Quick Look: Best Missouri Health Insurance
Need help finding health insurance in the Show-Me State? We researched the best Missouri health insurance to help you find coverage. Read on to learn more about health insurance costs and see our top picks for the best insurance companies.
Best Missouri Health Insurance
Health insurance is a great way to reduce the cost of medical services and treatments. We looked through providers to find the best health insurance in Missouri. Check out our picks for the top providers in the Show-Me State.
1. Anthem BlueCross BlueShield
Anthem BlueCross BlueShield is one of the largest health insurance providers in the country. Anthem operates in a large portion of Missouri. If you live within the BlueCross BlueShield service area, you have a lot of plan options available. Coverage is available as group insurance for employers as well as individual plans.
2. UnitedHealthcare
UnitedHealthcare is the largest health insurance company in the United States. The company provides Missouri residents in certain areas of the state with health insurance options. UnitedHealthcare is often a popular choice for Missouri employers to offer their employees.
UnitedHealthcare offers many plan options for individuals, families and groups. UnitedHealthcare has a plan for pretty much everyone.
3. Cigna
Cigna only operates in 12 states, but Missouri is one of the 12. You’ll find Cigna coverage in many counties in Missouri but the company doesn’t serve the entire state.
Check to see if your county is covered. Cigna often offers the most affordable health insurance options compared to other companies.
4. AmBetter
AmBetter provides local health insurance plans for a limited number of areas in Missouri. If you live within the AmBetter network, you have access to affordable health insurance plans with additional benefits.
AmBetter health insurance plans give you access to wellness benefits and discounts on certain wellness services. You’ll also get access to a 24/7 telehealth line, which allows you to connect with a doctor via phone or video call for certain health issues such as flu or allergies.
What is Health Insurance?
Health-related costs are expensive — surgery, prescription drugs and visits to your doctor cost a lot of money. It’s almost impossible to pay for all of your medical bills in Missouri out of pocket.
Health insurance is a type of insurance coverage that helps pay for medical bills and expenses. You pay a monthly or yearly fee, known as a premium, to enroll in a health insurance plan from an insurance company. When you visit the doctor or hospital, some or all of your medical costs are covered by your insurance.
Common Health Insurance Terms to Know
Before you can look for health insurance in Missouri, you need to understand how health insurance works. The health insurance industry uses a lot of technical terms. Use our list of health terms to navigate insurance:
- Premium: The cost to enroll in a health insurance plan, usually paid monthly.
- Claim: Your request to have medical treatments or services covered by your insurance plan. When you visit the doctor or hospital, you file a claim with your insurance company. Many times, the billing department of the medical office files the claim on your behalf.
- Coinsurance: Your portion of the cost of medical treatments in percentage form. For example, you may have 50% coinsurance for a certain treatment. You pay 50% and your insurance company covers the remaining 50%.
- Copayment: A copayment is similar to coinsurance, except that it is a fixed dollar amount. Let’s say you have a treatment that costs $100. Your copayment is $25, and your insurance company pays the last $75.
- Deductible: A deductible is an amount you pay for covered medical services before your insurance pays. Let’s say your deductible is $3,000, for example. You pay the first $3,000 of medical treatments out of pocket and your deductible resets at the beginning of each year.
- Out-of-pocket maximum: This is the maximum amount of money you’ll have to pay out of pocket for covered medical costs per year. Your premiums don’t count towards your out-of-pocket maximum, but deductibles, coinsurance and copayments do.
- Explanation of benefits: This is a written breakdown of how your insurance company pays for a specific claim. When you file a claim, you’re sent an explanation of benefits (EOB) with details on what the insurance company pays for and what you need to cover.
- Provider network: Your health care network is made up of doctors, hospitals and other health care providers who contract with your health insurance company. Using an in-network or contracted provider usually results in deeper discounts and a lower overall cost than visiting an out-of-network doctor.
How Do You Get Health Insurance in Missouri?
Wondering where and how to get health insurance in Missouri? Your age and employment status plays a big role in how you get insurance. You’re eligible to stay on your parents’ health insurance policy until age 26, according to the Marketplace.
