Medicare in Missouri

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Missouri Medicare Insurance plans:

Medicare is a federal run health insurance program for senior citizens who are 65 or older. The program is applicable for those as well who may qualify because of a disability or another special situation.

Since its inception, Medicare has helped millions of American to cover their health care expenses.

According to a data released in 2018, Missouri had 1,194,124 residents with Medicare coverage. They received their coverage from a variety of Medicare options available. Medicare in the state comes with choices how you receive benefits. They can receive coverage from Original Medicare (Parts A & B), Medicare Advantage plans (Part C) and Medicare Part D drug coverage plans. To note these different parts of Medicare covers the costs of specific services.

Medicare Part A:

Medicare part A is an integral part of original Medicare. It’s also called hospital insurance that covers hospital services and supplies that are critical to treat a condition or disease. These benefits include hospital services, skilled nursing facility care and hospice care etc. In Medicare Part A coverage for inpatient hospital care, you will get following facilities:

  • General hospitals
  • Long-term care hospitals
  • Acute care or critical access hospitals
  • Rehabilitation facilities (inpatient)
  • Psychiatric hospitals

Medicare Part A also provides coverage for limited inpatient stays in a skilled nursing facility. Medicare Part ‘A’ covers skilled nursing facility stays that include facilities like semi-private room, skilled nursing care and meals etc.

Medicare Part B:

Medicare Part B, another important component of original Medicare covers medically necessary services and supplies that include doctor visits, preventive care, and durable medical equipment etc. Major benefits that Medicare part B brings to the beneficiaries includes ambulance services, Chemotherapy, Diagnostic tests and lab work, Doctors services and Home health services. Moreover, it also offers good coverage for occupational therapy services, Outpatient mental health services and preventive-care services as well.

To avail Medicare part B benefits, you have to be a United States citizen or legal permanent resident of at least five continuous years and 65 years or older. You can also avail these benefits if you’ve been receiving disability benefits from federal government.

Medicare Part C (Medicare Advantage):

If have been already receiving Medicare A and B benefits, you can enroll in Medicare Part C. The plan is also called Medicare Advantage. In the state, Medicare plan C Medicare Advantage plans are offered by private health insurance carriers in cortication with Medicare Part A and Part B benefits.

Medicare Advantage plans combine the Medicare Parts A & B benefits together. Medicare Advantage plans in Missouri are offered by Medicare approved private insurance carriers. As stated, Medicare Advantage Plans are required to offer hospital (Part A) and doctor (Part B) benefits except hospice care. Some Medicare Advantage (Part C) plans even include prescription drug coverage and routine eye and dental care coverage that aren’t covered in Original Medicare.

Moreover, Medicare Advantage plans are bound to offer annual maximum cap on out-of-pocket costs. It implies that even if the coverage limit reaches the threshold, beneficiary needs to pay nothing for additional covered medical services.

Medicare Part D (Medicare Prescription Drug Coverage):

Medicare Part D is also called prescription drug coverage and offered by Medicare approved private insurance carriers. Beneficiaries, who are availing Original Medicare, Part A and/or Part B, and permanent residents of service area of a Medicare Prescription Drug Plan, can sign-up for Medicare Part D. Though, Medicare Part D coverage is optional by nature yet if you don’t enroll in Part on eligibility you might pay a late-enrollment penalty if you enroll later.

Every Medicare Prescription Drug Plan has a list of drugs covered under the prescription drug coverage. The list is called ‘formulary’ and tends change at any time. If Prescription Drug Plan comes with an annual deductible, you have to pay the full amount of your prescription drug purchases until the deductible reaches its threshold. Once annual deductible is met, beneficiary is required to pay share of the costs according to the plan terms.

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