Missouri · St. Louis County

Health insurance plans in St. Louis County, Missouri (2026)

I pulled every 2026 marketplace plan sold in St. Louis County, Missouri out of the official CMS plan file. There are 68 plans from five carriers, and a 40 year old in St. Louis pays $532 a month at full price for the benchmark silver plan. That is $49 less than in Jackson County, the other Missouri county I track. Across all 79 counties and parishes I track in 24 states, only nine have a lower benchmark. Below are the carriers, the plan counts, the full prices before subsidy, and what I think the numbers mean if you live in Florissant, Chesterfield, Kirkwood, Ballwin or anywhere else in the county.

Who sells marketplace plans in St. Louis County

St. Louis County and Jackson County, the two Missouri counties I track, have the same number of carriers, five each. Across all 79 counties and parishes I track in 24 states, 30 have more carriers than St. Louis. The biggest lineup in St. Louis belongs to Medica with 18 plans, about 26 percent of everything on offer.

CarrierPlansBronzeSilverGoldNetwork types
Medica18666EPO 18
Ambetter Health16646EPO 16
UnitedHealthcare13454EPO 13
OscarOscar Insurance Company11452EPO 11
Anthem Blue Cross and Blue Shield10441EPO 10

St. Louis plan counts from the CMS 2026 landscape file (county FIPS 29189, Rating Area 6). Bronze includes expanded bronze, and companies CMS lists under more than one legal issuer are grouped with the legal names underneath.

What it costs in St. Louis County before any subsidy

These are the full monthly prices, before any premium tax credit, for the cheapest St. Louis plan at each metal level. I show the sticker price because it is what your subsidy is subtracted from, and most people who enroll in St. Louis pay less, often a lot less.

Monthly premium, full priceAge 21Age 40Age 60Couple, both 40Couple 40 + 2 kids
Lowest bronze$317$405$860$809$1,294
Lowest silver$409$523$1,111$1,047$1,673
Benchmark silver (second lowest)$416$532$1,129$1,063$1,699
Lowest gold$399$510$1,083$1,020$1,630

Benchmark silver is the second lowest of the 24 silver premiums listed for St. Louis. The last column is two adults aged 40 plus two children.

What these numbers mean if you live in St. Louis County

The gold row is the surprise in St. Louis County. The cheapest gold plan for a 40 year old, $510 a month, is $14 cheaper than the cheapest silver plan at $523. That happens because Missouri carriers load the cost of the extra silver discounts into silver premiums. If your income is too high for those discounts, silver is the worst value on the St. Louis shelf, and a gold deductible here tops out at $3,300.

In St. Louis County the benchmark is $127 above the cheapest bronze at age 40, and ten of the other 78 counties and parishes I track have a narrower one. That gap decides whether bronze can be free, because your subsidy is the $532 benchmark minus what the government expects you to pay from your income. A 40 year old in St. Louis whose expected share is $127 a month or less would pay nothing for the cheapest bronze. At 60 the St. Louis gap grows to $269 and at 21 it shrinks to $99, which is why older enrollees are the ones most likely to find a $0 plan.

Jackson County, around Kansas City, is the other Missouri county I track. Compared with Jackson County, the St. Louis benchmark is $49 lower at 40 and the cheapest bronze is $38 lower. Anthem Blue Cross and Blue Shield sells in St. Louis and not in Jackson County. Blue Cross and Blue Shield of Kansas City sells in Jackson County and not in St. Louis.

This page covers St. Louis County only. The City of St. Louis is a separate county of its own in the CMS file and is not included here.

St. Louis plans by metal level, network and deductible

Metal levelPlans$0 deductibleDeductible range
Catastrophic10
Bronze20$10,150 to $10,600
Expanded Bronze224$0 to $8,450
Silver242$0 to $7,200
Gold191$0 to $3,300
Total687

There is not a single PPO on the 2026 marketplace in St. Louis County. All 68 plans are EPO plans. Outside emergencies, the 68 EPO plans in St. Louis generally pay nothing out of network, so the network list matters more than the premium. 7 plans in St. Louis have a $0 medical deductible (4 expanded bronze, 2 silver and 1 gold). The 4 bronze ones among them still have out of pocket maximums of $10,500 to $10,600, so a $0 deductible does not mean a small bill.

Every St. Louis price on this page is before subsidies, and most enrollees pay less. For a 40 year old in St. Louis the premium tax credit is measured against the $532 benchmark. Estimate your own subsidy, or send me your ZIP and I will run the St. Louis numbers for you.

2027 plans for St. Louis County

These are the 2026 plans and prices for St. Louis County. The 2027 plans and prices are published around November 1, 2026, and I will update this page with the new St. Louis numbers then. Open enrollment for 2027 coverage in Missouri runs from November 1, 2026 to January 15, 2027, and December 15 is the last day to pick a plan that starts January 1.

Questions about St. Louis County coverage

How many health insurance companies sell marketplace plans in St. Louis County, Missouri?

For 2026, five carriers sell individual marketplace plans in St. Louis County: Medica, Ambetter Health, UnitedHealthcare, Oscar and Anthem Blue Cross and Blue Shield. Together they offer 68 plans across the metal levels, according to the CMS plan landscape file.

What is the cheapest health insurance in St. Louis County?

At full price before any subsidy, the cheapest bronze plan in St. Louis County is $317 a month for a 21 year old, $405 at 40 and $860 at 60. In St. Louis a couple both aged 40 pays $809 for the cheapest bronze, and two 40 year olds with two children pay $1,294. Catastrophic plans in St. Louis, open only to people under 30 or with a hardship exemption, start at $286 at age 21. Most people in St. Louis who qualify for a premium tax credit pay less than these prices.

What is the benchmark silver plan premium in St. Louis County for 2026?

The second lowest cost silver plan, the benchmark your subsidy is calculated from, is $532 a month for a 40 year old in St. Louis County before subsidies. In St. Louis it is $416 at age 21 and $1,129 at age 60, and the lowest silver plan is $523 at 40.

Is any insurance company leaving St. Louis County for 2027?

None of the five carriers selling in St. Louis County in 2026 is one of the confirmed 2027 exits I flag for Missouri, which is Cox HealthPlans. Smaller changes can still happen, so read your renewal notice. The 2027 carrier lineup and prices for St. Louis are published around November 1, 2026, and I will update this page then.

Can I get a PPO plan in St. Louis County?

Not on the 2026 marketplace. All 68 plans in St. Louis County are EPO plans. 7 of them have a $0 medical deductible, and the cheapest gold plan for a 40 year old in St. Louis is $510 a month before subsidies.

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