Health insurance in St. Louis County, Missouri
6 insurers sell 68 marketplace plans here, and 6.6% of under-65 residents have no coverage at all.
Source: CMS Marketplace Open Enrollment Public Use Files and US Census Small Area Health Insurance Estimates, 2026 release.
Who sells here, and how much choice that gives
6 insurers compete in St. Louis County with 68 plans between them, about 11 plans each. It gained 1 since the previous plan year, up from 5.
How many people here have no coverage
6.6% of St. Louis County's 777,655 under-65 residents have no health coverage — 51,674 people. That is below the Missouri rate of 9.2%, and puts St. Louis County in the bottom quarter of the 1,817 counties on this site (1616th).
How much the marketplace is used
61,362 St. Louis County residents selected a marketplace plan for 2026: 79 per thousand under-65 residents, 1105th of 1,817. That is close to the 78 per thousand typical of published counties. 9,035 of them — 15% — were new rather than renewing.
St. Louis County against Missouri
St. Louis County is the largest of the 12 Missouri counties we publish, by under-65 population. Its uninsured rate runs 2.6 points lower than Missouri overall and with 6 insurers it is as well served as anywhere in Missouri. Marketplace use is close to the Missouri rate.
| St. Louis County | Missouri | Published median | |
|---|---|---|---|
| Uninsured, under 65 | 6.6% | 9.2% | 9.9% |
| Insurers selling | 6 | 2–6 | 4 |
| Plans offered | 68 | — | 57 |
| Selections per 1,000 | 79 | 74 | 78 |
| New rather than renewing | 15% | 13% | 15% |
Counties of a similar size nearby
| County | Under 65 | Uninsured | Insurers | Plans |
|---|---|---|---|---|
| Jackson County | 596,930 | 10.2% | 5 | 58 |
| St. Charles County | 348,262 | 5.3% | 6 | 68 |
| Greene County | 247,489 | 9.9% | 4 | 48 |
| Clay County | 221,547 | 8.0% | 5 | 55 |
All of them have fewer insurers than this county's 6, which makes it the stronger market locally.
68 plans is a lot to work through. Start with network type, then the metal tiers. Other Missouri counties.