Compare St Louis County Missouri
Medicare Advantage Plans

A Medicare Advantage Plan in St Louis County, MO can provide additional benefits above and beyond Original Medicare. There are 46 Medicare Advantage Plans (Part-C) available in St Louis County from 11 different health insurance providers to compare in 2023. 21 of these Medicare Advantage Plans offer additional gap coverage to help avoid the “donut hole”. The plan with the lowest out-of-pocket expense is $1700 and the highest out-of-pocket is $8300. St Louis County Missouri qualifying beneficiaries can also pick from 0 Medicare Special Needs Plans. The highest rated Medicare Advantage Plan in St Louis County Missouri received a 5 overall star rating from CMS.



Most Popular Plans by Enrollment in St Louis County, Missouri

Plan Name Plan ID Marketing Name Monthly
Premium
Enrollment
AARP Medicare Advantage Plan 1 (HMO-POS)
H2802-028
UnitedHealthcare $0 75256
Essence Advantage (HMO)
H2610-005
Essence Healthcare $0 41749
Aetna Medicare Gold Advantage Prime (HMO)
H2663-005
Aetna Medicare $0 30718
Humana Honor (PPO)
H5216-140
Humana $0 14517
Humana Gold Plus H0028-014 (HMO)
H0028-014
Humana $0 14278


2023 Medicare Advantage Plans in St Louis County, MO

(Click the Plan Name for More Details)
(⇅ Click the Header to Sort)


Name ⇅ Monthly
Premium
Deductible MOOP Gap 2023 Plan
Stars
Rating
Wellcare No Premium Open (PPO)
(H7518-001)

$0 $0 $3,900 NoNA
Wellcare No Premium (HMO)
(H1664-004)

$0 $0 $3,000 Yes
Wellcare Low Premium Open (PPO)
(H7518-004)

$20.00 $0 $3,500 NoNA
Wellcare Giveback (HMO)
(H1664-006)

$0 $505.00 $8,300 No
Wellcare Community Assist (PPO)
(H7518-005)

$36.30 $280.00 $5,000 NoNA
Wellcare Assist (HMO)
(H1664-007)

$12.90 $505.00 $3,400 No
UnitedHealthcare Medicare Advantage Choice Plan 3 (Region
(R3444-023)

$21.00 $245.00 $6,700 Yes
UnitedHealthcare Medicare Advantage Choice Plan 2 (Region
(R3444-012)

$56.00 $275.00 $6,700 Yes
SSM Health Plan Integrity (HMO-POS)
(H8019-002)

$0 $0 $2,500 YesNA
SSM Health Plan FlexSpend (HMO-POS)
(H8019-005)

$0 $0 $2,750 YesNA
HumanaChoice R1532-002 (Regional PPO)

$54.00 $505.00 $6,700 No
HumanaChoice H5216-318 (PPO)

$0 $0 $3,600 Yes
HumanaChoice H5216-032 (PPO)

$70.00 $195.00 $6,700 No
Humana Gold Plus H0028-014 (HMO)

$0 $0 $2,900 Yes
Humana Gold Choice H8145-125 (PFFS)

$53.00 $195.00 $- No
Essence Advantage Select (HMO)
(H2610-016)

$0 $0 $2,800 No
Essence Advantage Plus (HMO)
(H2610-006)

$60.00 $0 $1,700 Yes
Essence Advantage Choice Plus (PPO)
(H6200-002)

$27.00 $0 $3,900 NoToo New
Essence Advantage Choice (PPO)
(H6200-001)

$0 $0 $4,200 NoToo New
Essence Advantage (HMO)
(H2610-005)

$0 $0 $1,950 No
Cigna True Choice Savings Medicare (PPO)
(H7849-077)

$0 $0 $3,700 No
Cigna True Choice Medicare (PPO)
(H7849-057)

$0 $0 $3,700 No
Cigna Preferred Medicare (HMO)
(H7389-003)

