limit, which could leave you owing substantial medical bills. Medicare Supplement plans in Missouri help pay a variety of out-of-pocket healthcare costs under Medicare Parts A and B. Commonly known as Medigap, the right amount of coverage for you depends on your unique situation.
How Does Medigap Work in Missouri?
Across the country, Medigap plans help pay your out-of-pocket costs with Original Medicare. This includes Part A, inpatient care, and Part B, medical services.
There are 10 standard Medicare Supplement plans available in Missouri (A, B, C, D, F, G, K, L, M, and N). Some insurers also offer high-deductible versions of one or more Medigap plans.
Supplement plans are standardized, meaning that you get the same benefits with Plan A (or D, G, etc.) no matter where you buy it. Costs, however, may vary, but Medigap insurers must follow state and federal guidelines when setting premiums.
Unlike Original Medicare, you can be denied Medigap coverage if you don't have a guaranteed issue right – even if you qualify for Medicare. This is because insurance companies use a process called medical underwriting to decide whether to offer you a plan and at what rate. If you smoke, have preexisting health conditions, or are otherwise considered a high-risk enrollee, Medigap insurers may charge you higher premiums or even refuse to sell you a plan.
Who Qualifies for Medicare Supplement Insurance in Missouri?
At the federal level, you qualify for Medicare Supplement Insurance in Missouri once you enroll in Original Medicare and are at least 65 years old. Most states, including Missouri, also require Medigap insurers to offer plans to beneficiaries who qualify for Medicare due to a disability and are not yet 65 years old.
Missouri is also one of the few states to limit how much insurers can charge under-65 beneficiaries for a Medigap policy. The Missouri Code of State Regulations requires Medigap insurers to charge younger enrollees premiums that equal the "weighted average" of what their over-65 counterparts pay.
What Does Medigap Cover?
Medicare Supplement coverage varies according to the plan you choose, although every Medigap plan pays the Medicare Part A coinsurance and gives you an additional 365 lifetime reserve days as a hospital inpatient.
Compare Medigap plan benefits with the following table:
Please note that Medicare Supplement Insurance does not include prescription drug coverage. You get those benefits with a standalone Medicare Part D prescription drug plan.
Medigap Plan C and Medigap Plan F in Missouri
Thanks to a change in federal law, Medigap Plan C and Medigap Plan F are not available to people who qualify for Medicare on or after January 1, 2020. This new law prohibits Supplement plans that pay the Medicare Part B deductible.
We recommend either Medigap Plan D or Medigap Plan G instead, which offer the same benefits as Plans C and F, minus the Part B deductible. You also usually pay less for Plans D and G.
When Is the Best Time to Join a Medicare Supplement Plan in Missouri?
The best time to join a Missouri Medicare Supplement plan is during your 6-month Medigap Open Enrollment Period (OEP), which starts the day you enroll in Original Medicare.
Your OEP is one of the few times you have guaranteed issue rights. If you're at least 65 years old, your application cannot be rejected AND you can't be charged a higher premium.
If you're under age 65, you're guaranteed a Medigap policy during your OEP but you'll most likely be charged a higher premium. The limits we mention above, though, curtail those extra costs. You receive a second Medigap Open Enrollment Period when you turn 65. At that point, you'll have the same protections as someone who's brand new to Medicare.
Missouri also protects Medigap beneficiaries' rights with the Anniversary Rule. This allows you to switch to a different insurance company as long as you keep the same plan letter (i.e. from Plan A to Plan A, not Plan A to Plan G). This guaranteed issue window lasts for 2 months, opening 30 days before your Medigap plan anniversary date and closing 30 days after it.
Choosing a Medigap Plan in Missouri
Since Missouri Medigap plans are standardized, the first step is deciding how much coverage you want. We recommend choosing a plan with the most comprehensive benefits you can afford.
Look at pricing next. Most Medigap insurers use one of three pricing methods:
- Attained-age rated: Premiums start out low but go up as you get older. These policies cost the most over time.
- Community rated: This pricing method does not consider your age. Over time, these plans cost the least.
- Issue-age rated: Premiums are based on your age at the time you join the plan but don't go up due to age. They may rise over time due to inflation, though.
Our Find a Plan tool makes it easy to compare Medigap plans in Missouri. Simply enter your location information and coverage start date to review Medicare plan options in your area.
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