Health Insurance in Missouri

Finding an affordable and comprehensive health insurance policy for you and your family in Missouri can be easier said than done. But with our help, you can make a significant amount of progress towards that goal. This website is run and managed by dozens of health insurance experts who have years of experience in the industry. We know tons of information about the best options available in your area, as well as how to find the most affordable ones. So if you’re still shopping for the health insurance coverage that you and your family need to stay healthy, all you have to do is keep reading.

Major Medical Insurance in Missouri

It’s almost hard to believe that the Patient Protection and Affordable Care Act of 2010 has been around for a full decade. In that short amount of time, millions of Americans have found qualifying and affordable major medical coverage to help improve the health and wellness of themselves and their family members. Also, in that time, the law has changed dramatically. For example, most people might not know that the legal requirement of the individual mandate was no longer effective as of the beginning of 2019. This one simple change can make a huge difference in how affordable your health insurance coverage is.

But just because there is no longer an individual mandate doesn’t mean you shouldn’t try to purchase qualifying health insurance coverage for you and your loved ones. After all, going without coverage can cost way more money if you or one of your children suddenly comes down with a devastating illness or injury. That’s why you should visit HealthCare.gov and fill out an application if you haven’t already. It’s a very simple process, you only have to answer a few questions, and those questions are limited to relevant factors like your household size, income status, and important health questions like whether or not you use tobacco. From there, you can figure out whether or not you qualify for coverage, whether or not you qualify for a financial tax break, and start shopping for plans right away. 

The ACA legislation has made major medical coverage through the ACA the most attractive option for the vast majority of Americans. The main reason for this is the fact that all of the policies available on the ACA are guaranteed issue policies. With guaranteed issue coverage, if you are eligible to apply for insurance, no company who sells insurance via the Marketplace can reject you – not even based on pre-existing conditions. They can’t charge you more for monthly premiums based on those pre-existing conditions either, unless one of the following four factors happens to make you a riskier Investment:

• Your age 
• Your location
• Your use of tobacco products
• Whether you are applying for an individual policy or a family policy

Another reason major medical ACA policies are so attractive is because of the guaranteed Health and Wellness Benefits. Providing consumers with the benefits in the list below is the best way to give them comprehensive medical care for optimal health and wellness. Without it, the lack of care can lead to neglect and prohibitively expensive health problems further down the road. Providing these benefits early, however, can help prevent such a scenario:

• Ambulatory/outpatient services
• Emergency services
• Hospitalization
• maternity/newborn care
• Mental health and substance abuse
• Prescription drugs
• hab/rehab services and devices
• Lab tests
• Preventive and wellness services and chronic disease management
• Pediatrics (including oral and vision) 

The benefits package that comes with ACA major medical insurance is certainly attractive; but the price tag required to offer that kind of comprehensive coverage is less so. That being said, this is a moot point if you are fortunate enough to qualify for a tax credit. The minimum threshold in the state of Missouri is around 138% of the federal poverty limit. If you make at least that, up to 400% of the federal poverty limit, you can qualify for a tax credit that will make your monthly insurance premiums substantially more affordable. This threshold is based on both your income and your household size, so take a look at the chart below to find out where you fall on the spectrum:

We added a third column to this chart – the chart that shows the difference between 100% of the federal poverty limit, and 138% of the federal poverty limit – because Missouri is one of the few states in the Union who still refuses to accept free federal funds to expand Medicaid for needy families and individuals. If you fall within the 100% to 138% income gap, you will neither be eligible for a federal tax credit, nor will you be eligible for Medicaid. People who fall into this income gap tend to fare well with alternative options like short-term health insurance or a health share plan – until their financial circumstances improve, anyhow.

It’s a little bit easier to qualify for at least some limited Medicaid-related services in the state of Missouri then it is compared to other states. But, strangely, it isn’t based on income alone. You have to be of a certain low-income level and have at least one other qualifying feature, such as a disability, before you can apply and qualify for Medicaid assistance via Missouri HealthNet. To find out whether or not you have a qualifying circumstance and to apply online, you should visit the myDSS website to learn more information.

Short Term Health Insurance in Missouri

Given the unfortunate Medicaid Expansion Gap which exists in the state of Missouri, among other things, you might be looking at short-term health insurance for an affordable alternative to major medical coverage. The rules for short-term health insurance work a little differently in Missouri than they do in other states, however. The maximum length of a short-term health insurance policy is 6 months, but they come with unlimited renewals. This means that you keep your short-term health insurance for as long as you want – but you will be subject to medical underwriting every time you renew. When an insurance company puts you through medical underwriting, it means that they can decide to charge you a higher monthly premium, cancel your plan, or deny you coverage in the first place based on any pre-existing conditions you may have. Under such circumstances, short-term health insurance can be prohibitively expensive for people who need it most.

