New Medicare Plan Finder

New Medicare Plan Finder

i Aug 30th No Comments by

CMS NEWS
FOR IMMEDIATE RELEASE
August 27th, 2019
Contact: CMS Media Relations
(202) 690-6145 | CMS Media Inquiries

Medicare Plan Finder Gets an Upgrade for the First Time in a Decade
It’s Now Easier to Compare Coverage Options and Shop for Medicare Health and Drug Plans
For the first time in a decade, the Centers for Medicare & Medicaid Services (CMS) today launched a modernized and redesigned Medicare Plan Finder. The Medicare Plan Finder, the most used tool on Medicare.gov, allows users to shop and compare Medicare Advantage and Part D plans. There are more than 60 million people with Medicare coverage. The updated Medicare Plan Finder also provides them and their caregivers with a personalized experience through a mobile friendly and easy-to-read design that will help them learn about different options and select coverage that best meets their health needs. The new Plan Finder walks users through the Medicare Advantage and Part D enrollment process from start to finish and allows people to view and compare many of the supplemental benefits that Medicare Advantage plans offer.
These changes are part of the Trump Administration’s eMedicare initiative – which expands and improves on current Medicare consumer service options. CMS is improving our online Medicare tools to meet the needs of a growing number of tech savvy beneficiaries. The online tools do not replace Medicare’s traditional customer service options. People with Medicare will continue to have access to paper copies of the Medicare & You handbook and be able get help over the phone using 1-800-MEDICARE.
“President Trump has made it clear that he wants to protect and strengthen Medicare.” said CMS Administrator Seema Verma. “The redesigned Medicare Plan Finder is another example of how CMS is empowering beneficiaries with price and quality information to take advantage of lower rates and new benefits in Medicare Advantage and Part D.”
In 2019, CMS added nearly 600 Medicare Advantage plans with average premiums declining to their lowest levels in 6 years. Over the past three years, average Part D basic premiums have decreased by 13.5 percent, from $34.70 in 2017 to a projected $30 in 2020, saving beneficiaries about $1.9 billion in premium costs over that time.
The redesigned Medicare Plan Finder will make it easier for beneficiaries to see these changes and to:
• Compare pricing between Original Medicare, Medicare prescription drug plans, Medicare Advantage plans, and Medicare Supplement Insurance (Medigap) policies;
• Compare coverage options on their smartphones and tablets;
• Compare up to three drug plans or three Medicare Advantage plans side-by-side;
• Get plan costs and benefits, including which Medicare Advantage plans offer extra benefits;
• Build a personal drug list and find Medicare Part D prescription drug coverage that best meets their needs.
As part of a phased rollout, both the old and new Plan Finder will be available and run in parallel through the end of September 2019, to allow time for users to try out and become familiar with the new version. The new Plan Finder has been in use at the 1-800-MEDICARE call centers for over a month already. CMS has streamlined the information on the new Plan Finder and has conducted consumer testing throughout the development of the new Medicare Plan Finder to ensure that the information that is displayed is complete, understandable and is in plain language. In addition, CMS collaborated with stakeholders to include improvements in the new Plan Finder that directly addresses a number of issues with the old Plan Finder. For example, CMS has integrated information about Medicare coverage options, clarified the cost-savings benefits of low income subsidy programs, added functionality to use actual claims data to help build more accurate drug lists, streamlined the end-to-end flow for users, and ensured that mobile optimization allows for easy use on the device the user prefers – desktop, tablet, or smartphone. In 2018, approximately 25 percent of Medicare beneficiaries accessed Medicare Plan Finder on mobile devices, an increase of 40 percent from 2017.
CMS has been offering in-person and online training on the new Plan Finder throughout the summer and we plan to offer an additional webinar session in September. We are also producing several other tools to aid with learning the new Plan Finder, including videos and tip sheets.
“We want consumers to have the best tool possible when open enrollment begins on October 15. Try it out and let us know what you think,” said Administrator Verma.
CMS annually provides Medicare health and drug plan data for private sector developers and researchers to use to create innovative new products. CMS intends to release the real-time Medicare plan data in an API format by the end of this year to make it easier for the private sector to create additional tools to help beneficiaries make informed health coverage decisions.
In addition to upgrading Medicare Plan Finder, CMS has redesigned the Medicare.gov homepage and refreshed the personalized MyMedicare.gov portal to create a more seamless, easy to navigate, personalized online experience for people with Medicare.
Approximately 10,000 people join Medicare each day. Today’s announcement builds on the eMedicare initiative that first launched in 2018 to deliver simple tools and information to current and future Medicare beneficiaries. Other new tools launched under the initiative that seeks to deliver personalized and customized information that Medicare beneficiaries prefer include:
• The “What’s Covered” app that tells people what’s covered and what’s not in Original Medicare.
• A price transparency tool that lets consumers compare Medicare payments and copayments of certain procedures performed in both hospital outpatient departments and ambulatory surgical centers.
• Interactive online decision support to help people better understand and evaluate their Medicare coverage options and costs between Original Medicare and Medicare Advantage;
• An online service that lets people quickly see how different coverage choices will affect their estimated out-of-pocket costs;
• Webchat option in Medicare Plan Finder helps people get on-the-spot support; and
• Easy-to-use surveys across Medicare.gov so consumers can continue to offer feedback about their online experiences.
Medicare Open Enrollment is the time for people with Medicare to review their health coverage. It begins on October 15, 2019, and ends December 7, 2019. Medicare health and drug plan costs and covered benefits can change from year to year, so people with Medicare should look at their coverage choices and decide on the options that best fit their health needs. They can visit Medicare.gov (https://www.medicare.gov), call 1-800-MEDICARE, or contact their State Health Insurance Assistance Program. Those people with Medicare who do not wish to change their current coverage do not need to re-enroll in order to keep their current coverage.
For royalty-free, downloadable images of individuals using the new Medicare Plan Finder in English and Spanish to use for republishing, please visit: https://downloads.cms.gov/media/plan-finder-images.zip.
For a Spanish version of this press release, please visit: https://www.cms.gov/sites/drupal/files/2019-08/08-27-2019%20Press%20Release%20Spanish%20Plan%20Finder%20Redesign.pdf

