Presumptive Eligibility (PE) Resources for Providers

Forms

Qualified Entity PE Worksheet (PE-2 Worksheet)
Qualified Entity PE-2 Worksheet Instructions
MO HealthNet PE Authorization (PE-3)
MO HealthNet TEMP/SMHB-PE Authorization (PE-3TEMP)

Question & Answers

Applications
Citizenship and Alien Status
Eligibility Requirements
eMOMED
Existing Private or Employer Sponsored Insurance
Forms
Household Composition and Income
MO Healthnet Division
Presumptive Eligibility for Children
PE for Parents and Caretaker Relatives
PE for Pregnant Women
Performance Standards
Provider Issues

Training Presentations

Presumptive Eligibility Provider Training Slides (Children)
Presumptive Eligibility Provider Training Slides (Children and Pregnant Women)
Presumptive Eligibility Provider Training Slides (Pregnant Women)
Presumptive Eligibility Provider Training Slides (Hospitals)

Additional Information

Everything that a Heath Care Provider needs to Know about Presumptive Eligibility
PE Income Standards
PE Programs Flow Chart
PE Determination Checklist
Presumptive Eligibility Manual
Contact Information for Providers

Food Stamp (SNAP) benefits

You have the right to a hearing if you have applied for or are receiving Financial Assistance, MO HealthNet, or Food Stamp Benefits.

Learn more about your rights.

Voter Registration Application

If you wish to register to vote, please download and complete the Voter Registration Form and return it to your local FSD office. This has no impact on your application or continued eligibility for assistance.