Best Health Insurance Plans in Missouri

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Curious about health insurance in Missouri? According to a study by U.S. News, Missouri has the 39th best health care in the country. That's based on access, quality, and good public health.

Health Care Choices in Missouri

According to the MO Department of Insurance, state residents can get health insurance several different ways:

  1. Employer-provided
    1. From your employer
    2. Through your spouse's employer
    3. Through COBRA
  2. Individual or family plans
    1. Through HealthCare.gov
    2. Directly from a health insurance company
  3. Government-assisted
    1. Medicare
    2. Medicaid (MO HealthNet)

Where do most Missouri residents get their health insurance coverage?

Missouri Health Insurance Sources
Sources Percent
Employer-Provided 51%
Individual or family 8%
Medicaid 15%
Medicare 17%
Other Public Care 1%
Uninsured 8%
Source: Kaiser Family Foundation, Health Insurance Coverage of the Total Population

Eight percent of Missouri residents are uninsured, less than the national average. That's good news for policyholders. More uninsured people leads to higher rates for insured residents.

Missouri Health Insurance Costs and Rate Factors

Missouri residents spend an average of $8,107 on health care per year. What influences health care costs? Insurance companies analyze several factors to price your policy. Health care costs vary person to person, but here are the main things that will determine your rate:

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Body Mass Index

According to the CDC, having a body mass in the obese range leads to serious health risks. That's why insurers consider your BMI. A higher BMI leads to higher health insurance rates.

In 2016, Missouri had a 31.7 percent obesity rate, the 17th highest rate in the country. Out of the many MO residents who used QuoteWizard to compare health insurance plans, 34 percent of users have a BMI in the obese range.

Tobacco Use

Due to the high risks that come with smoking, tobacco users pay more for health insurance. According to America's Health Rankings, 22.1 percent of MO residents are smokers, the eighth highest rate in the country.

Age

Health insurance plans cost up to three times more for older people than younger people. Missouri residents who used QuoteWizard to shop for health insurance are, on average, 39 years old.

Plan Type

Marketplace plans come in metal tiers: bronze, silver, gold, and platinum. More coverage will cost you more in monthly premiums.

So, how much should you expect to pay in Missouri for health care? This is the average cost for each plan type for a middle-aged Missouri resident in 2018:

Missouri Martketplace Plan Rates
Bronze Silver Gold
$389 $495 $730
Source: Kaiser Family Foundation, Change in Average Marketplace Premiums by Metal Tier

Premiums for a gold plan cost about 87 percent more than a bronze plan. That's because gold plans cover 80 percent of medical costs, whereas bronze plans cover 60 percent of costs.

You may qualify for a catastrophic plan, the lowest level of health insurance coverage available. Catastrophic plans come with low monthly premiums but a yearly deductible of $7,150. Although bronze and silver plans have higher premiums, they may save you money if you need to use your health insurance.

Location

One of the biggest factors with cost comes down to where you live in the U.S. This is because every state has different rules, regulations, and providers surrounding the health care marketplace.

Also, your location-based prices could even be as specific as the neighborhood you live in. Many health insurance rates are community rated, meaning your prices depend on the combined claims everyone files. So if your neighbors file an abnormally high number of claims, your costs could jump.

Living in a health-conscious state could help keep your premiums low. According to America's Health Rankings, Missouri is the 40th healthiest state in the U.S.

Missouri Health Insurance Companies

There are several options for residents to get health insurance in Missouri. Here are some of the top health insurance providers in the state:

These companies offer both individual and family plans. Check insurer websites to find out how your zip code could affect policy options.

Missouri Health Insurance Laws

The Affordable Care Act mandates that insurance companies can't use certain factors to price your policy.

There's a limit to how much you'll be paying out-of-pocket for a marketplace plan. In 2018, the out-of-pocket maximum is $7,350 for an individual plan and $14,700 for a family plan.

Missouri law requires health insurance companies to provide at least some coverage for the following services:

  • Hospitalization after childbirth
  • Mental illness, alcoholism, and drug addiction
  • Outpatient diabetes management
  • Autism spectrum disorders
  • Well-child care
  • Coverage for severe mental disorders
  • Mammograms

There are more services that insurers are required to cover. Read the full list from cms.gov.

Medicare and Medicaid in Missouri

Medicare and Medicaid are both government-funded programs that offer affordable health care to Americans. They offer coverage to two different groups of people. Medicare provides health coverage to seniors 65 and over, and Medicaid aids low-income families and children.

Medicare

Medicare is meant for people 65 and older. There are plenty of options within the program including parts A, B, C, D, and supplemental coverage plans. As a Missouri resident, you may qualify for one of these Medicare Savings Programs:

Qualified Medicare Beneficiary (QMB):

  • Single person with a monthly income lower than $1,012.
  • Couple with a monthly income lower than $1,372.
  • Three people with a monthly income lower than $1,732.

Specified Low Income Medicare Beneficiary (SLMB):

  • Single person with a monthly income lower than $1,214 (Group One) or $1,366 (Group Two).
  • Couple with a monthly income lower than $1,646 (Group One) or $1,852 (Group Two).
  • Three people with a monthly income lower than $2,078 (Group One) or $2,338 (Group Two).

Medicaid

In Missouri, Medicaid is referred to as MO HealthNet. These are the state's Medicaid financial requirements:

Missouri Medicaid Financial Requirements
Household Size Maximum Yearly Income
1 $16,040
2 $21,599
3 $27,159
4 $32,718
5 $38,277
6 $43,837
7 $49,396
8 $54,956

Missouri Office of the Insurance Commissioner

Website:
Homepage
Insurance Commissioner:
Chlora Lindley-Myers
Insurance Hotline:
(800) 726 – 7390
Office Hours:
Monday - Friday
8:00 am to 5:00 pm
File a Consumer Insurance Complaint
Complaint Page

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