State of Missouri Health Insurance Exchange Options and Enrollment

The State of Missouri Health Insurance Exchange offers several options for individuals and families to purchase health insurance. You can enroll in a plan through the exchange during the annual Open Enrollment Period, which typically runs from November to December.

There are four metal levels to choose from: Bronze, Silver, Gold, and Platinum. Bronze plans have the lowest premiums but the highest out-of-pocket costs, while Platinum plans have the highest premiums but the lowest out-of-pocket costs.

The exchange also offers a Catastrophic plan, which is designed for people under 30 or those who are exempt from the Affordable Care Act's requirement to have health insurance.

You can enroll in a plan through the exchange if you're a Missouri resident, even if you have a pre-existing condition.

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The state of Missouri offers various health insurance options through its exchange.

You can enroll in a private health insurance plan through the exchange, which is available to individuals and families who do not have access to employer-sponsored coverage.

The exchange also offers Medicaid and CHIP (Children's Health Insurance Program) coverage to eligible residents.

Missouri's exchange has a network of over 200 health insurance carriers, providing a wide range of plan options.

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Hoping to improve your smile? Dental insurance may be a smart addition to your health coverage.

In Missouri, you can find affordable dental coverage by adding a dental plan to your existing health insurance.

If you're not eligible for employer plans, Medicaid, Medicare, or subsidies through the exchange, short-term plans are a low-cost option for people who want dental coverage.

However, short-term plans issued starting in September 2024 have new federal rules limiting initial terms to no more than three months, and total duration are capped at four months, including renewals.

But don't worry, there are other affordable options for dental coverage.

Our guide explores dental coverage options in Missouri, so be sure to check it out for more information.

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Short-term health plans offer temporary coverage for those without comprehensive insurance. This type of plan is available in Missouri.

These plans provide essential health insurance for a short period of time, usually up to a year. They can be a good option for people who are between jobs or have a gap in their coverage.

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Short-term plans often have lower premiums compared to traditional health insurance. However, they typically don't offer the same level of coverage and may have higher out-of-pocket costs.

It's essential to carefully review the terms and conditions of a short-term plan before purchasing it. Some plans may have exclusions or limitations that could leave you with unexpected medical expenses.

Medicare coverage and enrollment in Missouri can be a bit complex, but our guide can help you navigate the process.

You can use Medicare to cover healthcare costs if you're 65 or older, or if you have a disability.

Missouri has specific regulations regarding Medicare supplement (Medigap) coverage, so it's essential to understand what's available.

Medicare Advantage plans can be a great option for those who want to combine their Medicare coverage with other health insurance benefits.

Medigap plans can help fill the gaps in your Medicare coverage, but it's crucial to choose a plan that meets Missouri's regulations.

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You can enroll in an ACA-compliant plan in Missouri during the open enrollment period, which runs from November 1 to January 15.

If you enroll by December 15, your coverage starts on January 1, but if you enroll between December 16 and January 15, your coverage will start February 1.

You can also make plan changes or enroll in the Marketplace if you qualify for a special enrollment period (SEP), which often requires a qualifying life event like losing your job or having a baby.

However, there are exceptions where you don't need a qualifying life event to apply, such as if you're eligible for premium tax credits and your income is not more than 150% of the poverty level, or if you're an Alaska Native or American Indian.

To enroll in a Marketplace plan, you can choose from several options, including directly through HealthCare.gov, by phone, or by contacting agents or navigators.

You can also enroll in a plan that meets the ACA definition of a Qualified Health Plan (QHP), which will offer essential health benefits at four metal levels: Bronze, Silver, Gold, and Platinum.

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You can enroll in an ACA-compliant plan in Missouri during the open enrollment period, which runs from November 1 to January 15. If you enroll by December 15, your coverage starts on January 1.

If you miss the December 15 deadline, you can still enroll between December 16 and January 15, but your coverage will start on February 1.

There are also special enrollment periods (SEPs) available outside of open enrollment, which allow you to make plan changes or enroll in the Marketplace if you qualify for a qualifying life event, such as involuntary loss of coverage, marriage, or having a baby.

You don't need a qualifying life event to apply if you're eligible for premium tax credits and your income is not more than 150% of the poverty level, or if you're an Alaska Native or American Indian. You can enroll anytime in these cases.

Here are the key dates to keep in mind:

In recent years, enrollment in health insurance plans has seen a significant surge, with a 25% increase in the past year alone.

This growth can be attributed to the Affordable Care Act, which made health insurance more accessible and affordable for millions of Americans.

The majority of new enrollees are young adults between the ages of 18 and 34, with a 30% increase in this demographic.

Many of these young adults are taking advantage of the law's provision allowing them to stay on their parents' plan until age 26.

As a result, the average age of new enrollees has decreased, with 45% of new enrollees under the age of 30.

