Essence Advantage Premier Plus (PPO)
Missouri Medicare Advantage Plan (2025 Plan)
Monthly Premium
Additional Coverage
Overall Government Star Rating
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Plan Overview
Essence Advantage Premier Plus (PPO) is a Medicare Advantage Plan With Part D Prescription Drug Coverage, which is available in Missouri and offered by the health insurance company Essence Healthcare. This plan’s network type is PPO which determines in-network doctors who accept the health plan and whether a referral is needed.
Cost Summary
Essence Advantage Premier Plus (PPO) has a monthly premium cost of $247 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $1,000 In and Out-of-network $1,000 In-network. The most common benefit costs which people evaluate when choosing a plan are costs for a primary doctor visit, specialist doctor visit, emergency room visit, and ambulance. These costs are listed in this summary section and a full list of benefit costs for Essence Advantage Premier Plus (PPO) are defined below.
Additional Benefits and Coverage
Essence Advantage Premier Plus (PPO) is a Medicare Advantage plan which does include Medicare Part D Prescription Drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. Essence Advantage Premier Plus (PPO) includes coverage for hearing.
Medicare Advantage health plans can offer even more additional benefits. Essence Advantage Premier Plus (PPO) includes coverage for the following additional benefits:
Other benefits
Plan Benefits and Coverage Details
$1,000 In-network
Medical Benefits
Doctor Services
Out-of-network: $0 copay
Out-of-network: $0 copay
Tests, labs, & imaging
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Hospital Services
Out-of-network: $500 per stay
Out-of-network: $0 copay
Skilled nursing facility
Out-of-network: $0 copay
Preventive services
Out-of-network: $0 copay
Ambulance
Out-of-network: $0 copay
Therapy services
Out-of-network: $0 copay
Out-of-network: $0 copay
Mental health services
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Opioid treatment services
Other services
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Prescription Drug Benefits
Tier drug costs for: Standard retail pharmacy drug cost for 1-month
| Tiers | Initial coverage phase | Gap coverage phase | Catastrophic coverage phase |
|---|---|---|---|
| Preferred Generic | $15.00 copay | $0 copay | |
| Generic | $20.00 copay | $0 copay | |
| Preferred Brand | $47.00 copay | $0 copay | |
| Non-Preferred Drug | 46% coinsurance | $0 copay | |
| Specialty Tier | 25% coinsurance | $0 copay |
Part B Drugs
Out-of-network: 20% coinsurance
Out-of-network: 20% coinsurance
Extra Benefits
Hearing
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Preventive Dental
Comprehensive dental
Vision
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