| 
     
 Needed to read PDF's 
 
PDF Suite 
 
Adobe Reader | 
		MO HealthNet
 What is MO HealthNet?  
			
				We may be able to help you with certain medical costs. If 
					you are approved for help, you will have healthcare coverage 
					through Missouri Medicaid (MO HealthNet). This healthcare 
					coverage is different than Medicare and it can help with 
					benefits not normally covered through that program, like 
					nursing home care and personal care services. 
		  
 
		Who is eligible?
		  
			
				Eligibility for MO HealthNet depends on your income, 
		age, health, and individual needs. You may be eligible if you are a(n): 
					Senior (age 65 and 
					older)Parent or caretaker with 
					a child (under age 19)Child (age birth -18)Woman (age 18-55) with 
					no health insuranceAdult (age 19-64) 
					without disabilitiesPregnant woman 
					(including unborn child)Woman (under age 65) 
					with breast or cervical cancerPerson with disabilitiesBlind or visually 
					impaired adult   
 
		How do I apply?
		You can apply for healthcare coverage by completing these simple steps: 
		
			
				| Apply | Complete Form | Submit |  
				| There are four ways you can apply for healthcare coverage:Apply through the online 
				portal   Apply by phone at 855-373-9994Download & print, or scan application (aplicación 
				Español) 
				*You must use Adobe 
				Reader | You must complete & submit the Supplemental 
				Form (Forma 
				Español) with your application if you: Are age 65 or older Are blind or disabled Get Social Security Live in a medical or 
					nursing facilityHave Medicare or VA 
					healthcare | 
				You 
				can submit your completed form(s) in one of these ways: 
				Online: mydssupload.mo.gov 
				Mail: 
				Fax: 
				573-526-9400Family Support Division
 P.O. Box 2700
 Jefferson City, MO 65102
 |  
				|  |  |  |  
 
		When will I get coverage?
		  
			
				If you applied for healthcare 
		coverage, they will let you know what might be needed to process your 
		application. The time it takes to process your application may vary, and 
		if they have to make an eligibility decision based on a disability, it may 
		take longer than usual. If you do not receive anything from the Family 
		Support Division after 45 days, you can them Once your application is processed, you will get a letter that let’s you 
		know if you are eligible for healthcare coverage or not. If you are 
		approved, you will receive a MO HealthNet Identification Card and 
		information explaining the type of services and coverage you have. You 
		will need to follow the instructions in this letter for your coverage to 
		begin. 
		  
 
		Other MO HealthNet Programs
		  
			
				
					
					Spend Down: 
						If you make too much money, you may still be able to get 
						MO HealthNet coverage if you agree to pay, or “spend 
						down,” a certain amount. Once you spend this 
					amount, you will have MO HealthNet coverage for the month.
						
					Ticket to Work: If you are disabled and make too 
					much money to qualify for MO HealthNet, you can still get 
			help with your healthcare costs if you agree to take part in this 
			program.  
					Home & Community Based Services: These services may 
					be able to help you or a loved one stay at home and out of a 
					nursing home by providing the in-home 
					services you need.
					MO HealthNet Nursing Home Coverage: If you live in 
					a nursing home, they may be able to help 
					pay for any nursing home costs you aren’t responsible 
					for. You will be responsible for using all of your income 
					towards costs except for a $50 monthly allowance, any health 
					insurance premiums, and any income set aside for a spouse 
					or other dependents.
					The Health Insurance Premium Payment (HIPP): Program 
					helps pay for the cost of health insurance premiums for 
					certain MO HealthNet participants. 
					Supplemental Nursing Care Program: If you live in a 
					residential care facility or assisted living facility, the 
					Supplemental Nursing Care Program will give you a 
					monthly allowance of $50 for personal needs and a cash 
					payment to your facility ($156 per month for residential 
					care or $292 per month for assisted living).
					Medicare Cost Savings Programs (QMB & SLMB): You 
					may be able to get help paying for your Medicare premiums 
					and certain copayments through one of the Medicare 
					Cost Savings Programs.
					Supplemental Aid for the Blind: The Supplemental 
					Aid for the Blind program offers a monthly cash grant 
					and MO HealthNet coverage to help blind persons meet their 
					basic needs.
					Blind Pension: Blind 
					Pension offers a monthly cash grant and MO HealthNet 
					Coverage to blind persons who do not qualify for help 
					through Supplemental Aid to the Blind or Social Security 
					Income benefits.
					Show-Me Healthy Babies Program: If you are pregnant 
					and you were not approved for coverage through MO HealthNet 
					for Pregnant Women, help may still be available through the Show-Me 
					Healthy Babies Program.
					
