Instantly view health insurance plans in Missouri from all available companies and easily enroll. We compare Marketplace, non-Obamacare, short-term, and Senior Medicare Supplement, Part D prescription drug and Advantage (MA) plans. Whether you are self-employed, work for a company that offers healthcare benefits, or purchasing medical coverage for the first time, an affordable plan is available.
Missouri utilizes the Federal Marketplace Exchange to provide guaranteed coverage with pre-existing conditions covered for persons under age 65. Non-Obamacare plans are also offered. Senior plans are offered by a variety of small, large, and regional carriers. The standard Open Enrollment period is from October 15 to December 7.
Missouri Under-65 Private Health Insurers
Nine carriers offer on-Exchange and off-Exchange plans. The Marketplace carriers are Anthem (Healthy Alliance Life Insurance), Cigna, Ambetter, Medica, SSM/WellFirst, Oscar, Cox, Aetna, and Blue Cross Blue Shield Of Kansas City. The number of counties served by each company are listed below:
109 -- Ambetter
81 -- Anthem BCBS
80 -- UnitedHealthcare
55 -- Aetna
54 -- Medica
30 -- BCBS Kansas City
13 -- Oscar
7 -- Cox
4 -- SSM/WellFirst
Saint Louis, Saint Louis City, and St. Charles Counties have the most number of available insurers (seven). Six carriers offer coverage in the following counties: Barry, Cass, Christian, Christian, Clay, Clinton, Greene, Jackson, Lawrence, Platte, Warren, and Webster. The Missouri Department of Insurance regularly updates this information.
2024 Missouri Marketplace Plan Requested Rate Changes
Aetna -- 6.09% Increase
BCBS Of Kansas City -- 4.30% Decrease
Celtic -- 4.36% Decrease
Cox Health Systems -- 4.15% Decrease
Healthy Alliance (Anthem BCBS) -- 4.40% Increase
Medica -- 0.19% Decrease
Oscar -- 1.38% Increase
SSM Health -- 18.71% Increase
UnitedHealthcare -- 5.79% Increase
Most Affordable Missouri Health Insurance Plans
Catastrophic Level
Medica Catastrophic -- $30 copay for first three primary care clinic visits. $20 copay for first three retail health clinics. $9,450 deductible with 0% coinsurance and maximum out-of-pocket expenses of $9,450.
Anthem BCBS Catastrophic Pathway X 9450 -- $40 copay for first three primary care physician visits. $9,450 deductible with 0% coinsurance and maximum out-of-pocket expenses of $9,450.
WellFirst Catastrophic Safety Net -- $0 copay for first three primary care physician visits. $9,450 deductible with 0% coinsurance and maximum out-of-pocket expenses of $9,450.
Oscar Secure Plan -- $0 copay for first three primary care physician visits. $9,450 deductible with 0% coinsurance and maximum out-of-pocket expenses of $9,450.
Bronze Level
Aetna CVS Bronze S -- $50 and $100 office visit copays. $75 Urgent Care copay. $7,500 deductible with 50% coinsurance and maximum out-of-pocket expenses of $9,400. $25 generic drug copay ($62.50 mail order). $50 and $100 preferred brand and non-preferred brand drug copays (subject to deductible).
Aetna Bronze 2 HSA -- $6,200 deductible with 50% coinsurance and maximum out-of-pocket expenses of $7,500. HSA-eligible.
Ambetter CMS Standard Bronze -- $9,100 deductible with 0% coinsurance and maximum out-of-pocket expenses of $9,100.
Ambetter Clear Bronze -- $8,600 deductible with 0% coinsurance and maximum out-of-pocket expenses of $8,600. Preferred generic and generic drug copays are $5 and $25 ($12.50 and $62.50 Mail order).
Anthem Bronze Pathway X 9100/0% Standard -- $9,100 deductible with 0% coinsurance and maximum out-of-pocket expenses of $9,100.
Anthem Bronze Pathway X 6500 -- $50 and $85 office visit copays. $75 Urgent Care copay. $6,500 deductible with 40% coinsurance and maximum out-of-pocket expenses of $9,100.
Anthem Bronze Pathway X 0% for HSA -- $7,450 deductible with 0% coinsurance and maximum out-of-pocket expenses of $7,450. HSA-eligible.
BCBS Of Kansas City Choice Bronze 8700 Blue Select EPO -- $8,700 deductible with 50% coinsurance and maximum out-of-pocket expenses of $9,100. Generic drug copay is $50 ($150 mail order). Qualified low-cost generic drug copay is $5 ($15 mail order).
BCBS Of Kansas City Standard Bronze 7500 -- $7,500 deductible with 50% coinsurance and maximum out-of-pocket expenses of $9,000. $50 and $100 office visit copays. $75 Urgent Care copay. $25 generic drug copay ($75 mail order).
Cigna Simple Choice 9100 -- $9,100 deductible with 0% coinsurance and maximum out-of-pocket expenses of $9,100. $0 Telehealth copay.
Cigna Connect 6250 -- $6,250 deductible with 50% coinsurance and maximum out-of-pocket expenses of $9,100. $50 pcp office visit copay and $75 Urgent Care copay. $10 generic drug copay ($25 mail order). $0 Telehealth copay.
Cox Health Plans Bronze Standard -- $9,100 deductible with 0% coinsurance and maximum out-of-pocket expenses of $9,100.
Cox Health Plans Bronze Connect 1 -- $8,000 deductible with 0% coinsurance and maximum out-of-pocket expenses of $8,000. $20 generic drug copay ($50 mail order).
Medica Bronze Value -- $8,000 deductible with 10% coinsurance and maximum out-of-pocket expenses of $8,700.
Medica Bronze Standard -- $9,100 deductible with 0% coinsurance and maximum out-of-pocket expenses of $9,100.
Medica Bronze Copay $0 PCP -- $0 preferred primary care physician copay and $150 specialist visit copay. $0 Urgent Care copay. $7,500 deductible with 50% coinsurance and maximum out-of-pocket expenses of $9,100. Generic and preferred brand drug copays are $25 and $200.
