Frequently Asked Participant Questions
Spend Down Pay-in Questions
- What is spend down?
Spend down is a MO HealthNet program in which you have an amount that you must pay or reach each month before you can have MO HealthNet coverage. It is similar to an insurance premium.
- How do I pay my spend down?
There are three ways you can reach your spend down and get coverage. You must choose only 1 option.
Option 1: You may send a payment (check, money order, or cashiers check) to the MO HealthNet Division. You will have coverage for the whole month that you pay for.
Option 2: You may have your payment taken directly out of your bank account on the 10th of each month by the MO HealthNet Division to pay for your spend down for the following month. To have your payment automatically taken from your bank account you must complete the Spend Down Automatic Withdrawal Form. You must allow 30 days for the automatic withdrawal to process.
Option 3: You may get medical services to reach the spend down amount. When the cost of the services you are personally responsible for reaches your spend down amount, you must give the bills for which you are personally responsible to your eligibility specialist at your local Family Support Division office. The eligibility specialist will put your coverage for that month in the system. Coverage will start the day you reach your spend down amount. You will be responsible to pay this amount to the providers that gave you the services. For the day you reach your spend down amount, MO HealthNet will only pay for services over your spend down amount. Bills cannot be used to meet your spend down if you chose to have the payment taken from your bank account each month through automatic withdrawal.
- Do I have to pay or reach my spend down every month?
No, but you will not have MO HealthNet coverage for the months that you do not pay or reach your spend down.
- Where do I mail my spend down payment?
MO HealthNet Division
PO Box 808001
Kansas City, MO 64180-8001
You must put your MO HealthNet number (case number) on the check or money order. You should mail your payment along with the invoice stub for the month you want to pay. If you do not have the correct invoice stub to send you must write on the check or money order what month you are paying for. DO NOT SEND AN OLD INVOICE TO PAY FOR A CURRENT MONTH.
- Can I pay my spend down over the telephone using my debit card or credit card?
No, the MO HealthNet Division does not take payments over the telephone. The only way to use the payment option is to mail your payment or use automatic withdrawal. Do not take your payment to your Family Support Division eligibility specialist.
- Why is my spend down so high? Is my spend down amount correct?
If you have questions about the amount of your spend down or about why you are on the spend down program you must contact your eligibility specialist at your local Family Support Division office. The eligibility specialists determine MO HealthNet eligibility and spend down amounts.
- If I notify my eligibility specialist that I met spend down, do I also have to mail a payment to the MO HealthNet Division?
No, you have a CHOICE each month in how you want to pay your spend down.
The participant may choose to meet their spend down by either of the following options:
- submitting incurred medical expenses not subject to payment by a third party to the Family Support Division (FSD);
- paying their monthly spend down amount to the MO HealthNet Division (MHD).
- submitting incurred medical expenses not subject to payment by a third party to the FSD and paying in the remainder of their spend down amount to the MHD Premium Collections;
Reminder: You cannot use bills to meet your spend down if you have selected automatic withdrawal as the way to pay your spend down.
- Where do I call or write to see if my spend down payment was received or if I have questions?
MO HealthNet Division
Premium Collections Unit
PO Box 6500
Jefferson City, MO 65102
- How do I sign up for automatic withdrawal?
You need to complete a Spend Down Automatic Withdrawal Form. Mark the box that says START, complete and sign the form, attach a voided check, and return the form to the address indicated. When you start or change automatic withdrawal, please allow 30 days for the automatic withdrawal form to be processed. You will continue to receive monthly spend down invoices until the automatic withdrawal is effective. While you continue to receive a spend down invoice you must send a payment for that month or get medical services and take the bills to your eligibility specialist. You must do this until the automatic withdrawal becomes effective. Once effective, you will get a reminder each month that the payment was taken from your bank account. Reminder: You cannot use bills to meet your spend down once the automatic withdrawal process begins.
- If I sign up for automatic withdrawal when is the spend down payment taken out?
The automatic withdrawals are done on the 10th of each month for the next month’s spend down. For example, on April 10, the automatic withdrawal will be done for May’s spend down payment.
- If my payment is made by automatic withdrawal what do I do if I change banks or accounts?
You should complete the Spend Down Automatic Withdrawal Form. Mark the box that says CHANGE, complete and sign the form, attach a voided check for your new bank account, and send it to the address on the form. You should allow 30 days for the change to take place. If you have questions about the change call the Premium Collections Unit at 1-877-888-2811.
- If my payment is made by automatic withdrawal, do I need to complete the Automatic Withdrawal Authorization form each month?
No. Once you sign up for automatic withdrawal you only need to send an Automatic Withdrawal Authorization form to change your account or to stop the automatic withdrawal. If you stop automatic withdrawal or it stops because of a change in your eligibility, you need to send a new form to start it again.
- What happens if I don't have sufficient funds in my bank account to cover the automatic withdrawal?
It is your responsibility to make sure you have enough money in your bank account to cover your automatic withdrawal. When your payment is insufficient, you will receive an insufficient funds notice explaining you must send either a money order or cashier’s check to cover your payment. You will not have coverage until you make your payment. A personal check can not be accepted to cover an insufficient fund.
- What happens if I don't have sufficient funds in my bank account to cover my check?
It is your responsibility to make sure you have enough money in your bank account to cover your check. When your check is returned due to insufficient funds, you will receive an insufficient funds notice explaining you must send a money order or cashier’s check to cover your payment. You will not have coverage until you make your payment. A personal check will not be accepted to cover an insufficient fund. You cannot submit bills for coverage in the same month you have an insufficient check.
- What should I do if I sent a payment for my spend down and also paid for services that same month or am getting a bill?
The MO HealthNet Division cannot refund your payment. You must go to the provider you got the services from. If MO HealthNet covers the medical services you paid for, you should contact the provider to let them know you have MO HealthNet. You can ask the provider if they will refund the payment to you and bill MO HealthNet for the services. It is the provider’s choice to refund the money to you and bill MO HealthNet. YOU CANNOT USE PARTIAL BILLS AND PARTIAL PAYMENT TO MEET YOUR SPEND DOWN.
When you receive a bill from a medical provider and were MO HealthNet eligible for the dates of service on the bill, you must let the provider know that you were MO HealthNet eligible and ask them to bill MO HealthNet.