					The Program of All-Inclusive Care for the Elderly (PACE): is 
					administered by MO HealthNet and Medicare to provide 
			comprehensive health care, social, recreational, and wellness 
			services to their participants. One of the main goals of PACE is to 
			allow older adults to live safely in their homes instead of nursing 
			facilities. 
 
		Medicare Savings Program
		  
			
				Medicare is a 
		federal healthcare coverage program for qualified adults over the age of 
		65, or under age 65 if they are receiving Social Security Disability 
		benefits. The Medicare Savings Program (MSP) can 
		help Medicare (Part A and Part B) participants pay their medical 
		premiums.  Some participants may be eligible for: 
					Help paying their Medicare 
			deductibles and co-insurance copaysMSP and MO HealthNet (MO 
			HealthNet can help pay for medical costs that are not covered by 
			Medicare) 
			
				
					| Qualified Medicare Beneficiary (QMB)
 | Specified Low-Income Medicare Beneficiary (SLMB)
 | Qualified Individual 
				Program (QI-1)
 |  
					| 
						
						Helps pay for your 
					Medicare Part A and Part B premiums, your deductible, and 
					your coinsurance (your share in medical costs)
						You may be eligible for 
					QMB and MO HealthNet at the same time | 
						
						Helps pays your 
					Medicare Part B premiums
						You may be eligible for 
					both SLMB and MO HealthNet at the same time | 
						
						You can choose if this 
					program will pay for your Medicare Part B premiums or to 
					receive MO HealthNet coverage |  
			
				Who is EligibleIndividuals may 
		qualify for MSP, if they are: 
					A U.S. Citizen (or qualified 
			non-citizen) and Missouri residentHave Medicare Part AMeet certain income and resource 
			requirements How to Apply
					To apply for MSP, complete the Application 
			for Medicare Savings Program online. You can also download and 
			print, or scan the application. 
			You can upload a 
			copy of your form, or mail it to: Family Support Division | P.O. Box 
			2700 | Jefferson City, MO 65102, or drop it off at your local FSD 
			Resource Center.If you already have MO HealthNet 
			coverage and would like to add MSP, please visit the Change 
			Report online, select "Request changes to your MO HealthNet 
			coverage," enter your name, and the select "sign and submit." You 
			can also request to add on MSP at your local FSD 
			Resource Center.To apply for MSP and MO 
			HealthNet (Missouri Medicaid), visit mydss.mo.gov/healthcare/apply or you can apply in person at your local FSD Resource Center.   
 Nursing Home Coverage  
			
				Nursing Home Coverage 
			through MO HealthNet helps residents in nursing homes, or long-term 
			care facilities, pay for room and board, as well as necessary 
			medical and non-medical goods and services. Participants will use 
			all of their income towards nursing home costs, except for a $50 
			allowance, health insurance premiums, and any income set aside for a 
			spouse or other dependents. Who is Eligible?Individuals 
			may qualify if they meet certain 
			income requirements, and be: 
					Age 65 (or older), blind, or 
				permanently disabledA U.S. Citizen (or qualified 
				non-citizen) and Missouri residentApproved by the Dept. of 
				Health and Senior Services to get care from a nursing facilityEligible for, or currently 
				have, MO HealthNet There are set limits for the resources and income you can 
					have to qualify for help through this program.  How to Apply
					If you already have coverage 
				through MO HealthNet and you enter a nursing home/facility, you 
				(or an authorized representative) need to let FSD know by 
				reporting to the online Change 
				Report, or by visiting your local FSD 
				Resource Center.If you do not have MO 
				HealthNet, you will need to apply. Visit mydss.mo.gov/healthcare/apply to 
						get started. When you complete your application, make sure to 
				check the box that asks if someone in the household lives in a 
				medical facility or nursing home. 
				NOTE: You will know if your application was approved within 
			45-90 days.   
 Supplemental Nursing Care  
			
