Start date
January 1, 2027
Coverage group
MO HealthNet Adult Expansion Group
Qualifying activity
Generally 80 hours in one month or another pathway
Who may be affected?
The new requirements may apply if you:
- Are age 19 through 64; and
- Receive MO HealthNet through the Adult Expansion Group (AEG).
They do not apply to children, adults age 65 or older, or people who receive MO HealthNet through a different coverage group.
When do the requirements begin?
January 1, 2027. Missouri is also moving AEG members to eligibility reviews every six months. FSD will contact you if it needs information or action from you.
How can you meet the requirements?
If the requirements apply to you, qualifying pathways may include:
- Paid work or self-employment;
- Unpaid work, volunteer work or community service;
- Participation in a qualifying work program;
- School, education or training;
- A combination of qualifying activities; or
- Enough countable monthly income to meet Missouri’s standard.
Missouri’s current guidance says that 80 hours of qualifying activity in one month can satisfy the requirement. Attending school at least half-time can also satisfy it. The income standard is tied to the federal minimum wage and may change.
You may qualify for an exemption
You do not have to meet the Community Engagement Requirements if FSD confirms that an exemption or another exclusion applies to you.
Examples of possible exemptions
- Pregnancy or MO HealthNet postpartum coverage;
- Medicare Part A or Part B;
- Former foster youth under age 26 who meet the federal definition;
- American Indians or Alaska Natives who meet the federal definition;
- A 100% disability rating from the U.S. Department of Veterans Affairs;
- Medical frailty or special medical needs that greatly limit qualifying activity;
- Participation in a drug or alcohol treatment and rehabilitation program;
- Being a parent, guardian or caretaker of a dependent child age 13 or younger;
- Being a qualifying family caregiver for a person with a disability;
- Meeting Temporary Assistance work requirements;
- Being subject to a SNAP work requirement in a household receiving SNAP; or
- Current or recent incarceration during the applicable period.
A diagnosis alone does not automatically qualify someone for an exemption. FSD must confirm that a physical, mental, behavioral health, intellectual, developmental or serious medical condition greatly limits the person’s ability to meet the requirements.
What should you do now?
- Keep your information up to date. Make sure Missouri DSS has your current mailing address, phone number and email address.
- Open every notice. Read letters and electronic messages from Missouri DSS and follow the instructions.
- Learn whether the rules may apply. Use Missouri’s screening tool as a guide. It does not make an official eligibility decision.
- Keep records. Save information about work, school, training, volunteer service, program participation, income or a possible exemption.
- Follow every deadline. Respond by the deadline if FSD asks for information. Do not send records until FSD requests them.
Get official Missouri information
Use these Missouri Department of Social Services resources for current requirements and instructions.
Need help finding information?
Centerstone Navigators across Missouri can help you find information and resources. In some cases, they may be able to help you understand whether the requirements may apply or help you submit documents requested by the state.
Ask your Centerstone provider to connect you with a Navigator. Centerstone cannot make an official Medicaid eligibility or exemption decision.
Important: This page provides general information and is not an eligibility determination or legal advice. Rules and implementation details can change. Follow notices from Missouri DSS and use the official resources above for the latest information. Last reviewed September 2026.
