Missouri’s Healthy Children and Youth Program
Infants, children, and youth can get checkups and health care that help them to stay well. The Healthy Children and Youth (HCY) program covers the health care needed to treat medical and behavioral problems.
Frequently Asked Questions
Where Do I Go to Get Health Care?
Children in some parts of Missouri get care from a MO HealthNet Managed Care health plan. The MO HealthNet Managed Care health plan takes care of the child’s health care needs. The parent must pick a Primary Care Provider (PCP). The MO HealthNet Managed Care health plan’s Member Handbook tells what care they cover and how to get the care.
If you are not in a MO HealthNet Managed Care health plan you can make an appointment with any doctor, clinic, nurse practitioner, dentist or other health care provider who is an approved MO HealthNet provider.
Can My Child Get a Ride to Health Care Appointments?
Most children can get a ride to health care appointments. If you are in a health plan call the MO HealthNet Managed Care health plan for a ride.
Other children may get a ride through the state’s nonemergency medical transportation program. Call 1-866-269-5927 to find out more, or to get a ride.
Can I Get Care If I Go Out of the State?
The MO HealthNet Managed Care health plan must ok the care if you are in a MO HealthNet Managed Care health plan, except in the case of an emergency. If you are not in a health plan, care that you get out of state must be for an emergency, or have approval first. Your doctor or the provider in the other state needs to contact the MO HealthNet Managed Care health plan approved provider or the State’s Participant Services Agent for approval. Out of State means a state that does not border Missouri. You may have to pay for the service if:
- it was not an emergency;
- the MO HealthNet Managed Care health plan or the state did not ok it first; or
- the provider does not take MO HealthNet.
Can I Get Help to Pay for Other Health Insurance?
MO HealthNet has a program that pays the cost of health insurance. It also pays the amounts the insurance says you should pay for the service. You may contact the HIPP Section by calling (573) 751-2005, or by writing to PO Box 6500, Jefferson City, MO 65102-6500.
What Medical Care Can My Child Get?
Infants, children and youth should get regular health checks (screens) to make sure they are healthy. HCY pays for these screens. The HCY program covers medically necessary care if the doctor finds a problem during the health screen. Dental checkups and care begin at age 6-12 months. Children between 6 and 72 months should get a checkup for lead poisoning. Get your child a health checkup at the ages shown at left.
Do I Have Rights Under MO HealthNet?
- You may contact the health plan or the state’s Participant Services Agent:
- if you do not agree with, or do not know why a claim did not pay;
- if you do not agree with, or do not understand why the MO HealthNet Managed Care health plan or the state denied a service;
- if you complained to the MO HealthNet Managed Care health plan or the state, and you are still not happy with the answer.
- You have a right to a hearing if you do not agree with the MO HealthNet Managed Care health plan’s or Participant Services Agent’s reply to your medical claim question.
- You have 90 days to ask for a hearing if you do not like the answer from the MO HealthNet Managed Care health plan or Participant Services Agent or do not get a reply.
- If you do not ask for a hearing within 90 days, you cannot ask for a hearing.
- You may ask for a hearing by calling or writing the MO HealthNet Managed Care health plan or the MO HealthNet Division. You may also send a letter to ask for a hearing to the local Family Support Division office. They will send the request to the MO HealthNet Division.
Who Can I Call if I Have Questions?
Call the MO HealthNet Managed Care health plan’s member service’s phone number listed in the Member Handbook, or the state’s Participant Services Agent at: 1-800-392-2161
At what age does my child need a health checkup?
Get your child a health checkup at these ages:
- Newborn (2-3 days)
- By one month
- 2-3 months
- 4-5 months
- 6-8 months
- 9-11 months
- 12-14 months
- 15-17 months
- 18-23 months
- 24 months
- 3 years
- 4 years
- 5 years
- 6-7 years
- 8-9 years
- 10-11 years
- 12-13 years
- 14-15 years
- 16-17 years
- 18-19 years
- 20 years
Examples of Covered HCY Services:
- Case Management,
- Dental services (including braces, in limited situations),
- Diabetic supplies and educators,
- Drug & Alcohol treatment and rehabilitation,
- Emergency care,
- Eye exams, glasses and artificial eyes,
- Family Planning services,
- Head Injury rehabilitation,
- Hearing Aids and related services,
- Home Health,
- Hospital Care (Inpatient and Outpatient),
- Immunizations (shots),
- Lab and X-ray services,
- Medical equipment and supplies,
- Personal Care,
- Physical, Speech and Occupational Therapy
- Physician, Clinic, and Nurse Practitioner services,
- Prescription drugs,
- Private Duty Nursing,
- Psychology/Counseling services,
- Transplants, and
- Treatment of lead poisoning and a check of the child’s home for lead.
Ask the MO HealthNet Managed Care health plan or approved provider, if you do not know if HCY covers the service.