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New grant focuses on providing assistance to at risk populations in 9 rural Missouri counties

i Mar 11th No Comments by

Missouri CLAIM will provide a one-stop shop to provide screening and application help for multiple assistance programs

Jefferson City, Mo– The Missouri Department of Insurance announced a new grant from the National Council on Aging’s Center for Benefits Access (NCOA). The Benefit Enrollment Center (BEC) Grant provides funding for a twenty month period (January 2019 – September 2020) to the Department to implement a Benefit Enrollment Center in 9 rural Missouri counties.

Benefit Enrollment Centers (BEC) use person-centered strategies in a coordinated, community-wide approach to find and enroll Medicare beneficiaries—both seniors aged 65+ years and adults living with disabilities — who have limited income and resources to access available benefits, with the primary focus being on the following five core benefit programs:

  • Medicare Part D Extra Help (or Low-Income Subsidy, LIS)
  • Medicare Savings Programs (MSP)
  • Medicaid
  • Supplemental Nutrition Assistance Program (SNAP, formerly Food Stamps)
  • Low-Income Home Energy Assistance Program (LIHEAP)

A “person-centered” approach is one in which someone is screened for and assisted with applying for multiple benefits at one time, based on that individual’s needs. Currently the department’s CLAIM program assists Missourians with the first three of these core services through the State Health Insurance Program (SHIP) and the Medicare Improvements for Patients and Providers Act (MIPPA) funding. This additional grant will allow CLAIM to assist 1,000 individuals to apply for and receive much needed assistance for which they may qualify.

The BEC grant focuses on 9 rural counties, and senior and disabled individuals in those counties who are most in need of the services. The target area includes these central Missouri counties: Callaway, Camden, Cole, Laclede, Miller, Morgan, Moniteau, Osage and Pulaski. 

The total population in these targeted counties is 328,992, of which:

  • 15.77% are age 65 and older
  • 16.42% have a disability (higher than MO at 14.44% and the US at 12.52%)
  • 15.54% live at or below FPL. Per capita income is $23,004, below the MO average of $27,044;
  • Over 17.25% of the population receives Medicaid
  • 14.44% of the adult population, age 18-64, lacks health insurance

Current Medicare program data indicate there are 12,973 disabled individuals residing in this defined area, 15,881 are low-income, and 13,802 are estimated to need and be eligible for MSP.

About the Missouri Department of Insurance, Financial Institutions & Professional Registration

The Missouri Department of Insurance, Financial Institutions and Professional Registration (DIFP) is responsible for consumer protection through the regulation of financial industries and professionals. The department’s seven divisions work to enforce state regulations both efficiently and effectively while encouraging a competitive environment for industries and professions to ensure consumers have access to quality products.

