How to find the Best Medicare Insurance Brokers in Missouri

Finding a Medicare plan for you can be confusing and time-consuming, and choosing the wrong Medicare plan while dealing with unexpected health complications can be costly.

If you live in Missouri and need help finding the best licensed Medicare insurance agent? You can use the Certified Medicare Agent Directory website. The website will provide a local expert Medicare insurance agent who can help you understand your choice of plans and products available. 

On the home page, click the drop-down menu and select the state of Missouri. Click Search Now, and you’ll get your online result.

Why choose the Certified Medicare Agent Directory over other websites?

If you click “Find Professionals” and enter your state, you will find licensed and certified insurance agents. You can also check their login information and see their reviews. You get to know the agent a little before asking for help. 

Unlike other websites, you control who calls you, and multiple agents won’t contact you. It is our priority to ensure you can control who contacts you when you use the “Find Professionals” button. 

All About Medicare

Did you know that Missouri was at the forefront of creating the Medicare program?

Medicare was signed into law on July 30, 1965, by President Lyndon B. Johnson in Independence, Missouri. The first person to sign up in Missouri was Harry S. Truman.

Medicare is the most extensive senior insurance program in the U.S. The CMS, or the Centers for Medicare and Medicaid Services, is the federal agency that runs Medicare. It is funded partly by Social Security and Medicare Taxes you pay on your income (Partly through premiums that people with Medicare pay) and partly by the federal budget.

The original Medicare program consists of two parts. They are the Medicare Parts A and B. You will sign up for these two parts at the Social Security Office or Railroad Retirement Board. At the same time, private insurance companies offer Medicare Parts C and D.

The Four Parts of Medicare

Let’s take a closer look at the four parts of Medicare and its function.

• Medicare Part A: It is known as hospital insurance. It includes medical services such as inpatient hospitalizations, care at qualified Nursing facilities (SNSF), blood, home health care, and Hospice care. Most people pay it while they work, so there’s no monthly cost. 

Suppose you are aged 65 and already enrolled in Medicare Part A. In that case, you’ll be automatically enrolled in Medicare Parts A and B. However, you can waive this enrollment.

• Medicare Part B: helps pay for doctor services, outpatient hospital care, medical supplies, and other medical services that Medicare Part A doesn’t cover, like outpatient services provided by physical, occupational, and speech therapists, as well as some home health services. Part B also covers outpatient Mental Health care. It may even cover comprehensive dialysis care for people with kidney failure. 

Medicare beneficiaries pay a monthly premium. Most people in 2023 will pay $164.90 per month (a decrease from 2022 premiums of $170.10 per month).

But some will pay more. If you are a high-income earner, you could be subject to IRMAA and increase your premium. 

• Medicare Part C: It is also known as Medicare Advantage. Part C is an alternative to Original Medicare (since this plan covers Parts A and B and sometimes Part D, depending on the program). Private insurance companies contracted by Medicare offer Medicare Part C plans. Medicare Advantage plans can also include hearing & vision benefits, dentistry and fitness programs, meals after surgery, and more. 

Plans may apply different premiums, deductibles, and coinsurance than those under Original Medicare. The cost of a Medicare Advantage plan varies depending on geographic location and type of plan. Many of these plans don’t have monthly premiums. Instead, the Medicare program pays insurance companies a capitated fee. 

• Medicare Part D: The federal government created Prescription Drug Plan to reduce the Retail costs of prescription drugs. Each Part D plan includes a list of covered drugs, known as the drug formulary. 

If you enroll in Medicare Advantage Plan, you must still pay your Part B premium. The monthly premium for Medicare Part D varies by plan. If you have a higher income, you can spend more because of IRMAA. 

Medicare Advantage (Medicare Part C)

Common types of Medicare Advantage plans:

• Health Maintenance Organization (HMO): HMO plans use a network of providers. You usually need care and services from doctors, other health care providers, and hospitals in the plan’s network. For your insurance to pay for a doctor’s visit or different health care needs, you must use approved providers or organizations within your network. Exceptions include Emergency care, Out-of-area urgent care, and Temporary out-of-area dialysis. You’ll most likely need to get a referral to see a specialist. 

