MO HealthNet (Missouri Medicaid)
- When does the H.R.1 non-citizen Medicaid change take effect?
The H.R.1 non-citizen Medicaid change takes effect on October 1, 2026. Non-citizens who do not meet the H.R.1 citizenship or immigration status requirements may lose Medicaid eligibility on that date.
- Why are some non-citizens no longer eligible for Medicaid under H.R.1?
H.R.1 created new citizenship and immigration status requirements for Medicaid. Because of these new requirements, some non-citizens may no longer be eligible for Medicaid.
- Which non-citizen statuses are affected by H.R.1 Medicaid changes?
Under H.R.1, some non-citizen statuses are no longer listed as eligible for Medicaid. These include refugees, asylees, Amerasians, trafficking victims, immigration parolees, non-citizen U.S. veterans and their family members, and American Indians born in Canada. To be eligible for Medicaid under H.R.1, you must be one of the following:
- A U.S. citizen
- A U.S. national
- A Cuban or Haitian Entrant
- A Compact of Free Association (COFA) Migrant
- A Lawful Permanent Resident, also called a green card holder, who meets or is exempt from the 5-year bar
- How will I know if I no longer qualify for Medicaid because of my citizenship or immigration status?
FSD will send you a notice before ending your Medicaid coverage if you are affected by this change. To be eligible for Medicaid under H.R.1, you must be one of the following:
- A U.S. citizen
- A U.S. national
- A Cuban or Haitian Entrant
- A COFA Migrant
- A Lawful Permanent Resident, also called a green card holder, who meets or is exempt from the 5-year bar
- If I apply for Medicaid before October 1, 2026, can I get coverage until that date?
Yes, if you meet the Medicaid eligibility rules in place before H.R.1. The H.R.1 citizenship and immigration status requirements do not take effect until October 1, 2026. Applications received before that date will be reviewed using the Medicaid eligibility rules in place before H.R.1. Starting October 1, 2026, the H.R.1 requirements will apply.
- I am a refugee or asylee. Can I still get Medicaid under H.R.1?
No. Under H.R.1, refugees and asylees are not listed as non-citizen statuses that can still get Medicaid. To be eligible for Medicaid under H.R.1, you must be one of the following:
- A U.S. citizen
- A U.S. national
- A Cuban or Haitian Entrant
- A COFA Migrant
- A Lawful Permanent Resident, also called a green card holder, who meets or is exempt from the 5-year bar
Individuals who do not meet immigration status requirements may still qualify for Show-Me Healthy Babies (SMHB) or emergency coverage.
- I am a Lawful Permanent Resident. Do I still have to wait 5 years?
Yes, but the 5-year bar may still apply. Lawful Permanent Residents, also called green card holders, may still be eligible if they have met the 5-year bar or are exempt from the 5-year bar.
- Are refugees still eligible for Medicaid under H.R.1?
No. Under H.R.1, refugees are not listed as one of the non-citizen statuses that can still get Medicaid. To be eligible for Medicaid under H.R.1, you must be one of the following:
- A U.S. citizen
- A U.S. national
- A Cuban or Haitian Entrant
- A COFA Migrant
- A Lawful Permanent Resident, also called a green card holder, who meets or is exempt from the 5-year bar
Individuals who do not meet immigration status requirements may still qualify for Show-Me Healthy Babies (SMHB) or emergency coverage.
- Are asylees still eligible for Medicaid under H.R.1?
No. Under H.R.1, asylees are not listed as one of the non-citizen statuses that can still get Medicaid. To be eligible for Medicaid under H.R.1, you must be one of the following:
- A U.S. citizen
- A U.S. national
- A Cuban or Haitian Entrant
- A COFA Migrant
- A Lawful Permanent Resident, also called a green card holder, who meets or is exempt from the 5-year bar
Individuals who do not meet immigration status requirements may still qualify for Show-Me Healthy Babies (SMHB) or emergency coverage.
- Are Amerasians still eligible for Medicaid under H.R.1?
No. Under H.R.1, Amerasians are not listed as one of the non-citizen statuses that can still get Medicaid. To be eligible for Medicaid under H.R.1, you must be one of the following:
- A U.S. citizen
- A U.S. national
- A Cuban or Haitian Entrant
- A COFA Migrant
- A Lawful Permanent Resident, also called a green card holder, who meets or is exempt from the 5-year bar
Individuals who do not meet immigration status requirements may still qualify for Show-Me Healthy Babies (SMHB) or emergency coverage.
- Do trafficking victims still qualify for Medicaid under H.R.1?
No. Under H.R.1, trafficking victims are not listed as one of the non-citizen statuses that can still get Medicaid. To be eligible for Medicaid under H.R.1, you must be one of the following:
- A U.S. citizen
- A U.S. national
- A Cuban or Haitian Entrant
- A COFA Migrant
- A Lawful Permanent Resident, also called a green card holder, who meets or is exempt from the 5-year bar
Individuals who do not meet immigration status requirements may still qualify for Show-Me Healthy Babies (SMHB) or emergency coverage.
