How To Check Your Application Status
If you recently applied for Medicaid but havent heard anything back yet, it might be helpful to check your application status. You can check your status online by visiting the Missouri Department of Social Services website at mydss.mo.gov and clicking Check Your Status. After entering your information, if the screen reads no information available, it is likely that your application has not yet been approved or processed. However, if your screen shows active coverage with a start date listed, then you have officially been approved for Medicaid.
Who Can Be Covered By Medicaid
Most Missourians who get MO HealthNet coverage are people with low incomes, 65 or older, blind or disabled, or children from families with low incomes. If you qualify, depends on how much money you make and how many people are in your family. Medicaid in Missouri expanded in 2021, so even if you didnt qualify before, you might now.
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What Other States Have Voted On Medicaid
- See also: Medicaid expansion in 2018
In 2017, Maine was the first state to vote on a ballot initiative to expand Medicaid. Maine’s 2017 measure was approved. In 2018, ballot initiatives to expand Medicaid in Utah, Nebraska, and Idaho were approved. A 2018 initiative in Montana that would have renewed Medicaid expansion and increased tobacco taxes was defeated. On June 30, 2020, Oklahoma approved an initiative to expand Medicaid. It was approved 50.5% to 49.5%.
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Where Can Medicare Beneficiaries Get Help In Missouri
Missouri State Health Insurance Assistance Program
Free volunteer Medicare counseling is available by contacting the Missouri State Health Insurance Assistance Program at 800-390-3330. The SHIP program in Missouri is called CLAIM.
The SHIP can help beneficiaries enroll in Medicare, compare and change Medicare Advantage and Part D plans, and answer questions about state Medigap protections. SHIP counselors may also be able to offer referrals to local agencies for services like home care and long-term care. The SHIPs website has more information on services it offers.
Elder Law Attorneys
Elder law attorneys can help individuals plan for Medicaid long-term care benefits. You can use this National Academy of Elder Law Attorneys search feature to find an elder attorney locally.
Missouri Area Agencies on Aging
Medicare beneficiaries in Missouri can also receive help from Area Agencies on Aging . These organizations can provide information about services that help with aging or living with a disability, and assist with planning for long-term care needs. Here is a list of AAAs in Missouri.
How Much Money Can I Have And Still Qualify For Medicaid
There are several different factors that pertain to Medicaid eligibility in Missouri. Eligibility ultimately depends on the applicantâs specific health situation and marital status. The amount of money that you can have varies depending on these various factors. Below are 3 different types of Medicaid in Missouri and the maximum amount that applicants can make to become eligible for the program:
â Regular Medicaid:
â Single income limit: $904 per month / $4000 assets
â Married income limit: $1222 per month / $8000 assets
â Married income limit: $1222 per month / $4000 assets
â Medicaid Waivers and Home/Community-Based Services:
â Single income limit: $1370 per month / $4000 assets
â Married : $2740 per month / $8000 assets
â Married : $1370 per month / $4000 assets
â Institutional/Nursing Home Medicaid:
â Single income limit: All available income must go toward care. / $4000 assets
â Married : All available income must go toward care. / $8000 assets
â Married : All available income must go toward care. / $4000 assets
When only one spouse in a married couple applies for nursing home reimbursements from Medicaid or an HCBS Medicaid waiver, only the applicantâs income is counted to determine eligibility. When both spouses apply, the income and assets of both individuals are calculated together to determine their eligibility.
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Current News Bulletins And Alerts
Missouri: CPT® code changes for obstetrical services beginning Aug. 1, 2022
Effective Aug. 1, 2022, providers in Missouri are required to submit claims with the Current Procedural Terminology codes for obstetrical service provided to Medicaid plan members. Claims without the proper codes will be denied.
Medicaid: Changes to outpatient prior authorization process for non-oncology drugs
Effective Aug. 1, 2022, Optum will manage prior authorization requests for non-oncology injectable medications that are covered on the medical benefit forUnitedHealthcare Community Plans.
Medicaid: Take 5 minutes to share your point of view
UnitedHealthcare Community Plan network providers will have the opportunity to share their feedback about their experience working with us by taking our Physician Satisfaction Survey. This survey applies to physicians who participate in Medicaid.
Find COVID-19 vaccine availability for your state or territory
Use this list of local health departments to learn about availability in your area. Availability may vary by location and time. We encourage you to check back often as information becomes more available.
Access to care and appointment availability standards for Missouri
Missouri: CPT® code changes for obstetrical services beginning Aug. 1, 2022
Medicaid: Changes to outpatient prior authorization process for non-oncology drugs
Medicaid: Take 5 minutes to share your point of view
Find COVID-19 vaccine availability for your state or territory
Lawmakers Considered But Did Not Pass Legislation To Create Reinsurance Program
Reinsurance refers to a system in which insurance companies can pass off certain high-cost claims to a third party . Reinsurance kicks in when a claim reaches a certain level, and then the reinsurance program pays a percentage of the claim until it reaches another certain level. The ACA included a federal reinsurance program, but it was temporary and only lasted through 2016. To counter rising premiums and stabilize local insurance markets, states are increasingly pursuing their own reinsurance program. As of the 2013 plan year, seventeen states are receiving federal pass-through funding for reinsurance.
