Medicare Advantage Plans St. Louis 2025

Settling on the best Medicare Advantage plan in St. Louis can be perplexing. Are you getting the benefits you need at a price that’s right for you? This article will guide you through the specifics of Medicare Advantage plans in St. Louis, their costs, and the enrollment process, giving you the clarity you need to choose confidently.


Key Takeaways


  • Residents can choose from HMO, PPO, PFFS, and HMO-POS Medicare Advantage Plans, with diverse options like zero-dollar premiums, prescription drug coverage, and tailored plans for specific needs.


Compare Plans in One Step!

Enter Zip Code



Understanding Medicare Advantage in St. Louis


Medicare Advantage Plans St. Louis 2025, Understanding Medicare Advantage in St. Louis


Before we explore further, let’s first comprehend the concept of Medicare Advantage plans. Also known as Medicare Part C, these plans are an alternative to Original Medicare, provided by private companies. They offer the same benefits as Original Medicare Parts A and B, covering everything from hospital stays to doctor visits. But the benefits don’t stop there.

Most Medicare Advantage plans in St. Louis often cover the Original Medicare Part B premium and, if applicable, the Part A premium and may include additional prescription coverage benefits.

Qualifying for Medicare Advantage is straightforward. If you’re enrolled in both Medicare Part A and Part B and live in the coverage area, you’re good to go.

This means Missouri residents, particularly in St. Louis County, have access to a wide range of Medicare Advantage plans to cater to their specific health needs.

So, how does the Medicare Advantage scene unfold in St. Louis County?


St. Louis County Medicare Advantage Landscape

In 2025, a total of 58 Medicare Advantage Plans are available to residents of St. Louis County. Residents can choose from a variety of carriers, including:

  • Humana


  • AARP (UnitedHealthcare)


  • Aetna


  • Anthem


  • Wellcare


  • Cigna


These options allow residents to find a plan that suits their specific healthcare needs.

Quality is paramount when choosing a healthcare plan. That’s why it’s reassuring to know that 55% of the available plans in St. Louis County have earned a high-quality rating of 4 or more stars from CMS.

What about the cost factor? Well, the average monthly premium for Medicare Advantage Plans in St. Louis County is a mere $12.88. Plus, these plans come with an average annual out-of-pocket limit of $4,287 and an average drug plan deductible of $90.29.


Types of Medicare Advantage Plans in St. Louis


Medicare Advantage Plans St. Louis 2025, Types of Medicare Advantage Plans in St. Louis


The residents of St. Louis County have the liberty to choose from four distinct types of the 58 available Medicare Advantage plans:

  • HMO


  • PPO





These plans offer unique benefits and network structures, providing a variety of coverage options to meet different healthcare needs, including out-of-network services.

Take the HMO plans, for example. Medicare Advantage HMO plans by Anthem in Missouri necessitate care within their network for the lowest costs. This suits residents who prefer to use doctors and hospitals within a specific network.

On the other hand, PPO plans typically allow more flexibility, permitting members to access out-of-network care without needing referrals from specialists.

In addition to HMO and PPO, St. Louis residents also have access to PFFS and HMO-POS plans. These plans provide even more coverage options, ensuring residents can find a plan that best fits their lifestyle and healthcare needs.

Top Carriers and Plans in St. Louis County

St. Louis County is home to a competitive market of Medicare Advantage carriers. These include:

  • Aetna


  • Anthem


  • Cigna


  • Humana


  • Molina


  • UnitedHealthcare


Each carrier offers a range of Medicare Advantage plans, as well as other Medicare plans, with varying premiums and out-of-pocket limits. This caters to the diverse healthcare needs and financial situations of beneficiaries.

Different plan types, such as HMO, PPO, and HMO-POS, are offered by these carriers. Each comes with distinctive features like network flexibility and out-of-pocket expense structures.

What’s more, several plans come with the advantage of $0 premiums. This could be advantageous for members seeking to minimize their monthly insurance costs.


