Medicare

WellFirst Health intends to offer new Medicare coverage in your area. With WellFirst Health, you'll find comprehensive Medicare coverage combined with access to quality care and a strong network of providers. WellFirst Health may be launching later this year in St. Louis city and in a four-county service area in Missouri and Illinois: Madison, St. Clair, St. Charles and St. Louis counties.

All Medicare Advantage Plans offered by WellFirst Health include medical and comprehensive dental coverage. Most plans Include prescription drug coverage, and some cover in-home support and companionship. All plans have added benefits like over-the-counter allowance, hearing, vision, transportation, meal benefit, chiropractic, nurse line, gym membership and wellness rewards.

Are you new to Medicare?

Find out about Medicare eligibility and enrollment periods, as well as the resources available to ensure you know your Medicare coverage options.

Eligibility

You are eligible for Medicare if you are a legal U.S. resident and one of the following applies to you:

•    You are age 65 or older

•    You are any age and have a qualifying permanent disability

•    You are any age and have been diagnosed with end-stage renal disease

Learn about the ABCDs of Medicare

Senior couple holding hands and smiling

Original Medicare

Administered by the federal govenment
Once you decide to join Medicare, you have a few different options. The federal government refers to these Medicare benefits and options as Parts A, B, C and D. No matter which option you choose, the first step is the same: Enroll in Original Medicare, also known as Parts A and B.
 
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Part A

Hospital insurance inpatient care
Hospital room
  • Inpatient acute care
  • Inpatient mental health care
  • Skilled nursing facility care
  • Home health services
  • Inpatient tests and services
  • Other
Senior couple smiling while hiking in woods

Part B

Medical insurance outpatient care
  • Doctor visits (including annual wellness visit)
  • Outpatient services
  • Clinical lab services
  • Some preventive care
  • Durable medical equipment, such as oxygen and wheelchairs
  • Diagnostic tests such as X-rays and MRIs
  • Other
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Additional coverage

Original Medicare doesn't cover everything. Many Medicare recipients choose to buy additional plans from private insurance companies such as WellFirst Health for alternative coverage options and to spend less out-of-pocket.
Senior couple dining outside

Part C

Medicare Advantage
  • Replaces Original Medicare Parts A and B
  • Has an annual maximum out-of-pocket
  • May include Part D coverage (drug prescription)
  • May have additional benefits like dental, vision and more
Senior couple laughing while looking at a tablet outside

Part D

Prescription drug coverage 
  • Covers prescription medications
  • Offered in MAPD Plans (Medicare Advantage with Part D), or can be purchased separately in addition to Original Medicare.

When to sign up for Medicare

Initial Enrollment Period (IEP)

This is the seven-month period in which you can enroll in Medicare for the first time. If you are enrolling for the first time due to disability, your IEP timing is based on your disability date.

Annual Enrollment Period (AEP)

You can make changes to your medical and prescription drug coverage every year from Oct. 15–Dec. 7. Your changes are effective Jan. 1 of the following year.

Open Enrollment Period (OEP)

From Jan. 1 - March 31, if you currently have a Medicare Advantage plan you may switch to another Medicare Advantage plan, or disenroll from your current Medicare Advantage plan and return to Original Medicare.

Special Enrollment Period (SEP)

This is a period when Medicare recipients may change medical and prescription drug coverage outside of AEP, if they meet certain requirements and have a qualifying event, such as moving to a new service area or leaving an employer-based plan.

Questions about your qualifications?

For information about Medicare eligibility and enrollment policies and limitations, visit medicare.gov or call 1-800-MEDICARE (1-800-633-4227).

Medicare Resources


H8019_wellfirstbenefits.com: SSM Health Plan is an HMO/HMO-POS with a Medicare contract. Enrollment in SSM Health Plan depends on contract renewal. SSM Health Plan markets under the name WellFirst Health. You must continue to pay your Medicare Part B premium.