Financial Help for Individuals and Families

If you use the Missouri Health Insurance Marketplace, you may be able to save money through premium tax credits and cost-sharing reductions.

Premium tax credits and cost-sharing reductions are available to help make health care more affordable. This financial help uses a sliding scale so families making less money pay a smaller portion of their income for health insurance and health care.

When you fill out your Marketplace application, you'll find out if you can get financial help and how much you can save. The Missouri Health Insurance Marketplace opens October 1, 2013. Insurance coverage and financial help start on January 1, 2014.

Have questions?

Individuals can call 1-800-318-2596 (TTY: 1-855-889-4325) to speak to someone who can help. Small businesses can call 1-800-706-7893 (TTY: 1-800-706-7915).

Or, you can click here to find someone close to you who can help in person.

Premium Tax Credits

Premium tax credits can lower the amount you pay for your health insurance plan. The value of the tax credit depends on how much money you make and how many people are in your family. In general, the less money you make, the larger your tax credit will be. This amount can go up or down based on changes in your job status, size of your family, or marital status. There are two ways to use the tax credit to lower your premiums:
  1. Take it now: This allows you to lower your premiums every month. You can choose to take your tax credit in advance. Your tax credit will be paid directly to your insurance plan on a monthly basis. When you file your taxes, you'll report that you already used your tax credit.
  2. Take it later: If you choose this option, you'll pay your full premium each month. When you file your taxes, you'll subtract your premium tax credit from any taxes you owe. If you don't owe taxes, you'll get a bigger refund.
Chart
Your family size is based on the number of people that will be on your 2014 federal income tax return. If you don't file taxes, count the number of people who live with you. This includes your spouse, kids, other dependents, and yourself.

If you have more than six people in your family, add $4,020 for each additional person.

Cost-Sharing Reductions

Cost-sharing reductions – sometimes called subsidies – can help lower your out-of-pocket costs. These are different from premiums and include things like deductibles, co-insurance, and co-pays. Some people can get BOTH tax credits and cost-sharing reductions.
Chart

As mentioned above, if you have more than six people in your family, add $4,020 for each additional person.

Qualifying for Medicaid

Missouri's Medicaid program, called MO HealthNet, covers very low income people. Whether or not you qualify depends on how much money you make and how many people are in your family. Children, their parents, people with disabilities, and people age 65 or older are covered by Medicaid at different income levels. See the charts below.

Covered PopulationsIncome Guidelines
Children (up to age 19)Less than 300% of the federal poverty level.
Learn more here.
ParentsAt or equal to 18% of the federal poverty level.
Learn more here.
Pregnant WomenLess than 185% of the federal poverty level.
Learn more here.
Disabled IndividualsLess than 85% of the federal poverty level.
Learn more here.
Missourians (age 65 and over)Less than 85% of the federal poverty level.
Learn more here.
Blind IndividualsLess than 100% of the federal poverty level.
Learn more here.
Qualified Medicare BeneficiariesLess than 100% of the federal poverty level.
Learn more here.


2013 Federal Poverty Level (FPL)

Family SizeAnnual Income
~18% FPL85% FPL100% FPL150% FPL185% FPL300% FPL
1N/A$9,766$11,490$17,235$21,256$34,470
2$2,808$13,183$15,510$23,265$28,693$46,530
3$3,504$16,600$19,530$29,295$36,130$58,590
4$4,104$20,017$23,550$35,325$43,567$70,650

You may have heard talk about whether or not to expand Medicaid to cover more people. Each state can choose whether or not to expand their Medicaid program to cover people making up to 133% of the federal poverty level. At this time, Missouri has not chosen to expand Medicaid, but our state elected officials are continuing to have this conversation.

If you make less than 133% of the federal poverty level and don't qualify for MO HealthNet now, you won't have to pay a penalty if you don't have health insurance in 2014.

If you need more help figuring out if you can get financial help or qualify for Medicaid, visit the Missouri Health Insurance Marketplace or call 1-800-318-2596 (TTY: 1-855-889-4325). If you want help in person, click here to find a location near you.