Insurance Information
2026 Marketplace Plan Changes
There has been several changes to the Marketplace plans offered in our area effective January 1, 2026. Marketplace plans are often called Obamacare/ACA (Affordable Care Act) or purchased through healthcare.gov/pathway/metal plans (gold, silver, bronze)
CoxHealth Marketplace no longer has active plans for patients that live in Greene or Webster Counties, however CoxHealth Marketplace plans do remain active and are accepted from patients that live in Barry, Christian, Lawrence, Stone and Taney Counties. Patients that live in Greene or Webster counties are now out-of-network for the CoxHealth Network as well as any patient from any area with Anthem Marketplace plans.
Our office will no longer file claims for out-of-network insurance. We will request to be paid in full at the time of service and then will provide an itemized statement for the parent to file to their insurance on their own.
If your insurance if offered through an employer or you are unsure if you are in network, please call the office and request to talk to bookkeeping.
Well Child Visits
and Insurance
Requirements for health insurance coverage of well child visits have changed in the past few years. This link has information to help keep your child's health care on track, prevent surprise bills and help you choose the health insurance policy that suits your family's needs at the time. Please call our bookkeeping department at (417) 882-1600 if you have any questions.
Health Insurance Cost-Sharing
Health insurance has its own rules and language. Understanding them before you have an emergency or unexpected bill can save time and frustration. Explanations are presented in this article.
Pharmacy Discounts
We have had several families stop taking their medications lately due to cost. Some medicines are just very new and expensive. Some are not new but the manufacturers have no competition to keep prices down. Did you know, for example, you can get your kindergartener's chewable fluoride tablets for $3 a month instead of a $30 co-pay?
The first step in managing this is to ask us about alternatives. The vast majority of our prescriptions are written so the pharmacist may substitute a less expensive but equivalent option. Sometimes we can change your child's prescription to another medication with similar effectiveness but perhaps different side effects that may not matter for your situation (for example, two asthma inhalers work the same but the cheaper one can make young children overactive).
Drug makers often offer direct discounts on their websites or through coupons. These often have conditions, however, so read the fine print. Some online resources can help you find the best price at local pharmacies, such as GoodRx http://www.goodrx.com
Health insurance companies are working on similar online resources but nothing that works well in Springfield yet.
Some pharmacies have their own discount programs. In Springfield, a popular one is Walmart http://www.walmart.com (search under Health, Beauty and Pharmacy for $4 Prescriptions). Another option is to talk with your pharmacist directly; they may know of some other options to modify your prescriptions.
Charities such as Children's Miracle Network are one-time last resort options that we can help you with but the application process takes some time.
We want your child to get the medication he or she needs. Let us know if we can help in any way.