				The Supplemental Nursing Care Program provides monthly cash assistance to cover cost of living 
			fees, to aged, blind, and disabled adults living in assisted living 
			and residential care facilities. Supplemental Nursing Care (SNC) 
			will give you a monthly allowance of $50 for personal needs, as well 
			as a cash payment for your facility fees ($156 per month for 
			residential care, or $292 per month for assisted living). When you 
			apply for SNC, we will consider your monthly income from your job, 
			Social Security, and any other sources, and will compare that amount 
			to the monthly cost of the facility you live in. If your monthly 
			income is less than the monthly cost of the facility, SNC could help 
			cover the difference (up to the max amount allowed). Who is Eligible?Individuals 
			may qualify if they meet certain 
			income requirements, and are:  
					Age 21 (or older)Live in a supported living 
				facility (e.g. licensed residential care, assisted living, or 
				intermediate or skilled nursing facility)A U.S. Citizen (or qualified 
				non-citizen) and Missouri residentHave an income that is less 
				than the monthly cost to live in the facilityBe eligible for, or 
				currently have, MO HealthNet There are set limits for the resources and income you can 
					have to qualify for help through this program.  How to Apply
					If you already 
				have coverage through MO HealthNet and you want to add 
				Supplemental Nursing Care, you need to complete the MO 
				HealthNet Application 
				Addendum 
				and make sure to check the box for Supplemental Nursing Care. 
				You can submit this form online, 
				or to your local FSD 
				Resource Center.If you do not 
				have MO HealthNet, you will need to apply. Visit mydss.mo.gov/healthcare/apply to 
						get started. When you complete your application, make sure to 
				check the box that asks if someone in the household lives in a 
				medical facility or nursing home. 
				NOTE: You will know if your application was approved within 
			45-90 days. 
		  
 Home & Community Based Services  
			
				Home & Community Based Services provide in-home services to qualified MO HealthNet (Missouri 
			Medicaid) participants who live at home. These services may include, 
			home healthcare, physical or speech therapy, meal delivery or food 
			delivery, personal care (like dressing, bathing, eating, etc.), 
			house cleaning, and other services. Who is eligible?Individuals 
			may qualify if they meet certain 
			income requirements, and are: 
					Age 63 (or 
				older)A U.S. Citizen 
				(or qualified non-citizen) and Missouri residentApproved by the 
				Dept. of Health and Senior Services (DHSS) to get in-home 
				servicesBe eligible for, 
				or currently have, MO HealthNet 
				NOTE: If you are approved for Home & Community 
					Based Services, you will not be required to spend down your 
					MO HealthNet coverage. How to Apply
					If you already 
				have coverage through MO HealthNet and you want to add Home & Community Based Services, call
						877-304-7939.If you do not 
				have MO HealthNet, you will need to apply. Visit mydss.mo.gov/healthcare/apply to 
						get started.    
 MO HealthNet Programs  
			
				MO HealthNet 
					offers healthcare coverage through either a Managed Care 
					health plan (also 
					referred to as MAGI) or the Fee-For-Service Program (referred 
					to as non-MAGI). Which program you get your services 
					through depends on your age and eligibility. If you are not 
					sure which program you have, log in to the FSD 
					Benefit Portal for more information about your 
					coverage. Managed Care Health PlanYou will get your MO HealthNet coverage through one of 
						the Managed 
						Care Health Plans: Healthy Blue, United Healthcare, 
						or Home State Health if you are a: 
					Parent or 
							caretaker with a child under age 19Child age 
							birth-18Woman age 18-55 
							with no health insuranceAdult age 19-64 
							with no disabilitiesPregnant woman 
							(including your unborn child) Review the Managed 
						Care Guide for more information about your program.  Fee for Service ProgramYou will get your MO HealthNet coverage through the 
						Fee-For-Service Program if you are: 
					Age 65 or olderHave a 
							disabilityAre blind or 
							visually impairedAre a woman 
							under age 65 with breast or cervical cancer Review the MO HealthNet Fee-For-Service 
						Guide for more information about your program. 
				NOTE: Certain individuals will get their coverage 
					through Show 
					Me Healthy Kids (SMHK).  How do I contact my health plan?If you have questions about your health plan, covered services, or your 
		plan’s health care providers, you should reach out to your health plan 
		directly:   
			
