Spend down your income to activate MO HealthNet (Medicaid) coverage
What is Spend Down?
Spend Down is a way for people who are age 65 or older, blind, or disabled to receive MO HealthNet health coverage even if their income is slightly more than the program’s income limit. If you have Spend Down, use these tips to keep your monthly coverage active.
How does Spend Down work?
If your monthly income is over the MO HealthNet income limit, you can “spend it down” by making a payment or by submitting medical bills. This is called meeting your spend down. Once you’ve met it, your coverage is activated for that month. Your activated MO HealthNet coverage will pay for medical care you receive for the rest of that month. You do not have to activate your coverage every month. Some people only activate their coverage for the months when they know they need to get healthcare services, such as a doctor visit or a procedure.
There are 2 ways to spend down each month
When you’re approved for Spend Down, you’ll start getting a monthly invoice listing the amount you need to spend down to make coverage active for that month. To meet your Spend Down, you can:
Make a payment
To pay for certain months you want active coverage, pay online: mymohealthnetportal.com
If you want active coverage for every month, sign up for automatic withdrawal from your bank account.
You can mail a check or money order, but this is the least reliable way to pay. Send payment to:
MO HealthNet Division – Premium Collections Unit – P.O. Box 808001- Kansas City, MO 64180-8001
If you pay by check or money order, mail it at least 14 days before they’re due. In the memo line, write your DCN and the month you’re paying for. It will apply for the next month unless you specify differently.
Submit medical bills
You can submit copies of medical bills showing the amount you’re responsible for paying. The total amount must be as much as (or more than) your Spend Down amount. To submit bills, you can:
*Bring them to your local FSD Resource Center
*Fax them to: 1-855-600-3754
*Email them to: sesd@ip.sp.mo.gov
You can submit medical bills that you’ve already paid, and ones that you haven’t yet paid. The bills must show the amount that you’re responsible for paying. For example, if Medicare or another program pays part of the bill, submit proof of the amount you owe after they have paid their share.
If your spouse is also on Spend Down coverage, you can submit your spouse’s medical bills to help meet Spend Down for yourself or your spouse.
What medical bills can count toward your Spend Down?
To show the FSD how much you are spending down your income, each bill you submit must list certain things. Wait to get a bill that shows how much Medicare or any other insurer paid. That’s the bill you can submit.
Medical bills you submit for Spend Down must show these 7 things:
- Your name (patient name)
- Date of medical service
- Type of medical service
- Total charge
- Amount that Medicare or any other program or insurer has paid, if any
- Amount of insurance write-off (discount), if any
- Total amount you are responsible for paying
Bills you can submit include those for prescription medicines, eye care and dental care services, hospital services including emergency department services, and doctor visits.
What if I don’t have enough bills to meet Spend Down this month?
If you don’t have enough medical bills to meet your Spend Down in a single month, you can combine bills from different months – this is called carryover.
Carryover lets you submit medical bills for healthcare services you got in the current month or any of the 3 previous months. You can submit the bills and apply them to activate your MO HealthNet coverage for the current month or any of the next 3 months.
Need more help?
Find free, virtual or in-person help from a trained assister near you.
Visit covermissouri.org or call 800-466-3213 to set up an appointment.
Comments 20
Sandra Kruse
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Daphne Phillips
Great information given.Keep those receipts people. If possible, use a spreadsheet. Don’t know or unsure about how to log or spreadsheets, check out your local library on classes or assistance. Donna at the Florissant Valley library is great! 🙂
redie
very good data and info
Brenda Morgan
It is very confusing trying to find what insurance is good for you after they explain it to me I still have a hard time I just keep what I already had. The information was very helpful.
Kathleen Collins
I am quite familiar; I assist my sister on my laptop with her payments.
Carlyn Webber
Very helpful information!
Janet Ward
Thank you for making it easy to understand. I have a good understanding of spenddown.
Robert England
Great to know.
matias rodriguez
thanks for the inforrmation but i do not understand how to use other money than my social security money, that is all what i get.. God bless you all…
Aging Ahead
Please contact our Community Options Department at 636-207-0847 and they will be able to hemp you with your question.
Kenneth Lee
Im totally disabled and only 57 i had full services from 2015 till 2025 then got cut off. I had a nurse 3 times a week. This kept me from having to go to emergency room or to drs as much. I had cleaning services 3 times a week 4hrs a day they helped with laundry and every day chores that im unable to do. Now they say I have to pay $311 a month to continue services. By the time I pay my rent and power internet and phone car insurance and buy my ucentials for home toilet paper laundry soap and etc. I have $150 to buy gas for drs and other appointments. So here I sit no services and no way to get them back unfortunately. Im not sure what to do.
Aging Ahead
Please reach out to our Community Options Department to get some information. (636) 207-0847
Aging Ahead
Please reach out to our Community Options Department at (636) 207-0847.
Robin Meeks
Please help me Iam disabled an was on mo net was getting help with paying the 187.00 a month now I don’t I can barely make it at all. I have no heat now my lights getting close to shut off my rent will be behind soon Iam disabled by social security an lost my help because I don’t understand paperwork since my last stroke I had I make 890.00 a month an it takes more than what I make to live I need help to get mo net back k. I can’t get food either .
Aging Ahead
I will pass this along to our Community Options Specialist and they will be in touch. (636) 207-0847
Aging Ahead
I have sent your information to our Community Options department, here is the number to their department 636-207-0847 in St. Louis County. They can help direct you.
Karen Falconer
I have a $728 spend down! Help how am I suppose to pay$ 728 and have money to live on?
Aging Ahead
Please reach out to one of our Community Options Specialists to get help. 636-207-0847
Marguerite A Kuckenbaker
I have a spendown of 395.00. I recently rented an apartment. They calculated my rent according to my spendown expenses so my rent is lower. Do I have to continue paying the spendown to qualify for lower rent. I am asking because I read here that you can submit the bills toward your monthly spendown
Aging Ahead
Someone from our Community Options Department will be reaching out to you, if you need immediate assistance please contact them at 636-207-0847.