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Missouri Rx Changes Effective July 1, 2017

i Jun 20th No Comments by

Missouri Rx – Missouri’s State Pharmaceutical Assistance Program has been reauthorized by the state legislature for another 5 years until August, 28, 2022.  Missouri Rx works with a person’s stand alone Part D plan or Medicare Advantage plan to pay 50% of a person’s costs at the pharmacy.  Eligibility benefits for MO Rx benefit has been reduced to only those Medicare beneficiaries that are also enrolled into Medicaid. This change affects 64,000 enrollees. Our certified counselors can help you determine your options if you have lost this benefit. You have not lost your Medicare drug coverage.

Missouri Rx coverage will no longer pay 50% of the cost of Part D prescriptions for people enrolled in Medicare whose

  • Income $21,660 for a single person or $29,140 for a couple or
  • Enrolled into Extra Help from SSA sometimes called Low-Income Subsidy (LIS).

CLAIM Counselors can provide the following.

  • If you are affected by this change you have a Special Enrollment Period for two months to change your Part D plan. Counselors can assist with the comparison and enrollment into a another plan if this is your choice.
  • Counselors can screen and provide application assistance for Low-Income Subsidy through Social Security or Medicare Savings Program.
  • Check eligibility for Patient Assistance Programs to help cover some of your higher cost medications

www.rxassist.org – provides info and application links to assistance programs

www.needymeds.org – provides info and application links to assistance programs

www.rxoutreach.org  – discount purchasing program website

  • Other options may include talking with your doctor or going to a public health center that provides a sliding fee scale for prescriptions.

 

We encourage you to call or contact us to understand any options available to you.

May 2017 Medicare Minute

May 2017 Medicare Minute: Medicare Savings Programs

Script

Teaching Material

Handout

Medicare Minute

MEDICARE MINUTE PRESENTATION MATERIAL & TOPIC SCHEDULE

 

Each month, the SHIP Technical Assistance Center will distribute Medicare Minute presentation material, which will include:

 

  • Medicare Minute Script describing points the presenter should make during the presentation. Usually this includes 3 – 4 talking points along with “take action” steps and contact information. The Script could be used in presentations lasting 15 – 20 minutes.

 

  • Medicare Minute Teaching Material provides detail information to support the Medicare Minute Script. Each set of Teaching Material will include case studies that can be used to showcase a more “real life” application to the discussion topic. The Medicare Minute Teaching Material would be used for presentations of 30 – 60 minutes in length.

 

  • Medicare Minute Attendee Handout provides key information the attendee can review and retain at home. Attendees may receive paper copy handouts from the host site or be directed to the CLAIM website for access to the handout.

2019 Medicare Minute Topic Schedule (links to each month’s material in table)

Click here to download the Medicare Minute Presenter Checklist

Month Approved Topic   Month Approved Topic
January What’s New in 2019 July Medicare Savings Program 
February Medicare Enrollment and Election Periods August Medigaps 
March Medicare Coverage of Emergency/Urgently Needed Care September Fall Open Enrollment Period
April Medicare Coverage of Hospice Care  October Part A-covered Services
May Part B vs. Part D  November Accessing Supplemental Benefits 
June Original Medicare and Medicare Advantage Standard Appeals December Complaints, Grievances, and Beneficiary Resources 

 

2018 Medicare Minute Topic Schedule (links to each month’s material in table)

Month Approved Topic   Month Approved Topic
January What’s New in 2018? July Durable Medical Equipment (DME)
February Medicare Coverage of Preventive Services August Medicare Coverage of Home Health Care
March How Medicare Works with Federal and Military Benefits September Medicare’s Open Enrollment Period
April Explanations of Benefits (EOBs) and Medicare Summary Notices (MSNs) October Medicare Coverage of Mental Health Services
May Part D Appeals  November Original Medicare and Medicare Advantage Providers
June How to Afford Your Drug Costs December Speaking with your Doctor

 

2017 Medicare Minute Topic Schedule (links to each month’s material in table)

Month Approved Topic   Month Approved Topic
January What’s New in 2017 July Medicare and the Health Insurance Marketplace
February Special Enrollment Periods (SEPs) August Common Medicare Open Enrollment Notices
March Medicare Coverage of Hospital Stays September Open Enrollment Period
April How Medicare Works with Current Employer Insurance October Protecting Yourself from Enrollment Fraud
May Medicare Savings Programs November Discharge Appeals
June Medicare and Medicaid December Trouble Shooting Medicare

