In 2003, a group of St. Louis-area doctors grew frustrated with big insurance companies making it difficult for them to care for patients. They realized that in order to provide the high-quality care people with Medicare needed and deserved, something had to change. Instead of trying to transform those large insurance corporations, they decided to form their own unique health plan based on the simple, preschool-level concept of sharing. By working collaboratively and sharing information freely with the doctors and health systems in its network, Essence was able to help ensure that every patient received the right care, in the right setting, at the right cost. By collaborating and partnering with doctors, something remarkable happened: the quality of care members received improved while the cost of care actually decreased. Those savings enabled Essence to consistently offer generous benefits to its members and become a leading Medicare plan in the market.
Years later, Essence continues to spearhead this model, working side by side with its close-knit team of physicians and hospitals, and rewarding them for helping members manage chronic conditions, get well, and most importantly, stay that way. For Essence members, this means that our plans are designed to keep you healthy and active. That’s why you’ll find comprehensive hospital, medical and prescription drug coverage — as well as valuable extra benefits like dental and fitness — as part of our affordable all-in-one plans. It’s all part of a our truly unique approach to health insurance that has always been, and always will be, based on an unwavering commitment to protecting the health and wellness of our friends and neighbors with Medicare in the communities we serve. It’s that approach and dedication that has helped Essence Healthcare earn the trust of over 60,000 members in Missouri and Southern Illinois, as well as national recognition as a leader in the positive transformation of our country’s healthcare system.
Essence Healthcare is an HMO plan with a Medicare contract. Enrollment in Essence Healthcare depends on contract renewal. All Essence plans include Part D drug coverage. To enroll, you must have both Medicare Parts A and B and reside in the Missouri counties of Boone, Jefferson, St. Charles, St. Louis or St. Louis City, or in the Illinois counties of Madison, Monroe or St. Clair.
You must continue to pay your Medicare Part B premium. Please note that enrollment is limited to specific times of the year. This information is not a complete description of benefits. Call 1-866-509-5398 (TTY: 711) for more information. 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, neither Medicare nor Essence will be responsible for the costs.
For accommodations of persons with special needs at meetings call 1-866-509-5398 (TTY: 711).
Medicare beneficiaries may also enroll in Essence Healthcare through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov.
Essence Healthcare complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-866-597-9560 (TTY: 711).
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