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 broker who's licensed in Missouri, and I help people choose their own health coverage over the phone. In Missouri, one change is confirmed for 2027, and it's local: Cox HealthPlans is leaving the marketplace in its corner of southwest Missouri.
In 2026, Cox sold marketplace plans in five counties: Barry, Christian, Lawrence, Stone and Taney. That's Branson and Hollister, Nixa and Ozark, Cassville, Mount Vernon and the Table Rock Lake area. If you're on a Cox marketplace plan there, it ends December 31, 2026, and you need a new one for 2027.
You won't be stuck with a single option. Based on this year's plans, each of those five counties still has four other marketplace companies selling: Ambetter, Anthem, Medica and UnitedHealthcare. Oscar has also said it's adding marketplace plans in that area that use the CoxHealth network, which matters if your doctors are with CoxHealth. When 2027 plans post, look for those first and confirm your doctors by name.
Cox says it will keep selling plans off the marketplace in seven counties, Greene County and Springfield included. If you buy that way, two things change. Nobody automatically moves you anywhere, and the premium tax credit only works on marketplace plans. If your income qualifies you for the credit, an off-marketplace plan means paying full price.
Outside southwest Missouri, I found no company leaving for 2027. Some Missourians already moved once: Aetna left the individual marketplace in Missouri for 2026. If that was you, give this year's renewal a real look.
Missouri's marketplace had no PPO plans in 2026, so nothing here takes one away. But if you're healthy and paying full price, from Kansas City to St. Louis to the Bootheel, you can still get a nationwide PPO in Missouri through me, and it's worth pricing before you settle.
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.
A few other names come up in the news about this. Here's where each one actually stands.
When an insurance company leaves, your plan doesn't stop overnight. It runs through December 31, 2026, and the company has to tell you in writing first. Federal rules require at least 90 calendar days notice when a company drops a plan, and at least 180 calendar days when it leaves a state's individual market entirely. If your company is leaving and you haven't seen that letter, call the company and ask for it.
What happens next is the part people get wrong. If no plan from your company is left on the marketplace, the federal rule (45 CFR 155.335) says the marketplace may move you to a plan from a different company. It doesn't say it will. The move has to fit state law, it follows the state regulator's direction, and without that direction the marketplace picks a "similar" plan. Nothing in that rule checks your doctors or your prescriptions.
If you bought your plan straight from the company, off the marketplace, the marketplace's re-enrollment rule doesn't reach you at all. You need to pick a new plan yourself.
Open enrollment on HealthCare.gov starts November 1. By then you should get 2 letters: one from your current company and one from the marketplace. The marketplace letter tells you which plan, if any, you'll be moved into if you do nothing by December 15. HealthCare.gov is plain that in some cases you won't be automatically re-enrolled.
Pick by December 15 and your new plan starts January 1. Pick between December 16 and January 15 and it starts February 1, which leaves January uncovered if your old plan ended December 31.
Miss open enrollment and you may still have a way in. Losing a plan because it's discontinued is on HealthCare.gov's list of qualifying events, and the federal rule gives you 60 days before and 60 days after the day your old coverage ends to pick a new plan. Don't build your plan around that window. Confirm you qualify before you count on it.
Here's how I'd think about it, depending on where you are. Each path ends the same way: a call with me before the deadline.
If you earn too much for the credit, you're paying the full marketplace price, and now you're paying it for whatever is left in your county. You have another option. Private plans with medical underwriting run on nationwide PPO networks and are priced on your health, which is how the price for a healthy person can come in under the marketplace's full rate. They ask health questions up front, and the company can decline you or leave out a past condition, so we go through the details together before you choose.
Next step: Call me and I'll price a nationwide PPO for your household next to the Missouri marketplace plans in your county.
Whatever the marketplace looks like in your county, you can still get a nationwide PPO in Missouri through me. 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.
Private PPO plans with medical underwriting use networks that work across the country, and for a healthy person who pays full price on the marketplace, they're often worth pricing. I'm licensed in 36 states, and Missouri is one of them.
Straight answers, no sales pitch.
Cox HealthPlans (confirmed). Altogether, 5 of Missouri's 115 counties lose at least one marketplace insurer.
Maybe, but don't count on it. The federal rule says the marketplace may move you to a similar plan from a different company, as state law and your state regulator allow. HealthCare.gov says that in some cases you won't be automatically re-enrolled, and if you bought off the marketplace, nobody moves you. Pick your own plan.
On HealthCare.gov, pick by December 15 for coverage that starts January 1. Open enrollment runs to January 15, but a plan picked after December 15 starts February 1.
Yes. You can still get a nationwide PPO in Missouri through me. 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.
Tell me your county, who's on your plan and what your letter says. I'll show you what's left on the Missouri marketplace, price a nationwide PPO next to it, and help you pick before the deadline. I'm licensed in 36 states and work by phone.
Every state on the list, and guides for Missouri