Missouri Health Insurance

According to the Center for Disease Control, an average of 10.9% of Missouri residents went uninsured for Missouri health insurance each year between 2001 and 2003.

Missouri Health Insurance Regulations

All Missouri health plans through employers cannot deny or limit benefits to individuals employed by that business. Individuals in Missouri, however, can be denied access to Missouri health insurance based on age or health. If an individual is eligible for the Health Insurance Portability and Accountability Act (HIPAA) he or she cannot be denied access to Missouri health insurance and any medical insurance company must give such individuals designated options for health insurance.

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Pre-Existing Regulations

Most Missouri health insurance companies can have pre-existing exclusion periods for any condition claimed under the policy during the first two years of the plan. If an individual makes a claim, the Missouri health insurance company can look to see if that condition existed prior to the beginning of the plan and if so, can refuse to pay the claim. Missouri health insurance policies can also carry elimination riders that can permanently exclude certain medical conditions from coverage under the policy.

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Pregnancy Regulations

Pregnancy may be considered a pre-existing condition in some cases. No Missouri health insurance policy can impose pre-existing restrictions on HIPPA eligible individuals. No Missouri health insurance policy has to give credit for pre-existing conditions that were covered under previous policies.

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Guaranteed Renewable Regulations

All individual Missouri health insurance plans are guaranteed renewable which means that an individual is guaranteed the right to renew an existing Missouri health insurance plan as long as that individual has paid all premiums on time and has not provided any false information. Missouri health insurance rates can change after each plan and can vary based on an individual’s age, health and risk factors.

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Newborn Regulations

All newborns and adopted children are covered under the parent’s individual health insurance policy if that policy covers dependents. This coverage is automatic for the first 31 days after birth or adoption. After the initial period of coverage, however, adjustments to the Missouri health insurance policy must be made. Handicapped and Disabled children can remain under the parent’s Missouri health insurance policy beyond the time limit of most dependents.

For those individuals between jobs or health insurance plans, temporary Missouri medical insurance can be purchased through some companies.

Alternative Missouri Health Insurance Options

For individuals who cannot afford Missouri health insurance or who might otherwise be considered “uninsurable” there are state programs that may help:

• Missouri Medicaid is available for qualifying individuals who meet eligibility criteria.
• Missouri Health Insurance Pool (MHIP) is the high-risk pool for Missouri health insurance. Those individuals who might otherwise be “uninsurable” for most Missouri medical insurance companies can buy into a group plan under the state. Some pre-existing condition periods may apply.
• Missouri Children’s Health Program (MC+ for Kids) is the Missouri Children’s health insurance plan designed to provide insurance for children under 19 whose families may not qualify for Medicaid and who otherwise may not be able to afford Missouri health insurance.

Missouri Department of Insurance

Missouri Department of Insurance:

Mailing Address
PO Box 690
Jefferson City, MO 65102-0690

Consumer Affairs: 573-751-2640
Fax: 573-526-4898

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For other Missouri Insurance Resources, See:

• Missouri Auto Insurance
• Missouri Home Insurance
• Missouri Health Insurance

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