Missouri runs a Medicaid program called MO HealthNet, which offers health coverage for residents who qualify. In 2025-2026, your eligibility depends on how much income your household has, your family size, and what category you fall into (adult, child, pregnant, or disabled).
Below, you’ll find the latest income limits, who is already enrolled, and how you can apply.
What MO HealthNet Covers & Who It Helps
MO HealthNet offers coverage for:
- Doctor, hospital, and emergency care
- Mental health and substance use services
- Prescriptions
- Preventive and maternity care
- Long-term supports and nursing home care
Eligible groups include:
- Adults (ages 19–64) under expansion rules
- Pregnant individuals
- Children and youth
- Persons with disabilities
- Seniors needing institutional care
After Missouri expanded Medicaid, many more adults can now get covered under MO HealthNet.
Missouri 2025 Income Limits by Program & Household Size
These income thresholds come from the official MyDSS Benefit Program Income Limits chart: myDSS Benefit Program Income Limits
| Program / Eligibility | Household Size 1 | Household Size 4 | Notes |
| Expansion Adults | $20,814 | $42,759 | 133% of FPL band |
| MO HealthNet for Kids (infants) | $30,674 | $63,014 | ~196% of FPL for infants |
| MO HealthNet for Kids (age 1–18) | $23,162 | $47,582 | ~148% of FPL |
| MO HealthNet for Pregnant Women | $30,674 | $63,014 | Same as infant band |
| Aged & Disabled (non-MAGI) | $13,303 | $27,328 | ~85% of FPL for non-MAGI program |
| MO HealthNet for Families (non-expansion) | $1,692/month | $4,236/month equivalent | MAGI-based family program |
These caps reflect annual gross income (before deductions). Missouri uses MAGI for many eligibility calculations.
Program Breakdown: Who Qualifies Under What Rules
Here’s how different eligibility categories in MO HealthNet work:
| Category / Group | Threshold or Rule |
| Adults (Expansion) | Up to 133% of FPL; use the expansion cap |
| Children / Kids | Higher limits than adults; infants ~196%, older kids ~148% |
| Pregnant Individuals | Held to the same 196% of FPL cutoff |
| Aged / Blind / Disabled (non-MAGI) | Apply separate rules with lower incomes |
| Long-Term Care / Institutional | Income often must go toward care; asset limit in place |
If your income is above the standard limit, you may qualify via spend-down / medically needy options, medical expenses reduce countable income to the eligible range.
Enrollment Snapshot (2025)
MO HealthNet enrollment data provide a real-world look at who’s covered. The DSS Caseload Counter tracks this regularly: DSS Caseload Counter History
| Category | Enrollment (Approx.) | Period |
| Total MO HealthNet | 1,245,906 | May 2025 |
| Persons with Disabilities | 120,858 | May 2025 |
| Seniors / Elderly (65+) | 95,944 | May 2025 |
| Adult Expansion Group | ~342,395 | October 2025 (latest snapshot) |
These figures include all categories: expansion, children, aged, disabled, pregnant, and more.
Eligibility Beyond Income
Income is essential but not the only factor:
- Must reside in Missouri
- Must be U.S. citizen or qualified immigrant
- For aged / disable / institutional care: meet asset limits (for 2025: $6,068.80 for single)
- For long-term care: pass a functional needs test
- Spend-down / medically needy rules allow some with higher income to qualify
Programs that use MAGI (like expansion adults, children, pregnant) do not impose asset caps.
How to Apply for MO HealthNet
You can apply using any of these methods:
- Online: Use myDSS, Apply for Healthcare in Missouri
- By Mail: Send a completed application to Family Support Division
- In Person: Visit your local DSS or Family Support office
- By Phone / Assistance: Call DSS or partner organizations for help
You’ll submit proof of income, identity, Missouri residency, and household composition. Decisions are normally rendered within 45 days, unless additional disability review is required. In some cases, coverage may begin retroactively.
Frequently Asked Questions: Missouri Medicaid 2025
1. What is the Medicaid income limit for adults in Missouri in 2025?
Adults under expansion can qualify if their income is at or under 133% of the Federal Poverty Level. That corresponds to the official dollar caps for each household size as published by myDSS.
2. Do children qualify under higher income limits than adults?
Yes. Infants often qualify up to 196% of FPL, while older children may qualify at ~148% FPL, offering broader coverage for younger populations.
3. Are pregnant individuals held to higher thresholds?
Yes, pregnant individuals generally fall under the same 196% FPL cutoff used for infants, securing access to prenatal and postpartum care.
4. What if my income is slightly above the limit?
You may still be eligible via spend-down / medically needy, where qualifying medical costs reduce your countable income below the eligibility threshold.
5. How do asset limits affect eligibility in Missouri?
For non-MAGI categories (like aged or disabled), Missouri enforces resource limits (e.g., $6,068.80 for a single applicant in 2025). Surplus assets must be reduced or placed in exempt accounts.
6. What about long-term care eligibility?
While MO HealthNet doesn’t have fixed income caps for institutional care, applicants must meet a functional care test, allocate most income toward care, and adhere to asset caps.
7. How soon can I get a decision after applying?
If your application is complete, MO HealthNet aims to make a determination within 45 days. Coverage may start retroactively if eligibility conditions exist.
Final Thoughts
MO HealthNet is Missouri’s vital health coverage option for individuals and families across a range of needs. Understanding the 2025-2026 income limits and enrollment landscape empowers you to see if you or loved ones qualify.
Because policies and thresholds may shift, always double-check the latest figures via myDSS or the Missouri Department of Social Services. When you’re ready, gather documents like your income verification, ID, residency and apply. Health care coverage could be closer than you think.
