Missouri: Start Here
Beginner guide for Missouri—HealthCare.gov Marketplace, DCI external review, RSMo § 376.1363 PA deadlines, and what to open next.
Read guideState playbook
Missouri
State insurers, legislation, and appeal resources for patients and advocates in Missouri.
4 guides
Missouri Prior Authorization Law
RSMo §§ 376.1363–376.1372—36-hour prospective PA, electronic submission, 45-day revocation bar, website transparency.
Read guideMissouri Health Insurance Appeals and Grievances
Group two-level appeals, ACA 30/60-day timelines, DCI assistance, path to IRO external review, MO HealthNet fair hearing.
Read guideMissouri External Review (DCI)
Binding IRO review—4-month filing, 45-day standard, 72-hour expedited, exhaustion optional, Insurance Consumer Hotline.
Read guidePrior auth & internal appeals
Match the plan on the member ID card. Use the denial letter for where to file appeals.
- Anthem / Healthy Alliance (MO)
- Blue Cross Blue Shield of Kansas City
- Medica
- Ambetter / Home State Health
- UnitedHealthcare
- HealthCare.gov (Missouri Marketplace)
- MO HealthNet
External appeals
After internal appeal, for eligible Missouri fully insured plans only.
- DCI — external review
- MO HealthNet — fair hearing