Enrollment Process for St. Louis Residents

Medicare Advantage Plans St. Louis 2025, Enrollment Process for St. Louis Residents

How does the enrollment process for a Medicare Advantage plan work for St. Louis residents? Residents can enroll during key enrollment periods. These include the Initial Enrollment Period, the Annual Election Period, and Special Enrollment Periods based on specific life events.

The different enrollment periods for Medicare are:

  • The Initial Enrollment Period: This begins three months before your Medicare eligibility date and extends until three months afterward.



  • The Medicare Advantage Open Enrollment Period: This runs from January 1 to March 31. During this time, existing members can switch plans or revert to Original Medicare.


  • Disability Enrollment Period: Individuals eligible by disability have a seven-month period centered around their 25th month of disability benefits.


Special Enrollment Periods allow for Medicare Advantage plan enrollment changes after specific life events such as moving or losing current coverage.

If such an event occurs, you’ll have a period of two months to join or switch plans from January 1, 2024. For personalized enrollment assistance, St. Louis residents can call 1-833-641-4938 (TTY 711), available from Monday to Sunday between 8 am and 11 pm EST.

Compare plans and enroll online



Speak with a licensed insurance agent

TTY 711

Mon-Fri : 8am-9pm ET

compare medicare advantage plans

Extra Benefits and Coverage Options


Medicare Advantage Plans St. Louis 2025, Extra Benefits and Coverage Options


Medicare Advantage plans in St. Louis offer more than basic healthcare coverage. They extend a variety of additional advantages too. Some plans provide $0 deductibles on medical care and set various limits on maximum out-of-pocket expenses.

For example, Aetna Medicare and Anthem Medicare Advantage plans in Missouri often include added benefits such as Medicare Advantage coverage, which may consist of Medicare coverage components like:

  • Prescription drug coverage


  • Dental, vision, and hearing services


  • Allowances for daily living expenses like utilities, groceries, and over-the-counter health products


Some members even receive the essence advantage among these benefits.

Evaluating your personal needs is a critical step when considering Medicare Advantage plans. Varied options are available concerning:

  • Dental care


  • Vision care


  • Hearing Health


  • Fitness memberships


When comparing Medicare Advantage plans, one should verify whether additional benefits, such as dental care, eyewear, hearing aids, and fitness club memberships, are included.


Special Needs Plans (SNPs) in St. Louis


Medicare Advantage Plans St. Louis 2025, Special Needs Plans (SNPs) in St. Louis


Special Needs Plans (SNPs) provide tailored benefits for individuals with chronic conditions or those who are dual-eligible for Medicare and Medicaid. For instance, Dual Special Needs Plans (D-SNPs) and Chronic Condition SNPs (C-SNPs) offer support for transportation and a dedicated care team.

In St. Louis, individuals can enroll in Chronic Condition Special Needs Plans (C-SNPs), Institutional Special Needs Plans (I-SNPs), and Dual-Eligible Special Needs Plans (D-SNPs).

These plans are designed for qualifying chronic conditions, specialized institutional or nursing care needs, or those with dual eligibility for Medicare and Medicaid.

Members enrolled in Missouri’s SNPs have access to networks of healthcare providers who specialize in treating their specific health conditions. This ensures focused and effective clinical case management.

To maintain their enrollment in an SNP in St. Louis, members are required to continue meeting the plan’s eligibility criteria, which may include specific health conditions or care requirements.

Comparing Medicare Advantage Plans in St. Louis


Medicare Advantage Plans St. Louis 2025, Comparing Medicare Advantage Plans in St. Louis


There are multiple aspects to consider when comparing Medicare Advantage plans in St. Louis. Review benefits like $0 copays for primary care visits and consider bundled coverage options that might cater to individual chronic health conditions or other specific coverage needs.

Assess plan quality and performance by checking the CMS star ratings which reflect the enrollee experience. Also, confirm your preferred healthcare services are covered by considering the in-network hospitals and providers included in the Medicare Advantage plans.

To aid your comparison, utilize tools like’s plan finder to view available plans in St. Louis and make direct plan comparisons. Remember, $0 premium plans may not be available in all areas, so it’s important to research what plans are offered in your specific location.

