Missouri Health InsuranceIndividuals and Families
Health Plans for Individuals & Families
Missouri Affordable Health Insurance Quotes
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Health insurance offers average individuals a way to reduce their unexpected medical costs and create affordable access to cutting edge medical treatment. By pooling the premiums paid by all policyholders, an insurance company creates a reserve of funds from which they will pay their portion of medical expenses incurred by their policyholders. Any funds left unused at year end are carried over to cover expenses the following year. Since many policyholders who faithfully pay premiums are in good health, there is generally a large amount of unused funds available for carryover.
Information about Missouri Health Insurance
The state of Missouri has been more than vigilant in the creation of a fair and comprehensive system of health care to cover all Missouri residents. Studies conducted by the state of Missouri show that, in 2006, more than 700.000 residents were without health insurance coverage. This lack of health insurance coverage not only results in reduced preventative care among Missouri residents, but also causes extremely large medical bills for those uninsured individuals who do seek care.
Imagine the impact an insurance policy could have on your budget after a fall. Let's say you've had your insurance policy for six months, and you paid the entire annual premium ($1,300) when you took out the policy. On the first day of the seventh month, you take a drive to North Kansas City and have a small car accident. You have some minor cuts and scrapes and break your arm in the accident. After being rushed by ambulence to the hospital emergency room, you are given three ex-rays, you have a consultation with a physician, your arm is realigned and a plaster cast is applied. The total cost of your visit is $5,000 and you are asked to pay the hospital a copayment of $100. Your total cost for the insurance policy has been $1,400- which means on this incident alone you have saved over $3,000. Without the policy, you would be responsible for paying the entire $5,000 bill as well as any other medical expenses you incur during the course of the year.
Options for Missouri Health Insurance Coverage
By this point, the value of a health insurance policy has become apparent. But how do you decide which type of policy is right for you? There are many coverage options available to Missouri residents. No matter what your budget, health history or individual needs are, you're bound to find a policy that works for you.
Individual coverage: If you are of generally good health, an individual policy could be the perfect option for you. With individual coverage, you can choose to have a copayment or deductible. A deductible will make a big impact on the cost of your policy. Policies with deductibles are less expensive than policies without, and the higher the deductible the cheaper the policy. If you think you won't need to use your insurance that often, then you should consider setting high deductibles. If you have dependents, you choose a family plan to provide an umbrella of coverage for the whole family. It could be more affordable to cover your dependents with their own individual policy, so be sure to examine both options.
Medigap: If you are over 65, you are afforded individual coverage through Medicare. This means you only need supplemental coverage called, Medigap. Medigap coverage will pay for Medicare deductible and copayment expenses as well as any expenses not covered under your Medicare policy. Expenses like alternative healing costs, treatment related travel expenses and more may be covered under Medigap.
Group coverage: Many employers in Missouri make health insurance available to their employee group and their employees' families. Generally, employers pay part of the premium costs in order to make group insurance affordable for all employees. Since group insurance coverage underwriting does not consider your individual health history, you'll find you are able to get the coverage even if you've been turned down by other insurers. Some fraternal organizations and unions also offer group health insurance coverage. If at any point while covered you leave your employer or group, you will be offered COBRA coverage which provides up to 18 months after you leave. COBRA offers additional benefits for survivors after the death of the covered employee and in the event of divorce.
Major medical: If you are concerned only with defraying expenses incurred by a catastrophic illness or accident, you might consider major medical coverage. With major medical coverage, you'll have an inexpensive premium payment and the peace of mind in knowing that any major surgeries, accident-related health expenses and catastrophic illnesses are covered. Most major medical policies include a copayment or deductible.
State high risk pool: For those individuals who are uninsurable or who have been quoted health insurance premiums that are 150% more than standard premiums, there is the Missouri Health Insurance Pool (MHIP). MHIP is offered by the State of Missouri and administered by Anthem Blue Cross and Blue Shield and Blue Cross and Blue Shield of Kansas City. When insured by MHIP you will be expected to pay a premium for coverage. In exchange, you will be covered under a policy that provides the same great care and coverage as a standard insurance policy.
State subsidized program: For low income families and children, Missouri offers MC+ for Kids. MC+ for Kids is a program that acts as an expansion of the Medicaid program. MC+ for Kids provides health insurance to Missouri children under age 19 whose families cannot afford to provide their own health insurance policy.
Health savings accounts: HSA's can be used as a self-funded policy. All your health care expenses will be out of pocket, but you will benefit from the tax savings afforded by HSA contributions. You can also combine HSA's with major medical policies or high deductibles to offset your costs. HSA's can also reduce your need for supplementary coverage like vision or dental, since your HSA funds can be used to pay for those expenses.
Premium frequency: In order to avoid a lapse, you must consistently pay your insurance premium. You have the option of making payments monthly, quarterly, semi-annually or annually. You may be able to pay by mail, drop off or electronic bank transfer. However you decide to make your payments, be sure to choose an option you can stick to. Once your policy lapses, you will be required to provide current medical records and go through the underwriting process again. Any illnesses or chronic conditions you've been diagnosed with since you took the policy out originally will be seen unfavorably by the underwriter and could result in the denial of your reinstatement.
