Provider Partners Health Plans
Avg Star Rating
4.5 ★
Compare & Enroll — Part C & Part D
Compare & Enroll in Medicare Plans in 63080, MO
With 82 Medicare Advantage options from 12 insurers, 63080, MO has significantly more plan choices than the national average, suggesting a highly competitive market where insurers often lower premiums to attract members. Approximately 94% of local MA plans charge $0 beyond the standard Part B premium, reflecting strong price competition. With 2 hospitals within 25.0 miles, verifying your preferred hospital is in-network is especially important here. We've organized the CMS data below to help you cross-reference plan costs, quality ratings, and local provider access. Compare plans below, and when you're ready, enroll directly at Medicare.gov.
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🚫 No agents or commissions
✓ Just the data, no sales pitch
Compare Plans at Medicare.gov →
Data freshness: CMS data as of February 2026 •
ACS data as of 2023 •
Reviewed & approved on 2026-02-16
Reviewed by: Wes Ward, Founder & Data Lead •
View our methodology
Important: We are not affiliated with Medicare or any government agency. This site displays publicly available CMS data to help you compare plans. We do not sell insurance or represent any insurance company. For official enrollment and complete plan information, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227).
Important: Plan availability, benefits, and CMS Star Ratings shown here come directly from CMS public files. Plan details can change—always verify with the insurer and at Medicare.gov.
Part C Plans
82
Part D Plans
10
Top MA Star
4.5
Top Drug Star
3.5
Medicare Eligibility in 63080, MO
Approximately 2,494 residents (19.2% of the population) in 63080, MO are 65 or older and likely Medicare-eligible. Whether you're approaching 65, already enrolled, or a caregiver comparing options, the plan data below is organized to help you evaluate Part C (Medicare Advantage) and Part D (prescription drug) coverage side by side.
The median household income in 63080, MO is $65,349 (13.0% below the National Average), which may affect eligibility for Extra Help with Part D drug costs.
Part C: Medicare Advantage Plans
Medicare Advantage (Part C) replaces Original Medicare through private insurers who bundle hospital, medical, and often drug coverage into a single plan. 63080, MO's 82 Medicare Advantage plans are a mix leaning toward HMO networks (52 HMO, 28 PPO). 77 plans offer $0 monthly premiums. The average local star rating is 3.6 out of 5, with the top plan earning 4.5 ★.
Top Medicare Advantage Plans in 63080, MO
We organize CMS plan data into separate leaderboards so you can compare based on what matters most to you. Part C premiums in 63080, MO range from $0 to $191/month. Among rated plans, 32 plans rated 4+ stars.
Highest CMS Star Ratings
Star Ratings are assigned by CMS based on quality measures including customer service, preventive care, and managing chronic conditions.
| Plan Name | Insurer | Star Rating | Premium | Type | |
|---|---|---|---|---|---|
| Essence Advantage Select (HMO) | Essence Healthcare | 4.5 ★ | $0.00/mo | HMO | Enroll |
| Essence Advantage (HMO) | Essence Healthcare | 4.5 ★ | $0.00/mo | HMO | Enroll |
| Uhc Complete Care Mo-1 (PPO C-SNP) | Unitedhealthcare | 4.5 ★ | $0.00/mo | PPO C-SNP | Enroll |
| Humana Value Choice H7617-023 (PPO) | Humana | 4.5 ★ | $0.00/mo | PPO | Enroll |
| Humanachoice Snp-De H7617-006 (PPO D-SNP) | Humana | 4.5 ★ | $0.00/mo | PPO D-SNP | Enroll |
Lowest Monthly Premium
Lower premiums can save money, but check total costs including deductibles, copays, and MOOP.
