According to www.statehealthfacts.org, 5% of Missouri residents had individual health insurance in 2004. From 200 to 2004, employer-sponsored health insurance went down by 9.3% in conjunction with a 3.7% increase in the uninsured rate. As a result of this decrease in employer-sponsored health insurance, more Missourians are applying for individual health insurance.
In Missouri, medical underwriting is allowed without restriction. There is an unlimited month look back and 24 month exclusionary period for preexisting conditions for those without prior healthcare.
High Risk Pool
There is a high risk pool in Missouri called the MHIP. You may be eligible for this pool if you are a resident of Missouri and you have been denied health coverage in the past 6 months because of a condition or health history, you were offered insurance with a premium rate 300% higher than the standard rate, you were formerly covered by another state’s high risk pool within the past 30 days, you exhausted your COBRA options, or you were involuntarily dropped from an insurance carrier.
Coverage under MHIP includes doctor visits, prescription drugs, outpatient and in-hospital care, maternity, ambulance, labs and x-rays, skilled nursing care, hospice, home health visits, transplants, rehabilitation, durable medical equipment, mental health and substance abuse, physical, speech and occupational therapy, and preventive care.
Uninsured in Missouri
12% of Missouri residents are uninsured according to www.statehealthfacts.org. From 2002 to 2003, more than one in four nonelderly Missourians lacked health insurance. If you are one of these uninsured Missourians, Health Plan One can help you tailor an affordable plan to meet your specific needs. |
Missouri offers COBRA, the Consolidate Omnibus Budget Reconciliation Act of 1985. Many companies with 20 or more employees that offer health insurance are required to offer employees and their dependents continuation coverage for benefits that were lost due, for example, to job loss, reduction in hours worked, death, or divorce.
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Medicaid is a state/federal program that pays for medical and long-term care services for low-income pregnant women, children, certain people on Medicare, disabled individuals and nursing home residents. These individuals must meet certain income and other requirements.
Income requirements
Children
Children (ages 1-5)-300% of the Federal Poverty Level
Children (Ages 6-19)-300% of the Federal Poverty Level
Pregnant Women and Infants
Pregnant Women-185% of the Federal Poverty Level
Infants (ages 0-1)-300% of the Federal Poverty Level
Parents
Non-Working Parents-75% of the Federal Poverty Level
Working Parents-82% of the Federal Poverty Level
Other populations
Supplemental Security Income Recipients- 74% of the federal
Poverty Level
Aged, blind, and disabled- 100% of the Federal Poverty Level
Covered Services
Adult day care, Ambulance services for emergencies, ambulatory surgical center, birthing center, case management, community psychiatric rehabilitation services, dental, dentures, diabetes management, durable medical equipment, family planning, hearing aids, home health services, hospice, inpatient and outpatient hospital services, laboratory and x-ray, medical transportation, nurse midwife, nursing facility, optical services, orthodontics, pharmacy services, podiatry, psychologist services, rehabilitation, counseling, therapy, and transplants.
Co-Payments
Co-payments vary. There are no co-payments if you are under 18, pregnant, living in a nursing home, or receiving family planning services.
You may learn more about Missouri Medicaid at http://www.dss.mo.gov/pr_health.htm |
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