 

         2016 Medicare Minute Topic Schedule (links to each month’s material in table)

Month Approved Topic   Month Approved Topic
January What’s New in 2016 July Durable Medical Equipment
February Understanding Medicare Enrollment Periods August Planning Ahead: Advanced Directives and Long-term Care
March Medicare Preventive & Screening Services September Open Enrollment Period/Annual Election Period
April Medicare Notices & Appeals October Understanding Part D Plan Selection
May Medicaid & Other Programs that Make Medicare More Affordable November Medigaps
June Medicare Part A Covered Services December Who Pays First: Medicare & Other Types of Coverage

           

Source: Medicare Minute

 

2016 Medicare Parts A & B Premiums and Deductibles Announced

i Nov 12th No Comments by

Today, the Centers for Medicare & Medicaid Services (CMS) announced the 2016 premiums and deductibles for the Medicare inpatient hospital (Part A) and physician and outpatient hospital services (Part B) programs.

Part B Premiums/Deductibles

As the Social Security Administration previously announced, there will no Social Security cost of living increase for 2016. As a result, by law, most people with Medicare Part B will be “held harmless” from any increase in premiums in 2016 and will pay the same monthly premium as last year, which is $104.90.

Beneficiaries not subject to the “hold harmless” provision will pay $121.80, as calculated reflecting the provisions of the Bipartisan Budget Act signed into law by President Obama last week. Medicare Part B beneficiaries not subject to the “hold-harmless” provision are those not collecting Social Security benefits, those who will enroll in Part B for the first time in 2016, dual eligible beneficiaries who have their premiums paid by Medicaid, and beneficiaries who pay an additional income-related premium. These groups account for about 30 percent of the 52 million Americans expected to be enrolled in Medicare Part B in 2016.

“Our goal is to keep Medicare Part B premiums affordable. Thanks to the leadership of Congress and President Obama, the premiums for 52 million Americans enrolled in Medicare Part B will be either flat or substantially less than they otherwise would have been,” said CMS Acting Administrator Andy Slavitt. “Affordability for Medicare enrollees is a key goal of our work building a health care system that delivers better care and spends health care dollars more wisely.”

Because of slow growth in medical costs and inflation, Medicare Part B premiums were unchanged for the 2013, 2014, and 2015 calendar years. The “hold harmless” provision would have required the approximately 30 percent of beneficiaries not held harmless in 2016 to pay an estimated base monthly Part B premium of $159.30 in part to make up for lost contingency reserves, according to the 2015 Trustees Report. However, the Bipartisan Budget Act of 2015 mitigated the Part B premium increase for these beneficiaries and states, which have programs that pay some or all of the premiums and cost-sharing for certain people who have Medicare and limited incomes. The CMS Office of the Actuary estimates that states will save $1.8 billion as a result of this premium mitigation.

CMS also announced that the annual deductible for all Part B beneficiaries will be $166.00 in 2016. Premiums for Medicare Advantage and Medicare Prescription Drug plans already finalized are unaffected by this announcement.

To get more information about state-by-state savings, visit the CMS website at https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-11-10.html.

Since 2007, beneficiaries with higher incomes have paid higher Part B monthly premiums.  These income-related monthly adjustment amount (IRMAA) affect fewer than 5 percent of people with Medicare. Under the Part B section of the Bipartisan Budget Act of 2015, high income beneficiaries will pay an additional amount. The IRMAA, additional amounts, and total Part B premiums for high income beneficiaries for 2016 are shown in the following table:

Beneficiaries who file an individual tax return with income: Beneficiaries who file a joint tax return with income:

Income-related monthly adjustment amount

Total monthly premium amount

Less than or equal to $85,000 Less than or equal to $170,000

$0.00

$121.80

Greater than $85,000 and less than or equal to $107,000 Greater than $170,000 and less than or equal to $214,000

48.70

170.50

Greater than $107,000 and less than or equal to $160,000 Greater than $214,000 and less than or equal to $320,000

121.80

243.60

Greater than $160,000 and less than or equal to $214,000 Greater than $320,000 and less than or equal to $428,000

194.90

316.70

Greater than $214,000 Greater than $428,000

268.00

389.80

 

Premiums for beneficiaries who are married and lived with their spouse at any time during the taxable year, but file a separate return, are as follows:

Beneficiaries who are married and lived with their spouse at any time during the year, but file a separate tax return from their spouse:

Income-related monthly adjustment amount

Total monthly premium amount

Less than or equal to $85,000

$0.00

$121.80

Greater than $85,000 and less than or equal to $129,000

194.90

316.70

Greater than $129,000

268.00

389.80

Part A Premiums/Deductibles

Medicare Part A covers inpatient hospital, skilled nursing facility, and some home health care services. About 99 percent of Medicare beneficiaries do not pay a Part A premium since they have at least 40 quarters of Medicare-covered employment.

