If you’re among the 29 percent of Missouri adults who are living with a disability, then you might be eligible to receive medical care through Medicaid. Also known as MO HealthNet in Missouri.
In this article, we will cover all you need to know about applying for Medicaid in MO if you have a disability.
We will discuss what MO HealthNet covers for people with disabilities, what are the requirements to qualify, how to sign up (mail, online, in-person), and more.
What does MO HealthNet (Medicaid) cover for people with disabilities?
The Missouri state Family Support Division (FSD) determines who is eligible to receive benefits through Medicaid (MO HealthNet).
The MO HealthNet is designed to provide medical care to eligible low-income individuals to promote optimal health, prevent illness, provide rehabilitation, and to correct or limit disabilities.
If you’re eligible for Medicaid, then you’d receive all the basic medical services available through MO HealthNet. You may also qualify for special benefits for people with disabilities.
Let’s take a look at what you get with Medicaid.
When you sign up, you will get a MO HealthNet card, along with detailed information about all the benefits you are eligible to receive.
Here are some of the many services you will receive if you’re enrolled in MO HealthNet.
Basic medical services
- Inpatient services (surgeries, extensive medical treatment in a hospital, etc.)
- Outpatient services (X-rays, MRIs, consultations, routine exams, etc.)
If you need rehabilitation services because due to an injury, or another reason, you can receive adaptive training with the following:
- Prosthetic devices
- Orthotic devices
- Artificial larynxes
Long term care
If you have an ongoing disability or medical condition and you require long term care, MO HealthNet may cover the following benefits.
- Personal care at home instead of a nursing home (see section below on CDS)
- Care at a nursing home facility licensed by the Missouri Department of Health and Senior Services
- Long term care at the extended care facility of a licensed hospital
Consumer Directed-Services (CDS)
Consumer Directed Services (CDS) is a program run by MO HealthNet to help people with disabilities continue living in their homes and communities.
If you need long term care due to a disability, and you’re eligible for Medicaid, you can receive care services from a personal care attendant (PCA), instead of having to move to a facility like a nursing home.
CDS is a self-directed service, meaning that you get to be in charge of the care that you receive.
You know best when it comes to the assistance that you need, and you can hire and direct caregivers accordingly.
With CDS, you can hire your friends, family (except your spouse or guardian), and acquaintances, to provide care. You get to receive care from someone you like and trust, instead of a stranger at a nursing home.
And your caregiver gets compensated through MO HealthNet, so it’s a mutually beneficial arrangement.
What does CDS cover?
When you hire a care provider through CDS, their primary responsibility would be to help you with daily living activities.
If you’re living with a disability, then you might face challenges when going to the bathroom, preparing meals, cleaning, and with various other tasks.
Your caregivers job will be to provide assistance with these daily tasks to make you more comfortable.
But as we mentioned before, the biggest benefit of being able to hire a caregiver through CDS is that you get to keep living in your home and remain connected to your community, instead of having to move to a nursing home due to your disability.
For all the details, be sure to check out our in-depth and easy to understand guide on Consumer Directed Services.
What are the eligibility requirements to sign up for MO HealthNet?
In this section, we’ll discuss the different requirements that are needed for you to qualify for MO HealthNet due to disability.
You must meet the following residency and citizenship requirements.
- You must be a Missouri resident and you must intend to remain in the state
- You must be a U.S. citizen or a non-citizen who is eligible and qualified
- You must not be living in a public institution (unless it’s a public medical institution)
You must be permanently or totally disabled to be eligible for MO HealthNet through disability, according to their rules.
In other words, your disability must be ongoing, and not temporary due to an accident or injury.
Missouri Medicaid uses the definition of disability as set by the Social Security Administration (SSA).
The SSA defines disability as an individual’s inability to be gainfully and substantially employed for a year or longer, either due to a mental or physical incapacity.
Additional requirements for CDS
If you want to enroll in the CDS program, then there are a few additional requirements.
- You must be 18 years of age or older
- You must require the level of care that you would normally get at a nursing home.
- You must be able to hire, train, and direct your caregiver
Since Medicaid is designed to provide low-income individuals access to medical care, your income must be within a certain limit to qualify.
If you’re single, then the monthly income limit is $904. For couples, the limit is $1,222.
The income limit is tied to the Federal Poverty Level (FPL). At any given time, your income can’t exceed 85 percent of the FPL.
These limits are current at the time of writing (2020). For the most up-to-date income limits, be sure to check the Missouri HealthNet income limits chart.
If your monthly income exceeds the limit, you might still be eligible by reducing your income through qualified expenses.
Any medical or wellness related expense is typically considered a qualified expense.
After you pay your current medical bills, if your income falls below the required limit, you can still qualify.
For more details on qualifying expenses, and how to reduce your income, check out MO HealthNet spend down page.
Just like income, there are limits to how much you can own in assets.
Currently, the limits are $2,000 for individuals and $4,000 for a couple. Again, you might be eligible even if your assets exceed the limits.
The following assets are exempt from counting towards your limit.
- The home where you live
- The home where your spouse (or dependants) lives
- One vehicle
- Household goods and certain other property
If your child is the one who is disabled, and he/she is under 18, then the parent’s non-exempt asset will count towards the asset limit.
How do I sign up for MO HealthNet?
If you think you’re eligible for MO HealthNet, the next step is to get the application process started.
If you get stuck with any part of the process, have questions about your eligibility, income, assets, or anything else related to MO HealthNet, you can call this number with your questions.
Here are the different ways you can apply
Here’s a checklist of all the information you’ll need before you begin your online application.
Once you’ve gathered all the necessary information, you can get started with the application for MO HealthNet here.
Here are detailed instructions on how to complete the application form.
Here are some accompanying forms. They are not a necessary part of the application, but may expedite the application process in some cases.
Here is an application checklist to make sure you’ve included everything.
Apply by mail
Download this form and print it out for a paper application.
It includes all the necessary information and instructions, as well as the address where you need to send the completed application.
Apply in person
If you’d like to apply in-person, you can visit one of the Missouri Family Support Division offices close to you.
Check here for the most up-to-date information (and locations) about which FSD offices are operating and open to receive inquiries/applications.
How long does the approval process take?
For regular Medicaid, the states must respond to your application within 45 days.
But if you’re applying for Medicaid due to a disability, then the response can take up to 90 days. There can be additional delays if you don’t provide complete information and documents when you apply.
Can I start using my benefits before the official enrollment?
You can’t start using your benefits before your application is approved.
But once approved, the coverage is retroactive.
That means, Medicaid will pay for qualified medical expenses up to three months before you applied, assuming you were eligible for Medicaid at that time.
If you’re a Missouri adult living with a disability, then you can benefit in a variety of ways from the services provided through MO HealthNet.
Whether it’s inpatient services, outpatient services, rehab, or you need long term care and help with daily living activities, MO HealthNet has you covered.
Check the information above to see if you might qualify, and get the application process started.
And if you are interested in hiring your own care provider for long term care at home, be sure to check out CDS.