Adult Expansion Group (AEG) Community Engagement Requirements and Outreach Notice
Important: The Adult Expansion Group (AEG) Outreach Notice is an informational notice. It does not end anyone’s MO HealthNet coverage, and you do not need to respond or send proof now. Community Engagement Requirements start January 1, 2027.
About AEG and the Outreach Notice
- What is the Adult Expansion Group (AEG)?
The Adult Expansion Group, or AEG, is the MO HealthNet coverage group for adults ages 19 through 64 who are enrolled through Missouri’s Medicaid expansion program. The Family Support Division (FSD) decides which coverage group each person is in.
- Why did my household receive this notice?
FSD sent the AEG Outreach notice because their records show that at least one adult in your household receives MO HealthNet AEG coverage. The notice explains new Community Engagement Requirements that start January 1, 2027.
- Does this notice mean someone’s MO HealthNet coverage is ending?
No. This is an informational outreach notice. It does not end, reduce, or change anyone’s MO HealthNet coverage. This notice lets you know about upcoming Community Engagement changes that could affect your coverage in the future.
- Will MO HealthNet coverage automatically end on January 1, 2027?
No. January 1, 2027, is the date the new requirements start. FSD must review each person separately and send a written notice before making a decision that changes coverage.
- Do I need to respond to this outreach notice?
No. You do not need to call FSD, return a form, report hours, or send proof because you received this notice. Contact FSD only if the information in the notice is wrong or you need help understanding it.
- Is this notice a MO HealthNet renewal or an eligibility decision?
No. This outreach notice is not a renewal form, a notice of noncompliance, or an eligibility decision. You do not need to complete or return anything because you received this notice.
The renewal process for people receiving MO HealthNet through AEG is also changing. Instead of renewing once a year, AEG members will renew every six months. FSD will send a separate renewal form or letter when it is time to renew. Complete each renewal by the deadline in that letter.
- Does everyone in my household have to meet the new requirements?
No. FSD reviews each person separately. You must meet the Community Engagement Requirements only if all three statements below are true:
- You are age 19 through 64
- You receive MO HealthNet AEG Coverage
- You are not in a group that does not have to meet the requirements.
The requirements do not apply to children, adults age 65 or older, or people who receive MO HealthNet through a coverage group other than AEG.
- Who does not have to meet the requirements?
You do not have to meet the requirements if FSD confirms that you are in one of these groups:
- You are pregnant or receiving MO HealthNet postpartum coverage.
- You have Medicare Part A or Part B.
- You are a former foster youth under age 26 who meets the federal definition.
- You meet the federal definition of an American Indian or Alaska Native.
- The Department of Veterans Affairs has rated you 100% disabled, either temporarily or permanently.
- You are medically frail or have special medical needs that greatly limit your ability to meet the requirements.
- You are taking part in a drug or alcohol treatment and rehabilitation program.
- You are a parent, guardian, or caretaker of a dependent child age 13 or younger.
- You are a family caregiver for a person with a disability and meet the caregiver requirements.
- You are meeting Temporary Assistance work requirements.
- Your household receives Supplemental Nutrition Assistance Program (SNAP), and you are subject to a SNAP work requirement.
- You are in jail or prison. If you were in jail or prison at any time during the three months before the month FSD checks, FSD treats you as meeting the requirements for that month.
- Does a person’s name on the notice mean FSD has decided that person must meet the requirements?
No. A name on the outreach notice does not mean FSD has made a final decision. FSD will review the person’s information and will send another letter if it needs information about work, school, training, volunteer service, income, or a reason the person does not have to meet the requirements.
- Can a child lose MO HealthNet coverage because an adult does not meet the requirements?
No. Community Engagement Requirements do not apply to children. FSD reviews each household member’s MO HealthNet eligibility separately.
- What should I do if a name, address, or other information in the notice is wrong?
Contact FSD using the information listed on the notice. Tell FSD if someone has moved, no longer lives in your household, or if your mailing address, phone number, or email address has changed.
- What should I do if I believe I do not have to meet the requirements?
