MEDICAID

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Medicaid is a program that provides health coverage to some low-income Missouri residents. Medicaid covers families with children and pregnant women, the elderly, and people with disabilities, if state and federal guidelines are met. Legal residents who are not U.S. citizens may be eligible for Medicaid.  Non-citizens who do not have immigration documents cannot enroll in Medicaid.  MC+ for Kids is part of Missouri’s Medicaid program.  It provides coverage for some children from low-income families.

  • For certain categories of people, eligibility for Medicaid is based on the amount of your household income.

In Missouri you may be eligible for Medicaid if you are an infant, a child, a pregnant woman, or a parent of a child and your family income meets the Medicaid income standards.

Income eligibility levels for these categories are described below. Your assets and some expenses also may be taken into account, so you should contact the Division of Medical Services and Family Support Division more information.

Low income persons eligible for Medicaid in Missouri*

Category — Income eligibility (as percent of federal poverty level)

Infant – 300%
Child 1-19 – 300%
Working Parent – 42%
Non-Working Parent — 22%
Pregnant woman — 185%

* Eligibility information was compiled from State Health Facts Online, the Kaiser Family Foundation, and may have changed since this guide was published.  Contact your state Medicaid program for the most up to date information and for other eligibility requirements that may apply.

To get an idea of how your income compares to the federal poverty level, use the federal poverty guideline issued by the U.S. Department of Health and Human Services for the year 2006:

Size of Family Unit Poverty Guideline (annual income)
1                                                    $  9,800
2                                                    $13,200
3                                                    $16,600
-For larger families add $3,400 for each additional person
- So, for example, using this guideline, 300% of the federal poverty level for a family of 3 would be an annual income of $49,800, or a monthly income of $4,150.
- Contact your state Medicaid program for the most up to date information and for other eligibility requirements that may apply.

  • Families who get cash benefits from TANF (also known as Temporary Assistance for Needy Families) can get Medicaid. In addition, your children may qualify for Medicaid if your family’s income meets certain income standards.
  • Very poor elderly or disabled people who get Supplemental Security Income (SSI) benefits can also qualify for Medicaid. You do not need to submit a separate application for Medicaid.

Disabled individuals should know that if your income earned from a job increases so that you no longer qualify for SSI, you may be able to continue your Medicaid coverage if you are elderly or you are still considered disabled and you continue to have medical need.

  • People who have high medical expenses may also qualify for Medicaid. You may qualify as medically needy if you have high medical expenses that, when subtracted from your income, would make you eligible for Medicaid coverage. For example, people who have to pay a lot for prescription drugs, nursing home care, or other long term care services sometimes qualify as medically needy if their health insurance is limited or does not cover these services.
  • Retired or disabled people who have low incomes and are enrolled in Medicare may also qualify for help from Medicaid. Even though your income may be too high to qualify for Medicaid insurance coverage, there may be other ways Medicaid can help you.

If your household income is below the poverty level, Medicaid will pay your Medicare monthly premium and your Medicare deductibles and coinsurance.  This is called the Qualified Medicare Beneficiary (QMB) program.

If your household income is below 120% of the poverty level, Medicaid will pay for your monthly Medicare premiums only.  This is called the Specified Low-Income Medicare Beneficiary (SLMB) program.

  • There may be other ways that Medicaid can help. To find out if you or other members of your family qualify for Medicaid, contact the Division of Medical Services at (573) 751-3425 or the Family Support Division at (573) 751-3221.


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