Important Information About Your MO HealthNet Coverage
The Missouri Department of Social Services (DSS), Family Support Division (FSD), is writing to let you know about new federal rules that may affect your MO HealthNet coverage.
Starting January 1, 2027, some adults with MO HealthNet coverage will need to meet community engagement requirements to keep their health coverage. Adults who need to meet community engagement requirements will also have their eligibility reviewed every 6 months instead of once every 12 months.
You are getting this notice because our records show you may be affected by these new rules.
Who in your household may be affected?
This notice applies to adults enrolled in MO HealthNet coverage through Medicaid expansion, also called the Adult Expansion Group or AEG. The letter mailed to your household lists the household member(s) our records show may be affected by these new rules.
If the information in your mailed letter is not correct, or if someone in your household has had a change in their situation, please contact FSD or report a change using the options listed below.
At this time, you do not need to take action.
This notice explains:
- What is changing
- Who may need to meet the requirements
- Ways to meet the requirements
- Who may not need to meet the requirements
- What may happen if requirements are not met
- How to get help or report changes
What are community engagement requirements?
Community engagement requirements are activities some adults must complete to keep MO HealthNet coverage.
These activities include:
- Paid or unpaid work
- Going to school or job training
- Taking part in an approved work program
- Volunteering with a community service program with a public or nonprofit organization
To meet the requirement, you need to complete at least 80 hours of approved activities during at least one month in your 6-month renewal period. A combination of approved activities may be used to meet the 80 hours.
For example, you may work for 20 hours a month, attend school for 10 hours a month, and volunteer for 50 hours a month. Adding the hours for working, attending school and volunteering together allows you to meet the 80 hours of community engagement activities.
Who may need to meet these requirements?
Some adults ages 19 through 64 enrolled in MO HealthNet coverage through Medicaid expansion may need to meet community engagement requirements.
Not everyone with MO HealthNet coverage will need to meet these requirements.
Who may not need to meet the requirements?
Some people may be exempt and do not have to meet community engagement requirements.
This may include people who:
- Are pregnant or recently had a pregnancy
- Have Medicare
- Are a veteran with a temporary or permanent disability rating or compensation as 100% (total) from the Department of Veterans Affairs
- Are medically frail
- Are participating in a drug or alcohol addiction treatment and rehabilitation program
- Care for a child age 13 or younger
- Care for a person with a disability
- Are former foster youth under age 26
- Are members of federally recognized Tribal communities
- Are meeting Temporary Assistance work requirements
- Are in a household that gets SNAP and are subject to SNAP work requirements
- Are in jail, prison, or were recently released
- Qualify for another exemption allowed under federal or state rules
What does “medically frail” mean?
You may be exempt and not have to meet community engagement requirements if you are medically frail.
This may include people who have a condition that significantly impairs their ability to meet community engagement requirements, such as people who:
- Are blind or have a disability
- Have a substance use disorder, unless they have been in stable recovery for 5 or more years
- Have a serious mental health condition
- Have a physical, intellectual, or developmental disability that significantly impairs their ability to perform one or more activities of daily living
- Have a serious or complex medical condition
How do you report if you are exempt from community engagement requirements?
If you think you are exempt from community engagement requirements, FSD will first use information already available to verify that you meet an exemption.
You only need to meet an exemption in a single month within your 6-month renewal period.
If FSD cannot verify that you are exempt from community engagement requirements you will need to report how you are exempt to FSD. Reporting how you are exempt from community engagement requirements will be available through the existing renewal process. Starting January 1, 2027, FSD will update renewal forms so you can report an exemption.
If you are not exempt, how do you report you are meeting community engagement activities?
If you need to meet community engagement requirements, FSD will first use information already available to verify that you meet requirements.
You meet requirements if you or your household have an income of $580 in at least one month within your 6-month renewal period. If not, then to meet community engagement activities, you need to complete at least 80 hours of approved activities in at least one month within your 6-month renewal period.
If FSD cannot verify that you meet requirements you will need to report how you met community engagement activities. Reporting your community engagement activities will be available through the existing renewal process. Starting January 1, 2027, FSD will update renewal forms so you can report community engagement activities.
How will DSS check this information?
DSS will use information already available to check whether you:
- Met community engagement requirements
- Are exempt so you do not need to meet the requirements
If DSS needs more information, we will contact you through the existing renewal process and explain:
- What information is needed
- How to send it
- When it is due
Examples of documents that may be requested include:
- Pay stubs
- School or training records
- Volunteer records
- Other proof of approved community engagement activities
What happens if I do not meet the requirements?
If DSS cannot confirm that you met community engagement requirements or that you do not need to meet them, you will receive another notice.
That notice will explain:
- What information is missing
- What steps you can take
- How much time you have to respond
- Your rights and options
You will have time to respond before any action is taken on your coverage.
If you do not respond or do not meet the requirements, your MO HealthNet coverage could end.
Losing MO HealthNet coverage may also affect whether you qualify for financial help paying for health coverage through the Health Insurance Marketplace. If you lose your MO HealthNet coverage because you do not meet the community engagement requirements, you will not be eligible to receive advanced payments of the premium tax credit (APTC) and the premium tax credit (PTC) used to pay for coverage through the Health Insurance Marketplace.
What should I do now?
If you think you may need to complete community engagement activities to maintain your MO HealthNet coverage after January 1, 2027 you should begin to identify activities that you will perform.
These activities include:
- Paid or unpaid work
- Going to school or job training
- Taking part in an approved work program
- Volunteering with a community service program with a public or nonprofit organization
If you need help to get a job, job training, or finding a work program contact: https://mydss.mo.gov/employment-training-programs
Do I need to update my information or report community engagement activities right now?
You do not need to provide FSD any information on community engagement activities or if you are exempt from the requirements right now.
Reporting your community engagement activities or if you are exempt from the requirement will be available through the existing renewal process. Starting January 1, 2027, FSD will update renewal forms so you can report community engagement activities.
Right now, you only need to report changes that may impact your existing MO HealthNet coverage such as updating the number of people living in your household, your household income, your employment status, or contact information.
Please make sure your mailing address, phone number, and email address are up to date so you can receive future notices.
You can update your information or report a change:
- Online: mydssupload.mo.gov
- Fax: 573-526-9400
- Mail: PO Box 2700. Jefferson City, MO 65102
- In Person: Visit your local Resource Center (visit dss.mo.gov/dss_map/ for locations)
Need help or have questions?
If you have questions or need help understanding this notice, contact:
Missouri DSS Family Support Division
Phone: 855-FSD-INFO (855-373-4636).
Phone Hours: Monday – Friday (8AM – 5pm)
Free interpreter services and information in other languages and formats are available at no cost. See the Multi-Language Interpreter Services and Nondiscrimination Notice. or call 855-373-4636.
For updates and more information, visit: https://mydss.mo.gov/hr1
Legal Information
Federal law created community engagement requirements for some adults enrolled in Medicaid expansion programs. This notice is being provided in accordance with federal Medicaid regulations and guidance issued by the Centers for Medicare & Medicaid Services (CMS).
Sincerely,
Missouri Department of Social Services
Family Support Division