The MO HealthNet Presumptive Eligibility Authorization (PE-3) form and the Show Me Healthy Babies Presumptive Eligibility (SMHB-PE) Authorization form serve as proof of presumptive eligibility. Pharmacy providers should check the dates of eligibility on the authorization form to determine if the presumptive eligibility period is active. Pharmacy providers should make a photocopy of the form and maintain the copy in the pharmacy files for documentation of eligibility.
MO HealthNet will reimburse any medication dispensed within the eligibility period shown on the form. Pharmacies may contact Pharmacy Administration at (573) 751-6963 if they have questions. For more information, please refer to Provider Bulletin on Presumptive Eligibility Authorization Notices.