Missouri's marketplace offers EPOs only, but a nationwide PPO is still available. I'll walk you through how business owners covering their families can compare that option against this year's increased full-price premiums.
Hi, I'm Sam Jaber. I hold health insurance licenses in 36 states and help Missouri business owners over the phone. Whether your business is a Kansas City printing shop, a farm supply business around Sedalia or a Clayton consulting LLC, we can handle your coverage together.
I'm focusing here on a particular kind of Missouri household: a business owner with an established, profitable company who earns too much for marketplace assistance and needs insurance for a spouse and children. Full premiums have increased this year, while every available marketplace plan is an EPO. That combination makes automatically keeping last year's coverage something worth reconsidering before renewing.
This year, Missouri residents have 117 individual medical plans listed on the marketplace, and every single one is an EPO. HealthCare.gov offers no PPO option anywhere in Missouri.
I can help your entire household enroll in a nationwide PPO even though Missouri's marketplace doesn't offer one. Pricing depends on the health information each person provides, and the network extends nationwide. That wider reach can be especially valuable when your children attend college in another state or your family spends time traveling.
KFF measures each state's benchmark using the second-lowest-priced silver plan for a 40-year-old. In Missouri, that benchmark increased 23.7% heading into 2026. Families receiving tax credits are protected from much of the increase, but households with profitable businesses often receive no such protection. For those owners, the full increase affects every family member included on the policy.
There's another consideration beyond the higher premium: Missouri marketplace coverage consists entirely of EPOs. These plans generally don't pay for out-of-network treatment unless it's an emergency. Your family could therefore spend more while remaining limited to a particular provider network, which may be inconvenient when you travel or have children attending school outside Missouri.
Families paying the entire marketplace premium are often the ones who benefit most from comparing private coverage. The insurer evaluates a health questionnaire for every person and can approve coverage, deny it or approve it while excluding a particular medical condition. When everyone is healthy, a private plan frequently costs less than the marketplace's unsubsidized premium while offering nationwide network access. Having a family member with a medical condition doesn't automatically eliminate that possibility. The specific condition matters, so explain your situation and I'll compare both approaches for everyone.
Next step: Give me everyone's ages and the Missouri county where you live. I'll compare a nationwide PPO quote with the full premiums for your available EPO plans.
A major decline in business profits can change which coverage makes sense. Your household might qualify for premium credits again, and Missouri's Medicaid expansion covers eligible adults earning up to 138% of the poverty level during particularly difficult years. Hiring an employee who isn't part of the family can also make the small-business marketplace worth considering alongside individual plans. Track your company's earnings each month and revise your income estimate promptly whenever profits fall.
Next step: When your business finances have changed since last year, give me a call before renewing. We'll calculate the coverage costs again.
Here's what to have ready when we compare coverage:
Once I have those details, we can make a meaningful comparison between Missouri's full-price EPO coverage and a nationwide PPO. Sometimes the decision comes down to the needs of just one or two relatives. Maybe your teenager travels for sports, your spouse visits an out-of-town specialist, or your child attends college elsewhere. I'll base the quotes on how your household actually uses medical care rather than treating everyone as an interchangeable family of four.
Straight answers, no sales pitch.
Yes. KFF reports that Missouri's benchmark premium for a 40-year-old increased 23.7% between 2025 and 2026. Families without premium credits must absorb that entire increase themselves.
No. Missouri's 117 marketplace medical plans are all EPOs. If your family is healthy, I can help you obtain a nationwide PPO privately.
Not until the business has an employee on payroll who is neither an owner nor a family member. Until then, you purchase individual coverage.
Possibly, especially when profits are very low. Missouri's expanded Medicaid program covers eligible adults whose income doesn't exceed 138% of the poverty level.
Give me the ages of everyone needing coverage, your county and an estimate of the company's net earnings. I'll price your family's marketplace coverage alongside a nationwide PPO, so you can compare the difference yourself.
The guide for every state, and other work I help with