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

Learn About Requirements for Medicaid in Missouri

“Who is eligible for Medicaid in Missouri?” is an essential question that petitioners must answer in order to ensure a fast and favorable application determination. Missouri residents wondering how to qualify for Medicaid, which is referred to in the state as MO HealthNet, must adhere to a variety of eligibility requirements. Medicaid benefits eligibility guidelines require applicants to qualify based on income, disability, age or other factors. Once a petitioner is approved for benefits, he or she will be able to access the benefits immediately and can even receive coverage three months retroactively, meaning benefits can help pay for past medical services and bills. Candidates who qualify for MO HealthNet can receive different types of coverage depending on their income and situation. Learn all about Medicaid eligibility requirements by reading the information below.


What are the requirements for Medicaid in Missouri?

In order to qualify for Medicaid in Missouri, candidates must generally have a low income and meet additional eligibility criteria. MO HealthNet provides unique health coverage plans for certain categories of beneficiaries, including low-income children and their parents or caretakers, seniors and blind or disabled individuals, among others. MO HealthNet eligibility requirements for each specific type of Medicaid program will vary. For instance, Medicaid benefits eligibility for seniors will require applicants to meet income, resource and age requirements. MO HealthNet for Pregnant Women and Newborns will require the applicant to be a pregnant woman who meets different income guidelines.

However, some basic requirements for Missouri Medicaid pertain to all applicants. To be eligible for Medicaid, every candidate must be a U.S. citizen or a qualified non-citizen. They must also currently reside in Missouri and plan to remain in the state. Qualifying for Medicaid will require applicants to provide documentation to prove their legal presence in the U.S. and residency in Missouri. Some applicants automatically qualify for Medicaid benefits eligibility if they participate in certain programs, such as Adult Supplemental Payments, Nursing Care or other qualifying Missouri state programs. To learn more about requirements for Medicaid, download our free guide.

What are the income requirements for Medicaid in Missouri?

To qualify for Medicaid benefits in Missouri, most petitioners will have to meet a Medicaid income requirement, which varies according to the specific Medicaid program to which they are applying. However, applicants cannot be eligible for Medicaid on the basis of income alone. For instance, some low-income adults who do not have dependents will not meet eligibility requirements for Medicaid, as Missouri has not accepted the Affordable Care Act (ACA) Medicaid expansion that would extend eligibility to these groups.

The Medicaid income eligibility requirements in MO will depend on the applicant’s status. For example, seniors or disabled applicants must have a net monthly income that does not exceed $1129 per month for a couple. In addition, Medicaid benefits eligibility guidelines may require candidates to meet asset or resource guidelines. For example, to qualify for Medicaid for Seniors or Medicaid for People with Disabilities, a married candidate cannot have more than $4,000 in cash or other non-exempt resources. When determining income eligibility for Medicaid in MO, the program does not count certain assets, including the applicant’s home, one vehicle and other exempt resources. To learn more about income requirements for Medicaid, download our free guide today.

Some applicants whose income exceeds the requirements for Medicaid in Missouri may be eligible to participate in Medicaid spend down. In order to qualify for Medicaid spend down, applicants must either have a qualifying disability or be a senior who is 65 years of age or older. In the spend down program, participants will have to spend a certain amount of money before they can have their medical costs covered by Medicaid. If an applicant has a monthly income that exceeds the monthly Medicaid income maximum by $25, then his or her medical expenses will be covered by Medicaid after he or she has spent $25 on medical expenses in a month.

What are the Medicaid application guidelines in Missouri?

Candidates can apply for MO HealthNet benefits whenever they would like to become a participant. Applicants who are approved will receive their benefits immediately. Candidates interested in applying for Medicaid can submit their application at any time. The quickest way to be approved for MO HealthNet benefits is through Missouri’s online portal. Candidates can also enroll by completing a paper application and submitting it to a Medicaid office, and those who need assistance can obtain help by phone. Medicaid application guidelines require applicants to provide information about income, assets and other relevant information.