| Plan Name | Insurer | Monthly Premium | MOOP | Star Rating |
|---|---|---|---|---|
| Aarp Medicare Advantage Essentials From Uhc St-3 (HMO-POS) | Unitedhealthcare | $0.00/mo | $3,200 | 4.0 ★ |
| Aetna Medicare Signature (HMO-POS) | Aetna Medicare | $0.00/mo | $3,400 | 3.5 ★ |
| Aarp Medicare Advantage Extras From Uhc St-4 (HMO-POS) | Unitedhealthcare | $0.00/mo | $3,900 | 4.0 ★ |
| Essence Advantage Select (HMO) | Essence Healthcare | $0.00/mo | $3,900 | 4.5 ★ |
| Uhc Dual Complete Mo-S3 (HMO-POS D-SNP) | Unitedhealthcare | $0.00/mo | $9,250 | 3.5 ★ |
Lowest Maximum Out-of-Pocket (MOOP)
MOOP caps your financial risk. Once you hit this limit, the plan covers 100% of covered services for the rest of the year.
| Plan Name | Insurer | MOOP (In-Network) | Premium | Star Rating |
|---|---|---|---|---|
| Essence Advantage Premier Plus (PPO) | Essence Healthcare | $2,000 | $190.90/mo | 3.5 ★ |
| Healthspring Preferred (HMO) | Healthspring | $2,300 | $0.00/mo | 3.5 ★ |
| Humana Total Complete H4461-046 (HMO) | Humana | $2,700 | $0.00/mo | 4.0 ★ |
| Humana Gold Plus H0028-014 (HMO) | Humana | $2,700 | $0.00/mo | 3.5 ★ |
| Aarp Medicare Advantage From Uhc St-1p (HMO-POS) | Unitedhealthcare | $2,900 | $0.00/mo | 4.0 ★ |
Plan Type Mix in 63080, MO
HMO plans require referrals and in-network care. PPO plans offer more flexibility. SNP (Special Needs Plans) serve specific populations. MAPD plans include drug coverage.
| Plan Type | Count | Percentage | Description |
|---|---|---|---|
| PPO | 18 | 22.0% | No referrals; in and out-of-network |
| HMO-POS | 13 | 15.9% | HMO with some out-of-network options |
| HMO | 12 | 14.6% | Requires referrals; in-network only |
| HMO D-SNP | 11 | 13.4% | Medicare Advantage plan |
| HMO-POS D-SNP | 7 | 8.5% | Medicare Advantage plan |
| HMO I-SNP | 5 | 6.1% | Medicare Advantage plan |
| HMO C-SNP | 4 | 4.9% | Medicare Advantage plan |
| PPO D-SNP | 4 | 4.9% | Medicare Advantage plan |
| Regional PPO | 3 | 3.7% | Medicare Advantage plan |
| Regional PPO C-SNP | 2 | 2.4% | Medicare Advantage plan |
| PFFS | 2 | 2.4% | Private Fee-for-Service |
| PPO C-SNP | 1 | 1.2% | Medicare Advantage plan |
Choosing the Right Medicare Advantage Plan
The best Part C plan depends on your doctors, medications, and budget. Key factors to evaluate:
- Provider network: Verify your doctors and hospitals near 63080, MO are in-network before enrolling
- Total cost: A $0 premium may have higher copays—calculate your annual cost
- Star Ratings: 4+ stars indicate above-average quality and member satisfaction
Read our full guide on choosing Medicare Advantage → · Print our enrollment checklist →
Medicare Glossary: HMO, PPO, MOOP & more →
Medicare Advantage Insurers in 63080, MO
12 insurance companies offer Medicare Advantage plans in 63080, MO. Below, we group plans by insurer so you can compare options from each company. More insurers generally means more competition and better benefits for consumers.