Medica Bronze Share Plus-- $2,500 deductible with 50% coinsurance and maximum out-of-pocket expenses of $9,100. Generic and preferred brand drug copays are $15/$20 and $200.
Oscar Bronze Simple Standard -- $9,100 deductible with 0% coinsurance and maximum out-of-pocket expenses of $9,100. $3 and $30 Tier 1 and Tier 2 drug copays. $75 Urgent Care copay.
WellFirst Bronze Standard 9100X -- $100 copay for first three pcp office visits. $8,650 deductible with 0% coinsurance and maximum out-of-pocket expenses of $8,650.
WellFirst Bronze Copay PCP 8000X -- $30 pcp office visit copay. $8,000 deductible with 20% coinsurance and maximum out-of-pocket expenses of $9,100. $15 preferred generic drug copay.
WellFirst Bronze Value Copay 9050X -- $100 copay for first three pcp office visits. $9,050 deductible with 0% coinsurance and maximum out-of-pocket expenses of $9,050.
UnitedHealthcare Bronze Standard $9,100 Deductible -- $9,100 deductible with 0% coinsurance and maximum out-of-pocket expenses of $9,100.
Silver Level
Aetna Silver $25 Copay -- $25 and $75 office visit copays. $75 Urgent Care copay. $6,000 deductible with 40% coinsurance and maximum out-of-pocket expenses of $8,700. $15 and $50 preferred generic and preferred brand drug copays ($37.50 and $125 mail order).
Ambetter Balanced Care 30 -- $6,100 deductible with 0% coinsurance and maximum out-of-pocket expenses of $6,100.
Ambetter Balanced Care 31 -- $5,450 deductible with 10% coinsurance and maximum out-of-pocket expenses of $6,450. $60 Urgent Care copay.
Anthem Silver Pathway X 6800 -- $45 preferred primary care physician copay. $75 Urgent Care copay. $6,800 deductible with 35% coinsurance and maximum out-of-pocket expenses of $8,700. Generic drug copay is $20 and preferred brand and non-preferred brand drug copay is $60.
Anthem Silver Pathway X 6000 -- $30 preferred primary care physician copay. $75 Urgent Care copay. $6,000 deductible with 25% coinsurance and maximum out-of-pocket expenses of $8,500. Generic drug copay is $20 and preferred brand and non-preferred brand drug copay is $50.
Anthem Silver Pathway X 4500 -- $35 preferred primary care physician copay. $75 Urgent Care copay. $4,500 deductible with 20% coinsurance and maximum out-of-pocket expenses of $7,500. Generic drug copay is $20 and preferred brand and non-preferred brand drug copay is $50.
Cigna Connect 5500 -- $25 and $80 office visit copays. $35 Urgent Care copay. $5,500 deductible with 40% coinsurance and maximum out-of-pocket expenses of $8,700. $3 and $25 preferred generic and generic drug copays ($7.50 and $62.50 mail order).
Cigna Connect 7300 -- $40 and $80 office visit copays. $35 Urgent Care copay. $7,300 deductible with 0% coinsurance and maximum out-of-pocket expenses of $8,700. $0 and $35 preferred generic and generic drug copays ($0 and $87.50 mail order). Preferred brand drug copays are $75 and $225.
Cigna Connect 4500 -- $35 and $80 office visit copays. $35 Urgent Care copay. $4,500 deductible with 50% coinsurance and maximum out-of-pocket expenses of $8,700. $3 and $25 preferred generic and generic drug copays ($7.50 and $62.50 mail order).
Cox Health Plans Silver Connect 9 -- $40 and $75 office visit copays. $100 Urgent Care copay. $7,800 deductible with 30% coinsurance and maximum out-of-pocket expenses of $8,500. $25 and $60 generic and preferred brand drug copays ($62.50 and $150 mail order).
WellFirst HSA-E 4500X01 -- $4,500 deductible with 20% coinsurance and maximum out-of-pocket expenses of $7,000. HSA-eligible.
WellFirst Silver Classic 5000X01 -- $5,000 deductible with 20% coinsurance and maximum out-of-pocket expenses of $8,700. $15 preferred generic drug copay. $50 non-prefrrred generic and preferred brand drug copays.
BCBS Of Kansas City Spira Care BlueSelect 5000 -- $5,000 deductible with maximum out-of-pocket expenses of $6,500. Generic and preferred brand drug copays are $15 and $70 ($37.50 and $175 mail order).
Medica Silver Copay -- $45 and $110 office visit copays. $45 Urgent Care copay. $6,000 deductible with 40% coinsurance and maximum out-of-pocket expenses of $8,550. Generic and preferred brand drug copays are $10 and $120.
Oscar Silver Saver 2 -- $40 office visit copays. $75 Urgent Care copay. $6,200 deductible with 50% coinsurance and maximum out-of-pocket expenses of $8,550. Generic and preferred brand drug copays are $3 and $75 ($7.50 and $187.50 Mail order).
Oscar Silver Classic -- $50 and $80 office visit copays. $75 Urgent Care copay. $5,000 deductible with 50% coinsurance and maximum out-of-pocket expenses of $8,550. Generic and preferred brand drug copays are $3 and $75 ($7.50 and $187.50 Mail order).
Gold Level
Medica Gold Share-- $550 deductible with 35% coinsurance and maximum out-of-pocket expenses of $7,900. Generic and preferred brand drug copays are $30 and $200. Generic and preferred brand drug copays are $5 and $80.
Medica Gold Copay -- $30 and $75 office visit copays. $30 Urgent Care copay. $850 deductible with 30% coinsurance and maximum out-of-pocket expenses of $7,900. Generic and preferred brand drug copays are $5 and $80.
Oscar Gold Classic -- $30 and $55 office visit copays. $75 Urgent Care copay. $2,500 deductible with 30% coinsurance and maximum out-of-pocket expenses of $6,000. $55 copay for lab work. Generic and preferred brand drug copays are $3 and $55 ($7.50 and $137.50 mail order).
Ambetter Secure Care 5 -- $15 and $35 office visit copays. $35 Urgent Care copay. $15 copay for diagnostic tests. $1,450 deductible with 20% coinsurance and maximum out-of-pocket expenses of $6,500. Generic and preferred brand drug copays are $15 and $30 ($37.50 and $75 mail order).
