Haris Ashley
Medicaid is a federal and state program that provides health insurance to eligible low-income individuals. While each state has its own Medicaid program, the requirements and benefits vary across states. Kansas Medicaid, known as KanCare, offers coverage to children, pregnant women, and individuals who are elderly or disabled. On the other hand, Missouri's Medicaid program, MO HealthNet, provides coverage to low-income children and adults, as well as those with low incomes and low asset levels who are aged, blind, or disabled. This raises the question: can an individual use their Kansas Medicaid health insurance in Missouri, or vice versa?
| Characteristics | Values |
|---|---|
| Name of Medicaid in Kansas | KanCare |
| Name of Medicaid in Missouri | MO HealthNet |
| Income eligibility for children in Kansas | Family income up to 166% of the federal poverty level (FPL) for children up to age 1 |
| Income eligibility for children in Missouri | Household income up to 138% of the poverty level for adults under age 65 |
| Income eligibility for pregnant women in Kansas | Family income up to 166% of FPL |
| Income eligibility for adults in Missouri | Household income up to 138% of the poverty level for adults under age 65 |
| Application process in Kansas | KanCare Medical Self-Service portal or Healthcare.gov website |
| Application process in Missouri | Online through MO HealthNet or through HealthCare.gov |
| Additional benefits in Missouri | Nursing home coverage, Show-Me Healthy Babies Program, Program of All-Inclusive Care for the Elderly (PACE) |
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What You'll Learn
Medicaid expansion in Missouri
Medicaid in Missouri is called MO HealthNet. It provides coverage for low-income children and adults, as well as people with low incomes and low asset levels who are aged, blind, or disabled. Adults under 65 are eligible for Medicaid with a household income of up to 138% of the poverty level.
In 2019, Washington University backed the Healthcare for Missouri initiative, which aimed to expand the state's Medicaid program to cover more people. The initiative collected signatures to put Medicaid expansion before Missouri voters in 2020. A University of Missouri School of Medicine study in 2012 concluded that "Medicaid expansion would be highly beneficial to the Missouri economy and its citizens."
On August 4, 2020, Missouri voters approved a ballot measure to amend the state's constitution, requiring the implementation of Medicaid expansion by July 1, 2021. However, in May 2021, Republican Governor Mike Parson announced that the state would not implement the expansion as scheduled due to a lack of funding. The ballot measure did not include a revenue source, and the Republican-controlled state legislature excluded the program from its final FY 2022 budget. This decision was upheld by a circuit court judge, who ruled that the state was not required to implement the expansion.
The implications of not expanding Medicaid in Missouri are significant. Nearly 127,000 uninsured non-elderly adults fall into a coverage gap, with incomes above Missouri's current Medicaid levels but below the minimum eligibility for tax credits through the ACA marketplace. Additionally, not expanding Medicaid would result in the state forgoing more than $1 billion in additional federal funds available under the American Rescue Plan Act (ARPA).
While Kansas has not implemented ACA Medicaid expansion, Kansas Medicaid (KanCare) is available to individuals who meet certain income limits. Children from low-income families, pregnant women, the elderly, and people with disabilities may be eligible for coverage under KanCare.
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KanCare in Kansas
Medicaid in Kansas is called KanCare. It is the state's managed care program, which began in January 2013. The Division of Health Care Finance (DHCF) is responsible for purchasing health services for children, pregnant women, people with disabilities, the aged, and the elderly through the Medicaid program, the Children's Health Insurance Program (CHIP), and the state-funded MediKan program.
KanCare is provided to all Medicaid and CHIP consumers. Kansas has contracted with three health plans, or managed care organizations (MCOs), to coordinate health care for beneficiaries. The three plans are Healthy Blue Kansas (Healthy Blue), Sunflower State Health Plan (Sunflower), and UnitedHealthcare Community Plan of Kansas (United).
KanCare is available to individuals who meet specific income limits, with an extra 5% income disregard in most cases. The income limits are as follows:
- Children up to age 1 are covered with family income up to 166% of the federal poverty level (FPL).
- Children ages 1 to 5 are covered with family income up to 149% of FPL.
- Children ages 6 to 18 are covered with family income up to 133% of FPL.
- Pregnant women with family income up to 166% of FPL are covered, and coverage for the mother continues for 12 months after the baby is born.
Children with family incomes too high to qualify for Medicaid but not more than 227% of FPL are eligible for CHIP. Individuals who are elderly or disabled may also qualify for KanCare. For families in some income categories, monthly premiums ranging from $20 to $50 per family apply.
KanCare can be used in conjunction with Medicare benefits and covers some services not included in Medicare, such as nursing home and long-term care. Participants may also be eligible for Home and Community-Based Services (HCBS) as an alternative to institutional care. Additionally, financial assistance is available for Medicare Part D (prescription drug) expenses.
