Which marketplace plans include Children's Mercy in 2027?
Children's Mercy announced on October 20, 2026 that it will not be included in Affordable Care Act marketplace networks starting January 1, 2027. Most Kansas City area marketplace plans were already marked out of network on its 2026 list. The one change between its two lists is Medica, which is no longer sold in the Kansas City area.
| Marketplace plan | 2026 list | 2027 list |
|---|---|---|
| Ambetter from HomeState Health | Out of network | Out of network |
| Ambetter from Sunflower Health Plan | Out of network | Out of network |
| Anthem Pathway and Pathway X | Out of network at Kansas locations | Out of network at Kansas locations |
| BlueKC Blue Metro and BlueSelect | Out of network | Out of network |
| CoxHealth Network EPO | Out of network | Out of network |
| Oscar Health | Out of network | Out of network |
| UnitedHealthcare exchange plans | Out of network | Out of network |
| Blue Cross and Blue Shield of Kansas BlueCare EPO | Listed, no network warning | Listed, no network warning |
| Medica (Balance, and Medica with MU Health Care, which needs a referral) | Listed | Not offered in the Kansas City area |
The Blue Cross and Blue Shield of Kansas plan is the only marketplace plan on the 2027 list without an out of network note. Check that it is sold at your address before you count on it. A marketplace plan that is not on the list is not listed, so ask both the hospital and the insurer before you enroll.
What do Children's Mercy and the state say about why?
Both statements are public, and they describe the same situation from different sides. We report each one and take no side.
- Children's Mercy, quoted by KCTV5 on October 22, 2026: "The other ACA plans servicing the KC Metro were previously out of network with Children's Mercy and have elected not to contract with Children's Mercy in 2027."
- Missouri Department of Commerce and Insurance, October 2026: it is not aware of any pending contractual termination or dispute, and no Missouri health plans have recently dropped or plan to drop Children's Mercy from their 2027 networks. It says Children's Mercy has been out of network with most Missouri individual plans for a number of years, and that it knows of no change for employer plans in 2027.
Medica is the plan that does change. Children's Mercy says Medica is leaving the Kansas City marketplace in Johnson and Wyandotte counties in Kansas and Clay, Jackson, Johnson, Lafayette, Platte and Ray counties in Missouri, and that about 400 of its current patients have Medica plans. It says Medicaid, Medicare, employer insurance and TRICARE are not affected, and that its network with Medica stays in place through the end of 2026.
The state's advice is to ask both your insurer and Children's Mercy about your exact plan, to check hospital and physician networks before you pick a plan, and to check again before surgery or other major care. Missouri's insurance consumer hotline is 800-726-7390. Children's Mercy lists its Patient Access financial clearance line as 816-302-1650.
What is changing between Saint Luke's and Aetna Medicare Advantage?
Saint Luke's, which is part of BJC HealthCare, says that starting January 1, 2027 it will no longer participate in the Aetna Medicare Advantage plan. Its physicians and other providers will be out of network for that plan. Saint Luke's says it made the decision after years of trying to resolve administrative burden and payment issues with Aetna.
| Medicare coverage | What Saint Luke's says |
|---|---|
| Original Medicare | Accepted |
| Aetna Medicare Advantage | Out of network starting January 1, 2027 |
| UnitedHealthcare and AARP Medicare Advantage, including Dual Complete and Complete Care | Listed for 2027 |
| Humana Medicare Advantage, including Gold Plus and Choice PPO | Listed for 2027 |
| Devoted Health | Listed for 2027 |
| American Health Advantage of Missouri, Kansas Superior Select and Provider Partners Health Plan | Listed for 2027 |
In its statement to KCTV5 on October 21, 2026, BJC said its Aetna commercial agreements are current and that BJC stays in network for those plans in 2027 and beyond. It also said Aetna has not fully explained the higher out of network costs Medicare Advantage members could face. Aetna told KCTV5 it is willing to work with BJC and Saint Luke's. We found no announced agreement as of October 26, 2026.
Saint Luke's asks people to confirm with their own plan that a specific product includes its providers, because a company on the list can sell several plans.
