Are you guaranteed coverage in Missouri? Yes, but only if certain conditions have been met.

Many Missouri residents receive health care coverage through group plans offered by their employers. However, a significant number either work at jobs that do not offer health insurance benefits or remain otherwise uninsured. For these individuals, individual private plans are a favorable option in which they may receive the health care coverage they need.

However, there is no guarantee that your attempts to obtain insurance you will be successful. Rather, Missouri insurers are allowed to turn applicants down on account of their woeful health status inclusive of: medical condition and history, disability, or genetic information. And, in certain, often critical, circumstances, insurers may completely refuse or drastically limit coverage. If you are turned down or offered a severely restricted policy, you may want to check and see if you are eligible for MHIP coverage.

That is why it is helpful for insurance shoppers to know that, if you are HIPAA eligible, you cannot be turned down for private insurance. Yet, on account of its full-proof acceptable clause, insurers may charge higher (than standard) prices for HIPAA plans. In these instances, insurers are required to offer a choice of two plans – they can be either plans specially designed for HIPAA eligible individuals or two of their regular plans.

To meet HIPAA eligibility requirements, you must satisfy the following factors. First, you must have had 18 months of continuous creditable coverage, and at least the final day of this coverage must have been under a group plan. You must also have taken advantage of any state continuation or COBRA coverage that was made available to you. You cannot be eligible for Medicaid, Medicare, or another group health plan. You cannot currently have health insurance (however, you may apply early if you have insurance but know your coverage is quickly coming to an end). Finally, you have to apply for HIPAA eligible insurance coverage within 63 days of losing your previous coverage.

In Missouri, what your individual health insurance plan covers is completely dependant on what type of coverage you purchase from the insurer. Insurance companies are allowed to design a range of policies, each providing a host of varying benefits, and you will need to carefully analyze the policy you select to precisely learn the areas over which you are entitled to coverage and those you are not. Note: Under Missouri insurance law, there are some benefits such as: mammograms and diabetes care, which an insurer is mandated to provide. Should you have questions about the extent of your coverage and the benefits you are entitled to receive, the Missouri Department of Insurance can help you to determine these answers.