The Missouri Health Insurance Plans that are Available
Many nationally recognized insurance companies make policies available to Missouri residents. With licensed agents statewide and networked providers and clinics nationwide, these health insurance companies make it easy for Missourians to obtain and use their policies. Some of the best plans for Missourians are offered by:
Anthem Blue Cross and Blue Shield of Missouri: Anthem Blue Cross Blue Shield of Missouri is part of the Blue Cross Blue Shield Association of health insurance. They offer both individual and family plans, and their website is easy to navigate. They also have group plans, including, “360 Health” which offers a customizable group plan. They have offices statewide including in Saint Charles, Independence and East Independence.
Humana: Humana has many different options for policyholders. They have developed their website to be a comprehensive resource to both policyholders and uninsured individuals. They provide a provider search tool, health care budget builder and quote system. They have offices in cities and towns throughout Missouri, including in Saint Louis, Saint Joseph and Springfield.
Golden Rule Missouri: Golden Rule Missouri is a member of the United Health care family of health insurance providers. They provide Missouri residents with a vast array of plan choices, including: individual plans, family plans, HSA's, high deductible plans, short term plans and more. They have offices throughout the state including in Lees Summit, Kansas City and Columbia.
Important Health Insurance Definitions
- COBRA: Is a national program that requires the optional continuation of group health insurance coverage for those who have terminated employment with their group plan provider. COBRA allows policyholders to keep their coverage for eighteen months unless they get coverage under a new group or individual plan.
- Copayment: A copayment is the predetermined amount that policyholders are required to pay for medical treatment and/or medications. The copayment is due at the time of treatment but can sometimes be billed. Copayments generally ranges between $25 and $100. Copayments for visits with specialty doctors will be on the higher end.
- Deductible: A deductible is the amount of out of pocket expenses that a policyholder must absorb for medical costs before their policy will begin making payments. In the event that your policy has a deductible, you will pay all medical expenses out of pocket until your deductible has been met and then you'll pay only copayments. Deductibles can range from $500 to $5,000.
- Health Maintenance Organizations (HMO's): HMO's are plans with pre-established physician networks that policyholders are permitted to visit for medical treatment. HMO's do not pay any benefit if you work with a physician or clinic outside of the insurance company's network.
- Health Savings Account (HSA): Health Savings accounts are specialized savings accounts that retain deposited monies in order to pay for out of pocket medical expenses like co-pays or deductibles. The money placed in an HSA is tax deductible and can result in a lower tax burden. Monies in an HSA can be used to pay for medical treatment and expenses including some alternative therapy, massage therapy, eyeglass prescriptions and travel expenses related to an illness. Check with your HSA provider to find out what the allowable expenses are.
- Lapse: A lapse is the cessation of a policy because of nonpayment of premium.
- Limits: A limit is the maximum amount of funds an insurance company will pay for your medical needs annually.
- Preexisting Conditions: Preexisting conditions are illnesses and injuries that were treated and diagnosed prior to your acceptance of an insurance policy. Many insurance policies won't pay for any expenses related to that preexisting condition for a certain amount of time (usually one year). If this is the case, you will receive a notice of exclusion. In some cases, your insurance company may not exclude treatment for preexisting conditions but will, instead, charge you a higher premium.
- Preferred Provider Organizations (PPO's). PPO's are insurance plans are with a network of physicians who have agreed to work under contract with the health insurance company. PPO's pay a reduced insurance benefit if you visit physicians outside their network and full benefits when you seek medical treatment from physicians within their network. Premiums on PPO policies will generally be more expensive than HMO policies.
- Premium: A premium is the payment a policy holder must pay in order to avoid lapsing their policy.
Missouri Health Insurance Resources
- Defining Affordable Health Care for Missouri
- Guidlines for Acquiring Affordable Health Insurance in Missouri
- Study on Health Insurance Affordability in Missouri
- Health Care & Health Insurance Spending in Missouri
- Looking at Massachusetts Health Insurance for Ideas in Missouri
- Affordable Missouri Health Insurance Price Sensitivity Issues
- Developing an Affordable Health Insurance Scale in Missouri
Missouri Medicare Plans
Seniors age 65 and older are eligible for a variety of Medicare plans in Ohio. Medicare plan options include Medigap and Medicare Advantage policies:
- Missouri Medicare Plans
- Medicare Supplemental Insurance Plans in Missouri
- Medicare Advantage Plans in Missouri
- Medicare Part D Plans in Missouri
- Official U.S. Government Site for Medicare
Missouri Doctor Directory
Doctors practicing medicine in the State of Missouri are licensed by the state. Doctors accept different forms of health insurance which you can verify before setting an appointment.
- Directory of Doctors in Missouri - search by location and practice
