The State of Health Insurance in Missouri

Even if you purchased an individual health insurance policy, there is no reason for you to be compliant and just leave it all to the people handling your policy. Under Missouri laws, there is no regulation on premium rates. This translates to the right of insurance companies to raise premiums whenever they deem necessary. This is because the state encourages competition within the market and relies on this competition to determine and control premium rates. However, Medicare supplement insurance premiums are regulated under the law and should not be overly charged.

You should also know that Missouri allows insurance companies to deny new application for coverage. However, if the policy has been issued, the policyholder is protected against possible discrimination and potential cancellation of policy. There are only two just causes allowed for cancellation of policy—nonpayment and misrepresentation of information. If you have a pre-existing medical condition, the insurance provider may still decide to provide coverage but may exclude this medical condition from your coverage. In order to avoid confusion later on, it is important to meet with your prospective insurance provider and clarify any questions and queries you may have.

Under state law, an employer has the option of not offering health insurance to employees. In relation, they also have the right to change insurance carrier and the extent of benefits provided, so long as they deem it necessary. However, most employers offer group health insurance as part of their benefits package and this kind of health package typically waives any kind of preexisting medical condition an employee may have. In case group health coverage ends, employees have the choice of applying for individual coverage, as provided by the Health Insurance Portability and Accountability Act. The state also offers a similar package for individuals who are unable to get policy from private insurers. Such is the dilemma addressed by the Missouri Health Insurance Pool. This particular program, however, has rates that are 150 percent of that offered by the standard market.

The state also regulates group health insurance for small businesses. To this end, no insurance company may deny application for such coverage based on the health status of the employees and their dependents. There are actually several insurance plans to choose from, including Health Maintenance Organization Plan, indemnity plans, or preferred provider organization plans. Before selecting a particular health plan, however, employers do need to determine the company’s financial capability to pay the premiums though they are also not required by the state to provide one. Small business employers also have the option of transferring a portion of the cost to employees. Whatever the case may be, they still have the obligation to make their employees understand the policy thoroughly, in order to avoid confusions and complaints later on. Another viable option would be to offer individual insurance policies to employees as affordable coverage are also available through membership through trade associations or similar organizations.

Individual and group health insurance policies may provide coverage for dependents who are up to 25 years old. If for some reason you would wish to continue coverage on a dependent beyond that age, you have to shop around for a provider who might offer extended coverage. Some private agencies may approach you and offer medical discount cards. It is their obligation to let you know that these products are not insurance. Nevertheless, these products are still regulated by the State of Missouri so you can check with local authorities on the product’s credibility.

Should you have any questions or inquiries that your insurance provider could not clarify to your satisfaction or if you suspect something amiss with your insurance transaction, do take the time to contact the Missouri Department of Insurance, Financial Institutions, and Professional Registration.

We help our Missouri customers in Kansas City, St. Louis, Springfield, Independence, Columbia, Lee's Summit, O'Fallon, St. Joseph, St. Charles, St. Peters, MO and other cities in The Show-Me State lower their premiums and save money on all types of insurance. Use the form above to find low cost auto, homeowners, health, medical, life and long term care insurance. Using our Missouri insurance agent and broker network, you can compare rates quickly from the comfort of your home.

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