Reinsurance results in lower overall premiums, which means premium subsidies are also lower. Instead of having the federal government keep the savings from the lower premium subsidies, a state can use a 1332 waiver to have the savings pass through to the state. Then the money is used by the state to cover the majority of the cost of operating the reinsurance program.
H.B.2539 / SB1071 was considered by Missouri lawmakers in 2018, but neither bill reached a full vote. The legislation would have reactivated the former Missouri Health Insurance Pool , but it would have become the Missouri Reinsurance Pool instead. The fees that were previously assessed on insurers under the MHIP would have started to apply again, to be used to fund the reinsurance program. Between 1991 and 2014, carriers in Missouri paid an average of nearly $6.5 million per year in fees for MHIP.
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Why Are There Some States That Havent Implemented Medicaid Expansion
The ACA called for Medicaid expansion nationwide. But in June 2012, the Supreme Court ruled that states could not be forced to expand their Medicaid programs, so it was left to each state to determine whether to participate or not.
When Medicaid expansion first took effect in 2014, it was only available in 26 states and DC. In the ensuing years, there has been a slow but steady increase in the number of states implementing Medicaid expansion. As of 2022, Medicaid had been expanded in 38 states and the District of Columbia . Oklahoma and Missouri are the most recent states to have expanded Medicaid, both doing so in 2021.
But Wisconsin is not counted among the Medicaid expansion states. It has implemented what essentially amounts to a partial expansion of Medicaid, and has no coverage gap because Medicaid is available to low-income adults with income below the poverty level.
But because Wisconsin has not fully expanded Medicaid as called for in the ACA , the state does not receive the enhanced federal Medicaid funding that it would receive if it fully expanded Medicaid.
What Is The Medicaid Coverage Gap
In the states that have not expanded Medicaid, theres a coverage gap that leaves about 2 million people ineligible for any sort of affordable coverage. These people are not eligible for premium subsidies in the marketplace because their income is under the poverty level. But they are also ineligible for Medicaid because their states have refused to implement Medicaid expansion.
According to US Census data, the percentage of people below the poverty level who are uninsured is more than twice as high in states that havent expanded Medicaid, compared with states that have. To be clear, this is due to the decisions that their states have made, rather than a flaw in the ACA itself. The states could opt to accept federal funding to expand Medicaid at any time, thus closing the coverage gap.
Five states Texas, North Carolina, Florida, Georgia, and Tennessee account for the lions share of the coverage gap population, and they are among the 12 states where Medicaid expansion is still a contentious issue and the legislature and/or governor are still strongly opposed to accepting federal funding to expand Medicaid. .
For people in the coverage gap who received unemployment compensation for at least one week in 2021, the American Rescue Plan provided eligibility for premium subsidies. But this was a temporary provision for 2021.
However, there have been ongoing negotiations in 2022 about a budget bill that might include federal funding to close the Medicaid coverage gap.
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What Do I Need To Know About Advance Designation
You should be aware of another type of representation called Advance Designation. This relates to the Strengthening Protections for Social Security Beneficiaries Act of 2018, which was signed into law on April 13, 2018.
Advance Designation allows capable adult and emancipated minor applicants and beneficiaries of Social Security, Supplemental Security Income, and Special Veterans Benefits to choose one or more individuals to serve as their representative payee in the future, if the need arises.
To help protect whats important to you, we now offer the option to choose a representative payee in advance. In the event that you can no longer make your own decisions, you and your family will have peace of mind knowing you already chose someone you trust to manage your benefits. If you need a representative payee to assist with the management of your benefits, we will first consider your advance designees, but we must still fully evaluate them and determine their suitability at that time.
You can submit your advance designation request when you apply for benefits or after you are already receiving benefits. You may do so through your personal account, by telephone, or in person.
Who Qualifies For Medicaid Expansion Missouri Medicaid Has Expanded To Cover More People
- Now, more adults can get low-cost or free health insurance through Missouri Medicaid .
- For example, a single adult making up to $17,774 a year, or a family of 4 making up to $36,750 a year, may qualify for Medicaid through MO HealthNet.
- A single adult making up to $1,481 a month, or a family of 4 making up to $3,048 a month, may qualify for Medicaid through MO HealthNet.
- For the first time, more adults qualify for low-cost or free health insurance through MO HealthNet. This includes parents who have not qualified before, as well as childless adults.
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People Are Also Reading
Nearly 60,000 people are waiting for their applications to be approved and that wait time has stretched beyond the 100-day mark, said Kim Evans, director of family services at the Department of Social Services.