Do not send proof now. Keep records that show why you do not have to meet the requirements. FSD will send a letter if it needs those records or more information from you.
- Will FSD contact me again before my coverage can be affected?
Yes. If FSD needs information, it will send a separate letter that tells you exactly what to provide and the deadline. FSD must send a written decision before denying an application or ending coverage.
- Does receiving this notice change my SNAP or Temporary Assistance benefits?
No. This outreach notice is about MO HealthNet Community Engagement Requirements. Receiving it does not change SNAP or Temporary Assistance benefits.
Who these requirements apply to
- What are Community Engagement Requirements?
Community Engagement Requirements are federal work, school, training, or volunteer requirements for adults ages 19 through 64 who receive MO HealthNet AEG coverage. Adults in the groups listed later in this document do not have to meet the requirements. These are also called Medicaid work requirements.
- Why is Missouri adding these requirements?
Missouri is introducing Community Engagement Requirements to comply with the new federal law H.R. 1 (also known as the “One Big Beautiful Bill Act”), which was signed into law on July 4, 2025. The law mandates that states must implement these requirements for certain Medicaid participants (see question 7) as a condition of eligibility. A federal law often called H.R. 1 created the rules. Missouri must follow the federal law.
How to meet the requirements
- How can I meet the requirements for one month?
Complete at least 80 hours of paid work, self-employment, unpaid work, community service, or a work program.
Attend school or another education program at least half-time. Your school decides what “half-time” means.
Combine work, community service, a work program, and less-than-half-time school or training for a total of at least 80 hours.
Have enough countable monthly income. In 2026, the amount is $580 for the month.
If you are a seasonal worker, you have had enough average monthly income over the prior six months.
- Do I have to complete 80 hours every month?
No. Under Missouri’s current policy, if the Community Engagement Requirements apply to you, FSD will check one qualifying month. If you apply for MO HealthNet, FSD will look at the month right before you apply. If you already have MO HealthNet, you must meet the requirements in at least one month since your last renewal. Any one month in that period counts.
The 80 hours must be completed within one month. Extra hours from one month do not carry into another month.
- Can I combine different activities to reach 80 hours?
Yes. You can combine paid work, self-employment, unpaid work, community service, a work program, and less-than-half-time school or training. The combined total must be at least 80 hours in the same month.
- What types of work count?
- A job with an employer.
- Self-employment or independent contractor work.
- Gig or cash work, such as delivery work, rideshare driving, yard work, or babysitting.
- Work in exchange for food, housing, goods, or services.
You must be able to show the work and hours if FSD asks for proof.
- Does volunteer work count?
Yes. Volunteer or community service counts when it is part of a structured program run by a public agency or nonprofit organization and directly helps the community.
- Does school or training count?
Yes. If your school says you are enrolled at least half-time, you meet the requirements for that month. If you attend less than half-time, your school or training hours can be added to other qualifying hours until the total reaches 80.
- Can income count instead of hours?
Yes. FSD can use countable monthly income to meet the requirements. In 2026, the amount is $580 for the month. FSD will use the current federal minimum wage multiplied by 80 when the requirements begin.
- How do the requirements work for a seasonal worker?
FSD will average your countable income from the prior six months. The average must equal at least the current federal minimum wage multiplied by 80 hours.
More questions about who does not have to meet the requirements
- I receive SNAP. Does that automatically mean I do not have to meet the MO HealthNet requirements?
No. Receiving SNAP by itself is not enough. You do not have to meet the separate MO HealthNet requirements if both of the following are true:
- Your household receives SNAP, and
- You are required to meet a SNAP work requirement
If SNAP says you are excluded from its work requirement, then this SNAP exclusion does not carry over to MO HealthNet. You must still meet the MO HealthNet requirements unless another MO HealthNet exclusion applies to you.
- I receive Temporary Assistance. Does that mean I do not have to meet the MO HealthNet requirements?
Yes, if you are meeting the Temporary Assistance work requirements. FSD will verify this information.
