See your Missouri health insurance coverage options.

You can buy individual and family health insurance from Missouri’s Marketplace if:⁵

• You live in Missouri. 
• You are lawfully present in the U.S.
• You don’t have Medicare.
• You are not incarcerated.

Eligibility for financial assistance with your Marketplace coverage will depend on your income. In addition, to be eligible for financial assistance in the Marketplace:

• You must not be eligible for affordable employer-sponsored health coverage.
• You must not be eligible for Medicaid/CHIP (MO HealthNet).
• You must not be eligible for premium-free Medicare Part A.⁶

In Missouri, the open enrollment period to sign up for ACA-compliant individual and family health plans is from November 1 to January 15.

• If you enroll by December 15, your coverage starts on January 1.
• If you enroll between December 16 and January 15, your coverage starts February 1.⁷

Outside of open enrollment, you can still make plan changes or enroll in the Marketplace if you qualify for a special enrollment period (SEP). Most SEPs require a qualifying life event, such as involuntary loss of coverage, marriage, or having a baby.

But there are instances where you don’t need a qualifying life event to apply.⁸ For example:

• If you’re eligible for premium tax credits and your income is not more than 150% of the poverty level, you can enroll anytime until at least 2025.⁹
• If you’re a Native American, you can enroll anytime.¹⁰
• If you lose Medicaid or CHIP between March 31, 2023 and July 31, 2024, you can enroll through the extended SEP that continues throughout that window.¹¹

In Missouri, you have a few options to enroll in a Marketplace health plan:

• Directly through HealthCare.gov – the ACA exchange
• By phone at (800) 318-2596
• By contacting agents, navigators, certified application counselors or an approved enhanced direct enrollment entity.¹²
• By mailing in a paper application
  

Many people – like early retirees not yet on Medicare, self-employed people, and those who work for small businesses without health benefits – use the ACA Marketplace.

In Missouri, you can find affordable health plans through the ACA Marketplace’s website: HeathCare.gov.

Under ACA, you may qualify for income-based subsidies called Advance Premium Tax Credits (APTC). These credits lower your premiums.

In 2023, more than 90% of people enrolled in Missouri’s exchange received premium subsidies, saving about $584 per month. Those who received subsidies pay an average monthly premium of $94.¹³

If your income isn’t more than 250% of the federal poverty level, you may also receive cost-sharing reductions (CSR), as long as you enroll in a Silver-level plan.¹⁴ CSRs reduce your out-of-pocket costs when you use your health insurance. 

Missourians may also find affordable coverage through Medicaid if eligible. Missouri expanded Medicaid eligibility guidelines in 2021, under the terms of a voter-approved ballot measure that implemented the ACA’s Medicaid expansion. This allows adults to enroll in Medicaid with a household income up to 138% of the poverty level. Learn more in our Missouri Medicaid guide.

Short-term plans are also a low-cost option for people who are not eligible for employer plans, Medicaid, Medicare, or subsidies through the exchange.

Source: CMS.gov¹⁵

Nine insurers offer coverage in the Missouri Health Insurance Marketplace for 2024, including a few that have expanded their coverage areas for 2024, resulting in more available plans in some areas of the state.¹

There were ten insurers offering plans in 2023,¹⁶, but Cigna is exiting Missouri’s individual insurance market at the end of 2023.¹⁷ 

Here are the 2024 average approved rate changes for Missouri’s individual/family health insurance market (before any subsidies are applied):¹⁸

Source: Missouri Department of Insurance¹⁹

Cigna will not offer individual and family health plans on Missouri’s Marketplace in 2024. 

The approved rate increases are for full-price premiums, and amount to a weighted average rate increase of 4.6% for 2024.²⁰

Since most people on Missouri’s exchange receive premium tax credits, they don’t pay the full price.²¹ If you qualify for subsidies, your net rate change depends on changes in your plan rates and your subsidy amounts.

A note about rate review in Missouri: Prior to 2017, Missouri did not have an effective rate review program, but that changed in 2017 (as of 2023, only two states — Oklahoma and Wyoming — do not have an effective rate review program and thus rely on the federal government for this).²²

Since 2017, under the terms of SB865, the Missouri Department of Insurance has taken an active role in reviewing insurers’ proposed rate changes.²³ State regulators determine whether the proposed rates are justified, although they are not allowed to prevent an insurer from implementing a rate change, even if the state does not consider it to be justified (this is the same as the federal rate review process).

For perspective, here’s a summary of how unsubsidized premiums have changed over the years in Missouri’s individual/family health insurance market:

• 2015: Average increase of 9%.²⁴
• 2016: Average increase of 14%.²⁵
• 2017: Average increase of 25.5%²⁶
• 2018: Average increase of 40%.²⁷
• 2019: Average increase of 1.6%.²⁸
• 2020: Average decrease of 2%.²⁹
• 2021: Average increase of 4.7%.³⁰
• 2022: Average increase of 2.3%.³¹
• 2023: Average increase of 11%.³²

During the 2023 open enrollment, 257,629 people signed up for private health plans through Missouri’s exchange/Marketplace.³³

Usually, when a state expands Medicaid, Marketplace enrollment drops. That’s because people with income between 100 and 138% of the federal poverty level transfer from Marketplace plans to Medicaid.

But Missouri’s Marketplace enrollment grew in 2022 and 2023 despite the 2021 Medicaid expansion. This growth is likely because of larger subsidies from the American Rescue Plan and the Inflation Reduction Act. The larger and more accessible subsidies make coverage more affordable.³⁴

Source: 2014,³⁵ 2015,³⁶ 2016,³⁷ 2017,³⁸ 2018,³⁹ 2019,⁴⁰ 2020,⁴¹ 2021,⁴² 2022,⁴³ 2023⁴⁴

HealthCare.gov
The official federal website where you can sign up for health insurance plans through the ACA Marketplace. 

Missouri Department of Insurance
Oversees and regulates health plans, brokers, and agents.

MO HealthNet
Missouri’s Medicaid.

Missouri State Health Insurance Assistance Program (Missouri SHIP)
Helps Missourians with Medicare benefits.

Medicare Rights Center
National resource with a website and call center to provide information and help for people on Medicare.