Essence Healthcare is an HMO plan with a Medicare contract. Enrollment in Essence Healthcare depends on contract renewal. All Essence Healthcare plan include Part D drug coverage. To enroll in an Essence Healthcare plan, you must have both Medicare Parts A and B and reside in the Missouri counties of Boone, Christian, Greene, Jefferson, St. Francois, St. Charles, St. Louis, St. Louis City, Stone or Taney or in the Illinois counties of Madison, Monroe or St. Clair.
You must continue to pay your Medicare Part B premium. Enrollment in an Essence Healthcare plan may be limited to specific times of the year. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or copayments/co-insurance may change on January 1 of each year. The Formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.
Members must use plan providers except in emergency or urgent care situations. If a member obtains routine care from an out-of-network provider without prior approval from Essence Healthcare, neither Medicare no Essence Healthcare will be responsible for the costs.
Medicare evaluates plans based on a 5-star rating system. Star Ratings are calculated each year and may change from one year to the next.