Missouri Medicaid &
MO HealthNet

Finding the right answers and information about a complicated topic like Medicaid can mean searching through hundreds of pages at government and private websites. Our editors have compiled this digest of Missouri Medicaid help and resources to assist in your search.

topics: Missouri Medicaid: Missouri Public Health Insurance: medicaid insurance, centers for Medicaid; Medicaid In Missouri; Medicaid Assistance information; WI; definition Medicaid Missouri: Missouri Medicaid Eligibility: Applying for Missouri Medicaid: Medicaid: Health Programs for Children: Missouri CHIP:


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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



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Medicaid in Missouri: How It Works; An Introduction to Missouri Medicaid

  • brochure:
    Fee-For-Service Participant Handbook

    source:MO HealthNet Division, Missouri Department of Social Services
    28 pages; languages: English
    from the brochure:
    "Welcome to MO HealthNet ! This handbook explains the services you can get. It also tells you about your responsibilities. Please read it carefully and keep it in a safe place. You must meet certain income guidelines and other rules to become eligible for MO HealthNet. Your local Family Support Division Eligibility Specialist made this decision for you. If you have questions about your eligibility contact your local Family Support Division Eligibility Specialist...."
    • also from MO HealthNet Division, Missouri Department of Social Servicess:
      web page:
      Frequently Asked Participant Questions
      languages: English
      from the web page:
      "How can I become eligible for MO HealthNet?... What does MO HealthNet pay for? ... How can I find out if I have MO HealthNet coverage?... How can I find a doctor that takes MO HealthNet? ... What is co-pay? ..."
       
    • web page:
      Spenddown Pay-in Questions
      languages: English
      from the web page:
      "What is spenddown? ...How do I pay my spenddown? ...Do I have to pay or reach my spenddown every month? ...Where do I mail my spenddown payment? ...
       "
how to use this data

 

Missouri Medicaid Eligibility, How to get Medicaid in Missouri, Requirements

 

Missouri Medicaid Citizenship Requirements

 

Applying for Missouri Medicaid

 

Missouri Medicaid Offices

 

Missouri Medicaid Health Plans, Managed Care, HMO

 

Find Missouri Medicaid Physicians, Doctors

 

Children's Medicaid: Health Programs for Children: Missouri CHIP:

What is Medicaid for children in Missouri?

Children's Medicaid in Missouri; Children's Health Care: MO HealthNet for Kids

"Through the MO HealthNet for Kids program, children receive full, comprehensive coverage including primary, acute and preventative care, hospital care, dental and vision care as well as prescription coverage."
*source: MO HealthNet for Kids

What is CHIP?

"Originally created in 1997, the Children's Health Insurance Program (CHIP) is a state and federal partnership that provides low-cost health insurance coverage for children in families who earn too much income to qualify for Medicaid but cannot afford to purchase private health insurance coverage. States have considerable flexibility to establish income eligibility rules for CHIP, but children enrolling in the program must be otherwise uninsured."
source: InsureKidsNow.gov - Sponsored by the U.S. Department of Health and Human Services. , Washington, DC
 
 

Missouri Medicaid Benefits and Coverage: Medicaid Services

 

Medicaid Prescription Drugs; Preferred Drug List

  • web site:
    Missouri Rx Plan Enrollment

    source:Missouri Rx Plan
    languages: English
    from the web page::
    "You May Be Eligible If You Are... How Do I Get An Application?... What Do I Need To Send With My Application?... How Much Does It Cost To Enroll In or Belong To MoRx?..."
    • also from Missouri Rx Plan:
      web page:
      Benefits of MoRx
      languages: English
      from the web page:
      "•MoRx works with all Medicare Part D plans. MoRx pays for 50% of your out-of-pocket costs on medications that are covered by your Medicare Part D plan. This means you will save 50% on your deductible, 50% on your co-pays, including during the ..."

  • web site:
    Help and Frequently Asked Questions (F.A.Q.'s)

    source:MoRx Price Compare
    languages: English
    from the web page::
    " How are prices calculated?... How Do I Get An Application?... Brand versus Generic? ... I am unable to locate a pharmacy with pricing information for my drug. What can I do?..."
    • also from MoRx Price Compare :
      web page:
      Missouri Rx Price Compare (MoRx Price Compare) online system
      languages: English
      from the web page:
      "...interactively search and display pharmacy prices of commonly used prescription medications. This information will assist you in comparison shopping among pharmacies to get the best local price for your prescriptions..."
 