BCBS Of Kansas City Blue KC Community BlueSelect 1250 -- $15 and $40 office visit copays. $40 Urgent Care copay. $15 copay for diagnostic tests. $1,250 deductible with 20% coinsurance and maximum out-of-pocket expenses of $6,250. Generic and preferred brand drug copays are $15 and $70 ($37.50 and $175 mail order).
Cigna Connect 1000 -- $20 and $60 office visit copays. $50 Urgent Care copay. $1,000 deductible with 25% coinsurance and maximum out-of-pocket expenses of $7,000. Generic and preferred brand drug copays are $20 and $50 ($60 and $150 mail order).
Anthem Gold Pathway X 1250 -- $25 preferred primary care physician copay. $75 Urgent Care copay. $1,250 deductible with 15% coinsurance and maximum out-of-pocket expenses of $8,550. Generic drug copay is $10 and preferred brand and non-preferred brand drug copay is $35 ($30 and $105 mail order).
WellFirst Gold Value Copay Plus 3700X -- $25 copay for first three pcp office visits. $3,700 deductible with 0% coinsurance and maximum out-of-pocket expenses of $3,700. $15 preferred generic drug copay.
Non-Obamacare healthcare plans are also offered, although a federal subsidy is not available. The most common options include short-term plans, Christian Ministry plans, and limited-benefit plans.
Missouri Health Insurance Exchange Individual And Family Rates (Monthly)
30 Year-Old With Household Income Of $25,000 Residing In St. Louis County
$53 -- WellFirst Bronze Value Copay 8500X
$57 -- WellFirst Bronze Copay Plus 8500X
$71 -- WellFirst Bronze HSA-E 6850X
$155 -- Cigna Connect 2500-2
35 Year-Old Married Couple With Household Income Of $45,000 Residing In Jackson County
$94 -- Medica Bronze Value
$108 -- Medica Bronze Copay $5 Preferred Primary Care
$117 -- Medica Bronze Share Plus
$295 -- Ambetter Balanced Care 29
45 Year-Old Married Couple And One Child With Household Income Of $68,000 Residing In St. Charles County
$208 -- WellFirst Bronze Value Copay 8500X
$220 -- WellFirst Bronze Copay Plus 8500X
$266 -- WellFirst Bronze HSA-E 6850X
$536 -- Cigna Connect 5000
55 Year-Old Married Couple With Household Income Of $65,000 Residing In Greene County
$0 -- Medica Bronze Value
$0 -- Medica Bronze Copay
$0 -- Medica Bronze Share Plus
$530 -- Medica Silver Copay
60 Year-Old Married Couple With Household Income Of $65,000 Residing In Clay County
$20 -- Medica Bronze Value
$52 -- Medica Bronze Copay
$72 -- Medica Bronze Share Plus
$466 -- Ambetter Balanced Care 29
Missouri Short-Term Health Insurance Rates
Temporary coverage is offered for up to six months, and renewed for up to 36 months. Althopugh policies are widely-available, they are not ACA-compliant. Currently, the following carriers offer short-term plans: Blue Cross Blue Shield Of Kansas City, UnitedHealthcare, National General, Cox, United Security Health And Casualty, Everest, and Companion Life. Monthly rates for several scenarios in Jackson County are listed below:
30-Year-Old Male
$62 -- Everest $10,000 deductible with $1 million maximum benefit
$66 -UnitedHealthcare $10,000 deductible with $2 million maximum benefit
$72 -- Everest $5,000 deductible with $1 million maximum benefit
$84 -- Everest $2,500 deductible with $1 million maximum benefit
$113 -- UnitedHealthcare $2,500 deductible with $2 million maximum benefit
30-Year-Old Married Couple
$111 -- Everest $10,000 deductible with $1 million maximum benefit
$119 -UnitedHealthcare $10,000 deductible with $2 million maximum benefit
$131 -- National General $5,000 deductible with $1 million maximum benefit
$154 -- Everest $2,500 deductible with $1 million maximum benefit
$203 -- UnitedHealthcare $2,500 deductible with $2 million maximum benefit
45-Year-Old Male
$113- UnitedHealthcare $10,000 deductible with $2 million maximum benefit
$114 -National General $10,000 deductible with $1 million maximum benefit
$132 -- National General $5,000 deductible with $1 million maximum benefit
$185 -- Everest $2,500 deductible with $1 million maximum benefit
$193 -- UnitedHealthcare $2,500 deductible with $2 million maximum benefit
45-Year-Old Married Couple
$200- UnitedHealthcare $10,000 deductible with $2 million maximum benefit
$214 -National General $10,000 deductible with $1 million maximum benefit
$248 -- National General $5,000 deductible with $1 million maximum benefit
$332 -- Everest $2,500 deductible with $1 million maximum benefit
$341 -- UnitedHealthcare $2,500 deductible with $2 million maximum benefit
55-Year-Old Female
$162- UnitedHealthcare $10,000 deductible with $2 million maximum benefit
$192 -National General $10,000 deductible with $1 million maximum benefit
$219 -- National General $5,000 deductible with $1 million maximum benefit
$277 -- UnitedHealthcare $2,500 deductible with $2 million maximum benefit
$285 -- Everest $2,500 deductible with $1 million maximum benefit
55-Year-Old Married Couple
$283- UnitedHealthcare $10,000 deductible with $2 million maximum benefit
$371 -National General $10,000 deductible with $1 million maximum benefit
$387 -- UnitedHealthcare $5,000 deductible with $2 million maximum benefit
$484 -- UnitedHealthcare $2,500 deductible with $2 million maximum benefit
$692 -- Everest $2,500 deductible with $1 million maximum benefit
Senior Medicare Plans
State residents are assisted by CLAIM, which is the official state health insurance assistance program (SHIP). Provided benefits are completely free to all qualified persons. Coverage is not bought or sold by SHIP, and counselors do not charge for their services. Enrollment assistance for Part D plans and claim submission for Supplement and Advantage plans are several areas of provided help.