				If you need help with changing your health plan, call 800-348-6627. 
		If you are in Show Me Healthy Kids, you cannot change your health plan. Translation 
		services are available at no cost if needed. If you are deaf or 
		hearing impaired, call Relay Missouri at 711. How do I contact my Fee-For-Service health plan?If you have a disability, are age 65 and over, blind or visually 
		impaired, or have breast or cervical cancer, you most likely have MO 
		HealthNet Fee For Service coverage.  If you have questions about your 
		health plan or covered services, reach out to: 
					Online: visit mydss.mo.gov to 
			apply for benefits, check your status, report a change, or learn 
			more about benefitsEmail: Ask.MHD@dss.mo.govChat Online: Visit mydss.mo.gov and 
			select "DSS Chat" to get answers about your case or general 
			informationIn Person: Visit 
			your local Resource CenterCall: Constituent Services at 800-392-2161. 
					   
 Need a new card?
			
				
					| EBT Card   
		If your EBT card has been lost, stolen, or damagedplease call to ask for a replacement EBT card.
 
		 
		FSD Information Center at 
		855-FSD-INFO 
		800-997-7777 | Healthcare Card   
		If you need a new MO HealthNet ID card, please call
		855-FSD-INFO. 
		 
		
		MO HealthNet 
		855-373-4636 |  
		Managed Health Plan Card   If you need a new Managed Care health plan card, please reach out to 
		your health plan directly. Visit Contact 
		Your Health Plan for more information.
 
 Covered Services  Refer 
				to the chart below 
				for what services are covered based on your type of coverage. Work with your healthcare provider to determine if the service 
				you need is covered.    
		
			
				
					| Service | Managed Care Members | Fee-For-Service Participants
 |  
					| 24-hour access by phone | ✔ |  |  
					| Adult Day Health Care |  | ✔ ** |  
					| Ambulance | ✔ | ✔ |  
					| Ambulatory Surgical Center | ✔ | ✔ |  
					| Asthma | ✔* | ✔ |  
					| Behavioral Health & Substance Use Disorders (including 
					emergency) | ✔ | ✔ ** |  
					| Birthing Center | ✔ | ✔ |  
					| Care Management | ✔ | ✔ ** |  
					| Chiropractic services | ✔* | ✔ |  
					| Complementary health & alternative therapy for chronic pain | ✔* | ✔ |  
					| Comprehensive Day Rehabilitation (recovery from serious head 
					injury) | ✔* | ✔ ** |  
					| Diabetes education & self-management training | ✔* | ✔ |  
					| Diabetes Prevention Program | ✔* | ✔ |  
					| Dental services | ✔* | ✔ ** |  
					| Diabetic supplies & equipment | ✔* | ✔ ** |  
					| Doctor's office visits | ✔ | ✔ |  
					| Durable Medical Equipment | ✔* | ✔ |  
					| Emergency room | ✔ | ✔ |  
					| Family planning services | ✔ | ✔ |  
					| Habilitative skilled therapy services | ✔* |  |  
					| Healthy Children & Youth (HCY) services | ✔ | ✔ |  
					| Hearing aids & related services | ✔* | ✔ ** |  
					| HIV treatment |  | ✔ |  
					| Home Health Services | ✔* | ✔ |  
					| Hospice (last 6 months of life) | ✔* | ✔ |  
					| Hospital (overnight stay required) | ✔ | ✔ |  
					| Laboratory tests & x-rays | ✔ | ✔ |  
					| Lead poisoning | ✔ | ✔ |  
					| Maternity services | ✔ | ✔ |  
					| Nurse midwife | ✔ | ✔ |  
					| Nursing facility | ✔ | ✔ |  
					| Occupational therapy services | ✔* | ✔ ** |  
					| Outpatient (overnight stay not required) | ✔ | ✔ |  
					| Personal care | ✔ | ✔ ** |  
					| Pharmacy | ✔ | ✔ |  
					| Physical Therapy services | ✔* | ✔ ** |  
					| Preventative care | ✔ | ✔ |  
					| Podiatry (feet) | ✔* | ✔ ** |  
					| Sexually Transmitted Diseases | ✔ | ✔ |  
					| Specialist care (with provider referral) | ✔ | ✔ |  
					| Speech therapy services | ✔* | ✔ ** |  
					| Substance use treatment | ✔ | ✔ |  
					| Tobacco cessation counseling | ✔ | ✔ |  
					| Transplant related services | ✔ | ✔ |  
					| Transportation to medical appointments | ✔* | ✔ ** |  
					| Treat no transport services | ✔ | ✔ |  
					| Tuberculosis | ✔ | ✔ |  
					| Vision | ✔* | ✔ ** |    * Limited Benefit, refer to Your Guide to Managed Care or your health 
		plan’s member handbook for more information. ** Services may be limited or not covered based on your eligibility 
		group or age. 
		 To find out, refer to Your Guide to Fee-For-Service or 
		call the Participant Services Unit at 
		800-392-2161. 
					     