Consider your current coverage needs including prescription coverage, healthcare providers, and potential out-of-network situations when choosing the best Medicare Advantage plan.

Alternative Options: Medigap and Part D in St. Louis

As Medicare beneficiaries, those with Original Medicare in St. Louis possess the option to augment their coverage by enrolling in a Missouri Medigap plan along with a standalone prescription drug plan (Part D).

Medigap Plan G, for instance, is recommended for its cost-effectiveness in Missouri, providing comprehensive coverage for expenses such as copays and coinsurance, along with benefits like Part A Hospice Care and 80% foreign travel exchange coverage.

The average premium for Medigap Plan G in Missouri is around $204.86. The five cheapest providers have estimated monthly premiums ranging from $157.74 to $177.51.

Medigap Plan F, with an average premium of $257.64, offers the most coverage in Missouri but is available only to those who became eligible for Medicare before 2020; the top 5 cheapest providers have monthly premiums starting from $199.90.

In addition to Medigap plans, Standalone Part D prescription drug plans offer critical coverage for prescription drugs, fulfilling a key component of beneficiaries’ healthcare not covered by Medigap.

Local Resources and Support


Medicare Advantage Plans St. Louis 2025, Local Resources and Support


Though navigating through Medicare Advantage plans can seem complicated, remember that you are not alone in this process. Missouri SHIP provides essential resources and support for St. Louis residents seeking help with Medicare Advantage plans.

As Missouri’s official State Health Insurance Assistance Program, Missouri SHIP provides unbiased and professional counseling to educate residents about Medicare and assist in making informed plan choices.

Certified volunteer counselors, trained through Missouri SHIP, offer local Medicare counseling and Medicaid services across Missouri, ensuring residents have access to free, impartial, and confidential support.

The community also plays a significant role in providing support. Community members can:

  • Become Missouri SHIP volunteers


  • Help neighbors understand Medicare options


  • Receive comprehensive training


  • Make a positive community impact.


In conclusion, St. Louis residents have a wealth of options when it comes to Medicare Advantage plans. From understanding what these plans entail to exploring the diverse types of plans available, the journey is filled with decisions to make.

Whether you’re considering the top carriers and plans in St. Louis County, contemplating the enrollment process, exploring extra benefits and coverage options, or looking into Special Needs Plans, the key is to make informed decisions that best cater to your healthcare needs.

Remember, there are always local resources and support available to help guide you through your healthcare journey.


Frequently Asked Questions


  What is the most highly rated Medicare Advantage plan?

The most highly rated Medicare Advantage plans include Blue Cross Blue Shield, Humana, Aetna, UnitedHealthcare, Cigna, and Anthem. Consider exploring these options for comprehensive coverage.


  Does Missouri have Medicare Advantage plans?

Yes, Missouri offers between 11 and more than 45 Medicare Advantage plan options, depending on health plan service areas, to residents in 2025. This gives individuals the opportunity to choose the plan that best suits their needs.


→  What are Medicare Advantage plans?

Medicare Advantage plans, also known as Medicare Part C, offer an alternative to Original Medicare and are provided by private companies. They provide the same benefits as Original Medicare with the potential for additional benefits.


→  How many Medicare Advantage plans are available in St. Louis County?

There are 58 Medicare Advantage plans available for residents of St. Louis County.


 What types of Medicare Advantage plans are available in St. Louis?

In St. Louis County, you can choose from four distinct plan types: HMO, PPO, Private fee-for-service (PFFS), and HMO-POS. These options provide a variety of coverage and benefits to suit different healthcare needs.

call today for help


 ZRN Health & Financial Services, LLC, a Texas limited liability company

Find & Compare Plans Online 



Speak with a licensed insurance agent

TTY 711

Mon-Fri : 8am-9pm EST

Russell Noga
( Medicare Expert )

Russell Noga is the CEO of ZRN Health & Financial Services, and head content editor of several Medicare insurance online publications. He has over 15 years of experience as a licensed Medicare insurance broker helping Medicare beneficiaries learn about Medicare, Medicare Advantage Plans, Medigap insurance, and Medicare Part D prescription drug plans.