But if you are relatively healthy, you might be able to get some good coverage out of it. Many short-term health insurance policies cost almost as much as 33% less for your monthly premium then an unsubsidized policy from the ACA. Because these policies are less than one year in duration, they don’t have to sell you any benefits or coverage that they don’t want to sell you under Missouri law – so if you need something specific, like mental health counseling, you might not be able to get it. Short-term health insurance companies are all about lowering their own costs – so much so that they limit the number of benefits you can receive and the amount of money they pay out on claims on both an annual and a lifetime basis. These limits are called caps, but there are no caps on how high your out-of-pocket expenses can get. You should also know that many short-term health insurance policies start with something like a $5,000 deductible which must be paid by you, the customer, before your insurance company will pay out your medical claims. But the good news is that if a short-term health insurance company ever does unjustly deny you your benefits, you have plenty of consumer protections in place which will allow you to take them to court to get the issue settled.

Christian Health Plans/Health Share Plans in Missouri

Another alternative to major medical coverage and short-term health insurance would be a Christian health plan. Christian health plans were very useful back during the days of the individual mandate. They gave consumers a religious exemption to the ACA individual mandate, which required you to either purchase health insurance, get qualifying coverage through your employer, or pay a tax penalty. But now that this mandate no longer exists in the state of Missouri, there’s less of an incentive for people to choose a Christian health plan over, say, short-term health insurance or the Health Insurance Marketplace.

To help explain what Christian health plans are all about, it’s helpful to let you know that these are fairly similar to short-term health insurance. As a matter of fact, both Christian health plans and short-term health insurance have all of the following in:

• No guaranteed issue status
• Unlimited out-of-pocket costs
• Lifetime and annual benefit caps
• No guaranteed Essential Health Benefits
• Plans require a less costly “monthly share amount” than an unsubsidized ACA monthly premium
• Not considered to be a “real” health insurance plan by major organizations and care providers

Now let’s talk about the differences – because there are some important ones. You won’t have the same consumer protections with a Christian health plan that you do with short-term health insurance. So if your health share plan provider decides that they don’t want to pay out a particular claim, you won’t be able to take them to court and get the issue resolved. You will also likely have to follow certain participation guidelines, which usually involve declaring a specific faith and adopting religious-based lifestyle habits. Christian health plans don’t come with monthly premiums, but you will have to pay a monthly share amount in order to keep your plan current. You also have to pay an insured amount or a personal responsibility amount in lieu of things like co-pays, coinsurance, or deductibles. Not all Christian health plans are created equal, so it’s important to get with a local provider and find out what types of plans and benefits are available near you before you make a final decision.

Fixed Indemnity Plans in Missouri

Then there are fixed indemnity plans to consider. Truth be told, however, the best use of an indemnity plan is right alongside major medical coverage – not as a replacement for it. Fixed indemnity plans are named the way they are because they pay out a fixed amount of benefits, usually on a per day, per week, per month, per incidence, or per visit basis. They don’t cover a fixed percentage of your costs the way major medical does, or the way some short-term health insurance or Christian health plans do. their benefits are much too narrow in scope meaning that you won’t come close to getting the Essential Health and Wellness Benefits you will with major medical. One thing indemnity plans have in common with short-term health insurance is that you will likely face lifetime and/or annual benefit caps. 

There are different types of indemnity plans that you can purchase depending on what your medical needs are. You could get a hospital indemnity plan, a doctor visit indemnity plan, and you may even be able to find a dental indemnity plan in some areas. The reason indemnity plans work so well alongside more comprehensive forms of coverage is because they help take a substantial chunk out of the out-of-pocket costs you have left after insurance covers their share. So having an indemnity plan in your back pocket even if you aren’t carrying other forms of coverage can still help you save money in the event of an unexpected medical emergency.

Discount Cards in Missouri

You have a few different options when it comes to medical discount cards in Missouri. There is the state-sponsored Missouri drug card which we’ll talk about in a moment, and you can also choose to purchase a membership in a medical discount card program with a private company. These cards work similarly to other discount programs like AAA or the AARP: you pay a membership fee, they send you a card in the mail, and you present that card at the register whenever you purchase medical products or services. You will get a discount right there at the register, and you won’t have to file any claims or wait for any reimbursements. But be on the lookout for scams, because medical discount cards are not health insurance, and they are not meant to be substitutes for major medical coverage. Anyone who tells you differently is likely lying and trying to scam you.

You can choose a private medical discount card, you can choose the Missouri drug card instead of a medical discount card from a private company, or you can combine the two – although you may end up accidentally wasting money on redundant discount card benefits. The Missouri drug card is a statewide discount prescription assistance program that is free to all Missouri residents. Unlike some medical discount cards, the Missouri drug card is limited to prescription drug purchases, only. But it is easy to get – all you have to do is print it off from the website and present it at a participating pharmacy. You don’t need to apply or pay a fee. You can find out more about the Missouri drug card by going to the Missouri drug card website.