Missouri Medicare Supplement Rates
Monthly prices are based on a 65-year-old female residing in Greene, Lawrence, Howell, Oregon, Camden, Cedar, St. Clair, Hickory, Ozark, Taney, Douglas, Dade, Wright, McDonald, Newton, Sone, Polk, Dallas, or Christian County. Rates can vary, depending on age and county of residence.
Plan A
$93 -- AARP-UnitedHealthcare
$95 -- Anthem BCBS
$115 -- United World Life
$121 -- Humana
$124 -- Aetna
$133 -- SBLI USA Life
$134 -- National Health
$134 -- United American
$136 -- Accendo
$137 -- Medico
$149 -- Manhattan Life
$152 -- Lumico Life
$165 -- Americo
$173 -- Cigna
$193 -- Oxford Life
$198 -- GPM Health
$210 -- Assured Life
Plan B
$132 -- AARP-UnitedHealthcare
$152 -- Aetna
$188 -- Humana
$230 -- United American
Plan C
$186 -- Americo
$189 -- AARP-UnitedHealthcare
$249 -- Humana
$259 -- United American
Plan D
$152 -- Americo
$240 -- United American
Plan F
$162 -- Aetna
$169 -- Accendo
$174 -- AARP-UnitedHealthcare
$178 -- Anthem BCBS
$178 -- National Health
$188 -- Americo
$195 -- Lumico Life
$195 -- Humana
$196 -- Assured Life
$200 -- Cigna
$204 -- Oxford Life
$209 -- Manhattan Life
$240 -- Mutual Of Omaha
$249 -- United American
Plan F (HD)
$42 -- United American
$45 -- Cigna
$45 -- Aetna
$50 -- Mutual Of Omaha
$54 -- National Health
$55 -- Humana
Plan G
$112 -- AARP-UnitedHealthcare
$126 -- Aetna
$126 -- Anthem BCBS
$132 -- Oxford Life
$135 -- Manhattan Life
$137 -- Lumico LIfe
$139 -- National Health
$139 -- Americo
$146 -- Cigna
$149 -- Assured Life
$149 -- Accendo
$149 -- Mutual Of Omaha
$149 -- Humana
$231 -- United American
Plan G (HD)
$44 -- Mutual Of Omaha
Plan N
$98 -- AARP-UnitedHealthcare
$106 -- Accendo
$111 -- Lumico Life
$113 -- Aena
$114 -- Manhattan Life
$114 -- Americo
$116 -- National Health
$121 -- Anthem BCBS
$123 -- Cigna
$123 -- Assured Life
$125 -- Mutual Of Omaha
$126 -- Humana
$129 -- Oxford Health
$145 -- GPM Health
$181 -- Medico
$198 -- United American
Missouri Part D Prescription Drug Plan Rates
AARP MedicareRx Preferred -- $116.40 per month. $0 deductible and 3,624 formulary drugs available. 30-day preferred generic, generic, preferred brand, and non-preferred drug copays are $7, $12, $47, and 40%. 90-day preferred generic, generic, preferred brand, and non-preferred drug copays are $21, $36, $141, and 40%. Plan Summary Star Rating is 3.5. 28, 853 statewide members.
AARP MedicareRx Saver Plus -- $61.80 per month. $505 deductible and 3,170 formulary drugs available. 30-day preferred generic, generic, preferred brand, and non-preferred drug copays are $1, $8, 18%, and 42%. 90-day preferred generic, generic, preferred brand, and non-preferred drug copays are $3, $24, 18%, and 42%. Plan Summary Star Rating is 3.0. 5,491 statewide members.
AARP MedicareRx Walgreens -- $28.30 per month. $350 deductible and 3,251 formulary drugs available. 30-day preferred generic, generic, preferred brand, and non-preferred drug copays are $1, $10, $40, and 45%. 90-day preferred generic, generic, preferred brand, and non-preferred drug copays are $3, $30, $120, and 45%. Plan Summary Star Rating is 3.0. 15,695 statewide members.
Blue MedicareRx Plus -- $55.20 per month. $0 deductible and 3,233 formulary drugs available. 30-day preferred generic, generic, preferred brand, and non-preferred drug copays are $1, $4, $47 and 50%. 90-day preferred generic, generic, preferred brand, and non-preferred drug copays are $3, $12, $141, and 50%. Plan Summary Star Rating is 3.5. 8,243 statewide members.
Blue MedicareRx Value -- $78.40 per month. $505 deductible and 2,925 formulary drugs available. 30-day preferred generic, generic, preferred brand, and non-preferred drug copays are $1, $2, $40 and 40%. 90-day preferred generic, generic, preferred brand, and non-preferred drug copays are $3, $6, $120, and 40%. Plan Summary Star Rating is 3.5. 3,525 statewide members.
Cigna Secure Rx -- $33.90 per month. $505 deductible and 3,168 formulary drugs available. 30-day preferred generic, generic, preferred brand, and non-preferred drug copays are $1, $6, $32 and 48%. 90-day preferred generic, generic, preferred brand, and non-preferred drug copays are $3, $18, $96, and 48%. Plan Summary Star Rating is 3.0. 9,895 statewide members.
Cigna Secure-Essential Rx -- $23.90 per month. $445 deductible and 3,140 formulary drugs available. 30-day preferred generic, generic, preferred brand, and non-preferred drug copays are $0, $2, 18% and 48%. 90-day preferred generic, generic, preferred brand, and non-preferred drug copays are $0, $6, 18%, and 48%. Plan Summary Star Rating is 3.5.
Cigna Secure-Extra Rx -- $50.00 per month. $100 deductible and 3,271 formulary drugs available. 30-day preferred generic, generic, preferred brand, and non-preferred drug copays are $4, $10, $42 and 50%. 90-day preferred generic, generic, preferred brand, and non-preferred drug copays are $12, $30, $126, and 50%. Plan Summary Star Rating is 3.5.
Clear Spring Health Premier Rx -- $13.60 per month. $445 deductible and 3,276 formulary drugs available. 30-day preferred generic, generic, preferred brand, and non-preferred drug copays are $1, $3, $40 and 45%. 90-day preferred generic, generic, preferred brand, and non-preferred drug copays are $3, $9, $120, and 45%.