Remember that it is best to ensure that your favorite doctor is included in the network. You’ll also need to review your plan’s benefits to see if your drugs are covered. 

You can choose another in-network doctor if your doctor or other health care provider leaves the plan.

• Preferred Provider Organization (PPO): You can generally use in-network and out-of-network providers for care, including hospitalizations. You pay less when you go to doctors, hospitals, and other health care providers who are part of the plan’s network. You may incur copayments, higher coinsurance costs, and higher out-of-pocket costs if you go out of network.

• Private Fee-for-Service (PFFS): The plan determines how much to pay doctors, other health care providers, and hospitals and how much you will have to pay if you receive treatment. 

Suppose you Join a PFFS plan that has a network of contracted providers. You can also see all the providers in the network who have agreed always to treat plan members. The program does not require you to see only in-network health care providers.

However, your provider can decide not to accept the plan at any time, so each time you see a doctor, you’ll need to be sure they accept the program.

PFFS plans may cover Prescription drugs. Suppose your PFFS plan doesn’t offer drug coverage. You can enroll in a Medicare Drug plan (Part D) to get insurance coverage. 

• Special Needs Plans (SNP): Special needs plans are for people with unique situations or special health needs, such as Diabetes, end-stage renal disease, HIV/AIDS, chronic heart failure, and dementia. Medicare SNPs tailor their services, provider selection, and drug formularies to your specific needs. Special needs plans also offer prescription drug coverage from Medicare, which focuses on drugs used by people with the disease. 

This group of people is eligible to enroll in SNP:

1. People who live in specific facilities (such as RCFE communities or nursing homes).
2. Duo Eligibles:  People eligible for both Medicare and Medicaid.
3. People with certain chronic or disabling conditions (such as diabetes, end-stage renal disease (ESRD), HIV/AIDS, chronic heart failure, or dementia).

Plans can further restrict membership to a single chronic condition or related chronic diseases. 

• HMO-POS (Point-of-Sale): It offers the same features as an HMO plan, but the difference is that HMO-POS allows you to get some services out-of-network to take advantage of some or all of their services. For a higher copayment or coinsurance.

• Medical Savings Account (MSA): It is similar to HSAs (Health Savings Accounts). It allows eligible individuals to deposit pre-tax dollars into a savings account. MSA will be used to cover health care costs. 

Prescription Drug Plan (Part D)

A prescription drug plan can be added to Original Medicare (parts A and B) or purchased as part of a Medicare Advantage plan (part C). You should consider Medicare drug coverage even if you’re not taking prescription drugs. You will likely pay a late enrollment penalty if you decide not to get it when you’re first eligible. The late enrollment penalty is 1% for every MONTH you did not have a creditable drug plan. It is NOT a one-time penalty.

Each plan has a formulary: the plan’s list of covered drugs. These plans typically classify drugs at different tiers on the formulary. Different levels have different costs. (The lower the level, the lower the costs.) 

Medigap (Medicare Supplement Insurance)

Medigap is a Medicare supplement insurance that helps fill the “gaps” in original Medicare and is sold by private companies. (Medigap) can help pay for the remaining health care costs, such as copayments, coinsurance, and deductibles. Medigap plans also offer coverage for services that Original Medicare doesn’t cover, such as medical care when traveling outside the USA. 

Medicare Supplement Plans Options:

• Plan F: The benefits of Plan F and Medigap Plan G are almost the same, except for the Medicare Part B deductible. If you started Medicare on 1/1/2020 or later, you cannot purchase a Plan F. But suppose you began Medicare before that date. In that case, you can still get Plan F.  This plan did not have any deductibles, coinsurance, or copays.

• Plan G is the best Medigap plan for eligible new participants. After you pay the Part B deductible (which is $226, a decrease from the $233 deductible in 2022), Plan G covers

1. Medicare Part A hospital and coinsurance up to an additional 365 days after Medicare benefits expire.
2. Medicare Part B coinsurance or copayment
3. Part A hospice care coinsurance or copayment
4. First three pints of blood
5.  Medicare Part A deductible
6. Medicare Part B excess charges
7. Foreign Travel emergency coverage (80%, up to plan limits)

•  Plan N: Medigap Plan N typically costs less than plans F and G and offers higher benefits than plans A, B, K, L, and M. Plan N doesn’t have a copay if you go to the hospital. 

