Missouri Health Insurance at a Glance

Missouri Uses HealthCare.gov

Missouri does not operate a separate state-based health insurance Marketplace. Individuals and families who want Marketplace coverage use HealthCare.gov.

Qualified Health Plans sold through HealthCare.gov are ACA-compliant major medical insurance. They cover pre-existing conditions and include the protections required for ACA-compliant individual health plans.

Eligible households may also qualify for federal Premium Tax Credits that reduce the monthly premium for Marketplace coverage.

Missouri Marketplace Insurance Companies for 2027

Missouri's current 2027 individual-market filings show six insurance companies planning to offer coverage through HealthCare.gov.

Cox Health Plans Is Moving Off the Marketplace for 2027

Cox Health Plans offered individual Marketplace coverage in portions of southwest Missouri during 2026.

In Missouri's current 2027 individual-market filings, Cox Health Plans is listed as off-exchange only.

That distinction matters because federal Marketplace Premium Tax Credits can only be used for eligible coverage purchased through the Marketplace.

Missouri's Proposed Health Insurance Rates for 2027

Missouri's Department of Commerce and Insurance is reviewing proposed 2027 individual-market rates.

As of the state's July 31, 2026 preliminary filings, the six Marketplace carriers requested the following average rate changes:

Missouri's Department of Commerce and Insurance has said final 2027 rates will be published no later than October 31, 2026.

Missouri Open Enrollment for 2027

Open Enrollment for 2027 Marketplace health insurance runs from November 1, 2026 through January 15, 2027.

• November 1, 2026: Open Enrollment begins.
• December 15, 2026: Select a plan by this date for coverage beginning January 1, 2027.
• January 15, 2027: Open Enrollment ends. Coverage selected after December 15 generally begins February 1.

HealthCare.gov can automatically re-enroll some consumers if they don't actively select a new plan, but the plan, premium, provider network, or financial assistance can change.

Marketplace Financial Help for 2027

Federal Premium Tax Credits are still available to eligible Missouri households purchasing Marketplace coverage.

However, the temporary expanded Premium Tax Credit rules that applied through 2025 have ended.

Under the general federal rules now in effect, households generally must have income between 100% and 400% of the federal poverty level, in addition to meeting the other eligibility requirements.

For 2027, the IRS applicable percentage table ranges from 2.15% at the lowest income band to 10.22% for households between 300% and 400% of the federal poverty level.

Self-Employed Health Insurance in Missouri

Missouri has thousands of people who don't get coverage through a traditional employer, including contractors, farmers, owner-operators, truck drivers, real estate professionals, consultants, tradespeople, gig workers, and small business owners.

If you're self-employed, choosing health insurance can involve more than simply finding the lowest monthly premium.

Learn more about self-employed health insurance →

Marketplace Plans vs. Other Private Health Coverage

Missouri residents may see several products described as private health insurance. They do not necessarily offer the same benefits or consumer protections.

Your Missouri County Can Change Your Health Insurance Options

Missouri's individual health insurance market varies substantially by county.

A resident in the Kansas City or St. Louis area may see a different combination of insurance companies and networks than someone in rural Missouri, the Ozarks, or another part of the state.

Missouri's Department of Commerce and Insurance publishes a county-by-county carrier map because insurer service areas are not statewide.

Before choosing a plan, consider checking:

• Your primary care doctor
• Your specialists
• Your preferred hospital or health system
• Nearby urgent care facilities
• Your regular prescriptions
• Your preferred pharmacy
• Coverage when traveling outside your local area

MO HealthNet and Missouri Medicaid Expansion

Missouri's Medicaid program is called MO HealthNet.

Missouri expanded Medicaid beginning in 2021. The Adult Expansion Group covers qualifying adults ages 19 through 64 based on income and other eligibility requirements.

Under the expansion rules, eligible adults can generally qualify with household income around 138% of the federal poverty level after the applicable income methodology is applied.

Missouri also has separate MO HealthNet eligibility categories for children, pregnant women, parents and caretakers, people with disabilities, older adults, and other groups.

New MO HealthNet Requirements Begin in 2027

Federal Medicaid eligibility rules are changing for certain adults in expansion Medicaid programs, including Missouri's Adult Expansion Group.

Beginning in 2027, certain adults ages 19 through 64 will need to meet a monthly community-engagement requirement to qualify for or maintain Medicaid coverage unless an exemption applies.

The federal standard is generally 80 hours per month.

Activities that may count include:

• Paid employment
• Community or volunteer service
• Approved job-training programs
• College, technical school, GED, or other qualifying education
• A combination of qualifying activities

Who May Be Exempt?

Federal rules provide exemptions for a number of groups. Examples can include:

• Pregnant women and certain postpartum beneficiaries
• Certain parents, caregivers, and family caregivers
• People with qualifying disabilities or functional limitations
• People with certain serious mental health conditions
• People with qualifying substance-use disorders
• Certain veterans
• Current or former foster youth under applicable rules
• People who qualify for Medicare
• People already meeting certain SNAP or TANF work requirements
• Other federally recognized exemptions

What If You Lose MO HealthNet Coverage?

Losing Medicaid can create an opportunity to enroll in Marketplace coverage outside the normal annual Open Enrollment period.

If your MO HealthNet coverage ends, don't wait several months before looking at your alternatives.

Depending on your circumstances, options may include:

• A HealthCare.gov Marketplace plan
• Employer-sponsored health coverage
• A spouse's employer plan
• Other available individual coverage

Leaving a Job or Losing Employer Health Insurance?

Losing qualifying employer health coverage can create a Special Enrollment Period for Marketplace insurance.

Depending on your situation, you may want to compare:

• COBRA continuation coverage
• A spouse's employer-sponsored plan
• A HealthCare.gov Marketplace plan
• MO HealthNet if eligible
• Other available private coverage

COBRA lets many people temporarily continue the employer plan they already have, but the premium may increase significantly when the former employer stops contributing.

Learn more about COBRA alternatives →

Missouri Health Insurance for Early Retirees

Retiring before age 65 can leave several years between employer-sponsored health insurance and Medicare eligibility.

Depending on the situation, early retirees may compare:

• Marketplace major medical coverage
• COBRA
• A spouse's employer plan
• Other available private coverage

Income planning can be particularly important for Marketplace coverage because pensions, taxable investment income, retirement-account distributions, self-employment income, and other income can affect Premium Tax Credit eligibility.

Small Business Health Insurance in Missouri

Missouri small business owners have more than one way to provide health benefits.

Depending on the business, possible strategies can include:

• Traditional fully insured group health insurance
• Level-funded group plans where available
• Individual Coverage HRAs (ICHRA)
• Qualified Small Employer HRAs (QSEHRA)
• Dental and vision benefits
• Life and supplemental benefits

What Is an ICHRA?

An Individual Coverage Health Reimbursement Arrangement, commonly called an ICHRA, allows an employer to reimburse eligible employees for individual health insurance premiums and certain medical expenses under the applicable rules.

Instead of choosing one traditional group medical plan for everyone, the employer establishes an allowance and eligible employees purchase their own qualifying individual coverage.

Whether an ICHRA or traditional group plan makes sense depends on factors such as employee count, employee ages, where workers live, the employer contribution, and how the arrangement is designed.

Learn more about small business health insurance →

How We Help Missouri Residents

Serving Clients Across Missouri

We work with Missouri residents by phone and video, so you don't need to live near a local office.

Official Missouri Health Insurance Resources

These official resources can also help you verify current enrollment rules and coverage information.

Common Questions About Missouri Health Insurance