Health insurance in Missouri, 2027
Missouri uses HealthCare.gov and expanded Medicaid. In 2027, Medicaid for many adults comes with work rules.
Last checked October 16, 2026 · Written by licensed advisors · Sources are numbered and listed under Notes and sources
Missouri uses HealthCare.gov
Missouri has no state marketplace of its own: you compare plans and apply for a tax credit on HealthCare.gov, the federal marketplace, or with a licensed agent who works with it. For 2026 coverage, 365,734 Missourians picked a Marketplace plan during open enrollment.1
- Marketplace
- HealthCare.gov
- 2026 plan selections
- 365,734
- Medicaid for adults
- MO HealthNet, under 138%
The dates for 2027
Open enrollment for 2027 coverage runs from November 1, 2026 to January 15, 2027. Choose a plan by December 15 for coverage that starts January 1, 2027.
Losing other coverage, moving to Missouri, marrying or having a baby can open a special enrollment window, usually 60 days.2
- November 1, 2026Open enrollment for 2027 starts (key step)
- December 15Last day to choose a plan that starts January 1 (key step)
- January 15, 2027Open enrollment ends
- February 1, 2027Coverage starts for plans chosen December 16 to January 15
Heads up: Choose a plan after December 15 and it starts February 1, not January 1. If nothing else covers you in January, that is a month without coverage.
Who can get help paying
Missouri covers adults 19 to 64 with income under 138% of the poverty level through MO HealthNet, $22,025 for one person. Above that line, a Marketplace tax credit usually takes over, up to 4 times the poverty level. Children qualify at much higher incomes.34
Work rules start in 2027
Who it affects: Missouri expansion adults aged 19 to 64.
A federal law passed in 2025 requires adults in the Medicaid expansion group to show 80 hours a month of work, school or community service, or to qualify for an exemption, to get and keep coverage. It starts January 1, 2027, unless the state gets a delay. In Missouri, that group is covered through MO HealthNet.
Parents and caretakers of children 13 and under, and people who are medically frail, are among those exempt. People who aren’t eligible for Medicaid because they didn’t meet the rules can’t get Marketplace tax credits.5
What to do: If you get a Medicaid notice, call us before your coverage ends.
A family of three
For a family of three, MO HealthNet for the adults reaches about $37,700 a year, and children qualify up to about $83,300 through MO HealthNet and CHIP.34
Which insurers sell plans
Insurers file their 2027 Missouri plans with the state and with HealthCare.gov, and the final list appears when open enrollment opens on November 1. Which ones you can choose depends on your county.2
What to do: Send us your ZIP code, your doctors and your prescriptions. We check which plans in your county include them.
Help from a licensed agency
Our agency is licensed in Missouri, and we work with Missourians by phone and video, from our Chicago office. We compare the plans in your county and show you what to keep in mind on each one, at no cost to you.6
Related guides
Obamacare Hotline and/or Medicare Po Polsku are private companies not affiliated with any local, state, or federal government agency. This guide is general information, not tax or legal advice.