Missouri Medicare insurance is a federal program that offers health insurance coverage for qualifying beneficiaries over the age of 65, though some workers with certain disabilities who are under this age limit may be eligible as well. Missouri also offers assistance programs that can help Medicare beneficiaries in the state.
From Medicare, beneficiaries can obtain Original Medicare which is made up of Medicare Part A and Part B. Medicare Part A is often free, while the lowest premium for Medicare Part B is $134 a month. In a state like Missouri where the average cost of health insurance premiums is $462 a month, Medicare is much more affordable. However, both Medicare Part A and Part B have deductibles, coinsurance, and copays as part of the out-of-pocket expenses.
Medicare Part A covers hospital insurance, which includes inpatient hospital care and hospice care. Medicare Part B concentrates on medical insurance, which includes medically necessary treatments, durable medical supplies, and preventive services such as screenings.
For some, Medicare Part A and Part B may not be comprehensive enough. This may result in some Medicare beneficiaries looking for supplemental Medicare plans that can provide additional coverage. These plans are available from private carriers in Missouri which have Medicare approval.
These plans may cover other healthcare services that are not covered by Original Medicare. Other plans may instead cover the various out-of-pocket expenses arising from Medicare Part A and Part B.
A more common supplemental plan covers Medicare prescription drugs, and this type of supplemental plan is called Medicare Part D. All of these plans will require a monthly premium separate from the premium of Medicare Part B.
These Medicare-approved private carriers may also offer alternative Medicare Advantage plans. Like Original Medicare, they cover all the services that are covered by Medicare Part A and Part B, but these plans may also include supplemental aspects, such as coverage for other health care services or prescription drugs.
In Missouri, residents may be able to qualify for Medicare Cost Savings Programs that can help cover the cost of Medicare. To qualify for any of these programs, the applicant must be enrolled in Medicare Part A. They must also have total resources that do not exceed $7,560 for an individual and $11,340 for a couple.
One of these programs is for the Qualified Medicare Beneficiary (QMB). QMBs can have their Medicare premiums paid for, and the program can also pay for coinsurance and deductibles. To qualify, an individual must earn no more than $1,032 a month. A married couple’s combined income cannot exceed $1,392 a month.
The next program is for the Specified Low Medicare Beneficiary (SLMB). This SLMB program covers the Medicare Part B monthly premiums only, and it offers this benefit to 2 groups.
With SLMB-1, the monthly income for an individual cannot exceed $1,234. A married couple’s combined income must be less than $1,666. With SLMB-2, the monthly income limit for an individual is $1,386 while for a married couple the income limit is $1,872.
There is another federal program for qualified disabled and working beneficiaries (QDWI), but this is not available in Missouri so far. It would have paid for Medicare Part A premiums.
Any qualified beneficiary for the QMB and SLMB programs can also qualify for the Extra Help Program. This offers subsidies for prescription drugs. It covers the premiums for Medicare Part D plans and also reduces copays and deductibles.
The amount of Extra Help that a Medicare beneficiary will receive will depend on their income and asset levels. Beneficiaries with lower incomes and asset totals will receive more assistance.
Those who have both Medicare and Supplemental Security Income (SSI) or both Medicare and Medicaid are automatically included in the Extra Help program.
The law requires each state to form an organization devoted to providing free and unbiased counseling and education regarding Medicare. This is the State Health Insurance Program, but in Missouri, it is called “Community Leaders Assisting the Insured of Missouri.” The group is staffed by trained personnel who can assist Missouri residents regarding Medicare and other matters related to health insurance.
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