IM-15 February 24, 2023; IM-134 November 14, 2017
Individuals may apply for MO HealthNet (MHN) programs at any time by various methods.
Participants can submit an application online at https://mydss.mo.gov/.
Online applications can also be submitted for MO HealthNet using the Federally Facilitated Marketplace (FFM).
The application date for an online application is the date that the application was successfully submitted by the participant.
Participants can submit a phone application by calling the FSD Contact Center at 855-373-9994.
The application date for a phone application is the date the application is completed and a telephonic signature is captured. See 1802.020.20 Telephonic Signature.
A participant may apply by submitting a completed application form to FSD.
The Application for Health Coverage & Help Paying Costs (IM-1SSL) can be:
- Accessed online in the DSSManuals Forms Manual
- Picked up at FSD offices. Participants can find the nearest location on FSD’s website, https://dss.mo.gov/offices.htm
Note: Participants can apply for both MHN and Medicare Savings Programs (MSP) using the IM-1SSL. Participants requesting ONLY MSP must use Application for Medicare Savings Programs (IM-1MSP).
- Mailed to participants upon request for an application form. Participants may request an application form by phone or by written request.
Note: Anyone can request an application. Application requests from a third party (such as a family member, or community partner) can be sent to the participant or the third party. Do NOT provide any case-specific information about active cases or pending applications to an unauthorized third party.
An application form may be submitted:
- Online by using the FSD Upload Portal at mydssupload.mo.gov
- By mailing the form to Family Support Division, PO BOX 2700, Jefferson City, MO 65102
- By faxing the form to 573-526-9400
- In person by returning the completed form to an FSD office
When an application form is received, staff must verify the application contains a valid signature and must date stamp with the application date. For information regarding valid signatures, see 1802.020.00 Signing the Application and its subsections.
The application date for an application form is the date that the signed application form is received by FSD. If the application form is submitted on a weekend, holiday, or after business hours, the application is received as of the next business day.
FQHC, DSH, and Other Contract Agencies
Applications for MHN must be available and accepted at Federally Qualified Healthcare Centers (FQHC) and Disproportionate Share Hospitals (DSH). If a FQHC or DSH does not have FSD staff onsite, the facility’s staff is allowed to accept application forms and forward them to the local FSD office.
These same procedures apply to other facilities that contract with FSD to accept MHN applications, such as Rural Health Centers (RHC). All contracted facilities are required to send completed application forms to FSD within five (5) business days. The application date is the date the contracted facility’s staff received the application form.
Note: Not all FQHC, DSH, or RHC facilities are contracted with FSD to accept applications on behalf of FSD. If you need to verify contract status, FSD staff may send an email through normal supervisory channels to COLE.MHNPOLICY@dss.mo.gov.
In Home Request
If an application request is received and the person is unable to file an application in person, online, by telephone, or by mail, staff should consult their immediate supervisor. The supervisor should then contact the individual to discuss the need for an in-home visit. If the supervisor gives approval, staff should complete the in-home visit within one week of the request, if possible. The application date is the day FSD receives a signed application form.