Clear Spring Health Value Rx -- $27.50 per month. $445 deductible and 3,253 formulary drugs available. 30-day preferred generic, generic, preferred brand, and non-preferred drug copays are $1, $3, $42 and 32%. 90-day preferred generic, generic, preferred brand, and non-preferred drug copays are $3, $9, $126, and 32%.
Elixir RxPlus -- $48.50 per month. $445 deductible and 3,182 formulary drugs available. 30-day preferred generic, generic, preferred brand, and non-preferred drug copays are $1, $7, 15% and 25%. 90-day preferred generic, generic, preferred brand, and non-preferred drug copays are $3, $21, 15%, and 25%. Plan Summary Star Rating is 3.5.
Express Scripts Medicare-Choice -- $73.30 per month. $100 deductible and 3,224 formulary drugs available. 30-day preferred generic, generic, preferred brand, and non-preferred drug copays are $2, $7, $42 and 50%. 90-day preferred generic, generic, preferred brand, and non-preferred drug copays are $6, $21, $126, and 50%. Plan Summary Star Rating is 3.5.
Express Scripts Medicare-Saver -- $21.70 per month. $285 deductible and 3,074 formulary drugs available. 30-day preferred generic, generic, preferred brand, and non-preferred drug copays are $2, $7, $35 and 50%. 90-day preferred generic, generic, preferred brand, and non-preferred drug copays are $6, $21, $105, and 50%. Plan Summary Star Rating is 3.5.
Express Scripts Medicare-Value -- $26.30 per month. $445 deductible and 3,033 formulary drugs available. 30-day preferred generic, generic, preferred brand, and non-preferred drug copays are $1, $3, $32 and 50%. 90-day preferred generic, generic, preferred brand, and non-preferred drug copays are $3, $9, $96, and 50%. Plan Summary Star Rating is 3.5.
Humana Basic Rx -- $28.20 per month. $445 deductible and 3,033 formulary drugs available. 30-day preferred generic, generic, preferred brand, and non-preferred drug copays are $0, $1, 20% and 35%. 90-day preferred generic, generic, preferred brand, and non-preferred drug copays are $0, $3, 20%, and 35%. Plan Summary Star Rating is 3.5.
Humana Premier Rx -- $66.00 per month. $445 deductible and 3,251 formulary drugs available. 30-day preferred generic, generic, preferred brand, and non-preferred drug copays are $1, $4, $45 and 49%. 90-day preferred generic, generic, preferred brand, and non-preferred drug copays are $3, $12, $135, and 49%. Plan Summary Star Rating is 3.5.
Humana Premier Rx -- $66.00 per month. $445 deductible and 3,251 formulary drugs available. 30-day preferred generic, generic, preferred brand, and non-preferred drug copays are $1, $4, $45 and 49%. 90-day preferred generic, generic, preferred brand, and non-preferred drug copays are $3, $12, $135, and 49%. Plan Summary Star Rating is 3.5.
Mutual Of Omaha Rx Plus -- $75.60 per month. $445 deductible and 3,899 formulary drugs available. 30-day preferred generic, generic, preferred brand, and non-preferred drug copays are $0, $2, 20% and 37%. 90-day preferred generic, generic, preferred brand, and non-preferred drug copays are $0, $6, 20%, and n/a. Plan Summary Star Rating is 2.5.
Mutual Of Omaha Rx Premier -- $24.20 per month. $445 deductible and 2,943 formulary drugs available. 30-day preferred generic, generic, preferred brand, and non-preferred drug copays are $0, $2, 23% and 44%. 90-day preferred generic, generic, preferred brand, and non-preferred drug copays are $0, $6, 23%, and n/a. Plan Summary Star Rating is 2.5.
SilverScript Choice -- $26.80 per month. $245 deductible and 3,014 formulary drugs available. 30-day preferred generic, generic, preferred brand, and non-preferred drug copays are $0, $5, $35 and 40%. 90-day preferred generic, generic, preferred brand, and non-preferred drug copays are $0, $15, $105, and 40%. Plan Summary Star Rating is 3.5.
SilverScript Plus -- $57.10 per month. $0 deductible and 3,060 formulary drugs available. 30-day preferred generic, generic, preferred brand, and non-preferred drug copays are $0, $2, $47 and 50%. 90-day preferred generic, generic, preferred brand, and non-preferred drug copays are $0, $0, $120, and 50%. Plan Summary Star Rating is 3.5.
SilverScript Smart Rx -- $7.20 per month. $445 deductible and 3,564 formulary drugs available. 30-day preferred generic, generic, preferred brand, and non-preferred drug copays are $0, $19, $46 and 46%. 90-day preferred generic, generic, preferred brand, and non-preferred drug copays are $0, $57, $138, and 46%. Plan Summary Star Rating is 3.5.
WellCare Classic -- $27.50 per month. $445 deductible and 3,094 formulary drugs available. 30-day preferred generic, generic, preferred brand, and non-preferred drug copays are $0, $1, $30 and 34%. 90-day preferred generic, generic, preferred brand, and non-preferred drug copays are $0, $3, $90, and 34%. Plan Summary Star Rating is 4.0.
WellCare Medicare Rx Saver -- $35.50 per month. $445 deductible and 3,094 formulary drugs available. 30-day preferred generic, generic, preferred brand, and non-preferred drug copays are $0, $5, $38 and 37%. 90-day preferred generic, generic, preferred brand, and non-preferred drug copays are $0, $15, $114, and 37%. Plan Summary Star Rating is 3.5.
WellCare Medicare Rx Select -- $23.30 per month. $330 deductible and 3,466 formulary drugs available. 30-day preferred generic, generic, preferred brand, and non-preferred drug copays are $0, $3, $47 and 42%. 90-day preferred generic, generic, preferred brand, and non-preferred drug copays are $0, $9, $141, and 42%. Plan Summary Star Rating is 3.5.