The Medicare Part A annual deductible that beneficiaries pay when admitted to the hospital will be $1,288.00 in 2016, a small increase from $1,260.00 in 2015. The Part A deductible covers beneficiaries’ share of costs for the first 60 days of Medicare-covered inpatient hospital care in a benefit period. The daily coinsurance amounts will be $322 for the 61st through 90th day of hospitalization in a benefit period and $644 for lifetime reserve days. For beneficiaries in skilled nursing facilities, the daily coinsurance for days 21 through 100 in a benefit period will be $161.00 in 2016 ($157.50 in 2015).

Enrollees age 65 and over who have fewer than 40 quarters of coverage and certain persons with disabilities pay a monthly premium in order to receive coverage under Part A. Individuals with 30-39 quarters of coverage may buy into Part A at a reduced monthly premium rate, which will be $226.00 in 2016, a $2.00 increase from 2015. Those with less than 30 quarters of coverage pay the full premium, which will be $411.00 a month, a $4.00 increase from 2015.

 

Deductibles and Coinsurance for 2016

Part A Deductible and Coinsurance Amounts for
Calendar Years 2015 and 2016
Type of Cost Sharing 

2015

2016

Inpatient hospital deductible

$1,260

$1,288

Daily coinsurance for 61st-90th Day

315

322

Daily coinsurance for lifetime reserve days

630

644

SNF coinsurance

157.50

161.00

 

For more information on the 2016 Medicare Parts A and B premiums and deductibles (CMS-8059-N, CMS-8060-N, and CMS-8061-N), visit: https://www.federalregister.gov/public-inspection.  

Training Information

Cont Ed Schedule

CLAIM Time Webinar Schedule

IT Schedule (blue) 

**Don’t forget to let us know via email to claimcallcenter@primaris.org if you watch any recordings on this page. In order to receive training credit, please include the NAME and ORIGINAL DATE of the webinar in the email.**

Plan Finder Webinar  

Past CLAIM Time Webinars                                  

  • July 25, 2019: “Confidentiality” (Recording) (PowerPoint)
  • July 10, 2019: “Independent Living Facilities” (Recording) (PowerPoint)
  • June 27, 2019: “Social Security” (Recording) (PowerPoint)
  • May 23, 2019: “Miller’s Trust” (Recording) (PowerPoint)
  • April 25, 2019: “Missouri HealthNet and Medicare Savings Programs” (Recording) (PowerPoint)
  • March 13, 2019: “2019 MIPPA Numbers” (Recording)               
  • February 27, 2019: “New Director Intro & SHIP TA Center Info” (Recording)   
  • February 13, 2019: “Special Enrollment Periods” (Recording)
  • January 31, 2019: “CMS Unique IDs” (Recording)
  • December 12, 2018: “Reporting” (Recording)
  • September 19, 2018: “AEP & MIPPA” (Recording)
  • September 12, 2018: “AEP & MIPPA (for Newer Volunteers)” (Recording) 
  • August 24, 2018: “Helpful Resources” (Recording)
  • August 8, 2018: “MO HealthNet” (Recording)
  • July 27, 2018: “AmeriCorps” (Recording) 
  • June 22, 2018: “Patient Assistance Programs” (Recording; PowerPointHandouts)
  • June 14, 2018: “Medicare and Marketplace” (Recording) 
  • April 27, 2018: “Building Brand Champions” (Recording) 

  Past SHIP TA Webinars

Part D Extra Help (Low Income Subsidy)

i Jan 7th No Comments by

Part D Extra Help (Low Income Subsidy)

The most readily available assistance program for Medicare is the Part D Extra Help program. This pays for 85% or more of the costs that come with Medicare’s Prescription Drug Program (Part D). It is sometimes called the Low Income Subsidy program or LIS.

Extra Help has higher income and asset limits than programs such as Medicare Savings Programs and Medicaid. LIS offers assistance to beneficiaries by helping them pay a reduced amount for Medicare-covered prescriptions at the pharmacy. A beneficiary can be enrolled in a stand-alone Prescription Drug Plan or a Medicare Advantage plan with drug coverage. There are different levels of assistance that vary by income and asset levels. The lower the income and resource, the greater the help.

