Missouri health plans would cover recommended preventive care without cost sharing

Health carriers and health plans would cover specified preventive care without cost sharing. This applies to plans delivered, issued for delivery, continued, or renewed in Missouri on or after January 1, 2026. It covers services recommended for the person receiving care. Plans may charge cost sharing for care from an out-of-network provider when state or federal law allows it. A high deductible plan may apply its deductible unless the director determines that the coverage qualifies under a federal preventive care exception. The coverage rules apply to plans delivered, issued for delivery, continued, or renewed in Missouri on or after January 1, 2026.

The insurance director would enforce the coverage rules and adopt rules for later recommendations. The recommendations and guidelines are from the U.S. Preventive Services Task Force, the CDC immunization committee, and the federal Health Resources and Services Administration. The director would enforce the rules using recommendations and guidelines in effect on December 31, 2025, and related federal rules or guidance. Rules for later recommendations would follow state rulemaking requirements. Enforcement would use recommendations and guidelines in effect on December 31, 2025. The director would adopt rules for recommendations issued after that date.

The Department of Commerce and Insurance would create a committee to recommend updates to covered preventive care. The committee would make recommendations to the Department of Commerce and Insurance, the General Assembly, and the governor. The director would appoint five members: three health care provider representatives and two health carrier or health plan representatives. Members would serve without pay or expense reimbursement. The committee would meet at least once each year and send recommendations by November 1 each year.