Medicaid in Missouri is a health insurance program that provides medical coverage for low-income families, individuals, and people with disabilities. This program covers a range of medical expenses, including doctor visits, hospital care, prescriptions, vision care, and dental care. It also provides coverage for long-term care services, such as nursing home care and home health care. Additionally, Medicaid in Missouri offers a variety of preventive health services, such as immunizations and screenings, to help people stay healthy.
Medicaid Coverage Eligibility in Missouri
To qualify for Medicaid in Missouri, an individual must meet certain income, resource, and citizenship requirements. Income eligibility is determined based on the federal poverty level (FPL). In 2023, a family of four can earn up to $3,712 per month and still qualify for Medicaid.
Resource limits are also in place for Medicaid eligibility in Missouri. Excluding a primary residence and a single vehicle, resources cannot exceed $2,000 for an individual or $3,000 for a couple. Additionally, Medicaid recipients must be U.S. citizens or qualified non-citizens.
| Category | Income Limit | Resource Limit | Citizenship Requirement |
|---|---|---|---|
| Individuals | $3,712 per month | $2,000 | U.S. citizen or qualified non-citizen |
| Couples | $4,942 per month | $3,000 | U.S. citizen or qualified non-citizen |
| Families of Three | $6,043 per month | $3,000 | U.S. citizen or qualified non-citizen |
| Families of Four | $7,144 per month | $3,000 | U.S. citizen or qualified non-citizen |
Pregnant women, children under 19, and individuals with disabilities may also be eligible for Medicaid regardless of income or resources. Additionally, there are special programs available for certain populations, such as the Aged, Blind, and Disabled (ABD) program.
To apply for Medicaid in Missouri, individuals can visit the Missouri Department of Social Services website or contact their local Family Support Division office. Applications can be submitted online, by mail, or in person. Once an application is received, it will be reviewed to determine eligibility. If approved, Medicaid coverage will begin on the first day of the month following the application date.
Inpatient and Outpatient Services in Missouri
Medicaid in Missouri provides a wide range of inpatient and outpatient services to eligible individuals. These services are designed to help people maintain their health and well-being, and to prevent or treat illness and injury.
- Inpatient Services:
- Hospital care
- Nursing facility care
- Psychiatric hospital care
- Intermediate care facility for individuals with intellectual disabilities (ICF/IID)
- Skilled nursing facility care
- Outpatient Services:
- Doctor visits
- Specialist care
- Mental health services
- Substance abuse treatment
- Preventive care
- Dental care
- Vision care
- Hearing aids
- Durable medical equipment
- Home health care
| Service | Inpatient | Outpatient |
|---|---|---|
| Hospital care | Yes | Yes |
| Nursing facility care | Yes | No |
| Psychiatric hospital care | Yes | Yes |
| ICF/IID | Yes | No |
| Skilled nursing facility care | Yes | No |
| Doctor visits | No | Yes |
| Specialist care | No | Yes |
| Mental health services | Yes | Yes |
| Substance abuse treatment | Yes | Yes |
| Preventive care | No | Yes |
| Dental care | No | Yes |
| Vision care | No | Yes |
| Hearing aids | No | Yes |
| Durable medical equipment | Yes | Yes |
| Home health care | No | Yes |
Medicaid also provides coverage for a variety of other services, including transportation to medical appointments, personal care services, and case management.
Prescription Drugs Coverage in Missouri
Missouri’s Medicaid program provides comprehensive prescription drug coverage to eligible individuals and families. The program covers a wide range of medications, including generic and brand-name drugs, and it offers financial assistance to help low-income individuals afford their medications.
- Covered Medications: Medicaid covers a wide range of prescription drugs, including:
- Generic and brand-name drugs
- Prescription drugs for mental health conditions
- Prescription drugs for chronic conditions
- Prescription drugs for acute conditions
- Over-the-counter drugs (with a doctor’s prescription)
- Financial Assistance: Medicaid offers financial assistance to help low-income individuals afford their medications. This assistance includes:
- Co-payment assistance
- Deductible assistance
- Out-of-pocket expense assistance
- How to Apply: To apply for Medicaid prescription drug coverage, you can:
- Apply online at the Missouri Department of Social Services website
- Call the Missouri Department of Social Services at 1-800-392-1878
- Visit your local Missouri Department of Social Services office
| Covered Services | Co-Payment | Deductible | Out-of-Pocket Expense |
|---|---|---|---|
| Generic Drugs | $4.00 | $0 | $35.00 per month |
| Brand-Name Drugs | $8.00 | $0 | $70.00 per month |
| Prescription Drugs for Mental Health Conditions | $4.00 | $0 | $35.00 per month |
| Prescription Drugs for Chronic Conditions | $4.00 | $0 | $35.00 per month |
| Prescription Drugs for Acute Conditions | $8.00 | $0 | $70.00 per month |
| Over-the-Counter Drugs (with a doctor’s prescription) | $4.00 | $0 | $35.00 per month |
Note: Co-payments, deductibles, and out-of-pocket expenses may vary depending on your income and family size.
Missouri Medicaid Behavioral Health Services
Missouri Medicaid provides comprehensive coverage for behavioral health services to help individuals with mental health and substance abuse issues get the care they need. These services are provided through a variety of providers, including hospitals, clinics, and community mental health centers.
Missouri Medicaid Mental Health Services
- Inpatient and outpatient mental health services, including counseling, medication management, and crisis intervention
- Psychiatric care, including diagnosis, treatment, and management of mental illness
- Substance abuse treatment, including detoxification, counseling, and medication-assisted treatment
- Early intervention services for children and adolescents with mental health issues
- Case management services to help individuals coordinate their care and access needed services
Missouri Medicaid Substance Abuse Services
- Inpatient and outpatient substance abuse treatment services, including detoxification, counseling, and medication-assisted treatment
- Residential treatment programs for individuals with severe substance use disorders
- Outpatient opioid treatment programs, including methadone and buprenorphine
- Naloxone distribution programs to help prevent opioid overdose deaths
- Case management services to help individuals coordinate their care and access needed services
Missouri Medicaid Behavioral Health Services Coverage
| Service | Coverage |
|---|---|
| Inpatient mental health services | Up to 19 days per year |
| Outpatient mental health services | Unlimited visits per year |
| Psychiatric care | Unlimited visits per year |
| Substance abuse treatment services | Up to 30 days per year |
| Residential treatment programs | Up to 90 days per year |
| Outpatient opioid treatment programs | Unlimited visits per year |
| Case management services | Unlimited visits per year |
Note: Coverage may vary depending on the individual’s specific needs and circumstances.
Thank y’all so much for taking the time to learn more about what Medicaid covers in Missouri. I hope this article has been helpful in giving you a better understanding of the program and how it can benefit you or your loved ones. If you have any further questions, please don’t hesitate to reach out to your local Medicaid office. And be sure to check back in with us soon, as we’re always updating our content with the latest information on Medicaid and other important healthcare topics. Until next time, stay healthy and well!