Provider Partners Missouri Essential Plan (HMO I-SNP)

Provider Partners Missouri Essential Plan (HMO I-SNP) is a HMO I-SNP plan offered by Rifkin Managed Care Holding, LLC available for enrollment in 2025 to people living in Select Missouri Counties. This plan received an overall rating of 4.5 out of 5 stars in 2026.

It's important to know that Provider Partners Missouri Essential Plan (HMO I-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.

Key Plan Facts

Below are a few key facts and commonly-asked questions about Provider Partners Missouri Essential Plan (HMO I-SNP).

Plan Costs:

The cost of a Medicare Advantage Plan is made up of four main parts.

• First, the monthly premium — the amount you pay every month.
• Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
• Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
• Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.

You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.

Common Services:

Drug Coverage

The Provider Partners Missouri Essential Plan (HMO I-SNP) features an annual prescription drug deductible of $615. Before the plan begins to pay its share for your covered medications, you must meet this yearly deductible amount. Knowing this upfront cost is essential for estimating your total out-of-pocket prescription expenses on this Medicare Advantage plan. Specific drug coverage tier details, including individual copayment and coinsurance amounts for different formulary tiers, are currently unavailable for this plan. To understand your exact medication costs, you should review the plan's comprehensive formulary or contact the provider directly. This ensures you can verify if your specific prescriptions are covered and what you will pay after meeting the deductible.

Additional Benefits

The Provider Partners Missouri Essential Plan (HMO I-SNP) offers comprehensive medical coverage featuring no copays for primary care, specialist visits, outpatient care, and emergency services, which typically require a 20% coinsurance. Inpatient hospital stays and home health services are covered with no copay and no coinsurance, though Medicare-defined cost sharing or prior authorizations may apply. Additionally, ground and air ambulance services and medical equipment are covered with no copay and a 20% coinsurance. For supplemental care, the plan provides generous allowances with no copays or coinsurance, including up to $3,000 annually for dental services and a $300 annual limit for eyewear. Beneficiaries also receive up to $2,000 every two years for prescription hearing aids and a $170 quarterly allowance for over-the-counter items with no copay or coinsurance. Routine transportation is also covered with no copay and no coinsurance for up to 42 one-way trips per year.