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Availability of short-term health insurance in Missouri
Short-term health insurance may have initial terms up to 12 months and total duration up to 36 months
The Trump administration announced in August 2025 that it would no longer prioritize enforcement of the 2024 federal rule limiting short-term health plans to a total of four months in duration, and encouraged states to follow suit.1
As of early 2026, Missouri residents could purchase short-term policies with total durations of up to 36 months, as had been the case before the 2024 federal rule took effect.
Frequently asked questions about short-term health insurance in Missouri
Is short-term health insurance available for purchase in Missouri?
Yes. As of early 2026, at least five insurers offered short-term health insurance in Missouri. Available plan durations ranged from six months to 36 months, depending on the insurer and the specific policy.
Which short-term plan durations are permitted under Missouri rules?
After the Trump administration stopped enforcing the federal rule that limited short-term policies to no more than four months in duration, insurers began offering longer policy durations in Missouri.
Missouri statute allows short-term policies to be renewable for up to 36 months,2 and some insurers are offering policies with 36-month durations as of early 2026.
But policies do not have to be renewable, and some insurers choose to limit their short-term policies to much shorter durations.
Here’s a summary of how the rules have changed over time in Missouri:
In October 2018, a federal rule change began to allow short-term health insurance to have initial terms of up to 364 days and total duration, including renewals, of up to 36 months. These rules were applicable unless a state had more restrictive rules in place.
At that point, Missouri limited initial terms to six months,3 although renewals were allowed to follow federal rules, meaning that plans could be renewed to stay in force for up to 36 months.
Missouri then enacted legislation in 2021 that extended the initial term limit for a short-term major medical plan to 12 months.4 From that point on, the state’s rules aligned fully with the federal rules that had been in effect since late 2018.
When the federal rule change took effect in 2024, it limited short-term policies to total durations of no more than four months.
Once the federal government stopped enforcing that rule in 2025, insurers in Missouri went back to offering longer short-term policies. But as noted above, the maximum allowable duration varies considerably from one insurer to another: Some policies are capped at six months, while others can last for up to three years.
Who can buy short-term health insurance in Missouri?
Short-term health insurance in Missouri can be purchased by applicants who qualify for coverage based on the underwriting rules the insurers use.
Most short-term health plans can be purchased by people who are younger than 65 and who do not have any of the short list of medical conditions that will result in a declined application.5 But the specific requirements vary from one insurance company to another.
Most short-term health insurance plans exclude coverage for pre-existing conditions. It’s also common for them to use post-claims underwriting, which means that if a claim is filed they can go back through the person’s medical records to make sure that the claim isn’t related to a pre-existing condition.6
It’s also common for short-term health plans to exclude coverage for some of the ACA’s essential health benefits (most commonly, maternity care, prescription drugs, and mental health care),5 and impose dollar limits on the coverage they do provide. It’s important to double-check all of the plan information before purchasing a short-term policy, to make sure that you understand the limitations of the plan.
If you need health insurance coverage in Missouri, your first step should be to see whether you’re eligible to enroll in an ACA-compliant major medical plan (an Obamacare plan). Open enrollment for these plans runs from November 1 to December 15,with coverage effective January 1 (this enrollment window applies in Missouri’s Marketplace/exchange and also outside the exchange).
You may be able to enroll in an ACA-compliant plan outside the open enrollment period, if you’re eligible for a special enrollment period. (In most cases, special enrollment periods are triggered by a specific qualifying life event.)
ACA-compliant plans are purchased on a month-to-month basis, so you can enroll in one even if you’re only going to need it for a few months before another policy takes effect. And depending on your income, you may qualify for a premium subsidy (premium tax credit) that will make the monthly premiums much less costly than you may have been expecting.
But if you’re not able to enroll in an employer-sponsored plan or an ACA-compliant plan, or you just cannot afford the premiums, a short-term plan will likely be a better option than remaining uninsured, despite its limitations. And even though there are no premium subsidies for short-term health insurance plans, the monthly premiums tend to be relatively affordable, due to the plan limitations and the use of medical underwriting.
When should I consider buying short-term health insurance in Missouri?
Despite the limitations of the coverage, there are times when you may want to consider a short-term health insurance plan, including:
- You missed open enrollment for ACA-compliant coverage and do not have a qualifying event that would trigger a special enrollment period.
- You’re newly employed and will soon be covered by your employer’s health plan, but they have a waiting period of up to three months before you’re eligible for coverage.
- You’ll soon be enrolled in Medicare, but do not have any other coverage options in the meantime. If your Medicare won’t take effect until after the start of the coming year, you can enroll in an ACA-compliant health plan during the autumn open enrollment period, and then cancel it when your Medicare coverage takes effect.
- You’ve already enrolled in an ACA-compliant plan, but have to wait up to several weeks before it takes effect. You can use a short-term plan to bridge the gap until your new coverage is in force.
- You’re not eligible for Medicaid or a premium subsidy for Marketplace coverage, making an ACA-compliant plan unaffordable. This includes people who aren’t lawfully present in the U.S. and thus are not able to enroll in a plan through the exchange/Marketplace at all.
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Footnotes
- “Statement of U.S. Department of Labor, Health & Human Services, and the Treasury Regarding Short-Term, Limited-Duration Insurance” Centers for Medicare & Medicaid Services. Aug. 7, 2025 ⤶
- “376.1951” Missouri Statute. Accessed Mar. 10, 2026 ⤶
- “Short Term Health Policies: H15G.004 and H16G.004” Missouri Department of Commerce and Insurance. Accessed Apr. 1, 2025 ⤶
- “Missouri HB604” BillTrack50. Enacted July 7, 2021 ⤶
- “Examining Short-Term Limited-Duration Health Plans on the Eve of ACA Marketplace Open Enrollment” KFF.org. Oct. 15, 2025 ⤶ ⤶
- “Short-Term, Limited-Duration Insurance and Independent, Noncoordinated Excepted Benefits Coverage” U.S. Department of Health and Human Services. April 3, 2024 ⤶