Managed Care Enrollment Frequently Asked Questions
Does every eligible member of my family have to pick the same health plan?
If a member of your family is eligible for Show Me Healthy Kids (SMHK) they will be automatically enrolled. However, other family members not in SMHK can choose the health plan that best fits their individual needs.
What is the Health Risk Assessment Form?
Health Risk Assessment Forms are included in your assignment packet. The answers to the health questions will help your MO HealthNet Managed Care health plan understand your health care needs. Please fill out the form for each person in your household. You can submit the Health Risk Assessment by mail in the pre-paid envelope provided in your assignment packet or by phone.
What happens after I am approved for a Managed Care health plan?
You will receive a letter in the mail about your MO HealthNet Managed Care health plan and the date your services began. You will also receive a welcome packet with important information about your coverage from the MO HealthNet Managed Care health plan. Your health plan may also call you to ask you questions. We recommend you connect with your health plan directly once you have been enrolled with a plan. They can help you with any special medical needs or answer any specific questions you may have.
What should I do if I did not receive my assignment packet or misplaced it?
After your MO HealthNet application has been processed, you will receive a letter from the Family Support Division (FSD) letting you know if you are eligible for services through the Managed Care Program. If you are, you will be automatically assigned to a Managed Care health plan.
If you have not received an assignment packet in the mail yet, FSD may be reviewing your application.
If you have already applied for MO HealthNet, you check the status of your application online. You can also call the Family Support Division Automated Information Line 24 hours a day, 7 days a week at 1-800-392-1261.
If you have already been approved for the MO HealthNet Managed Care Program and still have not received your assignment packet in the mail, or if you have misplaced it, call the MO HealthNet Managed Care Enrollment Helpline at 1-800-348-6627. When you call the Enrollment Helpline, please have them check your mailing address to make sure the one they have is current. An old or incorrect address may be the reason you did not receive your packet.
If you are in Show Me Healthy Kids and need to report a change in your address or contact information contact your or your child’s Children’s Division case manager or subsidy case manager. If you are a former foster care youth, please email CDMHNQuestions@dss.mo.gov.
When can I start receiving services?
After you are approved and enrolled in a MO HealthNet Managed Care health plan, you will get a welcome kit in the mail about the health plan you were assigned to and the date your services began. You can start getting care once you receive your welcome kit.
Your new health plan will also send you a Managed Care health plan card. You will also get a MO HealthNet ID Card from the MO HealthNet Division (MHD). You should always carry both cards with you and show them each time you receive care. Call the phone number on your health plan card if you have any questions about your services.
If you need health care services, call your Primary Care Provider (PCP – your doctor) and they should refer you to specialists and other health services you may need.
I’ve already been enrolled with a health plan. Why did I get another packet?
You have the option to change your current MO HealthNet Managed Care health plan each year during your annual open enrollment period or if the MO HealthNet Managed Care health plan contract changes. If you are happy with your current health plan and Primary Care Provider, you do not need to do anything.
If you have questions about your annual open enrollment or if you believe you received an annual open enrollment packet in error, please contact the MO HealthNet Managed Care Enrollment Helpline at 1-800-348-6627. If you are in Show Me Healthy Kids and have questions, please call 1-877-236-1020.
I recently gave birth. Will my newborn receive Managed Care coverage? If so, how do I enroll my newborn?
The mother must notify the Family Support Division of the birth of her child by calling the Family Support Division’s Information Center at 1-855-373-4636. When a MO HealthNet Managed Care Program participant gives birth, the newborn is automatically assigned to the mother’s MO HealthNet Managed Care health plan. The mother will have 90 days from the date of birth to change the health plan for any reason.
If you are in Show Me Healthy Kids:
- Call your Children’s Division case manager
- Call Show Me Healthy Kids at 1-877-236-1020
- Call the MO HealthNet Managed Care Enrollment Helpline at 1-800-348-6627. The State will give your baby an identification number, known as a DCN, or MO HealthNet number
- Pick a PCP for your baby in the Show Me Healthy Kids network.
If your baby is enrolled in Show Me Healthy Kids, they are not able to change health plans.
Newborns born to mothers who are not in the Show Me Healthy Kids health plan but are in state care and custody are automatically assigned to SMHK.
What happens if I do not choose a Primary Care Provider (doctor)?
If you do not at first choose a Primary Care Provider (doctor), your health plan will contact you to select one. If you still do not choose, one will be chosen for you by your health plan.
What is a Federally Qualified Health Center?
You may also choose a Federally Qualified Health Center (FQHC) as your Primary Care Provider (doctor). An FQHC is a center or clinic that provides primary care and other services, such as:
- Preventive (wellness) health services from a physician, physician assistant, nurse practitioner, and/or social worker
- Mental health services
- Immunizations (shots)
- Home nurse visits
How can I enroll my child in Show Me Healthy Kids?
If you or your child is eligible for Show Me Healthy Kids, they will be automatically enrolled. Eligibility groups include:
- Children in the care and custody of the Missouri Department of Social Services
- Children or youth in alternative care
- Children receiving adoption or legal guardianship subsidy
- Former foster care youth under the age of 26, who were in foster care on their 18th birthday and covered by MO HealthNet (Missouri Medicaid), and who meet other eligibility criteria
- Former foster care youth under the age of 26, who were in foster care on their 18th birthday and covered by Medicaid from another state, and who are not currently eligible for Medicaid coverage under another program
If you are not in one of these groups or have Medicare, you cannot be in Show Me Healthy Kids.
Who do I contact if I have questions?
Visit https://dss.mo.gov/mhd/healthcare-benefit.htm or contact:
MO HealthNet Managed Care Enrollment Helpline: 1-800-348-6627
Call for help with changing a health plan or finding a primary care provider. The Enrollment Helpline is open from 7:00 a.m. to 6:00 p.m., Monday through Friday (except holidays).
MO HealthNet Participant Services Unit: 1-800-392-2161
Call for questions about eligibility, pharmacy or premium payments.
MO HealthNet Health Plans: Call if you need help finding a provider or if you have questions about your coverage or any unpaid medical bills.
|Health Plan||Contact Information|
|Home State Health||1-855-694-4663
|Show Me Healthy Kids||1-877-236-1020
Hearing or Speech Impaired
If you are deaf, hard-of-hearing, deaf-blind or have difficulty speaking, call Relay Missouri:
1-800-735-2466 (Voice) 1-800-735-2966 (Text Phone)