How to get MO HealthNet or low-cost care in Missouri

MO HealthNet is Medicaid in Missouri

MO HealthNet is the name Missouri uses for Medicaid. The MO HealthNet Division of the state Department of Social Services runs the program. The Family Support Division, often called FSD, decides who can get it.

Missouri voters approved Medicaid expansion in August 2020. Because of that vote, adults under 65 can qualify with income at or below 138 percent of the federal poverty level. That level is a yearly dollar amount the government uses to measure poverty, and it rises with household size. The state calls this group the Adult Expansion Group.

Before expansion, many working-age adults without children had almost no way into Medicaid. Our guide to the Medicaid coverage gap explains that history. If you were turned down years ago, you can apply again at no cost.

Applying in Missouri

The state lists four different ways to apply. You can use the myDSS portal online, or you can call 855-373-9994. You can visit a local Family Support Division Resource Center, and the state has an office map. The last way is to mail a paper form to Family Support Division, P.O. Box 2700, Jefferson City, MO 65102.

Some people also need to fill out a Supplemental Form. These are people who are 65 or older, people who are blind or disabled, and people with Medicare or VA health care. After you are enrolled, the My MO Health Portal lets you search for a provider. You can also use it to change your health plan and view letters from the state. Our guide on how to apply for Medicaid lists what to have ready.

The state also lets you start on HealthCare.gov, and your information is passed to Missouri if you look eligible.

Missouri's community engagement rule

Missouri calls the new federal work rule a community engagement requirement. The state says it starts on January 1, 2027. It applies only to adults ages 19 to 64 in the Adult Expansion Group. Children, adults 65 and older, and people in other coverage groups do not have to meet it.

In a qualifying month, you need to meet one of several tests. One test is 80 hours of paid work, self-employment, unpaid work, community service or a work program. Another is school or training at least half time. A third is income of $580 that the state counts, which is the amount for 2026. School that is less than half time can be combined with other activities to reach 80 hours.

New applicants must meet the rule in the month before they apply. Current members need one qualifying month since their last renewal. Renewals for this group will move to every six months.

The state lists many exemptions that FSD must confirm. They include pregnancy or postpartum (after birth) coverage, Medicare, medical frailty and caring for a child 13 or younger. Veterans with a 100 percent disability rating are exempt as well. So are people in treatment for drugs or alcohol, and so are American Indians and Alaska Natives.

Right now, the state says you do not need to send anything. The notice you receive is only informational and does not end your coverage. If the Family Support Division needs proof, it will send a separate letter with a deadline. You can answer through myDSS, by mail or fax, or at a Resource Center. The state also has a screening tool on its website that shows whether the rule may apply to you. The tool is only a guide, and it cannot approve or deny your coverage.

Earning too much for MO HealthNet

In Missouri, the Marketplace is the federal one at HealthCare.gov. A Marketplace plan is private health insurance, and many people get help with the monthly cost based on income. If you have lost a job, our guide on what to do after losing insurance explains the sign-up window.

Health centers in Missouri

The Missouri Primary Care Association works to improve access to community-based primary care. It says Missouri's community health centers often offer dental, pharmacy and mental health care on site. Its website has a Find a Health Center page.

You can also use the free Find a Health Center tool from the Health Resources and Services Administration. Federal health centers set their fees by income and family size, and everyone is welcome. Our guide on sliding-scale clinics explains how those prices work.

Checking a Missouri doctor

Doctors in Missouri are licensed by the State Board of Registration for the Healing Arts. The board is part of the state's Division of Professional Registration, and the division's website lists how to reach it. If you want to check a doctor's license, contact that board.

Monthly-fee care and emergencies in Missouri

Some Missouri doctors offer a kind of care called direct primary care. You pay a doctor a flat monthly fee, and the doctor does not bill insurance for those visits. The fee does not cover a hospital stay. Our directory includes cash-pay doctors who work in Missouri. Ask what the monthly fee covers, and get the answer in writing.

If someone is in danger, call 911 or head to the closest emergency room. Missouri hospitals with emergency rooms must check you and treat you until you are stable, even if you cannot pay. After that, our guide to hospital financial assistance shows how to ask for help with the bill.