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Missouri Health Insurance Consumer Guide
This guide was created to help you understand the health insurance options available to you and your family in Missouri. An Affordable Care Act (ACA) Marketplace plan is cost-effective for many people.
These plans are also called Obamacare or exchange plans. You can get ACA plans in Missouri on the Marketplace website. The federal government regulates the Marketplace website and lets you shop for health plans from private insurance companies. If you buy a plan on the Marketplace, the government may help pay for it through an advance premium tax credit.
Explore our other comprehensive guides to coverage in Missouri
Dental coverage in Missouri
Get protection from the high costs of dental work. Compare different plan options to find premiums and deductibles that fit your budget.
Missouri’s Medicaid program
In 2021, Missouri adopted the ACA’s Medicaid expansion.1 By April 2023, about 1.5 million people in Missouri were enrolled in Medicaid and CHIP plans.2
Medicare coverage and enrollment in Missouri
As of April 2023, nearly 1.3 million people in Missouri have Medicare coverage.3 Our guide includes details about Medicare Advantage, Medigap, and Medicare Part D plans in Missouri.
Short-term coverage in Missouri
Missourians can get short-term health insurance plans with initial durations up to 12 months with renewals up to three years. As of 2023, there were at least 11 insurers selling short-term health insurance plans in Missouri.
Frequently asked questions about health insurance in Missouri
Who can buy Marketplace health insurance?
You can buy individual and family health insurance from Missouri’s Marketplace if:4
- You live in Missouri.
- You are lawfully present in the U.S.
- You don’t have Medicare.
- You are not incarcerated.
When can I enroll in an ACA-compliant plan in Missouri?
In Missouri, the open enrollment period to sign up for ACA-compliant individual and family health plans is from November 1 to January 15.
- If you enroll by December 15, your coverage starts on January 1.
- If you enroll between December 16 and January 15, your coverage starts February 1.5
Outside of open enrollment, you can still make plan changes or enroll in the Marketplace if you qualify for a special enrollment period (SEP). Most SEPs require a qualifying life event, such as involuntary loss of coverage, marriage, or having a baby.
But there are instances where you don’t need a qualifying life event to apply.6 For example:
- If you’re eligible for premium tax credits and your income is not more than 150% of the poverty level, you can enroll anytime until at least 2025.7
- If you’re a Native American, you can enroll whenever necessary.8
- If you lose Medicaid or CHIP between March 31, 2023 and July 31, 2024, you can enroll through the extended SEP.9
How do I enroll in a Marketplace plan in Missouri?
In Missouri, you have a few options to enroll in a Marketplace health plan:
- Directly through HealthCare.gov – the ACA exchange
- By phone at (800) 318-2596
- By contacting agents, navigators, certified application counselors or an approved enhanced direct enrollment entity.10
- By mailing in a paper application
Many people – like early retirees not yet on Medicare, self-employed people, and those who work for small businesses without health benefits – use the ACA Marketplace.
How can I find affordable health insurance in Missouri?
In Missouri, you can find affordable health plans through the ACA Marketplace’s website: HeathCare.gov.
Under ACA, you may qualify for income-based subsidies called Advance Premium Tax Credits (APTC). These credits lower your premiums.
In 2023, more than 90% of people enrolled in Missouri’s exchange received premium subsidies, saving about $584 per month.Those who received subsidies pay an average monthly premium of $94.11
If your income is less than 250% of the federal poverty level, you may also receive cost-sharing reductions (CSR).12 CSRs reduce your deductibles and out-of-pocket costs.
Missourians may also find affordable coverage through Medicaid if eligible. See our Medicaid guide in Missouri.
Short-term plans are also a low-cost option for people who are not eligible for employer plans, Medicaid, Medicare, or subsidies through the exchange.
Source: CMS.gov 13
How many insurers offer Marketplace coverage in Missouri?
Ten health insurers sell plans on Missouri’s Marketplace in 2023.14 UnitedHealthcare rejoined the Marketplace for 2023 after leaving in 2016.
Here are the insurers offering plans in different areas of Missouri for 2023:
- Aetna
- Blue Cross Blue Shield of Kansas City
- Celtic Insurance Company
- Cigna
- Cox Health Systems Insurance Company
- Healthy Alliance Life Insurance Company (Anthem)
- Medica Insurance Company
- Oscar Insurance Company
- SSM Health Insurance Company
- UnitedHealthcare
Are Marketplace health insurance premiums increasing in Missouri?
Here are the 2024 proposed rate changes per the Missouri Department of Insurance:15
Missouri’s ACA Marketplace Plan 2024 Proposed Rate Increases by Insurance Company |
|
---|---|
Issuer | Percent Increase |
Aetna | 6.09% |
Blue Cross Blue Shield of Kansas City | -4.30% |
Celtic Insurance Company | 4.36% |
Cox Health Systems Insurance Company | -4.15% |
Healthy Alliance Life Insurance Company (Anthem) | 4.40% |
Medica Insurance Company | -0.19% |
Oscar Insurance Company | 1.38% |
SSM Health Insurance Company | 18.71% |
United HealthCare Insurance Company | 5.79% |
Source: HealthCare.gov16
Cigna will not offer individual and family health plans on Missouri’s Marketplace in 2024.
