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More people now eligible for state health insurance

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Missouri’s voter-approved Medicaid health insurance expansion is finally underway, which means some low-income college-age people, single adults and families can be treated for their health and medical issues by a provider or in a hospital at little or no cost. 

Medicaid is a federal and state program that helps people with limited income and resources with their health care costs. Before Missouri voters passed a constitutional amendment in August 2020 to allow more people to be covered, the people who qualified for the program included pregnant women, children, someone responsible for a child under 19, someone with a disability or caring for a disabled family member, or people 65 years or older. 

With the expansion, adults aged 19 to 64 at certain income levels are now eligible for health insurance under MO HealthNet, which is Missouri’s Medicaid program. This includes parents who have not qualified before, as well as adults without children.

Enrollment for coverage is currently open, and Tracy Ward, patient financial advisor at Bothwell Regional Health Center, has been busy helping patients in both the hospital and in Bothwell’s clinics apply for benefits.

“I submit at least 10 applications a week for Bothwell patients,” Ward said. “If a patient is in the hospital and doesn’t have insurance, either a social worker or I will visit them in their room to learn more about their financial situation and help them apply for Medicaid and other financial assistance.” 

People do not have to be uninsured to qualify for Medicaid expansion coverage; benefits can be secondary to any other health care coverage an individual has. Ward said eligibility for the expanded group is determined by the number of people in a household and income guidelines.

“The basic guidelines are that you must be a Missouri resident with a Missouri address or a qualified non-citizen and make less than the annual income limit for their household size,” she said. “In 2021, that amounts to about $17,774 for a single individual and $36,570 for a household of four.”

According to Missouri Hospital Association estimates, 42% of the uninsured in Pettis County would qualify for Medicaid under the new rules. Steve Davis, Bothwell’s chief financial officer, said people who have insurance coverage have more options for care.

“We know that people who have insurance are more likely to seek treatment in places other than the Emergency Department,” Davis said. “With expanded Medicaid coverage, those who are uninsured or under-insured can feel comfortable in establishing a relationship with a primary care provider and have access to routine checkups, early detection tests and screening and be treated for their medical conditions.” 

In addition to Medicaid health insurance, MO HealthNet includes at least nine other health care-related programs. Ward said the state’s application process has been streamlined to determine eligibility for all MO HealthNet programs, not just Medicaid expansion.  

“So, rather than someone applying and being denied for expansion coverage and giving up, the new application determines eligibility for all programs,” she said. “Someone may qualify for coverage through one of the other programs.”

People can apply for Medicaid expansion and other MO HealthNet programs in a variety of ways including online at mydss.mo.gov/healthcare/apply, by calling 855-373-9994 from 7 a.m. to 6 p.m. Monday through Friday or by submitting a paper application at the local Department of Social Services.

Ward is also available to answer questions and help someone complete the application.

“People can call me at the hospital at 660-827-9335, and I can help them do an online or paper application over the phone or in person. It takes about an hour depending on a person’s household and income situation,” she said. “This expansion is going to do great things for the people who are eligible and their ability to obtain quality health care if we can just get them to apply for coverage.”

Ward said many people wait to get treatment because they don’t have insurance, think they make too much money to qualify or don’t think they will receive the same quality of care as someone with private insurance when applying for Medicaid.

“Currently, people without insurance wait too long to seek treatment for chronic diseases and finally go to the Emergency Department after the symptoms become unbearable. Had they had coverage, they may have sought treatment sooner, resulting in better outcomes,” she said. “The different programs offered through MO HealthNet are quality programs that help Missourians get the health care that a lot of them so desperately need to maintain good health. My best advice to anyone who does not have insurance or enough insurance is to just apply.”

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