Important Plan Documents

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

Essence Healthcare is an HMO plan with a Medicare contract. 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 medical assistance from the Missouri Medicaid program 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 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, neither Medicare nor Essence Healthcare will be responsible for the costs.

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.