The health insurance marketplace in Missouri has big changes in store for some people in 2019.
Changes to the Missouri health insurance marketplace (aka Obamacare, aka healthcare.gov)
One big health insurance change in Missouri for 2019 is that Anthem Blue Cross and Blue Shield is exiting a large chunk of their counties that they had previously covered in 2018, especially in the Western half of Missouri and Saint Louis. All of these people losing coverage with Anthem should have received a letter informing them of this. Some of these people may also be getting a letter from Ambetter Health , as they have taken Anthem BCBS’s place in the Western half of Missouri. These people may also see an increase in price from the year before. Cigna and Ambetter health are the 2 companies offering coverage in St. Louis for 2019. Contact us for more details.
Another health insurance change is that Medica Health has entered the market on the Missouri side of Kansas City. In 2018 Medica was available in Kansas, Nebraska, Iowa, and other States. For Missouri in 2019 they are only available to the people living in the Kansas City metro.
Short-Term Health expanding, new coverage lengths for 2019
Maybe the biggest change for 2019 in Missouri are the rules regarding Short Term Health plans. Under the old ACA Obamacare rules, the maximum length a short term health plan could last was 3 months. Under the new rules, plans can last 6 months in length in Missouri, and 12 months for most other States. National General is the insurance company we often recommend for Short-Term-Health. In Missouri, National General offers back-to-back 6 month plans that you can purchase at the start of your plan, with prexisting conditions covered in the second term, that had started during the first term. This means that you can safely get 12 months of coverage for 2019 without having to renew your plan in the middle of the year.
Short term plans are much cheaper that paying the full price of Obamacare health insurance marketplace plans. However, they do not cover maternity, and do not cover pre-existing conditions. So if you are pregnant or planning on a pregnancy this type of plan is probably not for you. Or if you have had a disease or injury from the past 5 years, such as cancer, a short term health plan will likely not cover that condition, as it would be deemed “pre-existing”. Short term plans are to protect in case of catastrophic instances, and typically don’t cover doctor visits or RXs before meeting the deductible without an unjustifiable increase in price.
One of the greatest things about some of the short term health plans are the networks.
Small Group Health
Although not new for 2019, it is worth mentioning that small group health is available to people that own a business and have at least one non-family-member employee. Often times the price of the small group plan health insurance is cheaper than an Obamacare ACA health marketplace plan, even including paying for the employee’s insurance. Small group health is the coverage that we recommend if a person qualifies. The per-person price is lower, the networks are much better, and some plans offer a very large premium refund if the group stays healthy. Refunds of $10,000+ are not uncommon.
The bottom line is…
Small group health plans have lower prices compared to indivdual plans, pre-existing conditions are covered, and you have tons of plan & network options at your disposal.
Association Health Plans
The availability of Association Health plans hasn’t matched the hype. An association health plan allows small groups and sole proprietors in the same industry to join together to form a large group (100+ members). Groups of this size can often get a lower per-person rate on the group insurance, saving money for everyone involved. However, insurance companies have seen this as too high of a risk, and have not made these plans easily available. One insurance company representative told us they would consider it on a case-by-case basis, only if there are over 5000 members enrolling. Another insurance company rep said they are considering it for 2019 on groups of 100+, but have not committed. Another insurance company rep said they have decided against offering those plans. I got the vibe that they wanted to see other insurance companies try it first, and if they have success, more will follow.
Until then, people wanting to explore Association Health Plan options will have to wait.
For more information on any of the topics above, or any other insurance related questions, contact us here.