Missouri Medicaid &
MO HealthNet

Definitions of Medicaid in Missouri

Medicaid in Missouri*

"Each state administers its own Medicaid program. The federal Centers for Medicare and Medicaid Services (CMS) monitors state-run programs and establishes requirements for service delivery and quality, funding, and eligibility standards. State participation is voluntary, and all states have participated since 1982. Missouri’s participation in Medicaid (called MO HealthNet in Missouri) began in 1967.

Missouri's MO HealthNet:
• covers 1 out of every 7 Missourians
• covers 35% of Missouri’s children
• pays for 48% of all births in the state1
• covers 1 out of every 10 seniors over age 65
• pays for 61% of all nursing home care in the state
• covers Medicare premiums, deductibles, and coinsurance for eligible seniors and people with disabilities "
*source: Missouri Foundation for Health , St. Louis, MO 63103

• publication:
  The Missouri Medicaid Program - What is Medicaid?
  
  source:Legal Services of Southern Missouri
  from the publication:
  "Medicaid is medical coverage designed to help pregnant, low-income, disabled, or elderly residents with the costs of health care, including prescription costs, doctor and hospital bills, and various other services..."

  ---

• publication:
  Missouri Medicaid Basics
  
  source:Cover Missouri - a project of the Missouri Foundation for Health
  file size: 12 pg.; languages: English
  from the publication:
  "Missouri's MO HealthNet: covers 1 out of every 7 Missourians; covers 35% of Missouri’s children; pays for 48% of all births in the state; covers 1 out of every 10 seniors over age 65; ..."

  ---

• web page:
  MEDICAID | Missouri
  
  source:healthinsuranceinfo.net - Georgetown University's Health Policy Institute
  languages: English
  from the webpage:
  "...In Missouri you may be eligible for Medicaid if you are an infant, a child, a pregnant woman, or a parent of a child and your family income meets the Medicaid income standards. .."

  ---

• web page:
  Key Medicaid Information for Missouri
  
  source:Elder Law Answers
  "Explains important basics about Missouri Medicaid. Topics include protections for the community spouse, transfers, income, and estate recovery.."

  ---

• brochure:
  The Medicaid Program at a Glance
  
  source:The Kaiser Commission on Medicaid and the Uninsured
  file size: 2 pg.   languages: English
  This fact sheet provides an overview of the Medicaid program, the populations that it serves, the services that it covers and the expanded role it will play under the health reform law...
  • also from The Kaiser Commission on Medicaid and the Uninsured:
    web page:
    Medicaid: A Primer
    languages: English
    from the publication:
    "This primer provides an overview of the basic components of Medicaid, the nation's largest health coverage program, which covers nearly 60 million low-income individuals, including children and families, people with disabilities and seniors who are also covered by Medicare..."

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• web page:
  Missouri & United States State Medicaid Fact Sheets
  
  source:Kaiser Family Foundation
  file size: languages: English
  

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• web page:
  Missouri Medicaid
  
  source:GovBenefits.gov - Your Benefits Connection
  languages: English
  from the web page:
  " In order to qualify for this benefit program, you must be a resident of the state of Missouri, a US national, citizen, permanent resident, or legal alien, in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income. You must also be either pregnant, a parent or relative caretaker of a dependent child(ren) under age 19, blind, have a disability or a family member in your household with a disability, or be 65 years of age or older..."

• web page:
  Participant Eligibility
  
  source:MO HealthNet Division, Missouri Department of Social Services
  languages: English
  from the web page:
  "If the individual is determined eligible, the individual or family receives an approval letter from the FSD county office that is valid until they are issued a MO HealthNet identification card with the next regular payroll..."

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• web page:
  Do Your Children Need Health Coverage?
  
  source:MO HealthNet for Kids
  languages: English
  from the web page:
  "They may be eligible for MO HealthNet for Kids if..."

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• web page:
  2011 HHS Poverty Guidelines
  
  source: Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services
  languages: English
  from the web page:
  "...The poverty thresholds are the original version of the federal poverty measure... The poverty guidelines are the other version of the federal poverty measure.
  

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• web page:
  Medicaid Eligibility
  
  source: Centers for Medicare & Medicaid Services
  languages: English
  from the web page:
  Many groups of people are covered by Medicaid. Even within these groups, though, certain requirements must be met. These may include your age, whether you are pregnant, disabled, blind, or aged; your income and resources (like bank accounts, real property, or other items that can be sold for cash); and whether you are a U.S. citizen or a lawfully admitted immigrant. The rules for counting your income and resources vary from state to state and from group to group. There are special rules for those who live in nursing homes and for disabled children living at home.