Essence Healthcare
Avg Star Rating
4.1 ★
Plan
Premium
MOOP
Stars
Type
Cox Healthplans
Avg Star Rating
4.0 ★
Plan
Premium
MOOP
Stars
Type
Unitedhealthcare
Avg Star Rating
3.8 ★
Plan
Premium
MOOP
Stars
Type
Humana
Avg Star Rating
3.7 ★
Plan
Premium
MOOP
Stars
Type
Aetna Medicare
Avg Star Rating
3.5 ★
Plan
Premium
MOOP
Stars
Type
Anthem Healthkeepers
Avg Star Rating
3.5 ★
Healthspring
Avg Star Rating
3.4 ★
Plan
Premium
MOOP
Stars
Type
Anthem Blue Cross And Blue Shield
Avg Star Rating
3.0 ★
Plan
Premium
MOOP
Stars
Type
Wellcare
Avg Star Rating
2.7 ★
Plan
Premium
MOOP
Stars
Type
Devoted Health
Avg Star Rating
N/A
Plan
Premium
MOOP
Stars
Type
American Health Advantage Of Missouri
Avg Star Rating
N/A
Plan availability, premiums, and benefits shown are based on CMS data and may change. Always verify current details with the insurer and at Medicare.gov before enrolling.
Part D: Prescription Drug Plans (PDP)
Part D covers prescription drugs through standalone plans for those on Original Medicare, or as part of a Medicare Advantage bundle. Among the 10 standalone Part D plans in 63080, MO, some offer $0 annual deductibles while others charge up to the 2026 maximum of $590. 2 plans are at or below the regional premium benchmark, making them eligible for Low Income Subsidy auto-enrollment. The 2026 $2,000 out-of-pocket cap means drug costs are now more predictable regardless of which plan you choose, but formulary coverage still varies significantly—always verify your medications are covered before enrolling.
Part D Formulary Notice: Each Part D plan has its own formulary (list of covered drugs). The same medication may be on different tiers—or not covered at all—depending on the plan. Always check that your specific medications are covered before enrolling.
2026 Out-of-Pocket Cap: Thanks to the Inflation Reduction Act, your total out-of-pocket drug costs are capped at $2,000 per year in 2026. Once you reach this limit, you pay nothing more for covered Part D drugs for the rest of the year. This eliminates the old "donut hole" coverage gap that previously caused higher costs.
Low Income Subsidy (LIS / Extra Help): If you have limited income and resources, you may qualify for Extra Help paying Part D costs. Visit SSA.gov or call 1-800-MEDICARE.
Top Part D Drug Plans in 63080, MO
We organize Part D plans by CMS Star Ratings, premiums, and deductibles so you can find the best fit for your prescription needs. Part D premiums in 63080, MO range from $10 to $126/month. Remember: all Part D plans now cap your annual out-of-pocket drug costs at $2,000 thanks to the Inflation Reduction Act.
Highest CMS Star Ratings (Part D)
Part D Star Ratings measure drug pricing, customer service, member complaints, and pharmacy access.
| Plan Name | Insurer | Star Rating | Premium | Deductible | |
|---|---|---|---|---|---|
| Wellcare Value Script (PDP) | Wellcare | 3.5 ★ | $9.60/mo | $615 | Enroll |
| Wellcare Classic (PDP) | Wellcare | 3.5 ★ | $10.70/mo | $615 | Enroll |
| Humana Value Rx Plan (PDP) | Humana | 3.0 ★ | $33.70/mo | $601 | Enroll |
| Silverscript Choice (PDP) | Aetna Medicare | 3.0 ★ | $94.90/mo | $615 | Enroll |
| Humana Basic Rx Plan (PDP) | Humana | 3.0 ★ | $16.50/mo | $615 | Enroll |
Lowest Monthly Premium
Lower premiums help with monthly cash flow, but check drug tier costs and the deductible.
| Plan Name | Insurer | Monthly Premium | Drug Deductible | Star Rating |
|---|---|---|---|---|
| Wellcare Value Script (PDP) | Wellcare | $9.60/mo | $615 | 3.5 ★ |
| Wellcare Classic (PDP) | Wellcare | $10.70/mo | $615 | 3.5 ★ |
| Humana Basic Rx Plan (PDP) | Humana | $16.50/mo | $615 | 3.0 ★ |
| Humana Value Rx Plan (PDP) | Humana | $33.70/mo | $601 | 3.0 ★ |
| Healthspring Extra Rx (PDP) | Healthspring | $70.70/mo | $615 | 2.5 ★ |
Lowest Annual Drug Deductible
The deductible is what you pay out-of-pocket before the plan starts covering drug costs. The 2026 maximum Part D deductible is $590. Many plans offer $0 deductible options.