Many employers offer health insurance as a benefit for full-time employees and pay for part of your monthly premium. You pick up the other part of the monthly cost. Health insurance through an employer can greatly lower the cost of insurance. Individual plans, which you can enroll during open enrollment near the end of each year, tend to be much more expensive than a group plan through an employer.
Average Cost of Health Insurance in Missouri
The national average cost for health insurance premiums is $1,427 annually, according to the Kaiser Family Foundation. The average annual cost of health insurance premiums in Missouri is $1,403, which represents the cost for an employee who pays his portion of an employer’s health care plan.
Unlike other types of insurance, such as car or homeowners insurance, you’re probably not going to find discounts on health insurance. There are 3 major factors that affect the cost of health insurance:
- Your age
- Your location
- Whether you use tobacco or not
You can’t change your age, and you’re probably not going to change your location just to receive a lower health insurance premium.
If you’re a smoker or other tobacco user, you can expect to pay more in health insurance premiums. In fact, tobacco use could cost you up to 50% more than a non-smoker of the same age and in the same area.
How to Lower Health Insurance Costs in Missouri
Since health insurance premiums are mostly based on your age, location and tobacco use, your best choice to lower your monthly premiums is to choose a less expensive plan. For example, a high deductible health plan (HDHP) has a high deductible but often includes lower premiums. Let’s say you only visit the doctor for a yearly checkup but want coverage in case you are in a major accident. An HDHP could be the right choice.
Types of Health Coverage
There are several different types of health insurance coverage available in Missouri. The types of plans include:
- Health maintenance organization plans (HMOs)
- Preferred provider organization plans (PPOs)
- Exclusive provider organization plans (EPOs)
- Catastrophic plans
Each type of health coverage has advantages and disadvantages. It’s important to understand the different types of coverage to get a better idea of which type works best for your family.
- HMOs are one of the most common types of health care coverage. An HMO plan usually limits coverage to care from doctors or health care facilities that are contracted with the insurance company. Let’s say you go to an out-of-network provider. You may have to pay for the total cost out of pocket. Many HMO plans require you to live in a certain coverage or service area to be eligible.
- PPO plans also use a network of doctors and health care providers. If you visit an in-network provider, you’ll get the best price on care. However, you can still use out-of-network providers. You may have to pay a higher amount of coinsurance.
- EPO plans are much less common than HMO or PPO plans. You can only use in-network providers for your health care needs. These plans are often available for health care professionals so you can visit doctors in your employer’s network.
- Catastrophic plans are the least expensive type of health insurance in Missouri. You can only sign up for a catastrophic plan if you’re under 30 years old. Plans usually cover some preventive care. However, catastrophic plans come with incredibly high deductibles and often can only be used if you have a sudden, serious medical condition.
What Does Health Insurance Cover?
Most health insurance plans cover similar treatments or health care services. Check your specific plan to see what is covered, but most average health insurance plans cover:
- Emergency services, such as a visit to the emergency room after an accident
- Mental health and substance use disorders
- Maternity and newborn care
- Hospitalization, such as for a surgery
- Prescription drugs
- Rehabilitative and habilitative services to help people with injuries or disabilities recover mental and physical skills
- Laboratory services like bone marrow testing or blood tests
- Preventive screenings, exams and services
- Pediatric or child health care services
- Cancer treatment
- Urgent care visits
- Visits to a specialist
- X-rays
- Limited dental care for children
What Does Health Insurance not Cover?
Health insurance can help cover the cost of expensive medical treatments, but it doesn’t cover every procedure. Most services that insurance won’t cover are considered medically unnecessary or experimental. Non-covered procedures include:
- Plastic surgery, unless it is deemed medically necessary
- Fertility treatments
- Over-the-counter medications
- Dental care for adults
- Alternative treatments like acupuncture
- Weight loss treatment or surgery
- Long-term care, such as the cost of living in a nursing home
Find Health Insurance Companies in Missouri
Not all providers are available throughout the entire state of Missouri. You can check online to learn more about insurance companies to find out if they cover your location — it’ll help you find the most affordable health insurance plans.
Consider your health needs as well as your budget as you shop for health insurance. Get health insurance quotes today to see your coverage options.
Frequently Asked Questions
Does health insurance cover emergencies?
Health insurance covers emergency room care, but generally with a higher copay.
Does health insurance cover medication?
Yes, health insurance generally covers medication.