$0 $0 $2,600 YesToo New
Anthem MediBlue Plus (HMO)
(H3447-038)

$0 $0 $2,800 Yes
Anthem MediBlue Access Basic (PPO)
(H4909-016)

$0 $0 $3,900 Yes
Anthem MediBlue Access (PPO)
(H4909-015)

$39.00 $0 $5,000 Yes
Aetna Medicare Premier (PPO)
(H1608-013)

$50.00 $150.00 $7,550 Yes
Aetna Medicare Option 2 (HMO)
(H2663-002)

$57.00 $0 $4,900 Yes
Aetna Medicare Option 1 (HMO-POS)
(H2663-006)

$32.00 $0 $6,000 Yes
Aetna Medicare Gold Advantage Prime (HMO)
(H2663-005)

$0 $0 $2,800 Yes
Aetna Medicare Elite (PPO)
(H1608-050)

$0 $0 $4,500 Yes
AARP Medicare Advantage Walgreens (PPO)
(H2228-083)

$0 $0 $3,900 Yes
AARP Medicare Advantage Plan 2 (HMO-POS)
(H2802-052)

$0 $0 $3,400 Yes
AARP Medicare Advantage Plan 1 (HMO-POS)
(H2802-028)

$0 $0 $2,900 Yes
AARP Medicare Advantage Choice (PPO)
(H2228-030)

$29.00 $0 $4,400 Yes






Missouri Part-C Plans Without Drug Coverage







Types of MA Plan in MO


HMO - Health Maintenance Organization. A Health Maintenance Organization manages your Part A and Part B health insurance benefits. In most cases you need to choose a primary care doctor. Health Maintenance Organization's offers services through a network of contracted hospitals, doctors and other providers, and the plan pays the providers directly. You generally must receive all Healthcare from the plan providers or through referrals from the plan provider. Emergency care, and out-of-area urgent care is still covered. An HMO-POS plan allows you to get some services out-of-network.

PPO - Preferred Provider Organization. A Preferred Provider Organization offers a network of doctors, hospitals, and other providers you can choose from. Because providers are preferred, you can save money by using in network providers or usually pay a higher cost to use out-of-network providers. A primary care doctor is not required.

PFFS - Private Fee For Service. A Private Fee For Service plan allows you greater flexibility in choosing a Missouri provider. You may obtain covered services from any Medicare eligible provider who is willing to accept the plan's terms. The Healthcare provider must agree to accept the plan's terms before each visit. Some of these plans have a network of approved providers that have agreed to treat plan members.

SNP - Special Needs Plan. A Special Needs Plan is for individuals who receive Medicare and Medicaid, have specific severe or disabling chronic conditions or reside in a licensed nursing home or skilled facility. SNP plans must provide prescription drug coverage to St Louis County Missouri residents.

Cost - Cost Plan. A cost plan doesn't replace your Original Medicare. It offers additional benefits to Original Medicare. If the cost plan doesn't include prescription drug coverage, you can enroll in a Part-D plan separately.





Can I get help in the coverage gap in St Louis County, MO?


Yes. 21 Medicare Advantage Plans in St Louis County offer additional gap coverage. Once in the coverage gap, you’ll pay no more than 25% of the cost for brand-name and generic prescription drugs. If you choose a drug plan that includes coverage in the gap, you may get a discount applied to the drug's price.

Are there Medicare Advantage Plans in St Louis County, MO?


There are 46 Medicare Advantage Plans available in St Louis County, Missouri from 11 different health insurance providers. These plans offer additional benefits that aren't available through Original Medicare. Medicare beneficiaries who are interested in a Part-C policy may choose among many plans to compare versus St Louis City County Medicare Advantage Plans.



How much is a Medicare Plan in St Louis County, MO?


