This site is privately owned and is not affiliated with any government agency. Learn more here.

Learn About Medicaid Costs and Coverage in Missouri

Medicaid coverage in Missouri provides low-cost medical care to low-income individuals or families. The types of Medicaid insurance offered by Missouri HealthNet cover a broad range of medical services for many different potential beneficiaries. Medicaid benefits cover various medical services, but they also exclude coverage for other types of services. Additionally, while officials attempt to keep Medicaid cost estimates low, in some cases there are costs to the recipient. Medicaid costs include such expenses as deductibles and copayments, which are out-of-pocket costs that programs may sometimes not cover. Understanding what Medicaid covers and how much it will cost is vital for applicants seeking assistance. Answer the question “How much is Medicaid in MO?” and learn about Medicaid services by reading the sections provided below.

What services are covered by Medicaid in Missouri?

Missouri Medicaid coverage consists of some benefits outlined by the federal government. For instance, Medicaid covered services in MO include inpatient and outpatient care. Additionally, states may alter certain Medicaid coverage provisions depending on local needs and resources. The cooperation between officials helps create a system that is flexible, allowing each state to adjust accordingly and provide assistance to potential beneficiaries. However, a Medicaid covered service does not always mean that there is no cost associated with the assistance. Co-pays may be required for certain services.

Medicaid coverage benefits are either mandatory, meaning that states must make them available to residents, or optional, meaning they may or may not be adopted by the state. For instance, the Affordable Care Act introduced an expansion of Medicaid to cover more individuals. However, this provision is an option, and Missouri chose not to accept the Medicaid expansion. Often, what Medicaid covers in a state depends on local resources and needs, leading to the exclusion of certain provisions. Regardless of whether or not a service is mandatory or optional, there may be costs associated with the service. Some of the types of Medicaid insurance that are mandatory include:

  • Inpatient and outpatient care.
  • Services from a primary care physician.
  • Transportation to and from medical centers.
  • Doctor visits
  • Emergency room.
  • X-Rays.
  • Testing and treatment for specific diseases.

Missouri Medicaid coverage extends to a broad range of potential beneficiaries. Both families and individuals benefit from the assistance. However, HealthNet programs provide additional benefits to children younger than 19 years of age. Some of the Medicaid covered services provided to minors include vision, hearing and dental screens, psychological services such as counseling and special therapies (physical, occupational and speech). To learn more about Medicaid services, download our free guide today.

What services are not covered by Medicaid in Missouri?

The answer to “What does Medicaid not cover in Missouri?” is as vital for potential beneficiaries to understand as what the program covers. MO Medicaid coverage aims to provide low-income applicants with aid for health care, but it does exclude certain services that are considered elective. Examples of services that are not covered by Medicaid include:

  • Cosmetic alterations.
  • Occupational, speech or respiratory therapy.
  • Rentals from on-demand services while in a hospital room.
  • Hair transplants
  • Treatment of infertility.
How much does Medicaid cost in Missouri?

Missouri Medicaid cost estimates try to be as low as possible to help low-income applicants receive vital aid. However, it is essential to understand that additional costs may be required of beneficiaries. Before applying for Medicaid coverage, applicants benefit from knowing what expenses may be associated with Medicaid. For instance, families needing emergency services or requesting preventative services may face some out-of-pocket expenses.

MO Medicaid cost estimates for potential beneficiaries remain low because the program receives adequate funding. In cases where copayments are due, Medicaid coverage caps the amount that a provider may charge for services. Established limits for Medicaid benefit costs are based on the income level and size of a household. Officials notify approved applicants and provide detailed information such as the limits for costs. Note that Medicaid cost estimates in Missouri and expenses associated with the program may change based on available resources and other factors.

Additionally, certain Medicaid beneficiaries may be exempt from such extra costs. In specific situations, the answer to “How much does Medicaid cost?” is sometimes zero. Certain beneficiaries receive exemptions from ever paying copayments or other expenses associated with Medicaid. Some recipients, including minors and those living in nursing homes, typically do not have to pay any out-of-pocket costs. Additionally, Medicaid extends across a wide variety of health care services and procedures. Some services come with an additional charge and some do not. However, Medicaid coverage for procedures such as chemotherapy or home health services do not incur copayments. Furthermore, emergency services and a broad range of assistance provided to the elderly and disabled will not face such expenses either. Download our free guide today to learn more about Medicaid costs and coverage.