The following page is informational only and contains links and/or requirements from the state or national agencies that maintain and administer the programs detailed below. Please call an HCC Network Community Health Worker (CHW) at 877.344.3572 if you need assistance with the application process or if you have specific questions about a program or your eligibility.

Medicaid

Thanks to an expansion of Medicaid in Missouri, healthcare coverage has been expanded to many more state residents. Through MO HealthNet, previously ineligible Missourians are able to receive free and low-cost insurance. The expanded coverage includes primary physical, behavioral and dental care, among other services.

Eligibility for Medicaid

Eligibility for Medicaid through MO HealthNet depends on your income, age, health and individual needs.

With the Medicaid expansion in Missouri, you may be eligible if you are a(n):

• Parent or caretaker with a child (under age 19)
• Adult (aged 19-64) without disabilities
• Woman under the age of 65 with breast or cervical cancer
• Person with disabilities
• Blind or visually impaired adult

For help determining eligibility or with enrolling in Missouri Medicaid, please contact a Community Health Worker (CHW) at 877.344.3572.

Services Covered by Medicaid

Missouri Medicaid covers a variety of benefits for adults, children and families.

These services can include:

• Ambulance services
• Behavioral health and substance-use services
• Family-planning services
• Hospice
• Maternity and midwife services
• Pharmacy
• Preventive care, including wellness checks, mammograms and cancer screenings
• Primary care
• Specialist care
• Tobacco-cessation counseling
• Local health department services like immunizations; screenings for, diagnoses of and treatments for sexually transmitted diseases; HIV care; tuberculosis care and lead-poisoning treatment.
• Much more, including some limited-coverage options for certain services.

Community Health Workers

HCC has Community Health Workers (CHWs) here to stand by your side, step-by-step, throughout the application process. They can assist you in filling out the application for Medicaid, as well as provide you with updates on your case from Medicaid, until the review of your application is complete.

Presumptive Eligibility from CHWs

Community Mental Health Centers (CMHCs) and Comprehensive Substance Treatment and Rehabilitation (CSTAR) providers may now become a qualified entity (QE) to determine and authorize presumptive eligibility (PE) for MO HealthNet (Medicaid) in the following categories:

• Presumptive eligibility for children (PC)
• Temporary MO HealthNet during pregnancy (TEMP)
• Show-Me healthy babies presumptive eligibility (SMHB-PE)
• Presumptive eligibility for parents/caretaker relatives (MHF-PE)
• Former foster care youth presumptive eligibility (FFY-PE)
• Presumptive eligibility for adult expansion group (AEG-PE)

Contact a Community Health Worker (CHW) at 877.344.3572 to see if you qualify.

Enroll Today

For assistance with applying for Missouri Medicaid, contact a CHW at 877.344.3572.

If you would like to apply on your own, you can do so at mydss.mo.gov/healthcare/apply.

The Missouri Family Support Division processes applications and any supporting documentation. In the past, processing has been known to take up to 45 days. Once your application is processed, you will get a letter from the Missouri Family Support Division letting you know if you are eligible for healthcare coverage.

If you are approved, you will receive a MO HealthNet Identification Card from the State of Missouri, as well as information explaining the type of coverage and available services. You will need to follow the instructions in the letter from the Missouri Family Support Division so that coverage can begin.

Medicare

Missouri SHIP

HCC partners with Missouri SHIP, which is the official state health insurance assistance program (SHIP), to provide reliable Medicare and Medicaid information and assistance.

Missouri SHIP offers certified volunteers who are trained to help people compare Medicare plans for their prescription drug coverage. They can answer questions about Medicare and Medicaid eligibility, benefits and claims.

You can contact Missouri SHIP by calling 1.800.390.3330, or by clicking the MO SHIP button below.

HCC encourages everyone to review their Medicare plan information annually, especially during Open Enrollment, which runs from October 15 to December 7, every year.

Affordable Care Act

Affordable Care Act (ACA) Coverage Eligibility

The Affordable Care Act is a federal law, as well as the law’s supporting amendments, that address healthcare coverage, healthcare costs and preventative care. Eligibility and enrollment are both processed through the Health Insurance Marketplace. See if you qualify for coverage by clicking the button below.

We are Ready to Assist

HCC is an approved Certified Application Counselor (CAC) organization for the Health Insurance Marketplace. We provide factual information about the Affordable Care Act and the Health Insurance Marketplace, equipping community members with sound information, so they can make decisions about healthcare insurance options.

Enrollment Info

HCC has trained and certified application counselors who help individuals and families enroll in Missouri’s Health Insurance Marketplace. They can answer enrollment questions, help community members see if they are eligible for Medicaid or other insurance options or help with enrollment during the Marketplace’s special enrollment period.

There are also a variety of programs and resources, available through HCC, to help those in need. For enrollment support, or for more information, call 877.344.3572 and ask for ACA Open Enrollment assistance from a CHW.

Other Ways to Enroll

To enroll online, visit HealthCare.gov or call 1.800.318.2596, which is available 24/7. (TTY: 1.855.889.4325)

Additional Information

Get helpful ACA resources from CoverMissouri.org. Cover Missouri is a project of Missouri Foundation for Health (MFH), promoting quality, affordable health coverage for every Missourian.