Missouri Medicaid Office

Missouri Medicaid office (MO HealthNet)

Missouri splits its Medicaid work across two divisions of the Department of Social Services. The MO HealthNet Division (MHD) runs the program — setting policy, certifying providers, administering managed care contracts, and operating the participant-facing programs Missourians know as MO HealthNet. The Family Support Division handles eligibility: it receives applications, calculates income and resource tests, opens cases, and processes annual renewals.

What that two-division split means for members

An applicant in Missouri files with the Family Support Division to be approved. Once approved, the member's day-to-day relationship is with MHD — managed care plan selection, provider directories, pharmacy benefit, and dental coverage all flow through MHD's vendors. The mydss.mo.gov portal merges both divisions' user-facing tools in one place, so applicants and members rarely need to think about which division is handling a given task.

Where MHD publishes program information

• MHD program hub — mydss.mo.gov/mhd indexes information for participants, applicants, providers, and managed care health plans.
• Apply for healthcare — healthcare/apply handles new applications across all MO HealthNet eligibility tracks.
• Annual renewals — Family Support Division checks eligibility on all MO HealthNet participants every year through the renewal flow on mydss.mo.gov.
• Show Me Healthy Kids — MHD operates this dedicated coverage track for current and former foster youth.

Who qualifies for MO HealthNet?

MO HealthNet sorts Missouri Medicaid applicants into ten distinct eligibility tracks. Adopting the ACA expansion in 2021 added an Expansion Adults pathway for residents age 19 through 64, but the older categorical paths remain — and which one fits depends on age, household composition, pregnancy status, disability, and the type of coverage being sought.

The ten tracks at a glance

• Expansion Adults — adults age 19 through 64 who live in Missouri, are U.S. citizens or qualified non-citizens, and fall under the published annual income limit. Applicants who are eligible for other MO HealthNet categories (Families, Pregnant Women, ABD) use those instead.
• Families — parents or caretakers of a child under 19, with Social Security numbers, cooperation with child support for medical support, and income under the families standard. The child is covered alongside the adult.
• Seniors (Aged & Disabled) — adults 65 and older with income at or below 85% of the federal poverty level. Income too high doesn't automatically disqualify: medical costs can be used to bring countable income within the limit (a spenddown approach).
• Children & Youth — Missouri residents age 18 or under in households under the annual income standard for their category.
• People with Disabilities — adults who are permanently and totally disabled (defined as unable to be gainfully and substantially employed for one or more years due to physical or mental incapacity) and have applied for other benefits such as Social Security.
• MO HealthNet for Pregnant Women — Missouri residents who are pregnant and under the published income limit.
• Show Me Healthy Babies — for pregnant residents not approved through MHN for Pregnant Women, with income guidelines that extend up to 300% of the federal poverty level for ineligible aliens.
• Women Without Health Coverage — family-planning-only coverage for women age 18 to 55 with income under 201% of the federal poverty level.
• Blind & Visually Impaired — adults 18 and older who are legally blind (vision less than 5/200) and meet income and resource tests.
• Women with Breast or Cervical Cancer — women under 65 diagnosed through the DHSS Show Me Healthy Women screening program who need treatment.

Resource tests still apply to several tracks

Expansion Adults, Families, Children & Youth, MHN for Pregnant Women, and Show Me Healthy Babies are tested on income only (using modified adjusted gross income, MAGI). The Seniors, People with Disabilities, and Blind tracks add a resource test in addition to the income test. The home, one vehicle, household goods, and certain other property are not counted. The Family Support Division publishes the active resource limits in a PDF appendix — verify the current dollar figures with the agency before applying.

MO HealthNet income limits

The Family Support Division publishes a benefit program income limits chart with the current effective date. The version cached for this page is dated 04/01/2026 and is the source for the percent-of-FPL anchors below. Verify current dollar figures against the live agency chart before relying on any specific number — both FPL and Missouri's category thresholds update annually.

MO HealthNet income standards by category

Medicare Savings Programs in Missouri

• Qualified Medicare Beneficiary (QMB) — income at or below 100% FPL; pays Part A and B premiums, Medicare deductibles, and coinsurance.
• Specified Low-Income Medicare Beneficiary (SLMB) — income up to 135% FPL; pays the Part B premium only.

