How to Get Missouri Medicaid Benefits 

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We have scoured the internet to provide you with all you need to know about the Missouri Medicaid Benefits.

Medicaid is a joint federal-state initiative that covers health insurance for low-income people who qualify, including children, households, pregnant women, the elderly, and people with disabilities. It is simple to apply for Medicaid in person, over the phone, or online.

This post will teach you all you need to learn about Medicaid in Missouri.

What is Missouri Medicaid?

Medicaid is a service for people and families with income and resources that fall within certain parameters. Resources primarily apply to the elderly, blind, or disabled population within the bounds of specified rules.

Who is eligible for the Missouri Medical Program?

Missouri  Medicaid offers certain limited Medicare beneficiaries who are not eligible for the full Medicaid benefit package partial financial help with Medicare premiums, copayments, or coinsurance through the Medicare Savings Plan.

  • Expectant mothers
  • People who are blind or disabled, or who have a spouse who is blind or disabled; 
  • People whom someone adopts;
  • People whom someone adopted; 
  • People who are blind or disabled, or who have a spouse who is disabled.

The Annual Household Income Limits (before taxes)

Household Size*Maximum Income Level (Per Year)
1$18,075
2$24,353
3$30,630
4$36,908
5$43,186
6$49,463
7$55,741
8$62,018

* Add $6,277 for every extra member in families with 9 or more inhabitants.

How do I contact Medicaid in Missouri?

Phone

800-392-1261

Mailing Address

The State of Missouri, MO HealthNet Division, 615 Howerton Court, PO Box 6500, Jefferson City, MO 65102-6500

FAX:  573-751-6564

What are the Medicaid plans in Missouri?

The option to enroll in a health home to manage all Medicaid services, both physical and behavioral health, was made available to those with major mental illness and numerous chronic medical problems in Missouri. A dedicated care team, consisting of a case manager, nurse care manager, and a community mental health consultant.

But also, administrative staff receive a per capita per month (PMPM) payout from health homes to coordinate care for individuals who may also be enrolled in managed care. All other Medicaid facilities are repaid on a fee-for-service basis.

Missouri entered into contracts with three major national, for-profit health insurers that are publicly traded .  Prior to 2012, Missouri had no limits on the number of companies it could contract with, but it did limit the number of participating companies to three per area. 

Prior to 2012, the state had contracts with all healthcare plans that satisfied state requirements (“any willing plan”). Currently, the state chooses plans through an open bidding procedure and determines rates through an actuarial procedure that modifies anticipated costs based on  demographic considerations.

Missouri Medicaid

How do I apply for Missouri Medicaid?

Call: 1-800-348-6627 to enroll. 

Apply in person: At the Family Support Division office in your area.

Online:  Download and print the MO HealthNet Managed Care application.

Mail: To MO HealthNet Service Center at 525 Jules Street #127, St. Joseph, Missouri 64501.

What is covered by Missouri Medicaid?

The following services are covered by Missouri Medicaid:

Ambulatory surgeryHospital stays
Audiology servicesLaboratory tests
Behavioral health servicesVision care
Women’s health careNon-emergency transportation
DialysisOrthotic and prosthetic devices
Doctor visitsOccupational therapy
Smoking cessation servicesPharmacy (medications)
Emergency carePhysical rehabilitation
Family planning servicesPreventive care
Hearing aidsX-rays and other radiology services
Home health careHospital outpatient care
Hospice services

Copayments?

They do not have to pay a copayment, When a member is: 

  • under 21 years old; 
  • pregnant; 
  • Held by the state
  • Placed under government supervision
  • Native American participants who qualify for Contract Health funding
  • Services or Tribal Union of Indian Health Services
  • Residing in one of the facilities listed below and funding a portion of their care:
  • The hospital (inpatient)·
  • A facility for skilled nursing
  • A nursing home

What is not covered by Missouri Medicaid?

Medicaid does not provide coverage for private podiatrists, chiropractors, naturopaths, psychologists, or therapists (physical therapists, audiologists, or speech therapists).

Medicaid is not obligated to pay for personal care services or nursing supplied by a family member. Bandages, adult diapers, as well as other disposable items are frequently excluded from coverage, as well as cosmetic surgery and other elective procedures.

How many types of Missouri Medicaid are there?

Missouri offers both a controlled care plan or a fee-for-service scheme for MO HealthNet (Medicaid) coverage. Your individual circumstances and requirements will determine the kind of coverage you are qualified for.

What is the highest income limit for Missouri  Medicaid?

Missouri Medicaid is now available to those under 65 with family earnings up to 138 percent of federal poverty level. This comes to around $17,774 for a single in 2021 or $24,039 for a two-person household.

How much money can you have in the bank on Missouri Medicaid ?

For this program, the maximum asset limit is $2,000 for a person and $3,000 for just a pair. Study up on the medically needy route. 2) Asset Spend Down – Seniors with assets above the MT Medicaid cap may “spend down” their assets to become asset eligible.

Does the disabled person get Missouri Medicaid?

Medicaid in Missouri is administered by MO HealthNet. It is a government-run healthcare plan that covers medical costs for those who are pregnant, disabled, young, old, or on a low income.

  • Your Countable Annual Income is $0. 
  • The federal poverty level is $1,133.

Will you still have Missouri Medicaid once you are over 18?

You may be eligible for MO HealthNet if you are 19 years of age or older if your family has a low income, irrespective of if you have a handicap (in DB101, this is referred to as “revenue MO HealthNet,” but you may hear people refer to it as the “Medicaid expansion”.

What documents do I need to apply for Medicaid?

The following papers must be included with the application.

  • The Social Security Number;
  • Evidence of citizenship or authorized residency in the United States, such as a passport, driver’s license, birth certificate, green card, or job authorization card
  • Evidence of all income sources, both legal and illegal 
  • Proof of origins 
  • Proof of residency 
  • Including the Medicare card, any insurance cards
  • Pregnancy (doctors’ certification of the pregnancy and, if applicable, the expected delivery date);
  • When non-parents apply for Medicaid according to their own behalf, they must provide proof of their financial position.

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Editor
Sabrina is a former campaign manager who has decided to focus her effort to help people contact senators and get help. She leads our Editorial Team with Ronald and Lawrence to curate content and resources that help us navigate the system.

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