In addition, it covers the cost of blood. For hospice care, there are no other payments or coinsurance. There is also no copay or coinsurance for qualified nursing. For Plan N:

1. You’ll pay the Part B deductible.
2. You pay $50 if you need emergency care and are not immediately hospitalized. 
3. Pay a $20 copay to see a medical provider, such as a doctor.
4. You’ll pay any excess doctor charges for doctors that don’t accept “Medicare Assignment.”

Insurance plans that aren’t Medigap

• Medicare Advantage Plans (like an HMO, PPO, or Private Fee-for-Service Plan)
• Medicare Prescription Drug Plans
• Medicaid
• Employer or union plans, including the Federal Employees Health Benefits Program (FEHBP)
• Veterans’ benefits
• Long-term care insurance policies
• Indian Health Service, Tribal, and Urban Indian Health plans

Source: Medicare.gov

How To Enroll In Medicare

For some people, enrollment in Medicare is automatic, while for others, it may depend on when and how eligible they are. The following are the ways to enroll in Medicare Part A and Part B. 

• You can enroll by calling the Social Security National 800 number (1-800-772-1213) Monday through Friday between 8:00 a.m. and 7:00 p.m. 
• Enroll online at www.socialsecurity.gov.
• You can also enroll by visiting your local Social Security office.

If you worked on a railroad, sign up for Medicare by contacting the Railroad Retirement Board (RRB) at 1-877-772-5772 (TTY user 1-312-751-4701). They are open Monday through Friday from 9:00 a.m. to 3:30 p.m. to speak with a representative of the RRB. 

What are the types of Medicare agents or brokers?

• Captive agent: A captive agent only works for one insurance company. The insurance company offers training, leads, and support to their Medicare agent staff. A company-owned agent cannot offer rates from other providers. The broker only has to talk to potential clients (potential customers), explain the insurance company’s programs, and sell them to you.

• Independent agent: Independent agents and brokers represent more than one company. Suppose you Work with an independent Medicare insurance agent. You can choose from various policies from their expansive portfolio of plans. They are more qualified to find the plan that fits your needs. 

Why work with an independent Medicare agent?

An Independent Medicare agent’s responsibility will help narrow down your options when applying for insurance. They desire unparalleled service to ensure individuals receive financial and healthcare security. They will also offer options and solutions to help you achieve your goals within your budget. Working with an independent agent will also help you avoid choosing the wrong plan.

Salespeople in large companies usually have to meet a monthly or annual quota. When you cancel your plan a month later, that agent doesn’t care. But it matters with independent Medicare representatives because they work for YOU! 

Things to consider when choosing a broker

• Check the license status with your state’s insurance department to ensure you’re dealing with an approved broker. 
• Choose a representative or broker with excellent customer service.
• Choose a broker with solid experience in selling Medicare plans in your state. A knowledgeable Medicare representative can help you choose the right Medicare plan. 

Do I need a Medicare representative near me? 

An agent from another state provides the same service. As long as a Medicare agent is licensed to sell Medicare in their state, you don’t have to work with a local representative. However, sometimes it’s nice to have someone who knows your area.

Medicare Agents in Missouri

Missouri residents can find the nearest team of Medicare agents using the Certified Medicare Agent Directory website. Find the representative of your choice and contact them to schedule a free consultation. 

Originally Published on https://www.certifiedmedicareagents.com/blog/

Katherine Kline Podcaster, Blogger

I host the Rock Your Retirement Show, which is about Lifestyle, not money or insurance! I started the show in 2016 before anyone knew what a podcast was, and now it's had over one million downloads. At this point, there is a lot of information in our back catalog and we try to release an episode every month.

I'm a retired Financial Advisor (after 25 years) and now I try to have fun with my husband, my dog, and my friends.

I'm also the founder of CertifiedMedicareAgents.com, a site that brings insurance agents together with people who are looking for help with Medicare.