How Health Benefits Work

Income-Based MO HealthNet

Look at income-based MO HealthNet if:

  • You are less than 65 years old

  • You don’t qualify for SSI or Medicare

  • You are a U.S. citizen or eligible immigrant, and

  • Your household has low income.

Is It Right for You?

MO HealthNet is government-funded health coverage for people in certain situations. You may qualify if you:

Note: Children under the age of 19, their parents or caretaker relatives, and pregnant women may also qualify for MO HealthNet. Learn more in DB101's article on MO HealthNet Eligibility for Young People.

Answer the questions on this page to see if you might qualify for MO HealthNet for people with disabilities, the blind or visually impaired, or seniors age 65 and older. If so, it’s probably your best health coverage option because it doesn’t usually have a premium, the copayments for services are generally lower than copayments required by private plans, and MO HealthNet covers more services than most private plans. Also, if you qualify for MO HealthNet, you cannot get government help paying for an individual plan on HealthCare.gov.

Note: DB101 keeps track of changes to health coverage and related laws. DB101 articles and tools have recently been updated to include MO HealthNet's expansion of coverage for adults 18-64 years old (Medicaid Expansion). Get more information about applying for this coverage.

Do You Meet Income-Based MO HealthNet’s Basic Requirements?

To qualify for income-based MO HealthNet, you must:

  • Be under 65 years old
    • You can be 65 or older if you are the parent or caretaker of a child.
  • Not qualify for Medicare
    • You can be on Medicare if you are the parent or caretaker of a child or are pregnant.
  • Be a U.S. citizen or meet specific noncitizen requirements

If you are under 65, do not qualify for Medicare, and are either a U.S. citizen or a noncitizen who qualifies, income-based MO HealthNet might cover you.

MO HealthNet’s rules for immigrants:

Is Your Income Low Enough for Income-Based MO HealthNet?

These are the main income rules for income-based MO HealthNet:

  • If your family’s income is at or under 138% of the Federal Poverty Guidelines (FPG) ($20,783 per year for an individual; $43,056 for a family of four), you may qualify.
  • If you are 18 or younger and your family’s income is at or under 148% of FPG ($46,176 per year for a family of four), you may qualify for MO HealthNet for Kids Non-SCHIP and won't have to pay a monthly premium.
  • If you are 18 or younger and your family’s income is up to 300% of FPG ($93,600 per year for a family of four), you may qualify for MO HealthNet for Kids Non-SCHIP with a monthly premium.

Income-based MO HealthNet, sometimes called "MO HealthNet expansion," is based on your Modified Adjusted Gross Income (MAGI), which includes most earned and unearned income. However, some income is not counted, including Supplemental Security Income (SSI) benefits, growth of the investments in an ABLE account, and some contributions to retirement accounts. Learn more about what types of income affect income-based MO HealthNet eligibility.

Note: There are no limits to how much money or other resources you can have for income-based MO HealthNet.

Health Coverage Income Limits for Your Family

If your income is low enough and you meet all other requirements, you should sign up for MO HealthNet.

More Ways to Qualify for MO HealthNet if You Have a Disability

There are other ways to qualify for MO HealthNet if you have a disability. You might qualify for disability-based MO HealthNet if:

  • You make more money at work than income-based MO HealthNet allows. In that case, you could apply for MO HealthNet's Ticket to Work Health Assurance program.
  • You also get Medicare. Usually, MO HealthNet doesn’t cover people getting Medicare, but disability-based MO HealthNet does. It may even help pay your monthly Medicare premiums.
  • You are 65 years old or older.

You might qualify for income-based MO HealthNet, even though you have a disability, if:

  • Your disability does not meet Social Security’s definition of disability. Disability-based MO HealthNet is only for people who have disabilities meeting this standard.
  • You have more resources than are allowed by disability-based MO HealthNet.
  • You make enough money that you would have to pay a monthly premium for Ticket to Work Health Assurance.

Learn more about disability-based MO HealthNet and Ticket to Work Health Assurance.

How to Sign Up

To apply for MO HealthNet, you can:

If you need help filling out an application, talk to a benefits specialist.

Staying on MO HealthNet

Usually, once approved for MO HealthNet, you continue to qualify as long as your situation doesn’t change. If your income, immigration status, residency, or household size changes, let the Family Support Division (FSD) office know within 10 days of the change. You can do this in person, by phone, or online. When you report your changes, the FSD tells you if you can no longer get MO HealthNet or if you have new health coverage options, like MO HealthNet Spend Down or Ticket to Work Health Assurance.

Learn more