- I have a disability or medical condition. Do I have to meet the requirements?
You do not have to meet the requirements if FSD confirms that your physical, mental, behavioral health, intellectual, developmental, or serious medical condition greatly limits your ability to work, study, train, volunteer, or take part in a work program. A diagnosis by itself does not automatically mean you do not have to meet the requirements. FSD must confirm that the condition limits your ability to meet the requirements.
- I care for a child or a person with a disability. Do I have to meet the requirements?
You do not have to meet the requirements if you are a parent, guardian, or caretaker of a dependent child age 13 or younger. You also do not have to meet the requirements if you regularly care for a person with a disability and meet one of the listed conditions. If FSD needs information to confirm your caregiver situation, FSD will let you know what information is needed and how to provide it.
You live with the person you care for.
You are related to the person you care for.
You are not related to the person and do not live with the person, but you provide at least 80 hours of care in a month.
- Can I get a short-term hardship exception if I lose my job, get sick, or have a family emergency?
No. Missouri is not using the optional short-term hardship exception. Losing a job, having a short illness, or having a family emergency does not automatically excuse you. If you already have MO HealthNet, FSD can use another qualifying month since your last renewal. If you are applying, you must meet the requirements in the month before you apply, unless you are in a group that does not have to meet them.
Proof, notices, and coverage
- Will I have to provide proof?
FSD must first check the information it already has or can get from other reliable sources. If FSD cannot verify the information, they will send you a letter. Send only the information the letter asks for and send it by the deadline.
Examples can include pay stubs, an employer statement, time sheets, self-employment records, school enrollment records, or a signed record from a volunteer or work program.
- How do I send information to FSD?
Do not send information until FSD asks for it. Your letter will tell you exactly what to send, where to send it, and the deadline. Depending on the instructions, you can use myDSS to upload documents, mail or fax documents, or take documents to an FSD Resource Center office.
- What happens if FSD cannot verify that I met the requirements, or I am not required to meet them?
FSD will send you a notice of noncompliance. You will have 35 calendar days from the date of the notice to provide information showing either that you met the requirements or that the requirements do not apply to you. Follow the instructions in the notice and respond by the deadline.
- If you are applying for MO HealthNet: You do not have active coverage during this period , FSD will review the information you provide before making a final decision on your application
- If you already receive MO HealthNet: Your current coverage will stay active during the 35-day response period while FSD reviews your information.
If you do not respond or the information does not show that you meet the requirements or do not have to meet it, FSD can deny your application or end your coverage. FSD must send a written decision and explain your fair hearing rights.
- Can I appeal if FSD denies my application or ends my coverage?
Yes. The written decision will explain how to request ask for a fair hearing and the deadline for requesting asking. Follow the instructions in that notice.
- Can I apply for MO HealthNet again if my coverage ends because I did not meet the requirements?
Yes. You can apply again at any time. You do not have to provide proof that you met the Community Engagement Requirements before submitting the application.
After you apply, FSD will review whether the requirements apply to you. If they apply FSD must verify that you met the requirements for the required month before it can approve you for AEG coverage. You may also be approved if FSD confirms that you do not have to meet the requirements or that you qualify for MO HealthNet through another coverage group.
- What should I do now?
Make sure FSD has your current mailing address, phone number, and email address.
Open and read every letter from FSD.
Keep records of your work, self-employment, school, training, volunteer service, program participation, and income.
Keep records that show why you do not have to meet the requirements.
Do not send records until FSD asks for them.
Respond by the deadline in every FSD letter.
About the planned screening tool
- Is the Community Engagement screening tool available now?
Yes, the screening tool is now available: Missouri Community Engagement Requirements Screening Tool
In addition to using the screening tool, continue to read and follow every letter you receive from FSD. FSD letters contain the official instructions and deadlines for your case.
- What does the screening tool do?
The tool will help you understand whether the Community Engagement Requirements apply to you, whether you meet the requirements, or whether you are in a group that does not have to meet them. The tool will not approve, deny, or end MO HealthNet coverage. Only FSD can make an official decision.