How to apply for MO HealthNet

Missouri's apply flow funnels every MO HealthNet eligibility track through the Family Support Division. The same application screens for Expansion Adults, Families, Pregnant Women, Children, and the Aged-Blind-Disabled tracks; applicants in the Aged-Blind-Disabled categories add a supplemental form to the base application.

Three apply channels

• Online — the FSD online portal at mydssapp.mo.gov accepts the application and lets you check status and report changes.
• By phone — call the application line to apply with a worker. (See the agency contact card for the current number.)
• By paper — download the IM-1SSL Single Streamlined Application (Adobe Reader required), complete it, and submit. A Spanish version is published alongside the English form.

Aged, Blind, or Disabled? Add the supplemental form

Applicants who are 65 or older, blind, disabled, receiving Social Security, living in a medical or nursing facility, or covered by Medicare or VA healthcare must complete the IM-1ABDS supplemental form alongside the IM-1SSL. The supplemental form captures the additional income, asset, and benefit-coordination information the ABD track needs.

Four submission paths

• Upload at mydssupload.mo.gov
• Mail to Family Support Division, P.O. Box 2700, Jefferson City, MO 65102
• Fax to 573-526-9400
• In person at a local Family Support Division Resource Center

How long a decision takes

If the applicant doesn't receive a decision from the Family Support Division within 45 days, FSD asks them to make contact. Disability-based decisions take longer than non-disability decisions because the disability determination is a separate medical review on top of the income and resource calculations. Federal Medicaid rules allow up to 90 days for disability-based applications.

Spend Down for over-income households

Households whose income is too high for the standard tests may still qualify through Spend Down. The applicant agrees to incur a set amount of medical bills each month, and once that threshold is met MO HealthNet covers the remaining costs for that month. Spend Down is most commonly used by older adults and people with a disability whose income sits just above the categorical limit.

What MO HealthNet covers

MO HealthNet covers the federally required Medicaid services and layers on a substantial menu of optional and specialty programs. The federal core — physician services, hospital care, lab work, prescriptions, family planning, pregnancy care, and EPSDT for kids under 21 — runs across all MO HealthNet eligibility tracks. On top of that, MHD operates roughly a dozen named auxiliary programs that target specific populations or specific kinds of care.

Core medical benefits across all MO HealthNet tracks

• Doctor visits, specialist care, urgent care, and emergency services
• Hospital inpatient and outpatient care
• Prescription drugs
• Lab work and imaging
• Pregnancy and maternity care
• Behavioral health and substance use disorder treatment
• Family planning services
• EPSDT for enrolled children under 21 (federal mandate)

Auxiliary MO HealthNet programs MHD lists

• Spend Down — lets over-income households qualify by covering a set amount of medical costs each month.
• Ticket to Work Health Assurance — coverage for working adults with disabilities who earn too much for standard MO HealthNet.
• Home & Community Based Services — keeps eligible older adults and people with disabilities at home instead of in a nursing facility.
• Nursing Home Coverage — pays nursing-home costs the resident isn't responsible for. The resident contributes all income except a $50 monthly personal allowance, any health insurance premiums, and any income set aside for a spouse or dependent.
• Health Insurance Premium Payment (HIPP) — pays an eligible member's commercial health insurance premium when doing so is cheaper than direct MO HealthNet coverage.
• Breast and Cervical Cancer Treatment (BCCT) — for uninsured women under 65 screened and diagnosed through DHSS Show Me Healthy Women.
• Supplemental Nursing Care Program — for residents of residential care or assisted living: $50 monthly personal allowance plus a cash payment to the facility ($156 monthly for residential care, $292 for assisted living).
• Medicare Savings Programs (QMB & SLMB) — help with Medicare premiums and certain copayments.
• Supplemental Aid for the Blind and Blind Pension — monthly cash grants plus MO HealthNet coverage for blind Missourians.
• Show-Me Healthy Babies — maternity coverage for pregnant residents who don't qualify for MHN for Pregnant Women.
• Program of All-Inclusive Care for the Elderly (PACE) — comprehensive care so older adults can live at home instead of in nursing facilities.

Other state Medicaid pages