Jane Dotson
If you are a US citizen over the age of 65 or have a qualifying disability, you may be eligible for Medicare. Medicare is a federal health insurance program that provides coverage for hospitalization, doctor visits, and other medical expenses. In Missouri, there are two ways to apply for Medicare: online or by mail. To apply online, visit the Social Security website and create an account if you don't already have one. Log in and fill out the online application, ensuring you have your Social Security number and other personal information on hand. You can also apply by visiting your local Social Security office, although it is recommended to schedule an appointment in advance to avoid long wait times.
| Characteristics | Values |
|---|---|
| Eligibility | Over 65 years old and a US citizen or permanent resident for at least 5 years |
| Under 65 with a qualifying disability, such as end-stage renal disease or Lou Gehrig's disease | |
| Application Process | Online, by mail, or in-person |
| Online Application | Visit the Social Security website (www.ssa.gov) and complete the online application |
| In-person Application | Visit your local Social Security office |
| Phone Application | Contact Social Security at 1-800-772-1213 (TTY: 1-800-325-0778) |
| Required Documents | Social Security number, proof of age, information about current health insurance coverage |
| Enrollment Options | Part A (hospital-related expenses), Part B (outpatient medical expenses), or both |
| Medicare Advantage | Bundles Parts A and B with drug coverage, supplemental benefits, dental, vision, and a monthly stipend for over-the-counter supplies |
| Medigap | Supplemental coverage for out-of-pocket expenses like copays and coinsurance |
| Assistance | Missouri SHIP, SLAAA, St. Louis Area Agency on Aging |
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What You'll Learn
Eligibility requirements
To be eligible for Medicare in Missouri, you must meet specific requirements. Firstly, you need to be aged 65 or older and have been a US citizen or permanent resident for a minimum of five years. If you are under 65, you may still qualify for Medicare if you have a qualifying disability, such as end-stage renal disease or Lou Gehrig's disease. In this case, you must be considered disabled for at least 24 months before becoming eligible for Medicare under the age of 65 in Missouri.
When applying for Medicare, it is essential to understand the different parts of Medicare coverage and choose the options that best suit your needs. Medicare Part A covers inpatient services received in a hospital, skilled nursing facility, or hospice care, as well as some limited home health services. Most people do not pay a premium for Part A as it is funded through payroll taxes. On the other hand, Medicare Part B covers outpatient services and medical supplies from regular doctor visits or specialist appointments. For Part B, you typically do pay a premium, and there are still significant out-of-pocket costs when seeking care.
You can choose to enrol in either Part A or Part B of Original Medicare, or both. Enrolling in both parts gives you the option to add Part D, which covers a portion of your prescription drug costs. Additionally, you may consider adding a Medigap plan, which is supplemental coverage that helps with out-of-pocket expenses like copays and coinsurance. However, it is important to note that you cannot be enrolled in both a Medigap plan and a Medicare Advantage plan simultaneously.
Medicare Advantage, also known as Part C, is a comprehensive alternative to Original Medicare, offered by private insurers. It bundles the benefits of Original Medicare (Parts A and B) with additional services like prescription drug coverage, dental, vision, and hearing benefits, as well as health and wellness programs. Medicare Advantage plans may also include a monthly stipend for purchasing over-the-counter supplies. These plans usually have a limited network of providers in your area, unlike Original Medicare, which can be used nationwide.
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Application methods
In Missouri, there are several ways to apply for Medicare. Firstly, you must determine if you are eligible for Medicare. Generally, you are eligible if you are a US citizen aged 65 or older, or under 65 with a qualifying disability, and have been a US citizen or permanent resident for at least five years.
Online Application
To apply online, visit the official Social Security website (www.ssa.gov) and create an account if you don't already have one. Log in and fill out the online application form, ensuring you have your Social Security number, proof of age, and information about any current health insurance coverage.
In-Person Application
If you prefer, you can apply in person by visiting your local Social Security office. It is recommended to schedule an appointment in advance to avoid long wait times.
Phone Application
You can also apply over the phone by contacting the Social Security Administration at 800-772-1213 (TTY users can call 1-800-325-0778). Again, ensure you have all the necessary documents and information ready before calling.
Automatic Enrollment
When you apply for retirement or disability benefits from Social Security, it also serves as your application for Medicare Part A. If you start receiving these benefits at least four months before turning 65, you will be automatically enrolled in Original Medicare (Parts A and B) when eligible.
Medicare Advisors
If you need help understanding the different Medicare policies and coverage options, you can seek guidance from expert Medicare advisors, such as those at Olympus Insurance Associates or GoHealth. These advisors can help you navigate the application process and choose the most suitable coverage for your needs.
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Parts A and B
Medicare is the federal health insurance program for people aged 65 or over in the US. If you are under 65, you may be eligible for Medicare earlier if you have a disability, permanent kidney failure, End-Stage Renal Disease (ESRD), or ALS (Lou Gehrig's Disease).