Enrollment numbers are expected to continue to rise, with projections showing a 10% increase in the next year.

This growth is not limited to individual plans, with a 15% increase in small business enrollment as well.

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Missouri residents can find affordable health insurance through the ACA Marketplace's website, HeathCare.gov, where they may qualify for income-based subsidies called Advance Premium Tax Credits (APTC).

These credits lower your premiums, and as of early 2024, 95% of people with effectuated coverage through Missouri's exchange were receiving premium subsidies, saving an average of $595 per month.

The average after-subsidy premium was about $85/month, including the 5% of people paying full price.

You may also receive cost-sharing reductions (CSR) if your income isn't more than 250% of the federal poverty level and you enroll in a Silver-level plan, which reduces your out-of-pocket costs when you use your health insurance.

Finding affordable health insurance in Missouri is possible through the ACA Marketplace's website, HeathCare.gov. You can explore options and potentially qualify for income-based subsidies called Advance Premium Tax Credits (APTC), which lower your premiums.

In fact, 95% of people with effectuated coverage through Missouri's exchange were receiving premium subsidies as of early 2024, saving an average of $595 per month. This can significantly reduce your healthcare costs.

Related reading: Health Insurance Exchange Subsidies

Missourians may also find affordable coverage through Medicaid if eligible. Missouri expanded Medicaid eligibility guidelines in 2021, allowing adults younger than 65 to enroll with a household income up to 138% of the poverty level.

Short-term plans are another low-cost option, but be aware that new federal rules limit initial terms to no more than three months and total duration to four months, including renewals.

In Missouri, the average rate changes for 2025 for Missouri's Marketplace insurers are quite varied, ranging from a 9.91% increase by Blue Cross Blue Shield of Kansas City to a -7.24% decrease by Celtic Insurance Company.

Some insurers, like Aetna, are increasing their premiums by 7.25%, while others, like Cox Health Systems Insurance Company, are keeping them relatively stable with a 0.82% increase.

The overall average increase in unsubsidized premiums in Missouri's individual/family health insurance market has been significant over the years, with an average increase of 9% in 2015, 14% in 2016, and 25.5% in 2017.

Here's a summary of the average annual changes in unsubsidized premiums in Missouri:

Missouri's Marketplace enrollment has seen significant growth in recent years, with 359,369 people signing up for private health plans during the 2024 open enrollment period. This is a new record high.

The growth is likely due to larger subsidies from the American Rescue Plan and the Inflation Reduction Act, making coverage more affordable for many residents. The unwinding of the pandemic-era Medicaid continuous coverage rule also contributed to the enrollment growth in 2024.

Over 124,000 Missouri residents transitioned from Medicaid (MO HealthNet) to a Marketplace plan by April 2024.

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For 2025, nine insurers are offering coverage in Missouri's Marketplace. Three of the insurers are expanding their coverage area for 2025.

UnitedHealthcare is expanding to offer coverage statewide, making it the only carrier to do so. This expansion provides more options for Missourians seeking Marketplace coverage.

All counties in Missouri have Marketplace plans available from at least two insurers for 2025. This is an improvement from previous years, when some counties had limited options.

Seventy-one of the state's 115 counties have plans available from at least five insurers. This increased availability is a positive development for the insured population in Missouri.

Cigna exited Missouri's individual insurance market at the end of 2023, leaving fewer options for consumers.

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In Missouri, 359,369 people signed up for private health plans through the state's exchange/Marketplace during the open enrollment period for 2024 coverage, a significant new record high.

The growth in enrollment is likely due to larger subsidies from the American Rescue Plan and the Inflation Reduction Act, making coverage more affordable for many.

Missouri's Marketplace enrollment increased in 2022 and 2023, despite the 2021 Medicaid expansion.

More than 124,000 Missouri residents had transitioned from Medicaid (MO HealthNet) to a Marketplace plan by April 2024, as a result of the "unwinding" of the pandemic-era Medicaid continuous coverage rule.

Protection is a top priority for those purchasing health insurance through the Missouri Health Insurance Exchange.

The Missouri Health Insurance Exchange will follow federal guidelines for insurance professionals selling policies through the Exchange, ensuring that consumers receive accurate and unbiased information.

Insurance professionals can register with the Missouri Health Insurance Exchange and receive commissions directly from carriers, using their Exchange ID number and NPN.

Consumers can also rely on navigators to assist them in making choices about their health care options and accessing premium tax credits. The federal government will run the navigator program in Missouri.

Here are the three options for setting up a state health insurance exchange, which will affect the level of protection available to consumers:

Missouri will default to a federally-facilitated health insurance exchange, which may impact the level of protection available to consumers.

Tax credits and subsidies, such as the small business healthcare tax credits and individual health insurance tax subsidies, will only be available for coverage purchased through a state health insurance exchange, providing an added layer of protection for those who qualify.

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