Missouri Medicaid Requirements

• Missouri's Medicaid program offers health care benefits to residents who meet income and other guidelines. doctor with patient 5 image by Paul Moore from Fotolia.com

  Medicaid health insurance plans receive funding from state and federal tax dollars and each state administers its own program. In Missouri, eligible residents can receive Medicaid heath care benefits through Missouri HealthNet, which offers coverage through programs for families, pregnant women, children, senior citizens, the disabled and blind citizens. Applicants must meet specific eligibility requirements and all programs include income limits.

Income

• Missouri HealthNet bases its income limits on poverty level guidelines consistent with the programs it administers.

  The State Children's Health Insurance Program is a federally established program that provides health insurance benefits for children based on income. Missouri HealthNet for Kids non-SCHIP benefits can help children not enrolled in that insurance program. Infants under 1 year of age may qualify for non-SCHIP coverage with a household income of 185 percent of the federal poverty level. Children from 1 to 5 years of age may receive benefits with a household income of 133 percent of the FPL. Children from 6 to 18 years of age may qualify with a household income of 100 percent of the FPL.

  Uninsured kids in families with household incomes above the earnings limits required for Missouri HealthNet for Kids non-SCHIP might qualify for coverage under HealthNet for Kids SCHIP. HealthNet for Kids SCHIP offers benefits for children in families with household incomes as much as 300 percent of the FPL, if the family meets other criteria and pays a premium of no more than 5 percent of its gross income.

  Missouri HealthNet counts a pregnant woman as two people when determining household size, and the maximum FPL is 185 percent. For example, a single pregnant woman would need to have no more income than 185 percent of the FPL for a household of two. The scale would shift accordingly if the household has more people.

  Senior citizens, disabled persons and blind citizens can receive Missouri HealthNet coverage, but can face spend-down requirements if they have incomes above 85 percent of the FPL. Spend-down requirements demand participants pay a specific amount before their HealthNet coverage begins, as with deductibles in private health care policies.

Residency

• All Missouri HealthNet applicants must hold, or have applied for, a Social Security number and must have U.S. citizenship or qualify as an eligible noncitizen. Applicants must live in Missouri and intend to continue living in the state.

Missouri HealthNet for Kids

• The HealthNet for Kids program offers coverage for children under the age of 19. Parents of participants must cooperate with the efforts of Child Support Enforcement in providing medical care.

Pregnant Women

• Pregnant women must provide proof of pregnancy. Children born to Missouri HealthNet participant mothers can receive HealthNet coverage for their first year. A mother must keep the child in her home and both must continue residency in Missouri to keep benefits.

Senior Citizens and Blind and Disabled Persons

• Permanently disabled persons can qualify for Missouri HealthNet coverage, along with senior citizens at least 65 years old. Persons 18 years old or older can qualify if they are legally blind, with vision levels below 5/200. Senior citizens and the disabled can face asset limits, which can include cash and securities investments. Blind persons who do not have a spouse and who do not solicit public funds, other than medical benefits, can meet eligibility requirements.