At a meeting of the states Medicaid oversight panel Wednesday, Evans said that processing times will drop to 45 days at the end of July and 30 days by the end of August. In March, waiting times were upward of 70 days.
Evans said giving workers raises and offering overtime pay and other incentives for employees who are tasked with the applications will help lower the time it takes to process an application.
We have a lot of work ahead of us, Evans said Wednesday.
The shorter waiting time also was good news to Sen. Jill Schupp, D-Creve Coeur, a committee member.
I think thats great, Schupp said.
Before the voter approved expansion, the Medicaid program did not cover adults without children. Coverage through MO HealthNet is now available to all Missourians with incomes below 138% of the federal poverty level, or about $18,800 per year for an individual.
MO HealthNet Director Todd Richardson said the budget for the program is positive heading into a new fiscal year beginning July 1.
Overall, we are very, very pleased, Richardson told the committee. This is certainly the best budget weve had since Ive been director.
Posted at 2:50 p.m. Wednesday, June. 1.
Vote Yes On Amendment 2
On August 4, Missourians will have the opportunity to have their voices heard on Amendment 2 to expand Medicaid, ensuring hardworking citizens have access to health care while bringing billions of our tax dollars home from Washington each year to strengthen our communities and grow our economy.
Washington University is deeply committed to supporting Amendment 2 because it is a common-sense approach to delivering health care to vulnerable Missourians that could radically shift the economic momentum of our state.
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When Will I Get Coverage
If you applied for healthcare coverage, we will let you know what might be needed to process your application. The time it takes to process your application may vary, and if we have to make an eligibility decision based on a disability, it may take longer than usual. If you do not receive anything from the Family Support Division after 45 days, you can contact us.
Once your application is processed, you will get a letter that lets you know if you are eligible for healthcare coverage or not. If you are approved, you will receive a MO HealthNet Identification Card and information explaining the type of services and coverage you have. You will need to follow the instructions in this letter for your coverage to begin.
Missouri Voters Passed Medicaid Expansion Now State Republicans May Not Pay For It
Missouri House Republicans blocked funding for Medicaid expansion multiple times Tuesday even though Missouri voters passed the measure in a statewide referendum in August.
Advocates for health care expansion called the move the latest example of political theatrics in the state, while Democratic lawmakers deemed it a threat to the state Medicaid program. The groups agreed that the move was deeply frustrating and noted that it imperiled billions of dollars of federal aid.
Dina van der Zalm, the health care organizer for the Missouri Rural Crisis Center, a progressive nonprofit that advocates for rural communities, called it a “political circus show.”
“We’re hoping cooler heads and hearts will win the discussion in the end, because there’s too much riding on it for Missouri, coming out of a pandemic, to really strip people of health care and then just forfeit all of that money we so desperately needed,” she said.
The state House Budget Committee voted on partisan lines, 20-9, late last week to drop $130 million for Medicaid expansion from the budget of Gov. Mike Parson, also a Republican. The House is expected to pass the budget in the coming days, sending it to the state Senate.
Neither Parson or Smith responded to requests for comment.
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How Will Missouri Pay For Medicaid Expansion
In the budget for the fiscal year that begins July 1, the cost of expansion is pegged at $2.5 billion. The House-passed budget plan does not use any general revenue to pay the cost. Instead, it taps extra federal funds being sent to Missouri because it expanded eligibility to pay a part of the states 10% match.
How Old Do You Have To Be To Get Medicare In Missouri
65 or olderYou may be eligible for Medicare in Missouri if youre a U.S. citizen or a permanent legal resident who has lived in the U.S. for more than five years and one or more of the following applies to you: You are 65 or older. You have been on Social Security Disability Insurance for two years.
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Why Is The Fishing For Medicaid Enrollees So Much Better In Oklahoma
One reason Oklahoma has been so successful is that the state went actively looking for residents who could benefit from expanded health coverage, automatically enrolling nearly 100,000 people who were getting more limited benefits but who now qualified for more comprehensive coverage under the new law or who had already submitted an application. Oklahomas Medicaid agency is also actively targeting counties with low enrollment, working with community partner groups to reach out to residents who might not know they can now get affordable health coverage.
Other states have employed the same outreach strategies that have been so successful in Oklahoma. For example, both Kentucky and Virginia looked for opportunities to enroll people by identifying state residents through other databases who also are likely to need affordable health coverage. Recently, both these states used a state unemployment database to identify individuals who may have lost their jobs and employer health coverage during the pandemic and then reached out to this group, letting them know of the existence of Medicaid expansion coverage.
And in states like Virginia, the early success of enrollment in expansion is self-reinforcing. Virginias later Medicaid expansion has resulted in substantial state savings in recent budgets with much of this savings attributable to reductions in state-paid uncompensated care and Medicaid now covering more mental health and substance abuse treatment.
