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 insurance
Adult (age 19-64)
without disabilities
Pregnant woman
(including unborn child)
Woman (under age 65)
with breast or cervical cancer
Person with disabilities
Blind or visually
impaired adult
Benefit Program Income Limits
As of 4/1/2025
Program
Household Size & Maximum Annual Income
Federal Poverty Level
1
2
3
4
5
6
7
8
MO HealthNet for Expansion Adults
$20,814
$28,129
$35,444
$42,759
$50,074
$57,389
$64,704
$72,019
133%
MO HealthNet for Families
$1,692
$2,892
$3,612
$4,236
$4,800
$5,340
$5,880
$6,384
N/A
MO HealthNet for the Aged and Disabled
$13,303
$17,978
$22,653
$27,328
$32,003
$36,678
$41,353
$46,028
85%
MO HealthNet for the Blind
$15,650
$21,150
$26,650
$32,150
$37,650
$43,150
$48,650
$54,150
100%
State Children's Healthcare Insurance Program
$23,475
$31,725
$39,975
$48,225
$56,475
$64,725
$72,975
$81,225
150%
MO HealthNet for Kids under age 1
$30,674
$41,454
$52,234
$63,014
$73,794
$84,574
$95,354
$106,134
196%
MO HealthNet for Kids ages 1-18
$23,162
$31,302
$39,442
$47,582
$55,722
$63,862
$72,002
$80,142
148%
MO HealthNet for Pregnant Women
$30,674
$41,454
$52,234
$63,014
$73,794
$84,574
$95,354
$106,134
196%
Show Me Healthy Babies
$46,950
$63,450
$79,950
$96,450
$112,950
$129,450
$145,950
$162,450
300%
Ticket to Work Health Assurance
$46,950
$63,450
$79,950
$96,450
$112,950
$129,450
$145,950
$162,450
300%
Qualified Medicare Beneficiary
$15,650
$21,150
$26,650
$32,150
$37,650
$43,150
$48,650
$54,150
100%
Specified Low Income Medicare Beneficiary
$21,127
$28,552
$35,977
$43,402
$50,827
$58,252
$65,677
$73,102
135%
SNAP
Gross: $19,584
Net: $15,060
Gross: $26,580
Net: $20,448
Gross: $33,576
Net: $25,824
Gross: $40,560
Net: $31,200
Gross: $47,556
Net: $36,588
Gross: $54,552
Net: $41,964
Gross: $61,548
Net: $47,340
Gross: $68,544
Net: $52,728
130% gross income & 100% net income
Temporary Assistance (TA)*
$1,632
$2,808
$3,504
$4,104
$4,656
$5,172
$5,688
$6,168
N/A
*NOTE:
Depending on certain circumstances, this annual amount may vary.
Program
Household Size & Maximum MONTHLY Income
State Median Income
1
2
3
4
5
6
7
8
Low Income Home Energy Assistance Program
$2,535
$3,315
$4,095
$4,875
$5,655
$6,435
$6,563
$6,691
60%
*NOTE:
For household sizes over 6, add $128 to the maximum monthly income for
each household member.
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:
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 copays
MSP 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 Eligible
Individuals may
qualify for MSP, if they are:
A U.S. Citizen (or qualified
non-citizen) and Missouri resident
Have Medicare Part A
Meet 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 disabled
A U.S. Citizen (or qualified
non-citizen) and Missouri resident
Approved by the Dept. of
Health and Senior Services to get care from a nursing facility
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 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 resident
Have an income that is less
than the monthly cost to live in the facility
Be 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 resident
Approved by the
Dept. of Health and Senior Services (DHSS) to get in-home
services
Be 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.
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 Plan
You 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 19
Child age
birth-18
Woman age 18-55
with no health insurance
Adult age 19-64
with no disabilities
Pregnant woman
(including your unborn child)
Review the Managed
Care Guide for more information about your program.
Fee for Service Program
You will get your MO HealthNet coverage through the
Fee-For-Service Program if you are:
Age 65 or older
Have a
disability
Are blind or
visually impaired
Are 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 benefits
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
information
Opt-out of Managed Care or
change health plans
View invoices and letters
Pay premiums and spend down
Search for a MO HealthNet
provider
View FAQs and helpful forms
Compare health plans
Pay 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