With the passage of the Affordable Care Act (ACA), also known as ObamaCare, Missouri residents have new choices when purchasing health insurance. Missouri did not implement a state-run insurance marketplace, so citizens of the state can fill out applications on the federal Healthcare.gov Marketplace.
In addition, Missouri also decided not to move forward with the expansion of Medicaid eligibility standards. Some Missourians may not qualify for Medicaid nor qualify for financial assistance to purchase insurance in the Marketplace. However, ObamaCare increased funding for community health centers, which may be able to offer assistance to state residents in the form of sliding scale or reduced fees.
Purchasing Health Insurance in Missouri
Missourians who intend to purchase health insurance through the Marketplace can visit Healthcare.gov to fill out an application. Applications will automatically be reviewed for eligibility for financial assistance, as well as for Medicaid or Children’s Health Insurance Plan (CHIP) eligibility. Missourians who earn between 100% – 400% of the federal poverty level will qualify for some measure of assistance with health insurance premiums, and those who earn between 100% – 250% of the federal poverty level will also qualify for assistance with cost-sharing, such as deductibles and copayments. In 2013, the federal poverty level was $23,550 for a family of four.
Missourians making decisions on health insurance should be sure they know the full scope of a plan before buying. While some plans have lower monthly payments, they may have higher cost-sharing or a narrow provider network. Many Marketplace plans do not offer coverage for out-of-network doctors, so ensuring that your providers are covered under the scope of your plan is essential. Finding the right balance of monthly premium, cost sharing, provider network, and prescription coverage may take some effort, but will be well worth the time.
Open enrollment for the Marketplace lasts until March 31st, 2014. Uninsured Missourians should make sure to have coverage by that date to avoid a tax penalty. Generally, plans purchased by the 15th of a month will go into effect the 1st of the following month. If insurance is unattainable for some reason, an exemption to the penalty may be available. Missourians with work-based health insurance, Medicare, or other qualified plans are considered covered and do not need to purchase additional coverage in the Marketplace.
Medicaid and CHIP in Missouri
While Missouri is not expanding Medicaid, there will still be lower-income Missourians who qualify for coverage. Missouri residents can apply for Medicaid through the Marketplace or by contacting the state office directly.
Families who do not qualify for Medicaid may still be eligible for CHIP coverage. This program provides health insurance coverage for uninsured children in families that have moderate income and do not otherwise qualify for Medicaid. CHIP coverage makes sure that the children of Missouri have a healthy start.
If insurance coverage is beyond an individual’s or family’s means, assistance may be gained through community health centers. These centers provide some assistance with medical care and generally charge on a sliding scale based on income. You can find a community center near you online through the Health Resources and Services Administration.
The ACA has brought changes to how all uninsured Americans can gain access health insurance, and Missouri is no exception. Through the federal Marketplace, Missourians can apply for, review, and purchase the best coverage for their families. Having the right insurance in place is the first step to a healthier future.