Missouri Medicare Advantage Plan Coverage

If you join a Missouri Medicare Advantage Plan, the plan must provide all of your Part A (Hospital Insurance) and Part B (Medical Insurance) benefits, including emergency and urgent care. The only major benefit not covered by these plans is hospice care – this benefit is covered by Original Medicare.  Many Medicare Advantage Plans offer vision, hearing, dental, general checkups and wellness programs. Medicare Advantage Plans are usually a HMO or a PPO.  These plans may require that you choose a primary care physician, get a referral to see a specialist, and use only doctors, hospitals, and other medical facilities and services that are part of that health plan’s provider network.  Some health insurance companies offer a Private Fee-for-Service (PFFS) Plan that may allow you to see any doctor or use any Medicare-approved hospital. However, unlike Original Medicare, you may have a copayment for doctor visits and not all providers may be willing to treat you. However, you do not have to choose a Primary Care Physician and you do not need a referral to see a specialist.  Most advantage plans include Medicare prescription drug coverage.

Missouri Medicare Advantage Plan Costs

Medicare pays your advantage plan a fixed amount of money to provide your care. The advantage plan is then responsible for paying your doctor, hospital, and other providers.  Advantage plans must follow Medicare’s rules.  Medicare Advantage plans can charge you a premium and additional out-of-pocket costs, such as a copayment, coinsurance for durable medical equipment, and an annual deductible for prescription medications. You also are responsible for your Medicare Part B monthly premium.

Joining a Missouri Medicare Advantage Plan

If you have Medicare Part A and Part B and you live in an area where there is a plan you can join a Medicare Advantage Plan. You must live in one of those counties where a plan is offered. You can enroll by calling the Medical Benefits Group office, filling out a contact form on our website for a licensed professional to get in touch with you, or on www.medicare.gov. If you are switching to a different advantage plan, all you have to do is join the new plan and you will automatically be disenrolled from your old plan. You will not have any lapse in your coverage.  Medicare limits when you can join, switch, or drop a Medicare Advantage Plan. 

It’s important that you understand the differences between Original Medicare and Medicare Advantage Plans. Some things to remember about advantage plans are:

• If you are enrolled in a Medicare Advantage Plan, you do not need to buy a Medicare Supplement Insurance

• If your advantage plan decides to no longer participate in Medicare, you can join another plan or return to Original Medicare

• You can join an advantage plan even if you have one or more pre-existing conditions. There is no waiting period.

For more details on Medicare Advantage Plan enrollment, call Medical Benefits Group today.