How Health Benefits Work

MO HealthNet's Ticket to Work Health Assurance

Look at Ticket to Work Health Assurance if:

  • You are 16-64 years old
  • You have a disability
  • You work
  • You have limited resources, and
  • You are a citizen or eligible immigrant.

Is It Right for You?

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

Answer the questions on this page to see if you might qualify for Ticket to Work Health Assurance. If so, it’s a good option to consider because it lets you earn a lot more money and pay a monthly premium, low copayments, and no deductible to get MO HealthNet’s comprehensive coverage. You can also download a Ticket to Work Health Assurance brochure.

Do You Meet Ticket to Work Health Assurance’s Basic Requirements?

To qualify for Ticket to Work Health Assurance, you must:

  • Be 16 – 64 years old
  • Have a disability or a medically improved condition that meets Social Security's standards
  • Be working
  • Have gross and net income at or below the Ticket to Work Health Assurance limits
  • Have available resources at or below the MO HealthNet limits
  • Live in Missouri, and
  • Be a U.S. citizen or meet specific noncitizen requirements.

If you live in Missouri, are 1664 years old, working, have a disability, are either a U.S. citizen or a non-citizen who qualifies, and your income and resources aren't more than the limits, Ticket to Work Health Assurance might be an option for you.

MO HealthNet’s rules for immigrants:

Do You Have a Disability That Meets Social Security’s Standards?

To qualify for Ticket to Work Health Assurance, you must either have a disability that meets Social Security’s definition of a disability or have a medically improved condition.

For adults, Social Security says you have a disability if:

  • You have a physical or mental impairment or combination of impairments, and
  • Your condition has lasted or is expected to last for at least 12 months.

If you work and no longer qualify for MO HealthNet solely due to medical improvement (your condition getting better), you can also get Ticket to Work Health Assurance coverage.

Note: For Ticket to Work Health Assurance, Social Security’s disability rules related to having earned income above the Substantial Gainful Activity (SGA) level do not apply.

If you currently get Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), your disability qualifies. If not, a Medical Review Team looks at your medical records and other documents to see if your disability qualifies for Ticket to Work Health Assurance.

If you already have a disability determination from Social Security, think that your disability meets Social Security’s standards, or have a medically improved condition, Ticket to Work Health Assurance might be an option for you.

Do You Have Low Resources?

Resources are money and property you own. For Ticket to Work Health Assurance, you must have less than $5,909 in available resources for an individual, or $11,818 for an eligible couple.

Some resources don’t count towards Ticket to Work Health Assurance’s resource limit, like the home you live in, one car, and money you have in an ABLE account.

If your resources are below the limit, Ticket to Work Health Assurance might be an option for you.

Is Your Income Below Ticket to Work Health Assurance’s Income Limit?

To get Ticket to Work Health Assurance coverage, you must have countable income at or below 250% of the Federal Poverty Guidelines (FPG). That’s $3,138 per month or less for an individual, $4,258 or less for a couple.

Any money you get in SSI payments does not count as income, and money you spend on health insurance premiums may be deducted. You may also deduct half of your wages and any wages between 250 and 300% of FPG. You could earn as much as $90,840 per year and still qualify!

If your countable income is more than 100% of FPG ($1,255 per month if you are single; $1,704 per month for couples), you have to pay a monthly premium for Ticket to Work Health Assurance. The amount you pay depends on your income, but the most you might have to pay is $156 per month for an individual and $211 for a couple.

Get more information about the Ticket to Work Health Assurance income limits.

If your income is low enough and you meet all other requirements, you should sign up for Ticket to Work Health Assurance. If you can also get employer-sponsored coverage, MO HealthNet may pay the premium for it.

How to Sign Up

To apply for Ticket to Work Health Assurance, you can:

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

Staying on Ticket to Work Health Assurance

Usually, once approved for Ticket to Work Health Assurance, you continue to qualify as long as your situation doesn’t change. If your income, immigration status, residency, or household size changes, let your 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, FSD will tell you if your Ticket to Work Health Assurance premium changes, or your coverage will end or change to another MO HealthNet category.

Learn more