About the Missouri Health Insurance Marketplace

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The Missouri Health Insurance Marketplace is a website where you can compare and buy the health insurance plan that that is right for you. Individuals and families can use the Missouri Marketplace.

 

How does the Marketplace work?

The Missouri Health Insurance Marketplace is a lot like a travel website where you can compare prices and buy hotel or airline tickets.

People are available to assist you with understanding and buying health insurance policies. Individuals and families can talk to a or a , by phone at 1-800-318-2596 (TTY: 1-855-889-4325), or in person (use this tool to find in-person help near you). You can get help at various locations across Missouri. They can answer your questions about the Missouri Health Insurance Marketplace.

On the Missouri Health Insurance Marketplace website you can:

  • Compare health insurance plans.
  • Calculate the cost of health insurance plans.
  • Find out if you qualify for a or .
  • Learn if you qualify for /.
  • Buy a health insurance plan for you or your family.

What if I need to enroll in health insurance outside the open enrollment period?

If you don’t enroll in a health insurance plan by the deadline, you may qualify for a Special Enrollment Period to enroll in Marketplace coverage.

A is a limited window of time outside of the normal period when you can apply for a Marketplace plan.

If you have any of these life changing events, you could qualify:

  • Get married or divorced.
  • Have a baby.
  • Adopt a child or put a child up for adoption or foster care.
  • Move from a different state or from a different county within Missouri.
  • Become a U.S. citizen.
  • Gain status as a member of an American Indian tribe.
  • Leave jail or prison.
  • Lose your health plan for any of these reasons:
    • Lose coverage through your job (does not usually include if you chose to end it).
    • You get divorced.
    • Your individual plan ends in 2018.
    • Your expired.
    • You turn 26 and can no longer be on your parent’s plan.
    • You lose Medicaid or CHIP coverage.

You generally have 60 days from the life changing event to apply and enroll in a Marketplace plan.

Navigator

People in communities throughout Missouri who are certified to provide free help to consumers enrolling in the Health Insurance Marketplace.

Certified application counselor (CAC)

People who provide free help to consumers enrolling in the Health Insurance Marketplace. CACs work at local community organizations, hospitals or health centers.

Premium tax credit

Money the government pays to help cover monthly premium payments for people who qualify. People who qualify, in general, are those who enroll in a Marketplace plan and have a yearly income that is between 100 percent and 400 percent of the Federal Poverty Level (FPL). Other rules for qualifying for tax credits are shown at www.healthcare.gov. To see how much you could save, use the calculator.

Cost-sharing reduction

Money the government pays to help cover out-of-pocket health care costs for people who qualify. People who qualify, in general, are those who enroll in a Marketplace Silver plan and have a yearly income that is from 100 percent to 250 percent of the Federal Poverty Level (FPL). Other rules for qualifying for cost-sharing reductions are shown at www.healthcare.gov.

Medicaid

A government health insurance program for Americans who have low incomes or disabilities. In Missouri, this program is called “MO HealthNet” for adults, and “MO HealthNet for Kids” for children up to age 19.

Children’s Health Insurance Program

The Children’s Health Insurance Program (CHIP) is public health insurance for children. CHIP covers children in families who may not have access to other health insurance coverage and have family income above the Medicaid eligibility level. In Missouri, this program is called MO HealthNet.

Special enrollment period

A period of time outside of Open Enrollment when some people can enroll in an insurance plan, or change their insurance plan, in the Marketplace. In general, you may get a Special Enrollment Period when you have a qualifying life event.

Open enrollment period

Open enrollment is a time period, usually a few months, when you can choose or change your health insurance plan. Open enrollment often happens in the fall with changes to the coverage starting in January. If you have a major life change, like getting married, having a baby, or losing your job, you may be able to change your health insurance outside of the open enrollment period.

The Open Enrollment Period for 2019 Marketplace health coverage is November 1 – December 15, 2018.

Job-based health insurance plans and Medicare have their own open enrollment periods where you can add family members who may have been covered by a different insurance plan the year before.

COBRA coverage

If you lose your job, you can temporarily keep your employee health insurance – but you must pay all of the monthly premiums yourself, including the share the employer used to pay.