WellCare Medicare Rx Value Plus -- $73.40 per month. $0 deductible and 3,476 formulary drugs available. 30-day preferred generic, generic, preferred brand, and non-preferred drug copays are $1, $4, $47 and 50%. 90-day preferred generic, generic, preferred brand, and non-preferred drug copays are $3, $12, $141, and 50%. Plan Summary Star Rating is 3.5.
WellCare Value Script -- $15.40 per month. $445 deductible and 3,466 formulary drugs available. 30-day preferred generic, generic, preferred brand, and non-preferred drug copays are $0, $7, $43 and 47%. 90-day preferred generic, generic, preferred brand, and non-preferred drug copays are $0, $21, $129, and 47%. Plan Summary Star Rating is 4.0.
WellCare Wellness Rx -- $15.20 per month. $445 deductible and 3,466 formulary drugs available. 30-day preferred generic, generic, preferred brand, and non-preferred drug copays are $0, $3, $40 and 46%. 90-day preferred generic, generic, preferred brand, and non-preferred drug copays are $0, $9, $120, and 46%. Plan Summary Star Rating is 4.0.
Missouri Medicare Advantage Plans
Medicare Advantage (MA) plans provide Medicare-covered services are available through approved private companies. Drug coverage (Part D) is often included, along with many additional ancillary benefits, such as dental, vision, and hearing. Participating network healthcare providers will need to be utilized. Out-of-network benefits may be covered.
Prices and availability of plans can differ, depending on the policy deductible, out-of-pocket expenses, other benefits, and county of residence. Listed below are popular MA plans that include prescription drug benefits. Additional plans not shown are offered with Part D benefits.
AARP Medicare Advantage Plan 1-- HMO-POS plan with $0 monthly rate, $0 deductible and $2,900 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $0, $12, and $47. Primary care and specialist office visit copays are $0 and $25. Diagnostic tests and lab services copays are $0-$85 and $0. Emergency Room and Urgent Care copays are $90 and $40. Inpatient and outpatient hospital copays are $245 for 8 days and $0-$250. Occupational, physical, and speech and language therapy copays are $20 (authorization needed).
AARP Medicare Advantage Plan 2-- HMO-POS plan with $0 monthly rate, 0 deductible and $3,400 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $0, $10, and $47. Primary care and specialist office visit copays are $0 and $35. Diagnostic tests and lab services copays are $15 and $0. Emergency Room and Urgent Care copays are $90 and $40. Inpatient and outpatient hospital copays are $325 for 8 days and $0-$295. Occupational, physical, and speech and language therapy copays are $20 (authorization needed).
AARP Medicare Advantage Choice -- PPO plan with $29 monthly rate, $0 deductible and $4,400 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $0, $5, and $45. Primary care and specialist office visit copays are $0 and $45. Diagnostic tests and lab services copays are $0. Emergency Room and Urgent Care copays are $90 and $40. Inpatient and outpatient hospital copays are $295 for 6 days and $0-$275. Occupational, physical, and speech and language therapy copays are $40 (authorization needed).
AARP Medicare Advantage Choice Plan 2 -- PPO plan with $0 monthly rate, $0 deductible and $3,900 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $0, $10, and $47. Primary care and specialist office visit copays are $0 and $25. Diagnostic tests and lab services copays are $0. Emergency Room and Urgent Care copays are $90 and $40. Inpatient and outpatient hospital copays are $295 for 6 days and $0-$295. Occupational, physical, and speech and language therapy copays are $25 (authorization needed).
AARP Medicare Advantage Walgreens -- PPO plan with $0 monthly rate, $0 deductible and $3,900 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $0, $10, and $47. Primary care and specialist office visit copays are $0 and $40. Diagnostic tests and lab services copays are $15 and $0. Emergency Room and Urgent Care copays are $90 and $40. Inpatient and outpatient hospital copays are $300 for 5 days and $0-$250. Occupational, physical, and speech and language therapy copays are $40 (authorization needed).
Aetna Medicare Option 1 -- HMO-POS plan with $34 monthly rate, $0 deductible and $6,900 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $0, $0, and $47. Primary care and specialist office visit copays are $5 and $45. Diagnostic tests and lab services copays are $0-$45 and $0. Emergency Room and Urgent Care copays are $90 and $45. Inpatient and outpatient hospital copays are $295 for 5 days and $0-$275. Occupational, physical, and speech and language therapy copays are $40 (referral and authorization needed).
Aetna Medicare Option 2 -- HMO plan with $66 monthly rate, $0 deductible and $4,900 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $0, $0, and $47. Primary care and specialist office visit copays are $0 and $35. Diagnostic tests and lab services copays are $0-$35 and $0. Emergency Room and Urgent Care copays are $90 and $35. Inpatient and outpatient hospital copays are $275 for 5 days and $0-$250. Occupational, physical, and speech and language therapy copays are $30 (authorization needed).
Aetna Medicare Elite -- PPO plan with $0 monthly rate, $0 deductible and $4,500 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $0, $0, and $47. Primary care and specialist office visit copays are $0 and $40. Diagnostic tests and lab services copays are $0-$35 and $0. Emergency Room and Urgent Care copays are $90 and $40. Inpatient and outpatient hospital copays are $325 for 6 days and $0-$250. Occupational, physical, and speech and language therapy copays are $25 (authorization needed).
Aetna Medicare Premier -- PPO plan with $52 monthly rate, $150 deductible and $7,550 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $0, $0, and $47. Primary care and specialist office visit copays are $15 and $45. Diagnostic tests and lab services copays are $0-$45 and $0. Emergency Room and Urgent Care copays are $90 and $45. Inpatient and outpatient hospital copays are $315 for 6 days and $0-$275. Occupational, physical, and speech and language therapy copays are $30 (authorization needed).
Aetna Medicare Premier Plus -- HMO-POS plan with $0 monthly rate, $0 deductible and $3,450 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $0, $0, and $47. Primary care and specialist office visit copays are $0 and $30. Diagnostic tests and lab services copays are $0-$30 and $0. Emergency Room and Urgent Care copays are $120 and $30. Inpatient and outpatient hospital copays are $295 for 6 days and $0-$325. Occupational, physical, and speech and language therapy copays are $40 (referral and authorization needed).