 MO HealthNet Portal  
			
				You can visit the MO HealthNet Portal to get helpful information and 
		access features to manage your benefit, including: 
					View your household member 
			informationOpt-out of Managed Care or 
			change health plansView invoices and lettersPay premiums and spend downSearch for a MO HealthNet 
			providerView FAQs and helpful formsCompare health plansPay Spend Down 
 Your Responsibilities  
			
				
				Bring your healthcare card to appointments You will get your MO HealthNet ID card in the mail, and if you have 
		Managed Care, you will also get a health plan card. Make sure to bring 
		ALL your cards with you to every appointment. If your ID card is lost or 
		stolen, you will need to request 
		a new card. 
				Complete an annual renewal each year Every year, you will be required 
		to complete an annual renewal which will check to see if you are still 
		eligible for MO HealthNet. Typically your annual renewal will be due 
		around the anniversary of when your MO HealthNet coverage began. For 
		example, if you were approved for MO HealthNet in June, your renewal 
		will be due in June each year. If you do not return your information by 
		the deadline on the form, you may lose your coverage. Visit mydss.mo.gov/renew for 
		more information about MO HealthNet annual renewals. 
				Keep your information up to date You need to let us know if your 
		information (address, household size, or income) has changed as soon as 
		possible. You can report 
		changes online any day, 
		any time. You can also report a change by phone at 
					855-373-4636 or by 
		visiting your local FSD 
		Resource Center.   
 Facts About Missouri Department of Social Services  
			
				| MO HealthNet | 
						| Facts | Count |  
						| Number of people enrolled for MO HealthNet 
									services | 1,030,053 |  
						| MO HealthNet dollars spent state fiscal year 
									2021 | $10.04 bil |  
						| Estimated federal portion of MO HealthNet 
									dollars spent | $6.53 bil |  
						| MO HealthNet dollars for inpatient hospital 
									services | $534.3 mil |  
						| MO HealthNet dollars for physician services | $428.8 mil |  
						| MO HealthNet dollars for nursing home 
									services | $1.04 bil |  
						| MO HealthNet dollars for pharmacy services | $1.41 bil |  
						| MO HealthNet dollars for managed care 
									payments | $2.52 bil |  
		
			| Family Support | 
					| Facts | Count |  
					| Child support collections (IV-D and 
									non-IV-D) | $807.4 mil |  
					| Average monthly temporary assistance 
									families | 8,607 |  
					| Total temporary assistance payments | $22.7 mil |  
					| Average monthly food stamp benefit 
									recipients | 717,668 |  
					| Total food stamp benefits received | $1.71 bil |  
		
			| Child Protection and Permanency | 
					| Facts | Count |  
					| Children involved in hotline reports | 73,466 |  
					| Children with substantiated abuse or neglect | 4,688 |  
					| Children with family assessments | 47,613 |  
					| Average monthly children in foster care | 13,924 |  
					| Children adopted | 1,513 |  
					| Total Children’s Services expenditures | $311.4 mil |  
					| Average monthly children receiving 
									subsidized child care | 21,861 |  
					| Child care expenditures | $120.8 mil |  
			
				| Youth Services | 
						| Facts | Count |  
						| Youths committed | 366 |  
						| Average monthly youths in DYS custody | 679 |      |