Missouri offers Marketplace plans from seven insurers in 2021. Premiums have decreased, so finding affordable coverage may be easier than ever before.
Missouri Health Insurance Overview
More than 6.1 million people call the Show-Me State home.1 Most residents get health insurance through an employer while one in three gets them through government programs. About 5.7% of the population have Obamacare health insurance through the Marketplace as of 2019.2 The majority of residents with Marketplace coverage get subsidies from the federal government to help offset the cost of coverage. Other residents with low income qualify for Medicaid.
Missouri and the Affordable Care Act
Fewer Missouri residents are uninsured since the Affordable Care Act (or Obamacare) took effect in 2013. The uninsured rate decreased every year until 2018. The rate had a slight uptick to 10% in 2019.3
Missouri is among 14 states that haven’t expanded Medicaid. Under the ACA, states can expand Medicaid to childless, able-bodied adults under 65 who earn up to 138% of the federal poverty level. Missouri currently has 124,000 uninsured residents who could access health insurance if the state extended eligibility for Medicaid.
Missouri’s Marketplace Enrollment
Missouri uses the federal exchange at HealthCare.gov for enrollment in ACA qualified health plans. Sign-up for 2022 plans start on November 1, 2021 and end on January 15, 2022.
More than 215,000 residents signed up for individual and family coverage for the 2021 enrollment season.4
If you miss buying a plan this year, you may be able to shop for 2021 plans if you have a qualifying life event.
Buying Missouri Health Insurance for Individuals, Families, and Self-Employed Entrepreneurs
Obamacare offers private health insurance to individuals, families, and self-employed entrepreneurs with no employees. The latter includes freelancers or independent contractors.
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If you buy an Obamacare plan, insurers can’t deny you coverage due to your health or a preexisting condition. You also get guaranteed coverage that includes essential health benefits, such as maternity care, hospitalization, and free preventive services. If any children enroll, the policy must provide them vision and dental benefits.
Plans are available in four metal levels: bronze, silver, gold, and platinum. Each level covers a percentage of your medical expenses from 60% to 90%. Bronze plans offer the lowest monthly premiums but higher costs when you get care. Platinum plans are the reverse: they have higher premiums but lower costs when you get care.
Health Insurance Costs in Missouri
Missourians who enrolled in 2021 health insurance through the state’s Marketplace paid an average of $479 per month (for a silver plan). This amount dropped from $483 in 2020. Marketplace premiums peaked at $529 a month in 2018.
Before 2021, if you earned between one to four times of the federal poverty level, you were eligible for subsidies to help you pay for any metal plan.
In 2021, the federal government expanded subsidies and removed the income cap for premium tax credits. Instead, you would pay no more than 8.5% of your annual household income on health insurance based on the price of the benchmark plan. The federal government would cover the balance through subsidies.
Important to Know
The average subsidy received in 2019 was $578 per month. (5) You qualify for Obamacare subsidies if you earn between 100% and 400% of the federal poverty level. This ranges from $12,760 to $51,040 per year for a single adult in 2020.
Health Insurance Companies in Missouri
For 2022 coverage, nine Missouri health insurance companies offer individual and family plans:
- Aetna (new)
- Blue Cross and Blue Shield Kansas City
- Celtic Insurance Company
- Cigna Health & Life Insurance Company
- Cox Health Systems Insurance Company
- Healthy Alliance Life Insurance Company
- Medica Insurance Company
- Oscar Insurance Company
- SSM Health Insurance Company (WellFirst Health)
Missouri’s Medicaid Program for Low-Income Adults and Children
Missouri’s Medicaid program, MO HealthNet, enrolled nearly 830,000 people as of September 2021.7 You may qualify for benefits if you earn $17,131 or less as a single adult. The income limit rises by about $6,038 for each additional person in your household.8
MO Health Net offers coverage through two programs: Managed Care and Fee-for-Service. You get comprehensive health benefits, such as hospital care, doctor visits, emergency care, and prescription drug coverage.
Managed Care Program is available to:
- Kids under 19 (provided through MO HealthNet for Kids)
- Pregnant women and newborns
Fee-for-Service Program is available to:
- People with disabilities
- Blind and visually-impaired adults
- Women with breast or cervical cancer
Missouri Medicare Coverage for Seniors and People Under 65 With Disabilities
You may know Medicare as a health insurance program for seniors turning 65. But younger people who collect Social Security Disability Insurance (SSDI) benefits also qualify for it. Among Missouri’s roughly 1 million Medicare enrollees, more than 204,000 are disabled.9
More than 8 out of 10 enrollees in Missouri have Original Medicare, which is the traditional program run by the federal government.10 The rest have private Medicare Advantage plans, which include all the benefits of Original Medicare and often come with prescription drug coverage.
Drug coverage is also available through standalone Part D prescription drug plans, which are often paired with Original Medicare. You may also add a Medicare Supplement (called Medigap) plan to help pay for some or all of your Original Medicare out-of-pocket costs.
Short-Term Health Insurance in Missouri If You’re In Between Jobs or a Coverage Gap
Missouri allows the sale of short-term health insurance plans, but only with coverage for up to six months.
You may consider buying a Missouri short-term health plan if you need basic health coverage temporarily. Losing coverage through a job, spouse, or parents’ health plan are among the reasons why some choose this type of coverage.
Short-term health plans usually cost less than comprehensive health insurance under the Affordable Care Act (ACA). But they have a downside: they don’t have to follow ACA rules to cover preexisting conditions or include essential health plans.
Before you buy a short-term health policy, be sure to ask questions to understand its limitations. You should also compare your Missouri health insurance options to choose the coverage that is right for you.