Did you know that the average American pays more than $3,000 a year for healthcare insurance? That’s low compared to what you might pay out of pocket for medical services, but it’s enough to put a dent in your budget.

You know how important health insurance is, but you’re also wondering if there’s a way to get better pricing. How can you get more affordable health insurance in Missouri?

If you’re asking that question, then this guide is for you. With it, you’ll be able to find the perfect balance of affordability and comprehensive coverage.

Learn Your Options for Health Insurance in Missouri

The first step to finding affordable health insurance in any state is to find out what choices you have.

If you’re employed, you may have a health plan offered by your employer. If you’re retired or disabled, you may qualify for the federal Medicare program.

Many states have a health insurance exchange. Missouri doesn’t operate its own marketplace. Instead, it uses the federal marketplace.

In the marketplace, you’ll find health plans in the four “metal” tiers. The different tiers refer to how costs are shared between you and the provider. The quality of care is standardized.

You can also choose to buy health insurance from a private insurer. Missouri doesn’t require individuals to carry health insurance. It does have mandates that offer some degree of standardization across policies.

If you qualify for Medicare, you may also want to consider Medigap and other supplemental plans. You can compare Medicare supplements here and discover which options best fit your needs.

Comparing the Metal Tiers

If your employer offers health insurance, this may be the most affordable option. If not, you may want to go to the federal marketplace and compare plans.

The metal tiers refer to how the plan shares costs with you. Platinum plans generally have high premiums, but the out of pocket costs are lower. Bronze plans have affordable premiums, but their out of pocket costs tend to be much higher.

Plans are geared to income. No matter which tier you choose, your income will affect what you pay in premiums.

Thinking about Your Needs

When you compare metal tier plans, it may be tempting to go with the lowest premium. After all, the plans provide the same quality of care, so why not pay less per month?

Before you sign up, you should think about your needs. If you have high healthcare needs, then a Bronze plan may not be right, even if the premiums are affordable.

Why is that? Bronze plans have high deductibles. That means you could spend thousands of dollars on medical care before your insurance kicks in.

Even then, your co-pay is 40 percent, so you’ll still end up paying a lot out of pocket.

The high premiums associated with Gold and Platinum plans may save you money in the long run.

If you don’t use much in the way of medical services, then you might be hoping to protect yourself from worst-case scenarios. A Bronze plan might make a lot of sense for you. There’s a good chance you won’t use your insurance, so it doesn’t make sense to pay a high premium.

Think about the Provider Network Structure

The next consideration for anyone shopping for health insurance in Missouri is the structure of the provider network. This is important for all health plans, whether you buy private or through an exchange. It even affects Medigap and supplemental policies.

There are four main types of provider network:

  • Health Management Organizations (HMOs)
  • Preferred Provider Organizations (PPOs)
  • Point of Service (POS)
  • Exclusive Provider Organizations (EPOs)

HMOs tend to be the most affordable type of network to join, while PPOs cost much more.

Why is there a difference? Each type of network offers different coverage for seeing providers outside your network.

HMOs, offer no coverage for visits to providers outside their networks. PPOs will cover services provided by medical professionals outside your network of care. It’s this extended coverage that makes the PPO more expensive.

If you live in an urban area with plenty of providers and specialists, then HMOs can be good options. If you live in a rural area, then you might find the HMO doesn’t cover many providers in your area. You’ll run up costs either by visiting professionals outside the network or incurring travel costs to see someone within the network.

POS and EPO networks usually fall somewhere in the middle. HMOs and EPOs tend to have more restrictions on who you can visit, but their premiums are lower. PPOs and POS networks offer you more freedom for a higher price.

Supplemental Coverage, Critical Care, and More

If you have coverage through an employer or Medicare, you may think you’re covered for everything. You should carefully review your coverage.

There are often gaps in coverage, so it may be a good idea to invest in supplemental health insurance. Medigap plans are one example.

You may also decide to choose a private plan instead of your employer’s. It may cost you more, but extra coverage could save you more in the long run.

Compare Total Costs

The final step in finding affordable health insurance in Missouri is to compare all costs. If you need Medicare plus a Medigap plan, make sure you compare the costs of both plans plus any out of pocket costs.

The same is true of comparing any employer-sponsored or private plan. It may be more affordable to switch plans than to add to your coverage with a second policy.

Getting better coverage may look like it costs more upfront. You may see lower bills as your out of pocket costs fall.

A Healthy Lifestyle Is Good for Your Wallet Too

By taking your time and carefully comparing your options, you can find more affordable health insurance in Missouri.

Staying in shape and living a healthy lifestyle can help reduce your healthcare costs. Check out more tips from our archives. You’ll feel better, and so will your wallet.

Cite this article as:
Editorial Staff, "How to Choose Affordable Health Insurance in Missouri," in Medicalopedia, October 1, 2020, [Permalink: https://www.medicalopedia.org/9277/how-to-choose-affordable-health-insurance-in-missouri/].