The purpose of the Medical Assistance (MA) program is to provide medical care for those aged, blind and disabled persons who do not qualify for cash benefits under any of the existing programs administered by the Family Support Division.  The program was developed to offer medical services to aged, blind and disabled adults who are not eligible for State Supplemental Payments, Supplemental Aid to the Blind Payments, or Supplemental Nursing Care Payments.  Persons eligible for one of these programs will automatically be eligible for Title XIX (Medicaid).  Persons eligible for Blind Pension are automatically eligible for state funded medical coverage.

Effective August 13, 1988, the Missouri General Assembly authorized Medical Assistance benefits for disabled children (MADC) under age 18 if they meet the December 1973 eligibility requirements for PTD.  Eligibility requirements for MADC are the same as those for other disabled individuals, except that income and resources of the disabled child’s parents are deemed in certain circumstances.


Refer to the end of this chapter for individuals who may be eligible under the following programs:

  1. Qualified Disabled and Working Individuals (QDWI).  Certain disabled and working individuals may be eligible to have their Medicare Part A (Hospital Insurance) premium paid.
  2. Qualified Medicare Beneficiary (QMB) program.  Payment of Medicare premiums, coinsurance and deductibles for certain Medicare beneficiaries.
  3. Specified Low-Income Medicare Beneficiary (SLMB) program.  Payment of the Medicare Part B premium for certain Medicare beneficiaries.
  4. Qualifying Individuals (QI).  Payment of the Medicare Part B premium for certain Medicare beneficiaries.
  5. Section 1619 A and B Cases.  Certain disabled individuals who lose their SSI benefits due to employment may retain Medicaid non-spend down eligibility.

    NOTE:  Contact IM Program and Policy to determine 1619 status before closing an MA case where a SSI claimant becomes employed.

  6. Medical Assistance for Workers with Disabilities (MA-WD).

0800.005.00  LEGAL BASIS

IM-69  June 27, 2005, IM-70  July 29, 2004, IM-114 August 22, 2003, IM-119 September 20, 2002

The legal basis for the administration of this program and the determination of eligibility of individuals for the program is set forth in Section 208.010, Eligibility for Public Assistance--Means Test:

In determining the eligibility of a claimant for public assistance under this law, it shall be the duty of the division of welfare to consider and take into account all facts and circumstances surrounding the claimant, including his living conditions, earning capacity, income and resources, from whatever source received, and if from all the facts and circumstances the claimant is not found to be in need, assistance shall be denied . . .

The legal basis for the administration of the Medical Assistance Program is contained in Section 208.151 through Section 208.215 RSMo.

Senate Bill-4, passed in the 2001 Special Legislative Session, revised Section 208.151(25) to authorize increasing Medical Assistance non-spend down income limit from SSI maximum payment level to 80% of the Federal Poverty Limit (FPL) in State Fiscal Year (FY) 2003, 90% of the FPL in FY04, and 100% of the FPL in FY05. Effective October 1, 2002, Medical Assistance non-spend down income limit was raised to 80% of the FPL for single individuals (for a married couple the SSI maximum payment level exceeded 80% of the FPL). Effective October 1, 2003 the non-spend down income limit was raised to 90% of the FPL for both single and couple cases. On July 29, 2004 the income limit was raised to 100% of the FPL effective July 1, 2004.

Senate Bill 539 (2005) changed the Medical Assistance (MA) non-spend down income limit for eligibility determinations based on old age assistance (OAA) and permanent and total disability (PTD) criteria effective August 28, 2005. There is no change in the income limit for determinations based on Aid to the Blind (AB) criteria. SB 539 also moved in the authority MA based on OAA, PTD, and AB criteria from subdivision (25) of RSMo. Section 208.151.1 to subdivision (24). The statute now sets the non-spend down income limit for determinations based on OAA or PTD at the Supplemental Security Income (SSI) payment maximum, unless a higher limit is authorized by annual appropriations. House Bill 11 (2005) appropriated funds to set the income limit at 85% of the Federal Poverty Level (FPL).