• brochure:
  Citizenship Documentation Requirements in Medicaid
  
  source:Kaiser Family Foundation
  3 pages; languages: English
  from the publication:
  "Medicaid citizenship requirements Under federal law, all U.S. citizens and certain legal immigrants who meet Medicaid’s financial and non-financial eligibility criteria are entitled to Medicaid. The Medicaid program has long required states to establish that individuals applying for Medicaid are U.S. citizens or satisfy the immigration restrictions.... "

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• brochure:
  Medicaid Citizenship Verification Requirement
  
  source:American Public Human Services Association
  5 pages; languages: English
  from the publication:
  "What has changed? In the Deficit Reduction Act of 2005, a new requirement was established with respect to citizenship verification of current and new Medicaid applicants. Citizen applicants were previously able to self-attest their citizenship and identity under penalty of perjury to qualify for Medicaid..... "

• form or publication:
  Medicaid Application/Eligibility Statement
  
  source:Family Support Division, Missouri Department of Social Services
  4 pages; languages: English
  from the form:
  "This is an application for health care benefits for people who are 65 years of age or older, blind, or have a disability..."

• web page:
  Family Support Division Offices
  
  source:Family Support Division, Missouri Department of Social Services
  languages: English
  
  

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• web page:
  Contact Your Local Department of Social Services Office
  
  source:Missouri Department of Social Services
  languages: English
  from the web page: "For contact information regarding questions about Department of Social Services programs or services, please select the county in which you live"

• web page:
  MO HealthNet Managed Care (formerly MC+ Managed Care)
  
  source:MO HealthNet Division, Missouri Department of Social Services
  languages: English
  from the web page: "Effective September 1, 1995, the state of Missouri introduced a new health care delivery program called MC+ Managed Care to serve certain MC+ participants that meet specified eligibility criteria. Effective September 1, 2007 MC+ Managed Care became known as MO HealthNet Managed Care."
  
  • also from MO HealthNet Division, Missouri Department of Social Services:
    web page:
    Health Plan Information
    languages: English
    from the web page::
    "Regional Health Plans... WESTERN REGION... CENTRAL REGION... EASTERN REGION..."
    
  • web page:
    Common Questions
    languages: English
    from the web page::
    "Do I Need to Enroll? ...How Do I Enroll? ...What If I Have Special Needs? ...Can I Change MO HealthNet Managed Care Health Plans? ..."
  
  
  • web page:
    MO HealthNet Managed Care Benefits
    languages: English
    from the web page::
    "MO HealthNet Managed Care is the way you will receive health care. Listed below are some benefits and services you will receive through MO HealthNet Managed Care. Please read the information carefully...."
  
  

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• brochure:
  MO HealthNet Managed Care
  
  source:Missouri Association of Health Plans
  2 pages; languages: English
  from the brochure: "the right care ...at the right time ...for the right cost..."
  
  • also from Missouri Association of Health Plans:
    web page:
    Medicaid Managed Care
    languages: English
    from the web page::
    "...In 2007 SB 577 established MO HealthNet, which replaced the state Medicaid program. The details of the program continue to be defined by an Oversight Committee. Missouri’s MO HealthNet managed care currently operates in 54 counties..."
    
  
  

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• web page:
  Missouri: Medicaid Managed Care
  
  source:Kaiser Family Foundation / statehealthfacts.orgn
  languages: English
  from the web page:
  "Medicaid Managed Care Enrollees... Medicaid Enrollment in Comprehensive Managed Care Plans... Medicaid Managed Care Enrollees as a Percent of State Medicaid Enrollees"
  

• web page:
  MO HealthNet Provider Search
  
  source:Missouri Department of Social Services
  languages: English, Spanish
  from the web page: "Choose from one of the two methods below then click on the Submit button. Note: It does not guarantee that they will accept you as a MO HealthNet patient."
  notes: Disclaimers: Call the Provider first to see if they are accepting new patients.
  
  • also from MO HealthNet Division, Missouri Department of Social Services:
    web page:
    Search for Primary Care Provider
    languages: English
    from the web page::
    "SEARCH FOR PROVIDER BY COUNTY, PLAN NAME, CATEGORY, SPECIALITY CODE OR PROVIDER LANGUAGE SPOKEN..."
    

• web page:
  Frequently Asked Questions
  
  source:MO HealthNet for Kids, Missouri Department of Social Services
  languages: English
  from the web page::
  "What is MO HealthNet for Kids... Who is eligible... Do you count student loans, grants, work-study, graduate fellowship and parental support as income... Are adopted children eligible for MO HealthNet for Kids... What does it cover... What doctors take MO HealthNet for Kids...
  • also from MO HealthNet for Kids, Missouri Department of Social Services:
    web page:
    Available Services
    languages: English
    
    from the web page::
    "MO HealthNet for Kids... participants get their care either through MO HealthNet Fee-for-Service or through MO HealthNet Managed Care. ..."