To apply for KanCare, individuals can use the KanCare Medical Self-Service portal or the Healthcare.gov website if they are under 65. If eligible, the information will be transferred to KanCare.
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Income requirements for eligibility
Medicaid in Missouri is called MO HealthNet. To be eligible for MO HealthNet, adults under 65 years of age must have a household income of up to 138% of the poverty level. This includes a built-in 5% income disregard added to the eligibility limits, which is used for all Medicaid eligibility based solely on income.
You can apply for Missouri Medicaid without assistance, either online or by phone, for the fastest results. You can also apply through MO HealthNet, either online or by phone at 1-800-318-2596. If eligible, your information will be sent to MO HealthNet, where you will complete your enrollment.
In Kansas, each medical program has different income rules. Your household's income must be less than the maximum income level for the program you apply for. Both earned and unearned income are counted. Earned income refers to money from jobs, while unearned income includes money from social security, child support, unemployment, pensions, etc. Gross income (the amount before taxes) is used, and deductions such as qualifying pre-tax and federal deductions are subtracted.
Resources and assets, such as bank accounts, cars, property, and stocks owned by anyone in the household, may also be considered in addition to income. Most plans for the elderly and persons with disabilities have a limit on the amount of resources, while family and children's plans do not.
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Applying for Medicaid in Missouri
Medicaid in Missouri is called MO HealthNet. It is available to low-income children and adults, and to people with low incomes and low asset levels who are aged, blind, or disabled. Adults under 65 are eligible for Medicaid with a household income of up to 138% of the poverty level.
There are several ways to apply for MO HealthNet. You can apply online, by phone, or in person. To apply online, you can visit https://mydss.mo.gov/healthcare/ or https://healthcare.gov/ to begin the eligibility determination process. If eligible, your information will be sent to MO HealthNet, where you can complete your enrollment. You can also apply by phone at 1-855-373-9994 or 1-800-318-2596. To apply in person, you can visit your local Family Support Division Office. You can also print or fill out a paper application and mail it to: MO HealthNet Service Center, 525 Jules Street #127, St. Alternatively, you can call 1-888-275-5908 to request an application.
If you are applying for MO HealthNet based on disability, you must complete and submit the Aged, Blind, and Disabled Supplemental Form (IM-1ABDS). If applying based on disability or blindness and needing an MRT Determination, you must submit the IM-1ABDS Supplement form and the MRT Packet. It may also speed up the application process to have a psychiatrist or licensed clinical psychologist complete the IM-60A form.
If you are applying for MO HealthNet Managed Care for pregnant women, you will need written medical proof of pregnancy and the expected date of delivery. You will also need social security numbers, proof of income, and immigration status.
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Applying for Medicaid in Kansas
Kansas's Medicaid program is called KanCare. It is available to individuals who meet certain income limits, with an extra 5% income disregard in most cases. Here is a rundown of the eligibility criteria:
- Children up to the age of 1 are covered with a family income of up to 166% of the federal poverty level (FPL).
- Children aged 1 to 5 are covered with a family income of up to 149% of the FPL.
- Children aged 6 to 18 are covered with a family income of up to 133% of the FPL.
- Pregnant women with a family income of up to 166% of the FPL are covered, and coverage for the mother continues for 12 months after the baby is born.
- Children with family incomes too high to qualify for Medicaid but not more than 227% of the FPL are eligible for the Children's Health Insurance Program (CHIP).
- Individuals who are elderly or disabled may also qualify for Kansas Medicaid.
- Individuals who are medically needy, between the ages of 19 and 64, and meet the disability criteria. If you are 65 or older, no disability criteria are required.
- Parents or caregivers living with a dependent child.
- Individuals under the age of 19 who live in a household at or below 255% of the FPL.
- Individuals who need treatment for breast or cervical cancer.
- Individuals who have aged out of a foster care program in Kansas or any other state.
- Individuals who need a nursing facility level of care and have an income at or below 300% of the current Supplemental Security Income (SSI) Federal Benefit Rate (FBR).
To apply for KanCare, you can use the KanCare Medical Self-Service portal. You will need to log in or create an account. You can also apply on the Healthcare.gov website if you are under 65 years old. If it appears that you are eligible, your information will be transferred to KanCare. You can call 1-800-792-4884 for help in determining which application to use or to have an application mailed to you.
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Frequently asked questions
Medicaid in Missouri is called MO HealthNet.
Kansas Medicaid is called KanCare.
You can apply for Missouri Medicaid online or by phone. You can also apply without assistance from KC CARE's Health Insurance Navigators.
You can apply for Kansas Medicaid on the KanCare Medical Self-Service portal or on the Healthcare.gov website if you are under 65 years old.