Aetna Medicare Gold Advantage Prime -- HMO plan with $0 monthly rate, $0 deductible and $3,450 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $0, $0, and $47. Primary care and specialist office visit copays are $0 and $35. Diagnostic tests and lab services copays are $0-$35 and $0. Emergency Room and Urgent Care copays are $120 and $35. Inpatient and outpatient hospital copays are $295 for 8 days and $0-$325. Occupational, physical, and speech and language therapy copays are $40 (referral and authorization needed).
Aetna Medicare Gold Advantage Value Prime -- HMO plan with $0 monthly rate, $0 deductible and $3,450 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $0, $0, and $47. Primary care and specialist office visit copays are $0 and $40. Diagnostic tests and lab services copays are $0-$40 and $0. Emergency Room and Urgent Care copays are $120 and $40. Inpatient and outpatient hospital copays are $310 for 8 days and $0-$270. Occupational, physical, and speech and language therapy copays are $40 (referral and authorization needed).
Aetna Medicare Premier Preferred -- HMO plan with $0 monthly rate, $0 deductible and $5,000 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $0, $5, and $47. Primary care and specialist office visit copays are $0 and $40. Diagnostic tests and lab services copays are $0-$40 and $0. Emergency Room and Urgent Care copays are $90 and $40. Inpatient and outpatient hospital copays are $325 for 6 days and $0-$325. Occupational, physical, and speech and language therapy copays are $40 (authorization needed).
Allwell Medicare -- HMO plan with $0 monthly rate, $0 deductible and $3,000 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $0, $5, and $37. Primary care and specialist office visit copays are $0 and $30. Diagnostic tests and lab services copays are $0-$30. Emergency Room and Urgent Care copays are $120 and $45. Inpatient and outpatient hospital copays are $275 for 7 days and $270. Occupational, physical, and speech and language therapy copays are $40 (authorization needed).
Allwell Medicare Boost -- HMO plan with $0 monthly rate, $445 deductible and $7,550 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $0, $9, and $37. Primary care and specialist office visit copays are $5 and $50. Diagnostic tests and lab services copays are $0-$45 and $0-$35. Emergency Room and Urgent Care copays are $90 and $65. Inpatient and outpatient hospital copays are $375 for 5 days and $350. Occupational, physical, and speech and language therapy copays are $40 (authorization needed).
Allwell Medicare Complement -- HMO plan with $23.10 monthly rate, $445 deductible and $3,000 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $2, $8, and $44. Primary care and specialist office visit copays are $0 and $30. Diagnostic tests and lab services copays are $0-$35 and $0. Emergency Room and Urgent Care copays are $90 and $45. Inpatient and outpatient hospital copays are $225 for 6 days and $225. Occupational, physical, and speech and language therapy copays are $40 (authorization needed).
Anthem MediBlue Access -- PPO plan with $39 monthly rate, $0 deductible and $5,000 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $4, $13, and $42. Primary care and specialist office visit copays are $5 and $40. Diagnostic tests and lab services copays are $0-$165 and $0-$20. Emergency Room and Urgent Care copays are $90 and $30. Inpatient and outpatient hospital copays are $295 for 6 days and $0-$270. Occupational, physical, and speech and language therapy copays are $35 (referral and authorization needed).
Anthem MediBlue Plus -- HMO plan with $0 monthly rate, $0 deductible and $3,400 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $0, $15, and $42. Primary care and specialist office visit copays are $0 and $35. Diagnostic tests and lab services copays are $0-$210 and $0-$10. Emergency Room and Urgent Care copays are $120 and $30. Inpatient and outpatient hospital copays are $310 for 8 days and $0-$285. Occupational, physical, and speech and language therapy copays are $40 (referral and authorization needed).
Blue Medicare Advantage Access -- PPO plan with $60 monthly rate, $0 deductible and $5,900 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $0, $5, and $47. Primary care and specialist office visit copays are $5 and $20-$35. Diagnostic tests and lab services copays are $0. Emergency Room and Urgent Care copays are $90 and $50. Inpatient and outpatient hospital copays are $285 for 5 days and $285. Occupational, physical, and speech and language therapy copays are $35.
Blue Medicare Advantage Complete -- HMO plan with $0 monthly rate, $0 deductible and $6,200 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $3, $10, and $47. Primary care and specialist office visit copays are $5 and $20-$45. Diagnostic tests and lab services copays are $0. Emergency Room and Urgent Care copays are $90 and $50. Inpatient and outpatient hospital copays are $325 for 5 days and $325. Occupational, physical, and speech and language therapy copays are $40.
Blue Medicare Advantage Essential -- PPO plan with $0 monthly rate, $0 deductible and $4,000 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $3, $10, and $47. Primary care and specialist office visit copays are $5 and $20-$25. Diagnostic tests and lab services copays are $0. Emergency Room and Urgent Care copays are $90 and $50. Inpatient and outpatient hospital copays are $250 for 5 days and $250. Occupational, physical, and speech and language therapy copays are $25.
Blue Medicare Advantage Plus -- HMO plan with $45 monthly rate, $0 deductible and $5,200 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $0, $5, and $47. Primary care and specialist office visit copays are $5 and $20-$40. Diagnostic tests and lab services copays are $0. Emergency Room and Urgent Care copays are $90 and $40. Inpatient and outpatient hospital copays are $285 for 6 days and $285. Occupational, physical, and speech and language therapy copays are $40.
CoxHealth Medicare Plus -- HMO plan with $0 monthly rate, $0 deductible and $3,200 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $3, $6, and $47. Primary care and specialist office visit copays are $5 and $35. Diagnostic tests and lab services copays are $0-20% and $5. Emergency Room and Urgent Care copays are $120 and $45. Inpatient and outpatient hospital copays are $295 for 6 days and $220 or 20%. Occupational, physical, and speech and language therapy copays are $40 (referral needed).
Essence Advantage -- HMO plan with $0 monthly rate, $0 deductible and $1,900 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $0, $0, and $39. Primary care and specialist office visit copays are $0 and $35. Diagnostic tests and lab services copays are $0-20% and $0. Emergency Room and Urgent Care copays are $120 and $35. Inpatient and outpatient hospital copays are $265 for 7 days and $250 or 20%. Occupational, physical, and speech and language therapy copays are $30 (referral needed).
