You can still get a nationwide PPO in Missouri, even though the marketplace sells only EPOs. Here is how owners covering a family are handling this year's higher full prices.
Hi, I'm Sam Jaber. I'm licensed in 36 states and based in Tampa, and Missouri business owners, whether you run a print shop in Kansas City, a family farm supply store near Sedalia or a consulting LLC in Clayton, can work with me by phone.
This page is about one Missouri situation: an established owner whose company does well enough that the household gets no marketplace credit, buying coverage for a spouse and kids. This year that owner faced higher full prices, and the plans on offer are all EPOs, so the usual habit of simply renewing last year's plan deserves a second look.
Missouri's marketplace lists 117 individual medical plans this year, every one an EPO. No PPO is available on HealthCare.gov in the state.
You can still get a nationwide PPO in Missouri, and I can arrange one for the whole family. Each family member answers health questions, the price reflects those answers, and the network spans the country, which matters when the kids go to college out of state or the family travels.
KFF tracks a benchmark for each state, the second-lowest-cost silver plan for a 40-year-old, and in Missouri it went up 23.7% over the year to 2026. Households that get the credit are shielded from much of that. A profitable owner's household usually isn't, so the increase arrives in full, multiplied across every person on the plan.
At the same time, the only plans on the marketplace are EPOs, which generally pay outside their network only for emergencies. So the family is paying more for coverage tied to one network, and for a household that travels or has a child at school out of state, that network may not reach where they actually need care.
This is the household that most often saves by going private. Each family member fills out a health questionnaire, and the company accepts, turns down, or accepts while writing out a specific condition. A healthy family can often pay less than full marketplace price and gain a network that works anywhere.
Next step: Send me the family's ages and your county, and I'll quote a nationwide PPO beside the full-price EPOs available to you.
Keep that person on the marketplace, even at full price. HealthCare.gov plans accept everyone and don't price by medical history. The work is choosing the EPO whose network includes their specialists; some families put healthy members on a private plan and keep one person on the marketplace, which we can price both ways.
Next step: Tell me that family member's doctors and prescriptions, and I'll show you which Missouri EPOs include them.
If profit drops sharply, the picture flips. The credit may return, and in a very lean year Missouri's expanded Medicaid covers adults up to 138% of the poverty level. And if the company later adds a worker from outside the family, the small-business marketplace becomes an option worth pricing against individual coverage.
Next step: If this year looks different from last, call me before you renew and we'll re-run the numbers.
To compare fairly, bring:
With that, the comparison between a full-price Missouri EPO and a nationwide PPO is straightforward. Families are often surprised by how much the answer depends on one or two people: a teenager who plays travel sports, a spouse who sees a specialist in another city, or a child away at school. We'll price the household as it really lives, not as a generic family of four.
Straight answers, no sales pitch.
Yes. On KFF's benchmark, the cost for a 40-year-old went up 23.7% from 2025 to 2026, and a family without the credit carries all of it.
No. All 117 individual medical plans are EPOs. A healthy family can get a nationwide PPO through me.
Only after your payroll includes someone who isn't an owner or a relative; before that, coverage is bought individually.
In a truly lean year, possibly: Missouri's expansion covers adults at or below 138% of the poverty line.
Tell me everyone's ages, your county and roughly what the company netted. I'll show you the family's marketplace price next to a nationwide PPO so you can see the gap.
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