Frequently Asked Questions

Healthcare for Pregnant Moms and Newborn Babies

If you are an eligible pregnant woman you may receive healthcare coverage during and after your pregnancy. Your newborn baby will also be covered. MO HealthNet plans cover the newborn through the first year of life, as long as the child remains in the mother’s home and lives in Missouri.

Are you…

• Applying for or already have a social security number?
• Living in Missouri and planning to stay here?
• A United States citizen or an eligible qualified non-citizen?
• Within family income limits for your household size (see income limits below)?
• Pregnant women whose family income must be less that 196% of the federal poverty level.
• Your family income must be less than the Federal Medicaid income limit.
• The income limit that applies to you will depend on your family size.
  • Income limit is $2,570 for a family size of two*.
  • Income limit is $3,233 for a family size of three.
  • Income limit is $3,896 for a family size of four.
  • Income limit is $4,559 for a family size of five.
  • Income limit is $5,222 for a family size of six.

(Income limits in effect on April 1, 2014)

If you answered Yes to all of the questions above, and your family meets the income requirements above, you may qualify for MO HealthNet Managed Care. Next, take a look at the benefits, or find out how to enroll.

Find out if your child might qualify for MO HealthNet Managed Care through Home State Health.

Who Is Eligible

A Child:

• who is under 19 years old?
• who applies for or already has a social security number?
• who lives in Missouri and planning to stay here?
• who is a United States citizen or an eligible qualified non-citizen?
• the parent must cooperate with Child Support Enforcement (CSE) in the pursuit of medical support; and
• whose countable family income meets the income guidelines below:
  • If your monthly income is between $1,907 and $6,978 you may be able to get MO HealthNet Managed Care for children
  • This will depend on the child’s age, family size and monthly income. 

If you answered Yes to all of the questions above, your child may qualify for MO HealthNet Managed Care. Next, take a look at the benefits, or find out how to enroll.

No, the form is one page, front and back, and can be mailed or phoned in. You’ll need social security numbers, proof of income (pay stub, federal income tax form, etc.) and immigration status.

Call toll-free 1-888-275-5908 for help completing your MO HealthNet Managed Care application.

After reviewing your application, MO HealthNet will contact you if they need more information. If you don’t have a phone, call them toll-free at 1-888-275-5908 a few days after you submit your application.

It takes about one month to process an application. You’ll be notified in writing after a decision has been made.

During open enrollment, providers (PCP’s) are added to the website daily. If you don’t see your PCP, please check again in a day or two. 

Call your doctor if you think you need health care services.  Some services may need review by Home State Health before they are given. The Home State Health Utilization Management Team does this review.  You can call Member Services at 1-855-694-HOME (4663) (TDD/TTY: 711) to see if something needs to be reviewed by Home State Health.

Emergency health care DOES NOT need to be approved before being given.

Home State Health reviews health care service requests to make sure they are medically necessary.  This means getting the right care, at the right place, and at the right time. Home State Health uses standard guidelines to check medical necessity. Home State Health does not reward its staff or its network providers to deny care or encourage decisions that result in underutilization.

Visit MO Health Net Managed Care to learn more.