Who’s Eligible?

Individuals

Couples

Monthly Income

$1,581

$2,134

Resources*

$14,390

$28,720

*Resources include bank accounts, CDs, stocks and bonds. Your home and car are not included.

(Numbers current as of April 2019.)

Enrollment in Extra Help is done through the Social Security Administration. An application can be submitted online or a paper application can be requested by contacting CLAIM or visiting your local SSA office. Click here for help finding your local Social Security office.

You automatically get Extra Help if you:

  • have both Medicare and Supplemental Security Income (SSI), or
  • have both Medicare and Medicaid.

Programs to Help You Pay

i Jan 7th No Comments by

Programs to Help You Pay

There are several different types of programs that can assist Medicare enrollees with their out-of-pocket costs for services. Here you can find some basic information about some of these programs, where to get more information and where to enroll in them.

Part D Extra Help
For those with Medicare Part D making $18,972 or less yearly ($25,608 for married couples)* and meet certain resource limits.

MO HealthNet
Missouri’s Medicaid Program.

Medicaid Spend-Down
For those who nearly qualify for MO HealthNet, but earn too much.

Medicare Savings Programs
Three programs for those earning $17,112 or less yearly ($23,076 for married couples)* and meet certain resource limits. Provides help with Medicare Advantage and Medicare Parts A, B, and D.

*Dollar amounts are current until March 2020.

Other Drug Assistance Options

RxOutreach
A fully-licensed mail order pharmacy that is committed to making the use of prescription drugs safer and more affordable.

RxAssist
A comprehensive database of patient assistance programs, as well as practical tools, news, and articles that helps provide free medications to people who cannot afford to buy their medicine.

NeedyMeds
An information resource dedicated to helping people locate assistance programs to help them afford their medications and other healthcare costs.

Missouri Drug Card
As a resident of Missouri, you and your family have access to a statewide Prescription Assistance Program (PAP).

Other Programs

EyeCare America
EyeCare America is a public service program of The Foundation of the American Academy of Ophthalmology. It matches eligible seniors in need with volunteer ophthalmologists to provide a medical eye exam and up to one year of care with no out of pocket of the patient.

Choosing a Medicare Advantage Plan

i Jan 7th No Comments by

Choosing a Medicare Advantage Plan

Medicare Advantage Plans are an alternative form of Medicare benefits. You still have Medicare benefits, however by enrolling in a Medicare Advantage plan you are giving a private company permission to administer your Medicare benefits according to their rules. You are subject to the plan rules and cost sharing, not Medicare’s. Plans must provide the same services as Original Medicare.

It may help to print this page for reference.

To find Medicare Advantage Plans, you can use the Medicare Plan Finder from Medicare.gov. You should always compare Medicare Advantage Plans carefully before enrolling. Some important questions to ask yourself as you look at several plans include:

  • Insist on a simple outline of coverage. Know what you are buying and how it works. Is this an Health Maintenance Organization (HMO), a Preferred Provider Organization (PPO) or a Private Fee-for-Servie Plan (PFFS)?
  • Are my prescription drugs covered?
  • What are my costs (premiums, doctor and hospital copays, out-of-pocket limit)?
  • Do I need to choose a primary care doctor?
  • Do I have to see a primary care doctor to get a referral to see a Specialist?
  • Does my providers (doctors, hospitals, etc.) accept the terms and conditions (payment) of this plan and are in network?
  • Can I return to Original Medicare at any time?
  • What other services does this plan offer (vision, dental, hearing)?

Don’t feel pressured to enroll right away. Open enrollment is October15th to December 7th.

Do not drop current insurance coverage until you are sure about your new coverage. Do not join more than one Medicare Advantage Plan. Do not buy a Medigap policy if you already have a Medicare Advantage plan. They will not work together.

Never buy from someone who claims to be from the government. The government does not sell insurance. Keep information on the agent or representative that enrolls you for future reference.

Do not enroll in a Medicare Advantage plan if you have MO HealthNet (Medicaid). Currently, MO HealthNet will not pay your plan co-payments unless you are enrolled in QMB or QMB Plus. Otherwise, you will be responsible for the co-payments.


Read the next section about Marketing Guidelines for Medicare Advantage Plans

Part A (hospital)

Part B (medical) 

Part D (prescription)