Who is leaving, what's left in your county, and what to do before the deadline. Last checked October 5, 2026.
One insurance company is leaving the Missouri marketplace for 2027.
Altogether, 5 of Missouri's 115 counties lose at least one marketplace insurer.
I'm Sam Jaber, a Missouri-licensed broker helping people find health coverage over the phone. There's one confirmed local marketplace change for 2027 in Missouri: Cox HealthPlans is pulling out of the southwest Missouri area it serves.
Cox offered marketplace coverage across five counties in 2026: Barry, Christian, Lawrence, Stone and Taney. That includes Branson, Hollister, Nixa, Ozark, Cassville, Mount Vernon and communities around Table Rock Lake. If you have a Cox marketplace plan in any of those places, coverage ends December 31, 2026. You'll have to choose another plan for 2027.
You'll still have choices. Looking at this year's plans, all five counties have four other marketplace companies: Ambetter, Anthem, Medica and UnitedHealthcare. Oscar has also announced plans to offer marketplace coverage using the CoxHealth network in that area. That's worth looking at if you see CoxHealth doctors. Once the 2027 plans are available, start with those options and verify that your specific doctors participate.
Cox plans to continue offering coverage outside the marketplace in seven counties, including Greene County and Springfield. But buying directly comes with two important differences. There's no automatic transfer into another plan, and premium tax credits are available only through the marketplace. Even if your income qualifies for assistance, you'd pay the entire premium on an off-marketplace plan.
I couldn't identify any insurer exiting elsewhere in Missouri for 2027. Some residents have already had to switch coverage because Aetna withdrew from Missouri's individual marketplace for 2026. If you went through that, I'd take another careful look at your renewal this year.
There weren't any PPO plans on Missouri's marketplace in 2026, so this departure doesn't eliminate PPO coverage there. If you're healthy and don't qualify for premium assistance, though, I'd compare a nationwide PPO before committing. I can help you get one in Missouri, whether you're in Kansas City, St. Louis or the Bootheel.
Different state? Pick yours here.
These are the 5 Missouri counties where at least one marketplace insurer is leaving. For each one you can see who's leaving, how many marketplace insurers are left, and which ones.
The Missouri marketplace had no PPO plans in 2026, so none of the exits takes a PPO away; you just have fewer HMO, EPO and similar plans to pick from.
| County | Insurer leaving | Insurers left | Who's left (2026 plans) | Marketplace PPO after |
|---|---|---|---|---|
| Barry | Cox HealthPlans | 4 | Ambetter (Centene); Anthem (Elevance); Medica; UnitedHealthcare | No |
| Christian | Cox HealthPlans | 4 | Ambetter (Centene); Anthem (Elevance); Medica; UnitedHealthcare | No |
| Lawrence | Cox HealthPlans | 4 | Ambetter (Centene); Anthem (Elevance); Medica; UnitedHealthcare | No |
| Stone | Cox HealthPlans | 4 | Ambetter (Centene); Anthem (Elevance); Medica; UnitedHealthcare | No |
| Taney | Cox HealthPlans | 4 | Ambetter (Centene); Anthem (Elevance); Medica; UnitedHealthcare | No |
County data: CMS 2026 marketplace plan data source. Insurers are counted by company, and the table uses each company's 2026 service area, so a company that enters or expands for 2027 isn't counted yet. I'll update it when the 2027 plan list publishes in late October.
You've probably seen a few other names mentioned in news coverage of this. Here's what their actual situations look like.
Your coverage doesn't end immediately just because the insurer is leaving. The existing policy continues through December 31, 2026, and you're entitled to written notice beforehand. Federal requirements call for at least 90 calendar days of notice when an insurer discontinues a plan, or at least 180 calendar days when it withdraws completely from a state's individual market. Haven't received anything yet? Contact your insurer and request the notice.
Here's where people often misunderstand the process. Under federal regulation 45 CFR 155.335, the marketplace may place you with another insurer when your current company has no remaining marketplace plan. That's permission, not a guarantee. State law and the regulator's instructions govern the transfer. Without specific direction, the marketplace chooses a "similar" plan. The regulation doesn't require anyone to verify that your doctors or medications are covered.
Purchased your coverage directly from the insurer rather than through the marketplace? Its automatic re-enrollment provisions don't apply to your policy. You'll have to select replacement coverage on your own.
HealthCare.gov opens enrollment November 1. You should receive 2 notices by that point, one from your insurer and another from the marketplace. The marketplace notice identifies any replacement plan you'll be placed in if you haven't acted by December 15. HealthCare.gov also warns that automatic re-enrollment doesn't happen in every situation.
Choose your replacement no later than December 15 to begin coverage January 1. Enrolling from December 16 through January 15 gives you a February 1 effective date. If your previous policy ends December 31, that means going without coverage for January.
You might still qualify to enroll after the regular window closes. HealthCare.gov recognizes discontinued coverage as a qualifying event, and federal regulations allow 60 days before and 60 days after your old plan's termination to select replacement coverage. I wouldn't rely on that as your first choice. Make sure you're eligible before planning around those dates.
The way I'd approach this depends on your particular situation and where things stand for you. Whichever route makes sense, the next step is the same: let's talk on the phone before the deadline.
If your income puts you outside the tax credit range, you're responsible for the entire marketplace premium, with your choices limited to the insurers serving your county. That's when I'd also consider private coverage. Medically underwritten plans use nationwide PPO networks, and their pricing reflects your health. Healthy applicants may pay less than the marketplace's unsubsidized rate. There are tradeoffs: insurers ask medical questions and can reject an application or exclude a preexisting condition. We'll review those details together before you decide.
Next step: Give me a call, and I'll compare a nationwide PPO quote for your household with the marketplace coverage offered in your Missouri county.
Regardless of which insurers remain on your county's marketplace, I can help you obtain a nationwide PPO in Missouri. The Missouri marketplace had no PPO plans in 2026, so none of the exits takes a PPO away; you just have fewer HMO, EPO and similar plans to pick from.
For healthy people paying the entire marketplace premium, it's worth comparing private, medically underwritten PPO coverage. These plans offer networks extending nationwide. I carry health insurance licenses in 36 states, including Missouri.
Straight answers, no sales pitch.
Cox HealthPlans (confirmed). Altogether, 5 of Missouri's 115 counties lose at least one marketplace insurer.
Possibly, but there's no guarantee. Federal rules permit the marketplace to assign a comparable plan from another insurer when state law and regulators allow it. HealthCare.gov specifically cautions that automatic re-enrollment isn't always available. And if your current coverage was purchased outside the marketplace, that process won't apply. My advice is to choose your replacement yourself.
To start coverage January 1 through HealthCare.gov, enroll by December 15. You have until January 15 before open enrollment ends, but selecting a plan after December 15 means it won't take effect until February 1.
Yes. I can help you find a nationwide PPO available in Missouri. The Missouri marketplace had no PPO plans in 2026, so none of the exits takes a PPO away; you just have fewer HMO, EPO and similar plans to pick from.
Last checked October 5, 2026. I update this page when the 2027 plan list publishes in late October.
Call me with your county, the people who need coverage and the details of your notice. I'll compare the remaining Missouri marketplace plans with a nationwide PPO quote and help you decide before enrollment ends. I'm licensed in 36 states, and we can handle everything by phone.
Every state on the list, and guides for Missouri