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This document serves as an application form for the MO HealthNet program, which provides Medicaid services to eligible residents of Missouri. It collects personal, household, income, and insurance
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How to fill out mo healthnet application

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How to fill out MO HealthNet Application

01
Gather all necessary documents such as proof of income, residency, and identification.
02
Visit the MO HealthNet application webpage or go to your local Family Support Division office.
03
Choose between filling out the application online or obtaining a paper application.
04
Complete the application form with accurate personal information, including household members.
05
Provide additional information regarding your income and expenses.
06
Review the application for accuracy before submission.
07
Submit the application online or return the paper form to the designated office.
08
Follow up with the Family Support Division to check the status of your application.

Who needs MO HealthNet Application?

01
Individuals or families with low income seeking health coverage.
02
People who are pregnant and need maternity care.
03
Children who require medical assistance.
04
Elderly individuals looking for health benefits.
05
Individuals with disabilities needing specialized medical services.
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The income limits for Medicaid applicants can change depending on the state where they live, their marital status and the Medicaid program. In general, however, the income limits are low. In most states in 2025, the income limit for receiving long-term care at home or in a nursing home through Medicaid is $2,901/month.
If you are approved for help, you will have healthcare coverage through Missouri Medicaid (MO HealthNet). This healthcare coverage is different than Medicare and it can help with benefits not normally covered through that program, like nursing home care and personal care services.
Benefit Program Income Limits Program18 Program MO HealthNet for Expansion Adults 1 $20,814 8 $72,019 Program MO HealthNet for Families 1 $1,692 8 $6,384 Program MO HealthNet for the Aged and Disabled 1 $13,303 8 $46,028 Program MO HealthNet for the Blind 1 $15,650 8 $54,15010 more rows
If you are approved for help, you will have healthcare coverage through Missouri Medicaid (MO HealthNet). This healthcare coverage is different than Medicare and it can help with benefits not normally covered through that program, like nursing home care and personal care services.
What You Will Need. Before your MO HealthNet Managed Care application can be approved, you may need to provide: Proof of income for the past 30 days, such as a pay stub or letter from your employer. If you're not a citizen: Immigration documents showing names, immigration status, registration number and date of entry.
Benefit Program Income Limits Program12 Program MO HealthNet for Expansion Adults 1 $20,814 2 $28,129 Program MO HealthNet for Families 1 $1,692 2 $2,892 Program MO HealthNet for the Aged and Disabled 1 $13,303 2 $17,978 Program MO HealthNet for the Blind 1 $15,650 2 $21,15010 more rows

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MO HealthNet Application is a form used to apply for health care benefits provided by the Missouri Medicaid program, which offers coverage for low-income individuals and families.
Individuals and families who meet certain income and resource guidelines, and who are seeking health coverage through the Missouri Medicaid program are required to file the MO HealthNet Application.
To fill out the MO HealthNet Application, individuals must provide personal information, income details, household composition, and any other relevant information required by the form, ensuring accuracy and completeness before submitting.
The purpose of the MO HealthNet Application is to determine an applicant's eligibility for health care services and benefits provided under the MO HealthNet program.
The MO HealthNet Application must include personal identification information, household size, income details, medical expenses, and other financial information that could impact eligibility for benefits.
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