Part A
Medicare Part A covers hospital-related expenses, including hospital, home, or skilled nursing, and hospice care. You can enrol in Part A of Original Medicare through your local Social Security office. If you start receiving Social Security benefits before turning 65, you will be automatically enrolled in Original Medicare (Parts A and B) when you turn 65.
Part B
Medicare Part B covers outpatient medical expenses. For Part B, you may have to pay a monthly premium, typically $185.00 per month, but this can vary depending on your situation. You can enrol in Part B of Original Medicare through your local Social Security office. If you have employer-sponsored coverage, you may wish to decline Part B, but you should check if you would have to pay monthly penalties if you choose to enrol in Part B in the future.
If you enrol in both Parts A and B, you have the option to add Part D to cover prescription medication costs. You may also choose to add Medigap, which is supplemental coverage that helps with out-of-pocket expenses like copays and coinsurance. Enrolling in Parts A and B also allows you to replace Original Medicare with Medicare Advantage, which bundles your coverage options and offers additional services like dental and vision coverage.
Application Process
Before applying, it is important to understand your eligibility and the enrollment periods associated with Parts A and B. Generally, you are eligible for Medicare if you are aged 65 or older, a US citizen, or a permanent legal resident who has lived in the country for at least five consecutive years. The Initial Enrollment Period (IEP) is a seven-month window that begins three months before your 65th birthday month and ends three months after it. This is usually the best time to enrol to avoid any late enrollment penalties.
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Medicare Advantage
To enrol in Medicare Advantage in Missouri, you must first be enrolled in Original Medicare Parts A and B. You can then enrol during your Initial Enrollment Period, which starts three months before your 65th birthday month and ends three months after it. You may also qualify for a Special Enrollment Period if you experience certain life events, such as moving out of your current plan's service area.
It is important to carefully consider your specific health needs and budget when choosing a Medicare Advantage plan. These plans can vary by region or county, and it is essential to understand the coverage offered and the costs involved.
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Supplemental coverage
Missouri residents can choose from a range of Medicare supplement plans, also called Medigap. Medigap plans are sold by Medicare-approved private insurance companies and help cover the out-of-pocket costs of Original Medicare Parts A and B. For instance, after Parts A and B pay for a service, Medigap plans cover the remaining costs, including copays, coinsurance, and deductibles.
In 2023, 49% of Missouri residents enrolled in Original Medicare also had a Medicare supplement plan. The most popular plans are Plan G and Plan F, which together account for about 75% of all Medicare supplement plans sold. Plan G offers the broadest coverage for most people and will pay for out-of-pocket costs that Original Medicare doesn't cover, except the Medicare Part B deductible. Plan F has the broadest coverage of Original Medicare out-of-pocket costs and helps cover Medicare deductibles, as well as some copayments and coinsurance. Plan N offers a lower premium with some copays and a small annual deductible.
You can enroll in a Medicare Supplement plan in Missouri at any time if you already have Original Medicare Parts A and B. The best time to enroll is during the Medigap Open Enrollment Period, starting the first month you have Medicare Part B and you're 65 or older. Missouri regulates how much Medigap insurers can charge under-65 enrollees, so those under 65 will end up paying premiums that are slightly higher than the rates charged for a 65-year-old.
Medicare Advantage beneficiaries cannot carry a Medigap plan, but they don't need one because Medicare Advantage plans offer their version of supplemental coverage to fill in the gaps. Medicare Advantage usually bundles the hospital and medical coverage offered by Parts A and B of Original Medicare with drug coverage and supplemental benefits, including dental and vision coverage.
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Frequently asked questions
To be eligible for Medicare in Missouri, you must be a US citizen or permanent resident for at least five years and be over the age of 65. If you are under 65, you may still be eligible if you have a qualifying disability, such as end-stage renal disease or Lou Gehrig's disease, and have been considered disabled for 24 months.
There are three ways to apply for Medicare in Missouri: online, by mail, or in person. To apply online, visit the Social Security website (www.ssa.gov) and complete the online application form. To apply by mail or in person, visit your local Social Security office. You can also call the Social Security Administration at 1-800-772-1213 for assistance.
When applying for Medicare in Missouri, you will need to provide your Social Security number, proof of age, and information about any current health insurance coverage. You may also need to provide additional personal information, such as your address and contact details.
Medicare in Missouri consists of several parts, including Original Medicare (Part A and Part B), Medicare Advantage (Part C), Medicare Part D (drug coverage), and Medigap (supplemental coverage) plans. Part A covers inpatient hospital services, while Part B covers outpatient medical services. Part D adds prescription drug coverage, and Medigap helps with out-of-pocket expenses like copays and coinsurance.
The best time to enroll in Medicare in Missouri is when you turn 65 to avoid late enrollment penalties. There is a seven-month initial enrollment period (IEP) around your 65th birthday when you can first sign up for Medicare. If you start receiving Social Security benefits before your 65th birthday, you will be automatically enrolled in Original Medicare in Missouri when you turn 65.
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