Missouri Medicaid Eligibility Calculator

Missouri Medicaid (MO HealthNet) Eligibility Calculator

function calculateEligibility() { var monthlyIncome = parseFloat(document.getElementById('monthlyIncome').value); var householdSize = parseInt(document.getElementById('householdSize').value); var applicantAge = parseInt(document.getElementById('applicantAge').value); var isPregnant = document.getElementById('isPregnant').checked; var isParentGuardian = document.getElementById('isParentGuardian').checked; var isBlindDisabled = document.getElementById('isBlindDisabled').checked; var resultDiv = document.getElementById('result'); var message = ""; // Validate inputs if (isNaN(monthlyIncome) || monthlyIncome < 0) { resultDiv.innerHTML = "Please enter a valid positive number for Monthly Household Income."; return; } if (isNaN(householdSize) || householdSize < 1) { resultDiv.innerHTML = "Please enter a valid household size (at least 1)."; return; } if (isNaN(applicantAge) || applicantAge < 0) { resultDiv.innerHTML = "Please enter a valid age for the primary applicant."; return; } // 2024 Federal Poverty Level (FPL) guidelines (monthly, approximate) // Source: Based on HHS FPL 2024, divided by 12. var fplData = [ 0, // Index 0 unused 1255, // 1 person 1703, // 2 people 2152, // 3 people 2600, // 4 people 3048, // 5 people 3497, // 6 people 3945, // 7 people 4393 // 8 people ]; var baseFPL; if (householdSize <= 8) { baseFPL = fplData[householdSize]; } else { // For household sizes greater than 8, add $448 for each additional person baseFPL = fplData[8] + (householdSize – 8) * 448; } var eligible = false; var programType = "General MO HealthNet"; var incomeLimit = 0; // MO HealthNet for Kids (Children 0-18) and Pregnant Women: up to 196% FPL var childPregnantLimit = baseFPL * 1.96; // MO HealthNet for Adults (19-64, non-disabled, non-pregnant): up to 138% FPL (includes 5% income disregard) var adultLimit = baseFPL * 1.38; // Determine the most favorable income limit based on applicant's situation if (isPregnant) { incomeLimit = childPregnantLimit; programType = "MO HealthNet for Pregnant Women"; if (monthlyIncome <= incomeLimit) { eligible = true; } } else if (applicantAge < 19) { incomeLimit = childPregnantLimit; programType = "MO HealthNet for Kids"; if (monthlyIncome = 19 && applicantAge <= 64) { incomeLimit = adultLimit; programType = "MO HealthNet for Adults"; if (monthlyIncome 64) { // Aged, Blind, Disabled (ABD) programs have different rules, often asset-based incomeLimit = adultLimit; // Use adult limit as a general reference, but note ABD programType = "MO HealthNet for the Aged"; if (monthlyIncome = 19 && applicantAge <= 64) { incomeLimit = adultLimit; programType = "MO HealthNet for Parents/Caretaker Relatives"; if (monthlyIncome <= incomeLimit) { eligible = true; } } message += "Based on your input:"; message += "Your Monthly Household Income: $" + monthlyIncome.toLocaleString() + ""; message += "Your Household Size: " + householdSize + ""; message += "Your estimated monthly income limit for " + programType + " is approximately: $" + incomeLimit.toLocaleString(undefined, {minimumFractionDigits: 2, maximumFractionDigits: 2}) + ""; if (eligible) { message += "You likely qualify for MO HealthNet under the " + programType + " program!"; } else { message += "Based on your income, you may not qualify for MO HealthNet under the " + programType + " program."; } if (isBlindDisabled) { message += "Since you indicated the applicant is blind or disabled, you may qualify for MO HealthNet for the Aged, Blind, and Disabled (MHABD) programs, which have different income and asset rules. It is highly recommended to apply directly or contact MO HealthNet for a full assessment."; } if (applicantAge > 64 && !eligible) { message += "Since the applicant is over 64, they may qualify for MO HealthNet for the Aged, Blind, and Disabled (MHABD) programs, which have different income and asset rules. It is highly recommended to apply directly or contact MO HealthNet for a full assessment."; } message += "This calculator provides an estimate based on common MAGI-based eligibility criteria and 2024 FPLs. Actual eligibility depends on a full application and review by the Missouri Department of Social Services. Other factors like residency, citizenship, and specific program rules apply."; resultDiv.innerHTML = message; }

Understanding Missouri Medicaid (MO HealthNet) Eligibility

MO HealthNet is Missouri's Medicaid program, providing healthcare coverage to eligible low-income individuals and families. Eligibility for MO HealthNet is determined by several factors, including household income, household size, age, pregnancy status, and disability status. This calculator helps you estimate your potential eligibility based on the most common criteria.

Key Eligibility Factors

The primary factor for most MO HealthNet programs is your Modified Adjusted Gross Income (MAGI) compared to the Federal Poverty Level (FPL). Different groups have different income thresholds:

  • Adults (ages 19-64): Generally, adults may qualify if their household income is up to 138% of the Federal Poverty Level (FPL). This includes a 5% income disregard.
  • Children (ages 0-18): Children typically have higher income limits, often qualifying with household incomes up to 196% of the FPL.
  • Pregnant Women: Pregnant individuals also have higher income limits, often up to 196% of the FPL.
  • Parents/Caretaker Relatives: Eligibility for this group generally falls under the adult expansion criteria if they are not otherwise eligible.
  • Aged, Blind, and Disabled (ABD): Individuals who are aged (65+), blind, or disabled may qualify for MO HealthNet for the Aged, Blind, and Disabled (MHABD) programs. These programs have different income and asset limits, which are often more complex and not fully covered by this MAGI-based calculator.

How the Calculator Works

Our Missouri Medicaid Eligibility Calculator uses your provided monthly household income, household size, and other demographic information to compare against the current Federal Poverty Level (FPL) guidelines for Missouri. It then applies the relevant income thresholds for different MO HealthNet programs (e.g., 138% FPL for adults, 196% FPL for children and pregnant women) to give you an estimated eligibility status.

Important Considerations

  • FPL Guidelines: The Federal Poverty Level (FPL) guidelines are updated annually. This calculator uses approximate 2024 FPL figures.
  • MAGI Rules: MO HealthNet primarily uses Modified Adjusted Gross Income (MAGI) rules for most eligibility determinations. MAGI considers taxable income and certain deductions.
  • Assets: For most MAGI-based MO HealthNet programs (adults, children, pregnant women), asset limits are generally not a factor. However, for MO HealthNet for the Aged, Blind, and Disabled (MHABD) programs, asset limits do apply.
  • Other Factors: Beyond income, eligibility also depends on factors like Missouri residency, U.S. citizenship or qualified immigration status, and not being incarcerated.
  • Official Application: This calculator provides an estimate only. To determine your definitive eligibility and apply for MO HealthNet, you must submit an official application through the Missouri Department of Social Services (DSS) or the Health Insurance Marketplace.

Disclaimer

This calculator is for informational purposes only and should not be considered a guarantee of eligibility. MO HealthNet rules can be complex and are subject to change. Always refer to the official Missouri Department of Social Services resources or contact them directly for the most accurate and up-to-date information regarding your specific situation.

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