Shopping for health insurance in the state of Missouri might seem like a daunting task. Thankfully, there are many options open to Missourians who are uninsured or underinsured. Whether you're healthy or not, this page can provide you with valuable information for obtaining health coverage. Read on to learn about the difference between group and individual coverage, and COBRA. If you're healthy enough to obtain coverage on the individual market or if you have a small business and qualify for small group, Health Plan One can help. If not, review the information on this page about MO HealthNet (Medicaid), MO HealthNet for Kids (SCHIP), and the high risk pool. All of these government programs can help those who are medically uninsurable or who cannot afford private coverage obtain basic health coverage.
What Every Missourian Should Know About Health Insurance
The type of health insurance familiar to most consumers is group coverage offered by an employer. With group health insurance through your employer the policy is partially paid for by the company on behalf of their employees. The company will contribute a large percentage toward the monthly premium and you (the employee) will be responsible for paying the difference, about 16-27%. With group plans you have little choice in the specific benefits of the plan (these are determined by negotiations between the company and the insurance carrier) but you also cannot be denied coverage under the group plan no matter what prescriptions you may take or preexisting conditions you may have. By insuring a large group of employees together under one plan of the company's choosing, individual employees are not medically underwritten, rather the entire group is underwritten as a whole to determine the premium level everyone will pay. Therefore, the amount you pay in premiums as well as the quality of the coverage you receive are dependent not on how healthy you are or what benefits you would like to have, but how healthy your group is as a whole and what benefits the company has chosen for you.
Unfortunately, companies frequently have a waiting period before new employees can qualify to receive health insurance benefits. If this is the case with your new job, consider getting a short-term policy from the point where your previous coverage ends to the time when your new company's insurance kicks in. Such options are available through Health Plan One. Simply visit our Short-Term information page for your free quotes. It is important not to have a lapse in coverage of more than 63 days. If you do, your new insurance carrier may refuse to cover treatment for pre-existing conditions you may have such as asthma or acne for up to a year after your policy goes into effect. For this reason, having continuous health insurance coverage is particularly important.
What If I'm Between Jobs?
As previously mentioned, it is important not to have a break in coverage of more than 63 days. As a result, if you've recently lost your job look into extending the coverage you had with your employer through COBRA. With the COBRA program through the federal government you can extend your plan for up to 18 months after losing your job. You will however have to pick up the entire premium cost which your employer had previously been paying. For this reason, it is frequently more economical for people who've lost their jobs to invest in an individual/family insurance policy through Health Plan One.
With individual coverage you choose the health insurance carrier and benefits you want with the help of Health Plan One. We will quote plans for you and your family from all the different carriers available in Missouri so that you can choose from a wide price range and spectrum of options to tailor a plan that fits your needs. Even if you are not between jobs, a plan on the individual market through Health Plan One could still be the best option for your family. Many companies do not offer benefits to their employees, and often those companies that do offer benefits do so at an exorbitant cost for low quality plans. It is important to note that with individual coverage in Missouri each person who applies is medically underwritten and may be approved, denied, or rated-up by the carrier depending on their health history in recent months.
If you're healthy and are unhappy with the health insurance offered by your employer, are between jobs, or are not offered benefits by your company, enter your zip code into the Health Plan One quoting engine at the top of this page to view the most competitively priced plans in your area with benefits tailored to your needs. Quotes are absolutely free, and you're under no obligation to buy. Our licensed insurance specialists are also available via LiveChat (see the button to the right) or toll-free at (877) 567-5267 to answer any questions.
Small Group Plans
If you are self-employed, you could apply for a small group plan for your company. You must have 2 or more eligible employees who each work full-time, at least 30 hours per week. Small group plans are medically underwritten by all carriers in Missouri. There are no requirements for the length of time you've been in business, but you must show proof of earning taxable income. All carriers do medical underwriting on their small groups. This means that though no one in the group can be denied coverage, the carrier can increase the rates based on the health history of employees enrolling.
Health Plan One can help you by quoting plans for small groups. Simply call us toll-free (877) 567-5267.
For more information on small group plans for this state please see our Missouri Small Group page.
If you're not healthy there are still many programs available to you. See below for details on the options which best fit your medical and financial situation.
MO HealthNet - Missouri Medicaid
There are many categories one might fall into which each provide full or partial coverage under Medicaid. These categories include low-income families with children under 19, pregnant women, and newborns. Benefits include preventive care, inpatient hospital care, lab and x-rays, pharmacy, dental/hearing/vision care, and much more. In order to be eligible, all applicants must meet certain income criteria which are available on the program's website athttp://www.dss.mo.gov/fsd/msmcp.htm
For information about Missouri Medicare visit MedicareSolutions.com.
MO HealthNet for Kids - Missouri SCHIP
Additional support for children in Missouri is provided through the federally-mandated SCHIP program, known in Missouri as HealthNet for Kids. The program administers benefits to children within Medicaid, but also provides basic low-cost coverage to uninsured children under 19 whose parents' income is too high to qualify them for Medicaid but too low to afford private insurance. In order to qualify, a child must:
- Have a family gross income over 150% of the federal poverty level (FPL) but under 300% FPL
- Be uninsured for 6 months
- Have family assets with a net worth of less than $250,000
- Not have access to affordable health insurance and must pay a monthly premium
For more information on the benefits of the program and further eligibility requirements, click here: http://www.dss.mo.gov/mhk/index.htm
Missouri Health Insurance Pool
The insurer of last resort for most Americans is their state's high risk pool. In Missouri, the pool is called Missouri Health Insurance Pool and is meant for residents who are medically uninsurable on the individual insurance market due to a preexisting medical condition. The program is administered by Anthem Blue Cross and Blue Shield. Eligible individuals are unable to obtain health coverage, have been involuntarily terminated from the health coverage, or are being charged more than 150% of standard premiums for their coverage. MHIP offers many of the same benefits available with other private insurance plans. For more information about MHIP including detailed eligibility requirements, plan benefits, and application instructions, click here: http://www.mhip.org/
Click here to review all health care services available through the Missouri Department of Social Services:http://www.dss.mo.gov/pr_health.htm