- Are non-citizen U.S. veterans or their family members still eligible for Medicaid under H.R.1?
No. Under H.R.1, non-citizen U.S. veterans and their family members are not listed as one of the non-citizen statuses that can still get Medicaid. To be eligible for Medicaid under H.R.1, you must be one of the following:
- A U.S. citizen
- A U.S. national
- A Cuban or Haitian Entrant
- A COFA Migrant
- A Lawful Permanent Resident, also called a green card holder, who meets or is exempt from the 5-year bar
Individuals who do not meet immigration status requirements may still qualify for Show-Me Healthy Babies (SMHB) or emergency coverage.
- Do immigration parolees still qualify for Medicaid under H.R.1?
No. Under H.R.1, immigration parolees* are not listed as one of the non-citizen statuses that can still get Medicaid.
*Immigration parole is a temporary permission granted by the U.S. government that allows someone who is not a U.S. citizen to enter or remain in the United States for a limited time, even without a visa or formal admission. It’s granted case‑by‑case for urgent humanitarian reasons or when there’s a significant public benefit.
This does not refer to U.S. citizens who are on parole through the criminal justice system.
To be eligible for Medicaid under H.R.1, you must be one of the following:
- A U.S. citizen
- A U.S. national
- A Cuban or Haitian Entrant
- A COFA Migrant
- A Lawful Permanent Resident, also called a green card holder, who meets or is exempt from the 5-year bar
Individuals who do not meet immigration status requirements may still qualify for Show-Me Healthy Babies (SMHB) or emergency coverage.
- Do non-citizen children qualify for Medicaid under H.R.1?
No, Non-citizen children must meet the same citizenship or immigration status rules as adults.
Being a child does not create a separate exception under H.R.1.
- Do Cuban or Haitian Entrants qualify for Medicaid under H.R.1?
Yes. Cuban or Haitian Entrants can receive Medicaid right away if they meet all other eligibility rules.
- Do COFA Migrants qualify for Medicaid under H.R.1?
Yes. COFA Migrants can receive Medicaid right away if they meet all other eligibility rules.
- I am an American Indian born in Canada. Can I get Medicaid under H.R.1?
No. Under H.R.1, American Indians born in Canada are not listed as one of the non-citizen statuses that can still get Medicaid. You may be eligible if your status changes to Lawful Permanent Resident, also called a green card holder, and you meet or are exempt from the 5-year bar.
Individuals who do not meet immigration status requirements may still qualify for Show-Me Healthy Babies (SMHB) or emergency coverage.
- Are pregnant non-citizens eligible for Medicaid under H.R.1?
Pregnant non-citizens must meet the same citizenship or immigration status rules as other adults. To be eligible for Medicaid under H.R.1, a pregnant non-citizen must be one of the following:
- A U.S. citizen
- A U.S. national
- A Cuban or Haitian Entrant
- A COFA Migrant
- A Lawful Permanent Resident, also called a green card holder, who meets or is exempt from the 5-year bar
Pregnant individuals who do not meet immigration status requirements may still qualify for Show-Me Healthy Babies Program (SMHB) or emergency coverage.
- Are undocumented immigrants eligible for Medicaid under H.R.1?
No. To be eligible for Medicaid under H.R.1, you must be one of the following:
- A U.S. citizen
- A U.S. national
- A Cuban or Haitian Entrant
- A COFA Migrant
- A Lawful Permanent Resident, also called a green card holder, who meets or is exempt from the 5-year bar
Individuals who do not meet immigration status requirements may still qualify for Show-Me Healthy Babies (SMHB) or emergency coverage.
- If I am a qualified non-citizen, can I get retroactive Medicaid coverage for past medical bills?
Yes, if you were eligible during that time. Adults in the Adult Expansion Group, also called AEG, may get up to 1 month of retroactive Medicaid coverage. People in other Medicaid coverage groups may get up to 2 months of retroactive Medicaid coverage.
- Do non-citizens have to meet community engagement requirements?
Yes, if they are enrolled in the Adult Expansion Group, also called AEG. All AEG participants must meet community engagement requirements unless they qualify for an exception.
- Are people who are blind or disabled exempt from the 5-year bar?
Yes. Lawful Permanent Residents who are blind or disabled under Supplemental Security Income (SSI) or Social Security Disability standards are exempt from the 5-year bar.
- What happens if my status changes to Lawful Permanent Resident?
If your status changes to Lawful Permanent Resident, also called a green card holder, your Medicaid eligibility will be reviewed again to see if you still qualify.
- How do I report a change in my citizenship or immigration status?
You may report a change online, by phone, by fax, by mail, or by visiting your local FSD office.