What is going on with NKC Health and UnitedHealthcare Medicare Advantage?
NKC Health says it has been out of network with UnitedHealthcare Medicare Advantage plans, including AARP and Optum plans, since October 1, 2026. What that means for you depends on the type of plan.
| Plan type | What NKC Health says |
|---|---|
| Group Medicare Advantage through an employer or retiree plan | Often open access, so out of network care may still be covered. Ask UnitedHealthcare what you would pay. |
| PPO | May cover out of network care, usually at a higher cost, and may need prior authorization |
| HMO or HMO point of service | Typically no out of network benefit, so you may owe the entire bill |
| Dual Complete | Typically no out of network benefit, and NKC Health will not schedule these patients |
NKC Health suggests that patients with a qualifying condition ask UnitedHealthcare for a continuity of care exception, which would allow treatment for 90 days at in network benefits. UnitedHealthcare alone approves those requests. NKC Health also says emergency care is always available to you, whatever its contract status.
Saint Luke's lists UnitedHealthcare Medicare Advantage for 2027 while NKC Health does not take it. Two systems in the same metro can treat the same insurer differently, so check each doctor and hospital by name.
What can I do if my Medicare plan changes?
Compare plans during Medicare's annual enrollment period, October 15 to December 7, 2026. A change you make by December 7 starts January 1.
- Look up each doctor and hospital you use in the 2027 directory of the exact plan, not just the insurer.
- Ask the doctor's billing office which plans it accepts for 2027.
- Check the drug list and the plan's yearly maximum you could pay out of pocket.
- If you are in a Medicare Advantage plan on January 1, you can make one change from January 1 to March 31, 2027.
Original Medicare with a Medigap plan and a Part D drug plan is another route. Saint Luke's notes that buying a Medigap policy after leaving Medicare Advantage can require medical underwriting. After your first six months on Medicare Part B, a Medigap insurer can usually ask health questions and may charge more or turn you down, unless you have a guaranteed right to buy. Ask an agent or your state's free Medicare counseling program before you drop a plan.
How many people use the marketplace around Kansas City?
| Area | People who picked a plan | Received a premium tax credit | Average monthly premium after credits |
|---|---|---|---|
| Jackson County, MO | 45,566 | 87.1% | $156 |
| Missouri | 365,734 | 86.1% | $173 |
| Johnson County, KS | 42,343 | 82.3% | $192 |
| Wyandotte County, KS | 15,136 | 93.2% | $90 |
| Kansas | 192,811 | 87.9% | $160 |
Wyandotte County's average premium after credits was the lowest of these areas and Johnson County's was the highest. These are 2026 numbers. Your 2027 price depends on your income, your household and the plans sold where you live.
Census estimates put Kansas City, Missouri at 521,220 residents, with 14.3% age 65 or older. Among people under 65, 12.7% in Kansas City have no health insurance, compared with 10.2% in Jackson County and 6.3% in Johnson County, Kansas. Marketplace open enrollment runs from November 1, 2026 to January 15, 2027, and a plan chosen by December 15, 2026 starts January 1.
How can a Kansas City agent help with hospital network questions?
An agent can look up your children's hospital, your doctors and your Saint Luke's or NKC Health locations in each 2027 plan you are considering, and point out the plan type that makes the difference. Have your insurance card, your doctors' names and your prescriptions ready.
Health Insurance Solutions agents are licensed in 22 states and help by phone and online. Marketplace plans cost the same with or without an agent, so the comparison does not add to your premium.
Insurers and hospitals mentioned
Explore the organizations or brands discussed in this article. A mention does not mean every plan or location is covered.
- Hospital · MissouriNkc Health
- Insurer · MissouriAmbetter Health
- Insurer · MissouriMedica
- Insurer · MissouriUnitedHealthcare
- Medicare Advantage · MissouriAetna Medicare
- Medicare Advantage · MissouriAmerican Health Advantage of Missouri
- Medicare Advantage · MissouriDevoted Health
- Medicare Advantage · MissouriHumana
- Medicare Advantage · MissouriUnitedHealthcare
- Small-group insurer · MissouriUnitedHealthcare Insurance Company
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