MO HealthNet

MO HealthNet is the Medicaid program for Missouri. MO HealthNet provides health insurance coverage for those with very low incomes and assets. There are several different types of MO HealthNet coverage, and this page is about “Programs for the Aged, Blind and Disabled.” This Medicaid works in coordination with Medicare, and can also provide coverage for those who do not yet qualify for Medicare benefits but who have been declared disabled by the Social Security Administration or the State of Missouri.

If you already have Medicare, MO HealthNet acts as a secondary insurance to Medicare. MO HealthNet will pay the costs left by Medicare as long as you use both Medicare and MO HealthNet providers. It’s important to check with your provider before receiving services to see if they accept MO HealthNet.

A person who is dual-eligible qualifies for other programs as well. This includes automatically qualifying for the greatest amount of assistance from Extra Help, which helps pay for prescription medication. Medicare will pay the premiums for a basic prescription drug plan, and pay for most covered medication costs except for very small copays. There is no gap in coverage (like the “donut hole”), and Medicare pays for all covered prescriptions after the out-of-pocket maximum.

People with both Medicare and Medicaid are sometimes called “full dual-eligibles” or “full duals.”

Spend Down

Spend Down allows some people who have income above the allowed income level to qualify for MO HealthNet (Medicaid). The Spend Down amount is the amount of income that is above the maximum allowed. You can meet your Spend Down amount by:

1. Making a monthly payment to the MO HealthNet Division;
2. Applying medical expenses you have incurred; or,
3. Using a combination of payment and incurred medical expenses