1. MyMercy Account
First Available Scheduling
WEB_Global_Banner

Health Insurance Marketplace
Woman and child blowing bubbles

It’s our privilege to care for you. We want to keep doing it.

Exploring your options for affordable health insurance coverage? We're here to help you navigate the Health Insurance Marketplace and understand your choices that keep Mercy in network for 2025. These plans cover essential health benefits like doctor visits, prescriptions and hospitalization, ensuring you can find the right coverage for your needs and budget.

 

Think you're eligible for an affordable Marketplace plan? 

Most U.S. citizens, U.S. nationals and lawfully present immigrants can enroll in a Marketplace plan. However, if you have affordable employer-sponsored insurance or qualify for programs, like Medicaid, you may not be eligible Marketplace subsidies. 

Open Enrollment begins November 1, 2024, and ends January 15, 2025.

You can sign up for a Marketplace health insurance plan during the Open Enrollment Period. After this period closes, you can only enroll if you qualify for a Special Enrollment Period. You may qualify for a Special Enrollment Period if you have certain life changes, like losing your health coverage, having a baby, getting married or moving to a new area. For more information, visit healthcare.gov

 

Coverage begins on January 1, 2025, or February 1, 2025.

If you enroll during the Open Enrollment Period by December 15, your coverage typically starts on January 1 of the next year. If you enroll between December 16 and January 15, your coverage typically starts on February 1. 

Plan Selection

Choosing the right Exchange plan can be difficult. It is helpful to talk through your unique needs with trusted resources. 

Contact a licensed, independent expert listed below to help you navigate your Exchange plan options, or visit the Federal Marketplace by visiting HealthCare.gov. 

Missouri

St. Louis/Jefferson/Washington/Lincoln - 833.337.1047

Springfield/Joplin - 833.337.1047 | 417.869.6464

Arkansas

Fort Smith/Northwest Arkansas - 833.339.3859

Oklahoma

Oklahoma City/Ada/Ardmore - 833.337.0831 | 405.842.0494

Illinois

Edwardsville/Maryville - 833.338.1903 

Exchange FAQs

Here are some frequently asked questions (FAQs) regarding enrolling in Marketplace health insurance plans:

Which Marketplace plans have Mercy as an in-network provider?
 
  • Missouri
    • East Region
      • Aetna CVS Health
      • Ambetter (MO)
      • Medica – Balance by Medica (St. Louis/East Region)
      • United Health Care – MO Individual Exchange Plan Benefit
    • SWMO Region
      • Aetna CVS Health
      • Ambetter (MO & KS)
      • Medica – Balance and Harmony (SWMO)
      • United Health Care – MO Individual Exchange Plan Benefit
  • Arkansas
    • Ambetter (AR)
    • Arkansas BlueCross BlueShield
    • QualChoice 
  • Oklahoma
    • BCBS-OK - Blue Advantage PPO (Bronze, Silver, Gold), Blue Preferred PPO (Bronze, Silver, Gold, Security), My Blue
    • Medica - Balance
  • Kansas
    • Pittsburg Region
      • Ambetter

Marketplace plans are categorized into four levels based on the percentage of health costs they cover:

  • Bronze: Covers about 60% of health care costs (lowest premiums, highest out-of-pocket costs)
  • Silver: Covers about 70% of health care costs (moderate premiums and out-of-pocket costs)
  • Gold: Covers about 80% of health care costs (higher premiums, lower out-of-pocket costs)
  • Platinum: Covers about 90% of health care costs (highest premiums, lowest out-of-pocket costs)

Yes. Many people qualify for premium tax credits and subsidies based on their household income and family size. These credits reduce your monthly premiums, and cost-sharing reductions can lower out-of-pocket costs like copayments and deductibles for those who qualify.

Subsidies are generally available to people with household incomes between 100% and 400% of the Federal Poverty Level (FPL). In some cases, people with incomes above this range may qualify for help depending on local costs and family size.

If your household income, family size or employment situation changes, you should report this to the Marketplace as soon as possible. You can update your application online or by calling the Marketplace, which can affect your eligibility for tax credits or coverage options.

It depends on the plan you choose. You’ll need to check if your doctor is in the plan’s network. Plans often charge more for out-of-network doctors or may not cover them at all.

If you don’t have health insurance coverage, you may have to pay for all your medical costs out-of-pocket. However, the individual mandate (which required people to have insurance or pay a penalty) no longer applies at the federal level as of 2019, though some states still have their own mandates.

You can change plans during the Open Enrollment Period or if you qualify for a Special Enrollment Period. Outside of these periods, changes to plans are generally not allowed.

If you enroll during the Open Enrollment Period by December 15, your coverage typically starts on January 1 of the next year. If you enroll between December 16 and January 15, your coverage typically starts on February 1.

Yes, you can cancel your Marketplace plan at any time, but you may be without coverage if you don't have another plan in place.

All Marketplace plans must cover a set of essential health benefits, including:

  • Doctor visits
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Mental health services
  • Prescription drugs
  • Preventive and wellness services
  • Pediatric services (including dental and vision)

To ensure continuity of care, we encourage you to carefully consider your insurance options during this open enrollment period. By selecting a plan that keeps Mercy in network, you can continue receiving care from the physicians you trust. Thank you for choosing Mercy and allowing us to be a part of your health care journey. We’re honored to provide compassionate, high-quality care, and we look forward to continuing to serve you.

celticknot-background