Adult Medicaid Expansion and MO HealthNet Coverage FAQs

What is Medicaid expansion and when did it begin?

Medicaid expansion changed the eligibility requirements for Missouri’s Medicaid program (MO HealthNet) to include adults between the ages of 19 and 64 who are eligible for the program. Missouri voters approved Medicaid expansion, the Supreme Court of Missouri held the expansion amendment to be constitutional, and the trial court ordered the state not to prohibit enrollment.

In accordance with the Cole County Circuit Court’s August 10, 2021 order, individuals were able to apply for healthcare coverage through MO HealthNet under Article IV Section 36(c) of the Missouri Constitution. The Family Support Division (FSD) began processing adult expansion applications in the Missouri Eligibility Determination and Enrollment System (MEDES) on October 1, 2021.

Who became eligible for MO HealthNet coverage due to Medicaid expansion?

Non-disabled adults between the ages of 19 and 64 may now be eligible for coverage through MO HealthNet if they:

  • Live in Missouri and are a United States citizen (or qualified non-citizen)
  • Make less than the annual income limit for their household size
  • Are not eligible for or receiving any of the following:
  • MO HealthNet for Pregnant Women
  • MO HealthNet for Families
  • MO HealthNet for the Aged Blind & Disabled Non Spenddown
  • Medicare Part A or B
  • MO HealthNet Coverage for Former Foster Care Youth
How do I know what services are covered by MO HealthNet?

Review the MO HealthNet Covered Services chart for a list of eligible  services. Some services may be limited based on your age or eligibility group, and other services may be available depending on your needs. You should always check with your provider (doctor) to see if the service you need is covered by MO HealthNet. 

How do I apply for MO HealthNet coverage?

There are three ways you can apply for MO HealthNet benefits. Visit the Apply for MO HealthNet webpage to learn more about how you can apply. 

Since the applications are online, are email addresses required to apply?

No. Email addresses are encouraged, but not required.

Are out-of-state students attending college in Missouri eligible for Medicaid if they meet the other requirements?

Yes. When they apply, they should provide their current Missouri address on their application.

If I was not born in Missouri, will I be required to submit a birth certificate?

FSD currently lacks the ability to verify citizenship electronically for applicants born outside Missouri. If you were born outside Missouri, you can submit documents that prove citizenship with your application. If additional documentation is needed FSD will request additional verification.  

How will the Family Support Division verify whether or not my employment status or income has changed after I submit my application for MO HealthNet coverage?

Anyone who has applied for services through the Family Support Division (FSD) should report any changes, including a change in employment or income, to the agency. FSD will also make every effort to obtain employment information and verify income through the electronic resources available to them. In cases where FSD is unable to verify income or the information does not match, you may be asked to clarify.

If I am covered by adult expansion and become pregnant, will I have to apply for MO HealthNet for Pregnant Women or will my pregnancy be covered automatically?

If you have MO HealthNet coverage and become pregnant, you should report this change. Once you report your pregnancy, FSD will determine if you are eligible for coverage through the MO HealthNet for Pregnant Women. Participants covered under MO HealthNet for Pregnant Women are eligible for additional benefits and services including 12 months of postpartum care. If you are eligible for MO HealthNet for Pregnant Women, you will be ineligible for adult expansion coverage until you are no longer pregnant. 

What happens after I apply for MO HealthNet coverage?

If you applied for healthcare coverage, we will let you know what is needed to process your application. The time it takes to process your application may vary. An eligibility decision based on a disability may require additional paperwork and additional processing time. If you do not receive anything from the Family Support Division after 45 days, you can contact us.

Once your application is processed, you will get a letter that lets you know if you are eligible for healthcare coverage or not. If you are approved, you will receive a MO HealthNet Identification Card and information explaining the type of coverage you have. Follow all instructions you receive regarding your healthcare coverage.

If I have MO HealthNet coverage, what changes do I need to report and how do I report them??

You must let us know about any changes in your household on the Report a Change website within 10 days of the change. You can also report these changes by phone, through the mail, and in person. Reporting a new address, mailing address, phone number, or email address allows the Family Support Division (FSD) to send you important information. Other changes are required depending on what benefits you are receiving.

If you become pregnant, report it on the Report a Change website as soon as possible. A pregnant participant receives additional coverage. Visit the Healthy Moms Healthy Babies website for more information

When applying for MO HealthNet coverage, does child support count towards my income?

No. Some types of income are excluded when applying for MO HealthNet coverage, such as Supplemental Security Income (SSI), Child Support, Veterans Benefits, Foster Care Payments, and Worker’s Compensation Payments

If a child age 19 to 21 lives with their parents, does the parents’ income count towards the child’s eligibility for MO HealthNet coverage?

Just as it is for MO HealthNet for Families and MO HealthNet for Kids, adult expansion eligibility is based on the modified adjusted gross income and the tax filing status of the household composition:

  • If the applicant is a dependent on their parents’ taxes, include the parents’ income
  • If the applicant is not a dependent, exclude the parents’ income
Will there ever be a review of my income and/or household in order to continue receiving MO HealthNet coverage?

Yes. Individuals will be required to complete an annual review each year they receive MO HealthNet to make sure they are still eligible. Your annual renewal will be due during your anniversary month, or the month when your coverage first began. You can find out when your annual renewal is due by logging into the FSD Benefit Portal.

For more information, visit Renewing Your MO HealthNet Coverage. 

If I am approved for MO HealthNet coverage and later become disabled, what should I do?

You will need to report this change to the Family Support Division (FSD) by completing the online Aged, Blind and Disabled Supplement (IM-1ABDS). This is to be completed in addition to the online portal application or by calling the FSD Contact Center at (855) 373-9994.   

Will a child age 19 to 21 need to apply for adult expansion coverage when they age out of MO HealthNet for Families?

No.  The Family Support Division (FSD) will complete an ex-parte and explore eligibility for adult expansion coverage when the individual turns 19

Who should I contact with questions?

If you have questions about applying for MO HealthNet, please visit our website or contact us at 855-FSD-INFO (855-373-4636)

If you already have MO HealthNet and you have questions about your health plan, covered services, or your plan’s health care providers, reach out to your Managed Care Health Plan or contact Participant Services at Ask.MHD@dss.mo.gov or by calling (800) 392-2161.

Revised October 2024