Essence Advantage Plus -- HMO plan with $73 monthly rate, $0 deductible and $1,700 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $0, $0, and $34. Primary care and specialist office visit copays are $0 and $30. Diagnostic tests and lab services copays are $0-20% and $0. Emergency Room and Urgent Care copays are $120 and $25. Inpatient and outpatient hospital copays are $195 for 6 days and $150 or 20%. Occupational, physical, and speech and language therapy copays are $20 (referral needed).
Essence Advantage Select -- HMO plan with $0 monthly rate, $0 deductible and $2,900 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $0, $0, and $39. Primary care and specialist office visit copays are $0 and $45. Diagnostic tests and lab services copays are $0-20% and $0. Emergency Room and Urgent Care copays are $120 and $35. Inpatient and outpatient hospital copays are $300 for 7 days and $250 or 20%. Occupational, physical, and speech and language therapy copays are $40 (referral needed).
Healthy Blue Essential -- HMO plan with $0 monthly rate, $0 deductible and $3,400 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $0, $15, and $42. Primary care and specialist office visit copays are $0 and $35. Diagnostic tests and lab services copays are $0-$210 and $0-$10. Emergency Room and Urgent Care copays are $120 and $30. Inpatient and outpatient hospital copays are $310 for 8 days and $0-$285. Occupational, physical, and speech and language therapy copays are $40 (referral and authorization needed).
Humana Gold Plus -- HMO plan with $0 monthly rate, $0 deductible and $2,900 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $5, $10, and $47. Primary care and specialist office visit copays are $0 and $35. Diagnostic tests and lab services copays are $0-$35. Emergency Room and Urgent Care copays are $120 and $0-$35. Inpatient and outpatient hospital copays are $245 for 8 days and $35-$245. Occupational, physical, and speech and language therapy copays are $35 (authorization needed).
HumanaChoice -- PPO plan with $78 monthly rate, $195 deductible and $6,700 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $8, $15, and $47. Primary care and specialist office visit copays are $20 and $50. Diagnostic tests and lab services copays are $0-$100 and $0-$35. Emergency Room and Urgent Care copays are $90 and $20-$50. Inpatient and outpatient hospital copays are $360 for 5 days and $40-$360. Occupational, physical, and speech and language therapy copays are $30-$40 (authorization needed).
SSM Health Plan Companion -- HMO plan with $0 monthly rate, $0 deductible and $2,500 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $0, $5, and $40. Primary care and specialist office visit copays are $0 and $35. Diagnostic tests and lab services copays are $0. Emergency Room and Urgent Care copays are $90 and $20-$50. Inpatient and outpatient hospital copays are $325 for 7 days and $0-$275. Occupational, physical, and speech and language therapy copays are $35 (authorization needed).
SSM Health Plan Unity -- HMO plan with $0 monthly rate, $0 deductible and $2,500 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $0, $5, and $40. Primary care and specialist office visit copays are $0 and $35. Diagnostic tests and lab services copays are $0. Emergency Room and Urgent Care copays are $90 and $20-$50. Inpatient and outpatient hospital copays are $325 for 7 days and $0-$275. Occupational, physical, and speech and language therapy copays are $35 (authorization needed).
UnitedHealthcare Medicare Advantage Choice Plan 2 -- Regional PPO plan with $55 monthly rate, $295 deductible and $6,700 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $4, $15, and $47. Primary care and specialist office visit copays are $10 and $50. Diagnostic tests and lab services copays are $20 and $0. Emergency Room and Urgent Care copays are $90 and $30-$40. Inpatient and outpatient hospital copays are $370 for 5 days and $0-$370. Occupational, physical, and speech and language therapy copays are $40 (authorization needed).
UnitedHealthcare Medicare Advantage Choice Plan 3 -- Regional PPO plan with $19 monthly rate, $245 deductible and $6,700 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $4, $15, and $47. Primary care and specialist office visit copays are $0 and $40. Diagnostic tests and lab services copays are $20 and $0. Emergency Room and Urgent Care copays are $90 and $30-$40. Inpatient and outpatient hospital copays are $325 for 5 days and $0-$325. Occupational, physical, and speech and language therapy copays are $40 (authorization needed).
WellCare Compass -- HMO plan with $16.10 monthly rate, $445 deductible and $7,550 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $0, $20, and $47. Primary care and specialist office visit copays are $0 and $30. Diagnostic tests and lab services copays are $0-$20 and $0. Emergency Room and Urgent Care copays are $90 and $30. Inpatient and outpatient hospital copays are $225 for 6 days and $250. Occupational, physical, and speech and language therapy copays are $40 (authorization needed).
WellCare Dividend -- HMO plan with $0 monthly rate, $200 deductible and $7,550 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $0, $15, and $45. Primary care and specialist office visit copays are $5 and $40. Diagnostic tests and lab services copays are $0-$50 and $0. Emergency Room and Urgent Care copays are $90 and $65. Inpatient and outpatient hospital copays are $375 for 5 days and $250. Occupational, physical, and speech and language therapy copays are $35 (authorization needed).
WellCare Premier -- PPO plan with $0 monthly rate, $0 deductible and $5,900 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $0, $0, and $47. Primary care and specialist office visit copays are $0 and $35. Diagnostic tests and lab services copays are $0-$50 and $0. Emergency Room and Urgent Care copays are $90 and $25. Inpatient and outpatient hospital copays are $300 for 5 days and $250. Occupational, physical, and speech and language therapy copays are $35 (authorization needed).
WellCare Value -- HMO plan with $0 monthly rate, $0 deductible and $3,450 maximum out-of-pocket expenses. The preferred generic, generic, and preferred brand prescription drug copays are $0, $7, and $45. Primary care and specialist office visit copays are $0 and $30. Diagnostic tests and lab services copays are $0-$50 and $0. Emergency Room and Urgent Care copays are $120 and $30. Inpatient and outpatient hospital copays are $275 for 5 days and $250. Occupational, physical, and speech and language therapy copays are $35 (authorization needed).