Individuals who are interested in a Medicare Advantage Plan in Missouri may choose among many cost options depending on your necessary benefits. The lowest plan premium is $0 and the highest premium is $70. The deductibles in St Louis County range from $0-$505. The plan with the lowest out-of-pocket (MOOP) expense is $1700 and the highest out-of-pocket is $8300.



Things to consider when choosing a MA Plan in St Louis


  • Are you eligible for a Medicare Advantage Plan?

  • How much are the premiums, deductibles, and other costs?

  • Is there a yearly limit on what you could pay out-of-pocket?

  • Does the plan cover your prescription drugs?

  • Will you hit the prescription drug coverage gap?

  • Is your pharmacy in the plan’s network?

  • Will your prescription drugs require prior authorization?

  • How well does the plan cover the services you need like vision, hearing, or dental?

  • Are your doctors in-network?

  • Will you need to be referred to see a specialist?

  • Does the plan cover services from out-of-network providers?

  • How does the plan compare to your current coverage?

  • Do you want to juggle multiple Medicare plans?


When to sign up for a Missouri Medicare Advantage Plan?


Below mentioned are the types of the enrollment period, along with the instructions on what to do during this period:

Initial Enrollment Period (IEP). This period starts 3 months prior to the month you will turn 65. It ends after 3 months you have turned 65. At this stage, you can sign up for a Missouri Medicare Advantage Plan.

Annual Enrollment Period (AEP). Also known as the Open Enrollment Period, it starts on the 15th of October and ends on the 7th of December. At this stage, you can either sign up for the plan, switch or leave your current plan.

Special Enrollment Period (SEP). This enrollment period depends on the personal circumstances of the beneficiaries, like if you move or lose insurance coverage. Check to determine if you qualify to modify your plan.

Open Enrollment Period. Jan 1 – Mar 31. If you’re enrolled in a Missouri Medicare Advantage Plan, you can switch to a different Medicare Part-C Plan in St Louis County, MO or switch to Original Medicare once during this time.

5-star Special Enrollment Period. Dec 8 - Nov 30. If a Centers for Medicare and Medicaid Services (CMS) 5-star plan is available in your area you can switch to the 5-star plan once during this period.



Check for CMS Star Ratings

Centers for Medicare & Medicaid Service (CMS) assesses the quality of medical services of Medicare Advantage Plan using a 5-star rating system. A report is released yearly for the public to assess the quality of healthcare services. Thus, if you are searching for the highest Medicare Advantage Plan in your state, research the CMS ratings and costs of the plans report for further information.


Can I get a Medicare Advantage Plans in St Louis County, MO?

Yes. There are 46 Medicare Advantage Plans available in St Louis County, Missouri from 11 different health insurance providers. These plans offer additional benefits that aren't available through Original Medicare.

How much is a Medicare Plan in St Louis County, Missouri?

Missouri residents who are interested in a Medicare Advantage Plan may choose among many cost options depending on your necessary benefits. The lowest plan premium is $0 and the highest premium is $70. The deductibles in St Louis County range from $0-$505

Can I get help in the coverage gap in St Louis County, MO?

Yes. 21 Medicare Advantage Plans in St Louis County offer additional gap coverage. Once in the coverage gap, you’ll pay no more than 25% of the cost for brand-name and generic prescription drugs. If you choose a drug plan that includes coverage in the gap, you may get a discount applied to the drug's price.

What is the most popular plan in St Louis, MO?

The most popular plan by enrollment in St Louis is the AARP Medicare Advantage Plan 1 (HMO-POS) with 75256 enrollment.



Source: CMS. Data as of Oct 1, 2022.
Plans are subject to change as contracts are finalized.
Includes 2023 approved contracts. Employer sponsored 800 series and plans under sanction are excluded. For 2023, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part-D benefit.


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MedicareHelp.org is a privately-owned Non-governmental agency. The government website can be found at HealthCare.gov.

Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options. Enrollment depends on the plan’s contract renewal.

Every year, Medicare evaluates plans based on a 5-star rating system.