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An Overview on Medical Insurance in Missouri

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Medical Insurance in Missouri

Medical Insurance in Missouri

Introduction: The overall health insurance situation in Missouri does not significantly vary from the situation in most of the states in United States. In accordance to a survey conducted between 2001 and 2003, by the Center for Disease Control, almost 11% of the total Missouri residents did not get the benefits of Missouri medical insurance, per year.

In this abstract, we have talked about some important aspects of Missouri medical insurance that includes Missouri medical insurance regulations as well as a brief discussion on Missouri medical insurance alternative options. A comprehensive list of top Missouri medical insurance companies is also included in the abstract. Being a dweller of Missouri, you can certainly depend on it to know the important health insurance facts of your state.

Regulations for Missouri Medical Insurance

To supervise the Missouri medical insurance situation and to regulate the activities of Missouri medical insurance companies, Missouri state government has introduced some rules and regulations that are discussed below:

  • Missouri individuals, asking for coverage through an employer, can't be refused access to Missouri medical insurance. Moreover, they can enjoy unlimited coverage.
  • Missouri individuals can be refused access to individual Missouri medical insurance, depending upon the age and health condition.
  • Missouri residents, who are qualified for HIPAA or Health Insurance Portability and Accountability Act, can not be refused access to individual Missouri medical insurance.
  • Missouri medical insurance companies should offer customized insurance options to the HIPAA qualified Missouri individuals.
  • Medical insurance companies in Missouri can impose a waiting period for any pre-existing medical condition and can refuse claims for pre-existing medical condition.
  • A pre-existing health condition may be considered as an illness for which an individual was treated or otherwise diagnosed, prior to commencement of new Missouri medical insurance plan.
  • However, no pre-existing medical condition waiting period can last for more than 2 years.
  • Some of the Missouri medical insurance plans can implement elimination riders for pre-existing health condition. Elimination riders restrict the right of an individual to get coverage for his or her pre-existing medical condition, for an indefinite period of time or even permanently.
  • Missouri medical insurance plans have not to offer credit for any pre-exiting condition that was covered previously.
  • All Missouri medical insurance should have a guaranteed provision for renewal.
  • Guaranteed renewability provision lets an individual renew his or her existing health insurance policy. Nevertheless, he or she should have disbursed all the premiums, in time and provided no fake information during the term of respective Missouri medical insurance policy.
  • Missouri medical insurance rates are likely to be changed after every policy, depending upon the health, age and other risk factors.
  • All Missouri medical insurance plans that provide dependant coverage should cover adopted children and newborns under their parent's Missouri medical insurance plans; for first 31 days from the day of adoption or birth. The plans should be adjusted accordingly, after that period to accommodate the newborns or adopted children.
  • Disabled dependants can enjoy coverage under their parent's Missouri medical insurance plans, even if they have crossed the upper age limit.
  • In Missouri, there are some special regulations for the pregnant women.
  • As per state laws, in some cases, pregnancy may be considered as a pre-existing health condition.
  • Missouri medical insurance companies can not inflict pre-existing limitations on HIPAA qualified pregnant women.
  • Missouri residents that are medical insurance plans or between jobs can opt for temporary medical insurance plans.

Missouri Medical Insurance Alternative Options

The state government of Missouri operates and sponsors some health insurance alternative programs to let the Missouri individuals avail the benefits of Missouri medical insurance. However, individuals, who are otherwise considered as “uninsurable” or unable to afford Missouri medical insurance, are only eligible for Missouri medical insurance alternative programs. The programs are as follows:

  • Missouri Medicaid: Missouri residents, who meet all the qualifying as well as income criteria, are eligible for Missouri Medicaid.
  • MC+ for Kids: This is Missouri Children's Health Program, which is created to offer health insurance coverage to the children below and up to the age 19. However, children from families, which are not able to pay for Missouri health insurance or otherwise ineligible for Missouri Medicaid, are only entitled to avail the benefits of MC+ for Kids.
  • Missouri Health Insurance Pool or MHIP: This is a high risk pool for Missouri medical insurance that enables Missouri individuals, who are otherwise considered as “uninsurable” by most of the Missouri medical insurance companies, to purchase group Missouri health insurance plans. Pre-existing conditions may be applied.

Missouri Medical Insurance Companies

The Missouri Department of Insurance has provided a list of top Health Maintenance Organizations or HMOs that are active within the state and sell medical insurance. The list is mentioned, below:

  • Aetna Health Inc.
  • Alliance for Community Health LLC. D/B/A Mercy Careplus
  • Blue Cross & Blue Shield of Kansas City
  • Blue-Advantage Plus of Kansas City Inc. D/B/A Blue-Advantage
  • Childrens Mercys Family Health Partners Inc.
  • Cigna Healthcare of Ohio Inc. D/B/A Cigna Healthcare of Kansas
  • Cigna Healthcare of St Louis Inc.
  • Community Health Plan
  • Coventry Health Care of Kansas Inc.
  • Cox Health Systems HMO Inc.
  • Essence Inc.
  • Firstguard Health Plan Inc
  • Good Health HMO Inc. DBA Blue-Care Inc.
  • Great-West Healthcare of Kansas/Missouri Inc.
  • Group Health Plan Inc.
  • Harmony Health Plan of Illinois Inc. D/B/A Harmony Health PLA
  • Healthcare USA of Missouri LLC
  • Healthlink HMO Inc. DBA Healthlink HMO
  • HMO Missouri Inc. D/B/A Bluechoice
  • Humana Health Plan Inc
  • Mercy Health Plan of Missouri Inc. D/B/A Premier Health Plans
  • Mercy MC + Inc.
  • Missouri Care LC
  • United Healthcare of The Midwest Inc.

Missouri Department of Insurance

For further enquiry on Missouri medical insurance, you can contact at the following address:

Missouri Department of Insurance

Mailing Address
PO Box 690
Jefferson City, MO 65102-0690
Telephone No: (573) 751-2640 (for consumer affairs)
Fax: (573) 526-4898


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