| Plan Name | Insurer | Drug Deductible | Monthly Premium | Star Rating |
|---|---|---|---|---|
| Humana Premier Rx Plan (PDP) | Humana | $0 | $126.40/mo | 3.0 ★ |
| Aarp Medicare Rx Preferred From Uhc (PDP) | Unitedhealthcare | $130 | $125.40/mo | 2.0 ★ |
| Humana Value Rx Plan (PDP) | Humana | $601 | $33.70/mo | 3.0 ★ |
| Wellcare Value Script (PDP) | Wellcare | $615 | $9.60/mo | 3.5 ★ |
| Wellcare Classic (PDP) | Wellcare | $615 | $10.70/mo | 3.5 ★ |
Understanding drug tiers: Part D plans organize medications into 5 cost tiers — Tier 1 (Preferred Generic) is cheapest; Tier 5 (Specialty) is most expensive. Two plans with the same premium can have very different costs for your drugs depending on tier placement. Learn more about drug tiers →
Choosing the Right Part D Drug Plan
The right Part D plan depends on your specific medications. Key factors to evaluate:
- Formulary: Verify your drugs are covered before enrolling
- Preferred pharmacies: Lower copays at certain locations—check your pharmacy is in-network
- Total annual cost: Premium + deductible + copays for your drugs
Read our full guide on choosing Part D →
What is a formulary? See our Medicare Glossary →
Part D Drug Plan Insurers in 63080, MO
5 insurance companies offer standalone Part D drug plans in 63080, MO. Below, we group plans by insurer.
Wellcare
Avg Star Rating
3.5 ★
Humana
Avg Star Rating
3.0 ★
Aetna Medicare
Avg Star Rating
3.0 ★
Plan
Premium
Deductible
Stars
Type
Healthspring
Avg Star Rating
2.5 ★
Unitedhealthcare
Avg Star Rating
2.0 ★
Plan availability, premiums, and benefits shown are based on CMS data and may change. Always verify current details with the insurer and at Medicare.gov before enrolling.
Ready to Enroll in 63080, MO?
Compare plans side-by-side at Medicare.gov or speak with a licensed Medicare specialist.
📋 Print our Medicare Enrollment Checklist — gather your info before you compare.
📅 Enrollment Dates & Deadlines · 🩺 Questions to Ask Your Doctor
Medicare.gov is the official U.S. government site for Medicare. Available 24/7.
Pharmacy Access in 63080, MO
Part D plans have preferred pharmacy networks where you'll pay lower copays. Here's a look at pharmacy options in and around 63080, MO.
Total Pharmacies
4
within 5.0 miles
Chain Pharmacies
3
CVS, Walgreens, etc.
Independent Pharmacies
1
locally owned
| Pharmacy | Address & Phone | Distance | Type |
|---|---|---|---|
| WAL-MART STORES EAST LP | 350 PARK RIDGE RD SULLIVAN, MO 630803334 573-346-5121 | 0.3 mi | Chain |
| MEDLEY PHARMACY, INC | 153 E SPRINGFIELD RD SULLIVAN, MO 630801311 573-346-4777 | 0.3 mi | Independent |
| WALGREEN CO | 6 E SPRINGFIELD RD SULLIVAN, MO 630801310 573-346-6464 | 0.4 mi | Chain |
| MISSOURI CVS PHARMACY LLC | 375 S HIGHWAY 185 SULLIVAN, MO 630801326 401-176-1500 | 0.8 mi | Chain |
| BOURBON DRUGS INC | 386 E PINE ST BOURBON, MO 654417506 573-373-4921 | 6.3 mi | Independent |
| MEDLEY PHARMACY, INC | 124 OLD HIGHWAY 66 BOURBON, MO 654416544 573-388-0885 | 6.4 mi | Independent |
| ST CLAIR REXALL DRUG STORE | 855 N COMMERCIAL AVE SAINT CLAIR, MO 630771118 636-662-0710 | 13.0 mi | Independent |
| KIKO ENTERPRISES, LLC | 920 H ST CLAIR PLAZA DR ST CLAIR, MO 63077 636-662-2022 | 13.6 mi | Independent |
| MEDLEY PHARMACY INC. | 1435 N. MAIN ST. ST. CLAIR, MO 63077 573-343-3440 | 13.9 mi | Independent |
| GERALD PHARMACY INC | 205 S MAIN GERALD, MO 630370049 573-376-2040 | 15.5 mi | Independent |
Pharmacy data from CMS. Network participation varies by plan—always verify with your specific Part D plan.
