Settling on the best Medicare Advantage plan in St. Louis might be difficult. This article will guide you through some of the specifics of Medicare Advantage plans in St. Louis, their potential costs, and the enrollment process, giving you the clarity you need to choose confidently.

Key Takeaways

• St. Louis County will likely offer several Medicare Advantage Plans in 2025 from various carriers, and a majority have a 4-star or higher rating from CMS.

• Residents can choose from HMO, PPO, PFFS, and HMO-POS Medicare Advantage Plans, with diverse options like prescription drug coverage and tailored plans for specific needs.

• Medicare Advantage enrollees in St. Louis will likely have access to local resources such as Missouri SHIP for support and could help compare supplemental coverage options like Medigap and Part D alongside Advantage Plans.

Understanding Medicare Advantage in St. Louis

Before we explore further, let’s first explain the concept of Medicare Advantage plans. Also known as Medicare Part C, these plans could be an alternative to Original Medicare, provided by private companies. Some plans will likely offer the same benefits as Original Medicare Parts A and B, covering everything from hospital stays to doctor visits. But the benefits might not stop there.

Some of these Medicare Advantage plans in St. Louis may also cover the Original Medicare Part B premium and, if applicable, the Part A premium and could include additional prescription coverage benefits.

Qualifying for Medicare Advantage is straightforward. If you’re enrolled in both Medicare Part A and Part B and live in the coverage area, you can enroll in a plan.

This might mean that Missouri residents, particularly in St. Louis County, could have access to a wide range of Medicare Advantage plans that could cater to their specific health needs.

St. Louis County Medicare Advantage Landscape

Several Medicare Advantage Plans will likely be available to residents of St. Louis County. Residents may choose from a variety of carriers, which might include:

• Humana

• AARP (UnitedHealthcare)

• Aetna

• Anthem

• Wellcare

• Cigna

These options could allow residents to find a plan that suits their specific healthcare needs.

Quality might be paramount when choosing a healthcare plan. That’s why it’s reassuring to know that a majority of the available plans in St. Louis County have earned a high-quality rating of 4 or more stars from CMS.

Types of Medicare Advantage Plans in St. Louis

The residents of St. Louis County will likely have the liberty to choose from four distinct types of available Medicare Advantage plans:

• HMO

• PPO

• Private fee-for-service (PFFS)

• HMO-POS

These plans will likely offer unique benefits and network structures and might provide a variety of coverage options that could meet different healthcare needs, including certain out-of-network services.

Take the HMO plans, for example. Medicare Advantage HMO plans by Anthem in Missouri necessitate care within their network for the lowest costs. This suits residents who prefer to use doctors and hospitals within a specific network.

On the other hand, PPO plans typically allow more flexibility, permitting members to access out-of-network care without needing referrals from specialists.

In addition to HMO and PPO, St. Louis residents also have access to PFFS and HMO-POS plans. These plans provide even more coverage options, ensuring residents can find a plan that best fits their lifestyle and healthcare needs.

Top Carriers and Plans in St. Louis County

St. Louis County may be home to a competitive market of Medicare Advantage carriers. These may include:

• Aetna

• Anthem

• Cigna

• Humana

• Molina

• UnitedHealthcare

Each carrier will likely offer a range of Medicare Advantage plans, as well as other Medicare plans, that may involve varying premiums and out-of-pocket limits. These plans could cater to the diverse healthcare needs and financial situations of beneficiaries.

Different plan types, such as HMO, PPO, and HMO-POS, are offered by these carriers. Each comes with distinctive features like network flexibility and out-of-pocket expense structures.

Enrollment Process for St. Louis Residents

How does the enrollment process for a Medicare Advantage plan work for St. Louis residents? Residents can enroll during key enrollment periods. These include the Initial Enrollment Period, the Annual Election Period, and Special Enrollment Periods based on specific life events.

The different enrollment periods for Medicare are:

• The Initial Enrollment Period: This begins three months before your Medicare eligibility date and extends until three months afterward.

• The Annual Election Period: This happens annually from October 15 to December 7.

• The Medicare Advantage Open Enrollment Period: This runs from January 1 to March 31. During this time, existing members can switch plans or revert to Original Medicare.

• Disability Enrollment Period: Individuals eligible by disability have a seven-month period centered around their 25th month of disability benefits.

Special Enrollment Periods allow for Medicare Advantage plan enrollment changes after specific life events such as moving or losing current coverage.

If such an event occurs, you’ll have a period of two months to join or switch plans from January 1. To enroll as well as personalized enrollment assistance, St. Louis residents can call 1-833-641-4938 (TTY 711), available from Monday to Sunday between 8 am and 11 pm EST.