The approved rate increases are for full-price premiums. Since most people on Missouri’s exchange receive premium tax credits, they don’t pay the full price.17 If you qualify for subsidies, your net rate change depends on changes in your plan rates and your subsidy amounts.
How many people are insured through Missouri’s Marketplace?
During the 2023 open enrollment, 257,629 people signed up for private health plans through Missouri’s exchange/Marketplace.18
Usually, when a state expands Medicaid, Marketplace enrollment drops. That’s because people with income between 100 and 138% of the federal poverty level transfer from Marketplace plans to Medicaid. But Missouri’s Marketplace enrollment grew in 2022 and 2023 despite the 2021 Medicaid expansion. This growth is likely because of larger subsidies from the American Rescue Plan and the Inflation Reduction Act. The larger and more accessible subsidies make coverage more affordable.19
Source: 2014,20 2015, 21 2016,22 2017,23 2018,24 2019,25 2020,26 2021,27 2022,28 2023,29 202430
What health insurance resources are available to Missouri residents?
HealthCare.gov
The official federal website where you can sign up for health insurance plans through the ACA Marketplace.
Missouri Department of Insurance
Oversees and regulates health plans, brokers, and agents.
MO HealthNet
Missouri’s Medicaid.
Missouri State Health Insurance Assistance Program (Missouri SHIP)
Helps Missourians with Medicare benefits.
Medicare Rights Center
National resource with a website and call center to provide information and help for people on Medicare.
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org.
Footnotes
- “Missouri Medicaid Expansion Brings Quality Essential Health Coverage to More than 275,000 Missourians” CMS.gov, Oct. 4, 2021 ⤶
- “Total Monthly Medicaid & CHIP Enrollment and Pre-ACA Enrollment“ KFF.org, April 2023 ⤶
- “Medicare Monthly Enrollment” CMS.gov, April 2023 ⤶
- ”A quick guide to the Health Insurance Marketplace” HealthCare.gov ⤶
- “A quick guide to the Health Insurance Marketplace®” HealthCare.gov, Accessed August, 2023 ⤶
- “Who doesn’t need a special enrollment period?“ healthinsurance.org, Accessed August 2023 ⤶
- “An SEP if your income doesn’t exceed 150% of the federal poverty level” healthinsurance.org. Accessed August 2023 ⤶
- “AIAN ACA 2021” CMS.gov, Accessed September 2023 ⤶
- “temp-sep-unwinding-faq.pdf” CMS.gov, Jan. 27, 2023 ⤶
- “Entities Approved to Use Enhanced Direct Enrollment” CMS.gov, April 28, 2023 ⤶
- “2023 Marketplace Open Enrollment Period Public Use Files” CMS.gov, March 2023 ⤶
- “Federal Poverty Level (FPL)” HealthCare.gov, 2023 ⤶
- “2024 Marketplace Open Enrollment Period Public Use Files” CMS.gov, March 2024 ⤶
- “Missouri 2023 Single Risk Pool Final Rates as of 11/1/2022” Missouri Department of Insurance, Accessed September 2023 ⤶
- “Missouri 2024 Single Risk Pool Proposed Rate Filings as of 7/26/2023” Missouri Department of Insurance, insurance.mo.gov, Accessed September 2023 ⤶
- “Missouri Rate Review Submissions” HealthCare.gov, 2023 ⤶
- “Effectuated Enrollment: Early 2023 Snapshot and Full Year 2022 Average” CMS.gov, March 15, 2023. ⤶
- “Marketplace 2023 Open Enrollment Period Report: Final National Snapshot” CMS.gov, January 2023 ⤶
- “Health Insurance Marketplaces 2023 Open Enrollment Report” CMS.gov, Accessed August 2023 ⤶
- “ASPE Issue Brief (2014)” ASPE, 2015 ⤶
- “Health Insurance Marketplaces 2015 Open Enrollment Period: March Enrollment Report”, HHS.gov, 2015 ⤶
- “HEALTH INSURANCE MARKETPLACES 2016 OPEN ENROLLMENT PERIOD: FINAL ENROLLMENT REPORT” HHS.gov, 2016 ⤶
- “2017 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2017 ⤶
- “2018 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2018 ⤶
- “2019 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2019 ⤶
- “2020 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2020 ⤶
- “2021 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2021 ⤶
- “2022 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2022 ⤶
- “Health Insurance Marketplaces 2023 Open Enrollment Report” CMS.gov, 2023 ⤶
- “HEALTH INSURANCE MARKETPLACES 2024 OPEN ENROLLMENT REPORT” CMS.gov, 2024 ⤶