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• brochure:
  SCHIP Reauthorization 2009
  
  source:Cover Missouri - a project of the Missouri Foundation for Health
  4 pages; languages: English
  from the brochure:
  "...The State Children’s Health Insurance Program (SCHIP) provides affordable health coverage to more than 7 million children nationally, including 66,000 in Missouri. In February 2009, the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) was passed by Congress and signed into law..."

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• web page:
  MC + For Kids
  
  source:healthinsuranceinfo.net - Georgetown University's Health Policy Institute
  languages: English
  from the webpage:
  "...MC+ for Kids is part of the federal Children’s Health Insurance Program and provides health insurance for uninsured children of low-income families who do not have access to affordable health insurance..."

  ---

• web page:
  MO HealthNet for Kids - Who Is Eligible ?
  
  source:Family Support Division, Missouri Department of Social Services
  languages: English
  from the web page::
  "A child: who is under 19 years of age; who applies for a social security number; who lives in Missouri and intends to remain...
  
  • also from MO HealthNet for Kids, Missouri Department of Social Services:
    web page:
    MO HealthNet for Families (MHF)- Who Is Eligible?
    languages: English
    
    from the web page::
    "This program provides healthcare coverage for families with income that does not exceed the July 16, 1996 Aid to Families with Dependent Children (AFDC) income standards..."

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• brochure or publication:
  Missouri MEDICAID FACTS
  
  source:AMERICAN ACADEMY OF PEDIATRICS
  languages: English
  from the web page:
  "How does Medicaid help children in Missouri? Children make up 54% of Missouri’s Medicaid population, but are of very low cost, accounting for only 23% of the state’s Medicaid spending. In general, Missouri children who are in families of four with incomesbelow $60,000 are eligible for Medicaid...."

  ---

• Medicaid brochure:
  Missouri Public Health Insurance for Children
  
  source:National Center for Children in Poverty (NCCP)
  languages: English, Spanish
  from the brochure:
  "...The two major federal funding sources for low-income children’s public health insurance are Medicaid and the State Children’s Health Insurance Program (SCHIP). States enjoy some flexibility in their Medicaid programs for children,..."
  • also from National Center for Children in Poverty (NCCP):
    web page:
    Missouri Public Health Insurance for Parents
    languages: English
    from the web page:
    "Most family plans are funded through Medicaid, but a handful of states have waivers to use State Children’s Health Insurance Program (SCHIP) funds to cover parents. ..."
     
  • web page:
    Missouri Demographics of Low-Income Children
    languages: English
    from the web page:
    "Research suggests that, on average, families need an income of about twice the federal poverty level to meet their most basic needs. Children living in families with incomes below this level—$40,000 for a family of four in 2006—are referred to as low income..."
     

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• bublication / brochure:
  Children’s Health Coverage Missouri
  
  source:Children's Defense Fund
  languages: English
  from the web page:

  "Applying for health insurance in Missouri... MC+ is a program that provides free and low-cost health care for Missouri children. If you are a family of four with income of $... or less, your child is eligible..."

  • also from Children's Defense Fund:
    brochure:
    Health Coverage for All Children: Missouri
    2 pages; languages: English
    from the brochure:
    "Do children in Missouri’s CHIP program receive the same comprehensive benefits as children in Medicaid? Yes. Missouri is one of 13 states (plus the District of Columbia) that has used CHIP funding to cover all children eligible for CHIP and Medicaid under one program....."
     

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• web page:
  Missouri MC+ for Kids (SCHIP)
  
  source:GovBenefits.gov - Your Benefits Connection
  languages: English
  from the webpage:
  "...Missouri MC+ for Kids, part of the Federal Children's Health Insurance Program (CHIP), is a health insurance program for uninsured children of low-income families who do not have access to affordable health insurance. ..."

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• web page:
  Missouri Medicaid, SCHIP, & Federal Authority
  
  source:State Coverage Initiatives
  languages: English, Spanish
  from the web page:
  " In 2007, Missouri embarked upon a transformation of its Medicaid program into MO HealthNet, with the vision of creating a model for the provision of high-quality health care focused on wellness..."

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• web page:
  Missouri: CHIP Program Name and Type
  
  source:Kaiser Family Foundation statehealthfacts.org
  languages: English, Spanish
  from the web page:
  "Individual state profiles..."

Missouri Medicaid Benefits and Coverage: Medicaid Services

Medicaid Prescription Drugs; Preferred Drug List

Missouri Medicaid Dental Services; Dentist

Missouri Medicaid and Nursing Homes, Assisted Living, Home Health Care

Medicaid Spousal Impoverishment Protection

Missouri Medicare / Medicaid Dual Eligibles - Missouri Medicare Savings Program

Missouri Medicaid Waiver Programs

More resources about Missouri Medicaid Waiver Programs:

Report Medicaid Fraud in Missouri

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MO: Missouri Medicaid: The Medicaid Project, Eligibility, Missouri Medicaid Rules, Application