Missouri Medicaid Dental Services; Dentist

  • web page:
    Find an Oral Health Provider: Missouri Dental Providers

    source:InsureKidsNow.gov
    languages: English

  • brochure or publication:
    Guide to Children's Dental Care in Medicaid

    source:Centers for Medicare & Medicaid Services
    52 pages; languages: English
    from the brochure: "The Guide is intended to serve as a resource of current information on clinical practice, evolving technologies and recommendations in dental care. The guide is not intended to change current Medicaid policies, nor is it intended to impose any new requirements on states..."
    • also from Centers for Medicare & Medicaid Services:
      web page:
      Medicaid Dental Coverage - Overview
      languages: English
      from the web page:
      "Dental services under Title XIX of the Social Security Act, the Medicaid program, are an optional service for the adult population, individuals age 21 and older. However, dental services are a required service for most Medicaid-eligible individuals under the age of 21, as a required component of the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit..."
 

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

 

Medicaid Spousal Impoverishment Protection

  • web page:
    Prevention of Spousal Impoverishment

    source:Missouri Department of Social Services Family Support Division
    languages: English
    from the web page: "If a person is living in a nursing facility, receiving vendor nursing care, or requesting Home and Community-Based Services (HCB), federal law provides a way to protect some of that person's assets for a spouse. The law also provides for setting aside income, if needed, for a spouse or dependents..."
  • web page:
    No Change in Medicaid Spousal Impoverishment Standards for 2010

    source:Elder Law Answers
    "For the first time since 1989... the federal Centers for Medicare and Medicaid Services is not raising its guidelines for how much money the husbands or wives of institutionalized Medicaid recipients may keep. With no increase in the consumer price index on which these figures are based, the resource and income guidelines that prevailed in 2009 will apply in 2010 as well. This follows the announcement by Social Security Administration that there would be no cost of living increase in Social Security benefits..."
  • brochure:
    MO HealthNet for the Aged, Blind and Disabled

    source:Alzheimer's Association - St Louis
    3 pages; languages: English
    from the brochure:
    ""Protecting the Spouse: Under MO HealthNet, married individuals may qualify for spousal impoverishment protection. This allows the spouse of the person using MO HealthNet to protect some of their resources so as to continue living in the community....."
 

Missouri Medicare / Medicaid Dual Eligibles - Missouri Medicare Savings Program

  • web page:
    Frequently Asked Questions - Dual Eligibles

    source:Missouri Department of Social Services MO HealthNet Division
    languages: English
    from the web page: "How do I contact Medicare? ...What types of questions can Medicare answer for me? ...How do I choose a Medicare Part D plan? ...Who can tell me about the different prescription drug plans to find the one that is best for me? ...What is Missouri's benchmark premium? What happens if a dual eligible chooses to enroll in a plan with a premium above the benchmark? ...What changed in my MO HealthNet coverage when I became a dual eligible?..."
  • web page:
    Medicare Savings Programs

    source:CLAIM - the Missouri State Health Insurance Assistance Program
    languages: English
    from the web page: "The Medicare Savings Programs are federal and state funded assistance programs that help pay for some Medicare expenses for those that do not qualify for Medicaid (MO HealthNet) benefits. They require that an individual have..."
  • brochure:
    Medicaid Coverage of Medicare Beneficiaries (Dual Eligibles) At A Glance

    source:Centers for Medicare & Medicaid Services
    4 pages; languages: English
    from the brochure:
    "Individuals who are entitled to Medicare Part A and/or Part B and are eligible for some form of Medicaid benefit are often referred to as “dual eligibles.” These benefits are sometimes referred to as Medicare Savings Programs (MSPs). Dual eligibles are eligible for some form of Medicaid benefit, whether that Medicaid coverage is limited to certain costs, such as Medicare premiums, or the full benefits covered under the State Medicaid plan..."

  • brochure:
    Dual Eligibles: Medicaid’s Role for Low-Income Medicare Beneficiaries

    source:Kaiser Family Foundation: Medicaid/CHIP
    languages: English
    2 pages; from the brochure:
    "Nearly 8.8 million Medicaid beneficiaries are “dual eligibles” – low-income seniors and younger persons with disabilities who are enrolled in both the Medicare and Medicaid programs. Dual eligibles are among the sickest and poorest individuals covered by either the Medicaid or Medicare programs..."
 

Missouri Medicaid Waiver Programs

Medicaid Community Waivers in Missouri

"People who would like to stay in their home and community with the assist of supportive services may be eligible for home and community services if certain requirements are met. The services available in Missouri are funded through state or federal revenues, or through Medicaid.

Missouri offers a variety of home and community-based services. They include programs to provide assistance with activities of daily living such as bathing, grooming, meal preparation, housekeeping, counseling, help with arranging medical services, therapy and relief for caregivers. "
*source: Missouri Disability Portal, Governor's Council on Disability, Jefferson City, MO 65102
for more information, see:

More resources about Missouri Medicaid Waiver Programs:



 

Report Medicaid Fraud in Missouri


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