Missouri Medicare Supplement Information
- All companies selling Medicare Supplement Insurance in Missouri can only sell the Approved Policies lettered Plans "A" through "J". The benefits provided by these policies will be identical regardless of which insurance company you select.
- All Missouri Medicare Supplement policies currently being offered cannot be cancelled by the insurance company unless you stop paying your premiums.
- Missouri Medicare Supplement policies allow you to choose any doctor and any hospital anywhere in the USA. Unlike HMO's, you do not need a referral or pre-authorization to see a doctor or to be admitted to a hospital. They allow you to be in charge of your health care.
- There are no co-pays with Medicare Supplement policies when you go to a Missouri doctor, or any other doctor, emergency room or hospital anywhere in the United States.
- When you first receive Part B of Medicare you have a six-month period called "Open Enrollment". During this time you can purchase a Missouri Medicare Supplement policy without having to answer heath questions.
- All companies offering Medicare Supplement Insurance in Missouri have automatic claims filing. You should not have to worry about filing a claim with Medicare or your insurance company.
- Medicare has an annual deductible of $135.00 for Part B charges. Some policies pay this deductible but you may pay more than $135.00 in additional premium each year if you select a policy that provides this benefit.
- Typically Medicare does not pay for routine Nursing Home Care. Be sure you thoroughly understand the Skilled Nursing Benefit in Part A of Medicare.
- Virtually all medicare supplement insurance companies will pay your claims. However, Medicare must first approve your claim. If Medicare does not approve your claim your Missouri Medicare Supplement Policy will not pay. (A good Missouri agent will help you if Medicare ever denies a claim.)
- Check with your doctors to see if they "Accept Assignment" before purchasing a Missouri Medicare Supplement Policy. If all of your doctors "Accept Assignment" you may not need to spend the extra money for Plans that pay for Excess Charges. (See FAQ page for more information.)
- All Medicare Supplement Policies currently being sold in Missouri must, by law, be "Issue Age". This means that the insurance companies cannot increase your premium just because you have a birthday. ("Attained Age" policies are the ones that increase each year as you get older.)
- If you currently have a Medicare Supplement policy and switch to a different policy or a different insurance company there cannot be a waiting period imposed for pre-existing conditions. You may, however, have to answer health questions on the application. If you cannot answer the questions successfully the company will not issue the policy.
- Insurance agents work on straight commission. The more expensive the policy is that they sell you, the more money they make. Make sure the agent has your best interests in mind, not the amount of commission he/she will make.
- Know and understand all of the benefits provided by the different plans before you purchase a Medicare Supplement Policy. If you have additional questions you can call toll-free at 877.633.0808. The information is Free and you are never under any obligation.
This is probably one of the most confusing, complicated programs Medicare has ever come out with.
It is a program that is constantly changing. The “best” plan this year may end up being the very worst one next year. By not reviewing your plan each year in November you may be loosing a lot of money.
If you are uncertain which of the multitude of plans will save you the most money please feel free to give me a call or send me an e-mail with a list of all of the prescriptions you are currently taking. I will do the research for you and recommend the top three companies for you to choose from.
There are over 45 different companies in Missouri for Medicare recipients to choose from for their Medicare Prescription Drug Program (PDP). Some of them may cover all of your medications today but may not cover all of them three, six or twelve months from now.
Each company has their own “formulary” or list of drugs that they offer discounts on. Each company can add or delete drugs from their formulary without having to give any advance notice. In other words, your drugs may be covered today but may not be in the future.
Once you sign up with a Medicare Part D Prescription Drug Program (PDP) you will only be able to switch to another plan between November 15 and December 31. The new plan you select will go into effect on January first of the following year.
• Premium – The monthly premium charged by companies can vary substantially from company to company and will most likely increase every year. Even if the monthly premium does not change dramatically, the co-pays for your medicine may. It is in your best interest to have your policy reviewed every year.
• Deductible – The annual deductible, if the plan you select has one, is $295. After you have paid the $295 deductible your plan’s benefits will begin and continue until your total drug costs reach $2,700.
• Initial Coverage Limit – The initial coverage limit for 2009 is $2,700. This $2,700 represents the amount both you and your plan have paid for your medication, not just the amount that you have paid. Once this limit has been reached your coverage stops. You will then be responsible for paying 100% of your medication costs up to $4,350. This “gap in coverage” is what people refer to as the “donut hole”.
• Catastrophic Coverage – Once your drug costs have reached a total of $4,350 you will then qualify for catastrophic coverage. Your costs for medications will only be 5% for the balance of the year. Ways to delay reaching the dreaded “Donut Hole”.
Many large chain pharmacies are now selling the most popular generics for only $4 for a 30 day supply. If you purchase your generic medicine and do not use your prescription drug card the cost will not go against the $2,700 limit this year. This will help you stay out of the “donut hole” for a longer period of time.
It is not “illegal” for you to do this. However, I understand that some pharmacies have been telling people it is “illegal” for them to not use their card and not “file a claim”.
Remember, the total amount paid by you and your plan is the amount that is charged against the $2,700 limit this year, not just the amount you have paid. Although you may have only paid $4, the total that is applied to your $2,700 limit may be as high as $50 or more. (The actual retail cost of the medication.)
Take a list of all your medications with you the next time you visit your doctor. Let your doctor look it over and see if there are any generics that can safely replace any of the name brand medicine you are taking. This could represent a huge savings in your prescription drug costs.
Medicare Home | Missouri Medicare FAQs | Missouri Medicare General Info | About Frank | Missouri Medicare Quote
Contact Info
© 2005 Missouri Medicare Supplement. All Rights Reserved.
© 2005 Missouri Medicare Supplement. All Rights Reserved.
