Plan Comparison

*8 a.m. to 8 p.m., seven days a week. You may reach a messaging service on weekends from April 1 to September 30 and holidays. Please leave a message, and your call will be returned the next business day.

Essence Healthcare includes HMO, HMO-POS, and PPO plans with Medicare contracts. Essence Healthcare also includes an HMO D-SNP plan with a contract with Medicare and the state Medicaid program. Enrollment in Essence Healthcare depends on contract renewal. All Essence Healthcare plans include Part D drug coverage.

To enroll in an Essence plan, you must have both Medicare Parts A and B and reside in the plan service area. You must have both Medicare Parts A and B and Missouri Medicaid with QMB or QMB Plus eligibility to enroll in an Essence Healthcare HMO D-SNP plan. You must continue to pay your Medicare Part B premium (unless your Part B premium is paid for you by Medicaid or another third party). Enrollment in an Essence Healthcare plan may be limited to specific times of the year.

Members enrolled in an Essence Healthcare HMO or HMO D-SNP plan must use plan providers except in emergency or urgent care situations. If a member obtains care from an out-of-network provider without prior approval from Essence Healthcare, Essence Healthcare will not be responsible for the costs.

Members enrolled in an Essence Healthcare HMO-POS or PPO plan may see out-of-network providers (non-contracted providers). Out-of-network providers are under no obligation to treat Plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

For accommodations of persons with special needs at meetings, call 1-866-509-5398 (TTY: 711).

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

Benefits, star ratings, and network may vary by plan, contract or market. Please refer to plan documents for additional information or contact Customer Service.