Medicaid vs. ACA Marketplace: Which Is Right for You in Missouri?
When it comes to health insurance coverage in Missouri, there are two primary options for individuals and families: Medicaid and ACA Marketplace plans. Both provide essential health coverage, but the eligibility requirements and benefits differ. Understanding the differences between Medicaid and Marketplace coverage will help you make the best decision for your health and budget.
Medicaid Coverage in Missouri
Medicaid is a state and federal program that provides free or low-cost health coverage to eligible low-income individuals and families. In Missouri, the state expanded Medicaid under the ACA, allowing individuals with incomes up to 138% of the federal poverty level (FPL) to qualify.
Key Features of Medicaid:
Eligibility: Medicaid is primarily for low-income individuals, pregnant women, children, elderly adults, and those with disabilities.
Cost: Medicaid is either free or has very low out-of-pocket costs, including low co-pays and no premiums.
Coverage: Medicaid covers a broad range of services, including hospital visits, doctor visits, prescriptions, mental health services, and preventive care.
ACA Marketplace Plans
The ACA Marketplace offers health insurance plans for individuals and families who do not qualify for Medicaid or employer-sponsored insurance. In Missouri, you can shop for ACA Marketplace plans through HealthCare.gov.
Key Features of ACA Marketplace Plans:
Eligibility: ACA Marketplace plans are available to individuals and families who do not qualify for Medicaid, employer coverage, or other government programs.
Cost: Premiums for Marketplace plans vary depending on income, household size, and the plan’s coverage level. Many individuals qualify for subsidies to reduce premiums.
Coverage: ACA plans cover a wide range of essential health benefits, including preventive care, maternity care, prescription drugs, and mental health services.
Which Option Is Right for You?
If your income is low enough to qualify for Medicaid, it may be the most affordable option. Medicaid offers comprehensive coverage with little to no out-of-pocket costs. However, if your income is too high for Medicaid but still within the subsidy range for the ACA Marketplace, you may be eligible for financial assistance to reduce your premiums.
Contact Us
Choosing between Medicaid and an ACA Marketplace plan can be complex. Our licensed agents at Riverside Insurance Professionals can help you assess your options and make the best choice for your healthcare needs.
Phone: (573) 535-6044
Email: Jennifer@RiversideInsuranceProfessionals.com
Office Hours: Monday – Friday, 9:00 AM to 5:00 PM
Visit HealthCare.gov for more details on ACA Marketplace plans and Medicaid eligibility.