Missouri now uses a single application form to apply for Medicaid.
There are three broad groups which applicants would fall under which determine how best to apply.
- If the client is applying for MO HealthNet Families/MO HealthNet Kids/Pregnant Woman Coverage:
For this type of application you can apply for the consumer online HERE. If the application cannot be completed online, the IM-1SSL Application Form can be used to apply and can be mailed, faxed, dropped off at a resource center, or emailed. No supplemental forms are needed for this type of application.
- If the client is applying for MO HealthNet based on disability and is receiving Social Security/SSI or is over age 65:
For this type of application best practice is for the DMH Agency or Facility to email the completed application and supplemental forms to Greene.CoDFSIM@dss.mo.gov. It can also be completed online following the instructions above. The IM-1ABDS Supplement form must be submitted with this type of application.
IM-1SSL Application Form (Fillable)
- If the client is applying for MO HealthNet based on disability or blindness and needs an MRT Determination:
For this type of application best practice is for the DMH Agency or Facility to email the completed application and supplemental forms to Greene.CoDFSIM@dss.mo.gov. It can also be completed online following the instructions above. The IM-1ABDS Supplement form must be submitted with this type of application. The MRT Packet must be included with this type of application.
IM-1SSL Application Form (Fillable)
MRT Packet (More information on these forms can be found on our Disability Determination's page)
- IM-61B - Disability History (Fillable)
- MO 650-2616 - Authorization for Disclosure of Consumer Medical/Health Information (Fillable)
- IM-61D - Doctor/Medical Facility List (Fillable)
- IM-61C - Work History (Fillable)
It may also speed up the application processing to have a psychiatrist or a licensed clinical psychologist* complete the IM-60A form.
Application/Supplement/MRT Forms packet for printing (Created DATE, Not Fillable)
Missouri Medicaid Expansion is effective beginning 07/01/2021.
- When can we assist DMH consumers with applying for Medicaid Expansion Coverage?
Applications are now being accepted for Missouri’s new Adult Expansion coverage. The consumer may apply online by going to mydss.mo.gov or can apply by phone at 855-373-9994. You may also print the application, it is the same single application as is linked above.
FSD will not begin processing applications until after 10/01/2021. The client will receive a notice of their determination once the application has been processed.
- When will Expansion coverage begin?
The application will not be processed until 10/01/2021. Family Support Division will explore coverage start dates back to 07/01/2021 provided the application is received prior to 11/01/2021. Applications received 11/01/2021 and on-going can request prior quarter coverage, which will explore eligibility for the month of application and the three months prior.
- How do we assist a DMH consumer with applying for Expansion coverage?
The IM-1SSL Application Form is now used to apply for all Medicaid coverage types. If the client is income eligible for Expansion (Household income is 138% of the Federal Poverty Limit) and does not have SSDI/SSI no supplemental forms are needed to apply for Medicaid Expansion, just complete the IM-1SSL Application Form and submit it to FSD.
If the client is disabled and going to need coverage sooner and waiting until after 10/01/2021 for the application to be processed this is not the best option and they should apply based on disability at this time.
Helpful links for DMH Agencies and Providers:
- The IM-6AR Appointing an Authorized Representative form should be used if the application has already been submitted and the "Appendix C" was not included with the application.
Disabled Application Flow Chart (outdated, we are in the process of updating this)
Please review this flow chart if you will be assisting a DMH consumer with the application process.
MO HealthNet Income/Asset Limits for the Elderly, Blind and Disabled
Guidelines for the income and asset (resource) limits for the MO HealthNet for the Disabled program.
MO HealthNet Eligibility Requirements
This document shows the eligibility requirements for the different MO HealthNet programs.
06/11/2018 Medicaid Application Process Webinar (Outdated)