Show Me Healthy Kids
ATTENTION: Effective April 1, 2023
Missouri is required to check Medicaid eligibility again, which includes members of Show Me Healthy Kids. If you are no longer in state custody, receiving adoption or legal guardian subsidy, or you are now 26 or older, you may no longer be eligible for healthcare coverage through Show Me Healthy Kids.
If you or a child in your care need healthcare coverage, please visit mydss.mo.gov/healthcare/apply to apply for MO HealthNet (Missouri Medicaid).
SMHK-230095 - 04/11/2023
Welcome Show Me Healthy Kids Members!
If you are new to Home State Health, we look forward to managing your care. If you are an existing member and moving to Show Me Healthy Kids managed by Home State Health, we look forward to continuing your care.
The Show Me Healthy Kids Health Plan (SMHK) provides health care to Missouri children in care and custody. The plan works with many doctors, clinics and hospitals to provide regular checkups, exams, primary care and specialist care when needed.
You can always call the Show Me Healthy Kids managed by Home State Health customer service phone number at 877-236-1020 (TTY 711).
A: Eligibility groups for Show Me Healthy Kids include:
- Children in the care and custody of the Missouri Department of Social Services
- Children or youth in alternative care
- Children receiving adoption or legal guardianship subsidy
- Former foster care youth under the age of 26, who were in foster care on their 18th birthday and covered by MO HealthNet (Missouri Medicaid), and who meet other eligibility criteria
- Former foster care youth under the age of 26, who were in foster care on their 18th birthday and covered by Medicaid from another state, and who are not currently eligible for Medicaid coverage under another program
A: Home State Health received information from the other managed care plans on your child’s existing authorizations and services. We are working with the other managed care plans to ensure a smooth transition of services that have already been started prior to joining Home State Health.
Starting July 1st your child was no longer with the other managed care plan and began coverage with Show Me Healthy Kids managed by Home State Health. For the transition of care period, we are not requiring authorization for any covered benefit, whether your provider is in our network, or not.
A: As our Show Me Healthy Kids program begins, your kids can continue to see their current doctors during our initial continuity of care period, which will last for several months. During that time, we will pay your kids’ doctors directly, for the care they provide at no cost to you. Our team will continue to contact out-of-network providers (with a focus on those who send us claims) and offer them contracts to participate with our Plan.
In addition, each family will have an assigned Care Manager who will help them navigate our network and ensure your kids have access to the care they need.
A: You do not need to take any action.
You should have received your Show Me Healthy Kids managed by Home State Health ID Card, along with a welcome packet.
For members currently on other managed care plans, Home State Health will be working with these plans to make sure your transition goes smoothly. Home State Health team members will be making calls to you to review the information, answer questions about Show Me Healthy Kids, and have a brief discussion about the child’s current health care needs and providers.
A: The Show Me Healthy Kids Health Plan is a new program that will provide coordinated health care services for children and youth in foster care, extended foster care, adoption support, young adult alumni of the foster care program. MO HealthNet has moved children into one health care plan – Show Me Healthy Kids managed by Home State Health.
A: The same medical and behavioral benefits you get today AND:
- Dedicated local team to assist with health care coordination and support for navigating the health care system.
- Help finding the right health providers.
- Health care coordination for members with multiple or complex health care needs.
- Smooth transition of health care services when members are hospitalized or change placements.
- Education and assistance to members who are transitioning from foster care to independence.
- Assistance with finding community resources through findhelp.org
- A 24-7 Nurse Advice and Crisis Line. Members and their families can talk to their assigned health care coordinator by phone during business hours and by voicemail at any hour of the day or night.
- 24/7 access to virtual telehealth doctors via Teladoc Health.
- Additional services to support better health outcomes like access to an online health library, wellness programs, maternity program, no cost cell phone and more. Some programs are subject to eligibility.
- If you need assistance with transportation* to your healthcare appointments—we can help!
- We can arrange non-emergency medical transportation to the many medical and health services that Home State Health covers.
- *For our members receiving transportation as a covered benefit.
A: Keeping the child’s current provider is extremely important. Home State Health is seeking contracts or already has contracts with providers in your community that deliver physical, behavioral health care and related services to children in care and custody. MO HealthNet is providing a list of providers currently serving children in foster care to facilitate additional Home State outreach and contracting activities.
A: Home State Health is actively reaching out to physical and behavioral health care providers who are not contracted with them in all regions of the state. Enrollees may need to transfer to alternate providers in some circumstances, but the goal is to keep such transfers to a minimum.
A: If your child is currently seeing an out of network doctor, please contact Show Me Healthy Kids Care Management to assist as an authorization will be needed. Contact us at 877-236-1020 (TTY 711)
A: No. Members of the Show Me Healthy Kids health plan are not able to change health plans, but you do have the option to opt out if you or your child meets one of the following:
- Eligible for Supplemental Security Income (SSI) benefits
- Meets the SSI medical disability definition
- A child with complex special health care needs
For help with opting out of Show Me Healthy Kids, call 800-348-6627
- The benefits will be the same MO HealthNet benefits the child previously had along with some extra programs and assistance that Home State designed specifically for the members of Home State Health plan.
- Home State Health will manage all health care services including physical health, routine vision and dental, and will now include behavioral health and substance use disorder treatment services.
- The Member handbook will be available online and via the member portal for more details about these benefits.
- All members have a 180-day Continuity of Care period. If they have health care providers or services that were already in place or in process prior to joining Home State Health, we will work with the member and their providers to ensure no disruption in care.
A: When members in Home State Health plan return home to their biological parent, they lose their Show Me Healthy Kids coverage and are assigned to Home State Health’s general MO HealthNet plan. At that time, they will have the option to choose a different managed care health plan within 90 days.
A: Yes, over the last two years many stakeholders were included in the creation of this new program. Feedback was solicited by the Missouri Department of Social Services (DSS) and Home State Health in their efforts to build the best program for Missouri's children and families.
A: You will need to contact the Children’s Division per case type below to report your change of address:
- For resource and kinship families, contact your CD case manager
- For subsidy cases, contact your subsidy case manager
- For former foster care cases, email CDMHNQuestions@dss.mo.gov
A: All materials are mailed to you. If you lost your state-issued enrollment packet, contact the MO HealthNet Enrollment Helpline at 800-348-6627 and ask for a new packet to be mailed to you. If you need a copy of your Show Me Healthy Kids Member Handbook as you do not have access to the internet, please call Member Services at 1-877-236-1020. Due to recent approval of the document, it may be mid-August until one is mailed.
SMHK-HSH22251 - 06/10/2022