Local Healthcare Access in 63080, MO
Before choosing a plan, consider the healthcare infrastructure in 63080, MO. Medicare Advantage plans restrict you to in-network hospitals, so understanding local hospital quality helps you pick the right plan — not just the cheapest one.
Note: The facilities below do not indicate which providers are in-network for any specific plan. Always verify network status with your plan before enrolling.
Hospitals Nearby
2
within 25.0 miles
Top-Rated Hospitals near 63080, MO
If hospital access matters to your plan choice, check quality ratings before you enroll. These are the highest CMS-rated hospitals near 63080, MO — click a hospital name to see its full profile and verify it's in your plan's network.
| Hospital | CMS Rating | Distance | Beds |
|---|---|---|---|
| Mercy Hospital Washington | 3 ★ | 24.6 mi | 185 |
| Mercy Hospital Jefferson | 3 ★ | 42.4 mi | 240 |
| Ssm St Clare Health Center | 3 ★ | 42.7 mi | 180 |
| Progress West Hospital | 3 ★ | 43.7 mi | 76 |
| Missouri Baptist Sullivan Hospital | 2 ★ | 1.7 mi | 50 |
| Phelps County Regional Medical Center | 2 ★ | 38.7 mi | 240 |
| Washington County Memorial Hospital | Not Rated | 29.2 mi | 25 |
| Hermann Area District Hospital | Not Rated | 36.3 mi | 25 |
| Parkland Health Center - Bonne Terre | Not Rated | 40.2 mi | 1 |
| Centerpointe Hospital | Not Rated | 43.2 mi | 104 |
View all 2 hospitals near 63080, MO to check quality before you enroll →
Hospital data from CMS Hospital Compare and Provider of Services file. Distance calculated from center of 63080, MO.
Telehealth in 63080, MO: Is Your Internet Ready?
Many Medicare Advantage and some Part D plans now include telehealth benefits, making routine check-ins and prescription refills easier from home. But telehealth requires reliable internet—here's a look at connectivity in 63080, MO. For official guidance on virtual visits, see Telehealth.HHS.gov from the U.S. Department of Health & Human Services.
Check Internet Providers at Your Address
Telehealth works best with reliable internet. Use this tool (provided free by ISP Reports) to see what's available at your address.
Opens ISP Reports in a new tab. This is not a paid relationship. Special thank you to ISP Reports for allowing free use of their address tool.
Internet Coverage in 63080, MO
Fiber Available
26.9%
of households
Cable/DSL Available
97.2%
of households
Top Provider
Sparklight
67.9% coverage
No Broadband
0.9%
of households
Internet coverage data from ISP Reports. View full internet report for 63080, MO.
Medicare-Relevant Demographics in 63080, MO
Understanding 63080, MO's demographics helps contextualize why insurers offer the plans they do. Areas with more seniors and higher incomes tend to attract more insurer competition, while areas with higher Medicaid enrollment may have more Dual-Eligible Special Needs Plans (D-SNP) available.
Total Population
12,991
Population 65+
2,494
19.2% of total
Median Age
43
5.2 years older than the national average
Median Income
$65,349
13.0% below the National Average
On Medicare
2,466
19.0% of residents
On Medicaid
1,768
13.6% of residents
Uninsured
1,470
11.3% of residents
Social Security Recipients
4,990
38.4% of population
Demographic data from U.S. Census Bureau American Community Survey (2023). View full 63080, MO demographics (BestNeighborhood.org).
