What You Need to Know
A Medicare Supplement Insurance plan helps pay for out-of-pocket costs not covered by Original Medicare, like your deductible.
Medicare Supplement plans are standardized into Plans A through N, making it easier to compare plans between private insurance providers.
Medicare is the federal healthcare program for seniors. It covers your regular medical expenses, like doctor visits and lab tests. However, Original Medicare doesn’t cover all of your out-of-pocket expenses. You’ll still have to pay costs like copayments or deductibles.
Medicare Supplement plans in Missouri help you supplement Original Medicare, Parts A and B, with coverage from private insurance companies. Medicare Supplement plans, or Medigap policies, are standardized and named by letters A through N. A Medigap policy in Missouri can help pay for out-of-pocket costs not covered by Original Medicare.
When Can You Enroll in Medigap?
You must first enroll in Original Medicare before you can join a Medicare Supplement Insurance plan in Missouri. Once you’re enrolled, you can sign up for a Medigap policy at a few different times, including:
- Medigap Open Enrollment Period (OEP): Your Medigap OEP is the six months after you turn 65 and enroll in Medicare Part B. During this period, insurance companies aren’t allowed to deny you coverage or charge you higher premiums based on your health. This is the best time to sign up for a Medigap policy in Missouri — especially if you have a preexisting condition such as cancer or diabetes. You’ll have access to the most plans at the best pricing. 1
- Outside Open Enrollment Period: You’re still able to join a Medicare Supplement plan outside of your OEP, but be aware insurance carriers can use your health in their decision. This means an insurance company could deny your application or charge you higher premiums because of health issues.
- Guaranteed Issue: A guaranteed issue right gives you the chance to buy a Medicare Supplement plan outside of your OEP without the risk of being denied or charged more for your health. Your insurance company also won’t be able to impose a waiting period on your coverage. 2
- Special Enrollment Period: Certain situations give you a guaranteed issue right and allow you to enroll outside of your OEP, such as:
When to Sign Up
The best time to sign up for a Medicare Supplement plan is during your Medigap Open Enrollment Period.
What Are the Most Popular Medicare Supplement Plans?
There are over 327,000 Medicare beneficiaries enrolled in Medicare Supplement Insurance plans in Missouri. The most popular plan is Medicare Supplement Plan F, which has over 186,000 enrollees. The next most popular plans are Plan G with over 87,000 enrollees and Plan N with over 21,000 enrollees. 3
- Plan F: This plan pays the Medicare Part A and B deductible. It also covers many of the costs of Medicare Part A, such as coinsurance for hospital stays, hospice care and care at a skilled nursing facility. Medigap Plan F isn’t available to anyone who became eligible for Medicare after January 1, 2020.
- Plan G: A popular alternative to Plan F is Plan G, which covers similar expenses. Plan G will help pay for coinsurance for hospital stays, doctor office visits and skilled nursing facility care. However, Plan G doesn’t cover your Medicare Part B deductible.
- Plan N: This plan covers your Medicare Part A and B coinsurance, as well as your Part A deductible. It doesn’t pay your Medicare Part B deductible or Part B excess charges if your doctor charges more than Medicare has agreed to pay for a service.
Outside the OEP
In certain situations, you may be able to sign up outside your OEP without facing higher costs.
How Do You Choose a Medicare Supplement Plan?
Medicare Supplement plans in Missouri are standardized. This means you’ll get the same coverage for the plan you choose regardless of the insurance company. This also makes it easy to compare plan prices between insurance carriers.
There are other costs to consider as well, such as medication coverage. Medigap policies don’t include prescription drug coverage. You can purchase a Medicare Part D plan to get coverage for prescriptions.
How Much Do Medigap Policies Cost?
There are three ratings insurance companies use to price Medicare Supplement plans in Missouri.
- Community-rated: All plan enrollees pay the same price.
- Issue-age-rated: Your premiums are based on your age when you join the plan and don’t increase as you age.
- Attained-age-rated: Premium costs go up as you age. 4
For example, if you live in St. Louis, you could pay a monthly premium between $136 and $620 for Plan G. You can also choose a high-deductible Plan G for between $42 and $152 per month. Your plan’s premiums are in addition to the Medicare Part B premium ($148.50 per month for most Medicare members in 2021). 5
Who Sells Medicare Supplement Plans in Missouri?
Insurance companies don’t have to sell every Medigap policy. Many insurers choose to sell different plans based on your location. Some insurance companies that offer Medicare Supplement plans in Missouri include:
- Anthem Blue Cross and Blue Shield – Missouri
- Aetna Health
- Humana Insurance
What If You Want to Change Your Medigap Policy?
You can change your Medigap policy whenever you like by applying for a new plan. If you’re outside of your OEP or don’t have a guaranteed issue right, however, insurance companies don’t have to sell you a plan. Insurers can also choose to charge you higher premiums or make you go through a waiting period based on your health.
If you apply for a new plan and are accepted, you’ll need to contact your current insurance company to cancel your existing coverage.
What Are Alternatives to Medicare Supplement?
Medicare Advantage plans usually use a provider network, such as an HMO or PPO. This helps keep costs down. Plans also commonly include a prescription drug plan and have additional benefits like dental or vision coverage.
What Are Medicare Resources in Missouri?
- CLAIM State Health Insurance Assistance Program (SHIP): CLAIM provides free counseling and resources for seniors enrolling in Medicare. You’ll get unbiased advice on choosing and enrolling in Medicare programs, including Medigap policies.
- Missouri Department of Insurance: The state Department of Insurance helps fight insurance fraud and protect consumers from scams, including Medicare enrollees.
- MO HealthNet (Medicaid): Medicaid services help low-income seniors and those with certain disabilities receive low- or no-cost health insurance. You must meet income eligibility to enroll in Medicaid.
Interested in a Medigap policy? Be sure to compare standardized plans before turning 65. This gives you a chance to find the plan that works for you before you enroll in Medicare and start your Medigap OEP.