Local Medicare FAQ: 63080, MO
Common decision points based on 63080, MO's specific plan market and local healthcare landscape.
How does 63080, MO's Medicare Advantage market compare?
63080, MO has 82 Medicare Advantage plans from 12 insurers. This is significantly above the national average of approximately 57 plans per area, indicating a highly competitive local market. More competition typically means lower premiums and better supplemental benefits for beneficiaries. The local mix includes 52 HMO and 28 PPO plans. Plan availability updates annually during the Medicare Annual Enrollment Period (October 15 – December 7).
Should I choose an HMO or PPO Medicare Advantage plan in 63080, MO?
With limited hospital access nearby, a PPO plan (28 available) could be worth the extra cost for out-of-network coverage, especially if you need to travel for specialized care. In 63080, MO, HMO plans dominate the market, which often means more competitive HMO pricing. Always verify your doctors are in-network before enrolling in any plan.
What's the real cost of $0 premium plans in 63080, MO?
77 plans (94% of available options) in 63080, MO charge $0 beyond the standard Part B premium. This high percentage reflects strong insurer competition in the area. However, $0 premium doesn't mean $0 cost. These plans may have higher copays, coinsurance, or out-of-pocket maximums. In 63080, MO, maximum out-of-pocket limits range from $2,000 to an average of $6,173. We recommend calculating your total expected annual cost (premium + copays + drug costs) rather than choosing based on premium alone.
How does the 2026 $2,000 drug cap affect 63080, MO beneficiaries?
The Inflation Reduction Act capped annual out-of-pocket drug spending at $2,000 starting in 2025, eliminating the old "donut hole" coverage gap. This applies to all 10 standalone Part D plans in 63080, MO.
What this means locally:
- Cost predictability — No matter which of the 10 Part D plans you choose, your drug costs are capped at $2,000/year
- $0 deductible options — Some local plans offer $0 deductibles, meaning coverage starts immediately
- Low-income options — 2 plans meet the regional benchmark for Extra Help/LIS eligibility
While the out-of-pocket cap standardizes maximum costs, formulary coverage still varies significantly between plans. A drug that costs $5/month on one plan's formulary might cost $50 on another. Always check that your specific medications are covered and compare tier placement before enrolling.
See all Medicare FAQs in our complete guide → · Enrollment checklist →
Medicare Glossary · Enrollment Dates & Deadlines · Doctor Questions
About the Data & Editorial Team
Wes Ward
Founder & Data Lead
Wes Ward is the founder of InsuranceDataNow.org and reviews all content for data accuracy and methodology compliance.
With 25+ years in data analytics — including work with highly regulated genomic data at Ancestry.com — Wes brings enterprise-level rigor to consumer data tools. He is also a co-founder of BestNeighborhood.org, CrimeGrade.org, and ISPReports.org.
Role: Reviews and approves all content for data accuracy, source verification, and methodology compliance.
Transparency & Disclosures
InsuranceDataNow is an advertising-supported publisher based in South Jordan, Utah. We are not affiliated with or endorsed by Medicare or the U.S. government.
TPMO Disclaimer: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (24 hours a day/7 days a week) to get information on all of your options.
Sources
- CMS Medicare Plan Finder Data (Part C & D): cms.gov
- CMS Provider Directory: Hospital and pharmacy data from data.cms.gov
- American Community Survey: Demographic data from census.gov
- FCC Broadband Map: Internet availability data from broadbandmap.fcc.gov
- ISP Reports: Internet provider coverage for 63080, MO from ispreports.org
- Telehealth.HHS.gov: Official telehealth guidance from U.S. Dept. of Health & Human Services
- BestNeighborhood.org: Community demographic profiles for 63080, MO from bestneighborhood.org
All data is sourced from official government databases and trusted third-party providers. Data is updated regularly—see page header for last refresh dates.