MO HealthNet Division

About MO HealthNet Managed Care

Missouri's MO HealthNet Managed Care is a way for you to get health care services. When you live in a MO HealthNet Managed Care area, you choose a MO HealthNet Managed Care health plan. You will get health care services through your MO HealthNet Managed Care health plan. If you need help choosing a MO HealthNet Managed Care health plan, call the MO HealthNet Managed Care Enrollment Helpline, 1-800-348-6627. The MO HealthNet Managed Care Enrollment Helpline is open from 8 a.m. to 5 p.m. Monday through Friday (except holidays). When choosing a MO HealthNet Managed Care health plan, you want to think about the doctors, hospitals, clinics and pharmacies you use now.

Important note:If you are approved for the MO HealthNet Managed Care Program you will receive an enrollment form in the mail. You must choose a MO HealthNet Managed Care health plan by the date shown on the enrollment form. Your completed enrollment form must reach us by the date on the enrollment form, or you can call the MO HealthNet Managed Care Enrollment Helpline at 1-800-348-6627 before that date to make your choice.

If you do not choose a MO HealthNet Managed Care health plan by the date shown on your enrollment form, one will be chosen for you. Once you make your MO HealthNet Managed Care health plan choice, you will get a confirmation letter in the mail telling you when your services will begin. You must also choose a Primary Care Provider (PCP). Your Primary Care Provider may be a doctor, nurse practitioner or a clinic in your MO HealthNet Managed Care health plan. You will call your Primary Care Provider when you need health care services unless it is an emergency.

If you are approved for the MO HealthNet Managed Care Program you will receive an enrollment form in the mail. You must choose a Primary Care Provider. If you do not have a Primary Care Provider chosen you may call the MO HealthNet Managed Care Enrollment Helpline for help. The provider you choose must be in the MO HealthNet Managed Care health plan you choose. If you need help choosing a Primary Care Provider, you can call the MO HealthNet Managed Care Enrollment Helpline at 1-800-348-6627. If you need to change your Primary Care Provider, please call your MO HealthNet Managed Care health plan.

Advocates for Family Health

Advocates for Family Health is an ombudsman service. An ombudsman is a problem solver who can advise you and help you. Advocates for Family Health can help you if:

  • You need help understanding your rights and benefits under MO HealthNet Managed Care.
  • You feel your rights to health care are being denied.
  • You are not able to solve the problem by talking to a doctor, a nurse, or your MO HealthNet Managed Care plan.
  • You need to talk to someone outside of your MO HealthNet Managed Care health plan.
  • You want help when filing a grievance.
  • You need help when appealing a decision by your MO HealthNet Managed Care health plan.
  • You need help getting a State Fair Hearing.

LEGAL SERVICES OF EASTERN MISSOURI serves the following regions/counties:

  • Eastern Region: Franklin, Jefferson, Lincoln, Madison, Perry, Pike, St. Charles, St. Francois, St. Louis, Ste. Genevieve, Warren, and Washington counties and St. Louis City.
  • Central Region: Macon, Marion, Monroe, Montgomery, Ralls and Shelby counties.
  • For help at no cost to you, call the Advocates for Family Health, Legal Services of Eastern Missouri at 314-534-1263. If calling from outside of St. Louis city or county call 1-800-444-0514. You may also write to the following address:
    • Advocates for Family Health
      Legal Services of Eastern Missouri
      4232 Forest Park Avenue
      St. Louis, MO 63108

LEGAL AID OF WESTERN MISSOURI serves the following regions/counties:

  • Western Region: Bates, Cass, Clay, Henry, Jackson, Johnson, Lafayette, Platte, Ray, St. Clair and Vernon counties.
  • Central Region: Benton, Camden, Linn, Morgan, Pettis and Saline counties.
  • For help at no cost to you in Clay, Jackson and Platte counties, call 816-474-6750. If calling from Benton, Camden, Cass, Henry, Johnson, Lafayette, Morgan, Pettis, Ray, Saline or St. Clair counties call 1-800-892-2943. If calling from Bates or Vernon counties, call 1-800-492-7095. If calling from Linn county, call 1-800-892-2101. You may also fax us at 816-474-9751 or write to the following address:
    • Advocates for Family Health
      Legal Aid of Western Missouri
      1125 Grand Boulevard, Suite 1900
      Kansas City, MO 64106

MID-MISSOURI LEGAL SERVICES serves the following regions/counties:

  • Central Region: Audrain, Boone, Callaway, Chariton, Cole, Cooper, Howard, Miller, Moniteau, Osage and Randolph counties.
  • For help at no cost to you, please call 573-442-0116 or 1-800-568-4931. You may also fax us at 573-875-0173 or write to the following address:
    • Advocates for Family Health
      Mid-Missouri Legal Services
      205 E. Forest Avenue
      Columbia, MO 65203

LEGAL SERVICES OF SOUTHERN MISSOURI serves the following regions/counties:

  • Central Region: Gasconade, Laclede, Maries, Phelps and Pulaski counties.
  • Western Region: Cedar and Polk counties.
  • For help at no cost to you, please call 417-881-1397 or toll free at 1-800-444-4863. You may also fax us at 417-881-2159 or write to the following address:
    • Advocates for Family Health
      Legal Services of Southern Missouri
      2872 South Meadowbrook
      Springfield, MO 65807

Important Facts About MO HealthNet Managed Care

  • Your Primary Care Provider may be a nurse practitioner, doctor or clinic in your MO HealthNet Managed Care health plan. If you have a chronic illness, your Primary Care Provider may be a specialist.
  • If you or your child gets sick, you must first call your Primary Care Provider unless it is an emergency. In an emergency, you do not need to call your Primary Care Provider first. Go to the nearest emergency room or call 911.
  • If you need a specialist, in most cases, your Primary Care Provider must refer you.
  • You do not need a referral for family planning services; you may use a MO HealthNet Managed Care health plan provider or a MO HealthNet Fee-for-Service approved provider.
  • Show your MO HealthNet Managed Care health plan card and your red or white MO HealthNet Managed Care card when getting health services. If you lose your MO HealthNet Managed Care health plan card, call your health plan.
  • To make a grievance or appeal, call or write your MO HealthNet Managed Care health plan.
  • If your address or phone number changes, call your local FSD Eligibility Specialist or call the MO HealthNet Managed Care Enrollment Helpline at 1-800-348-6627.
  • If you have a new baby, you must call your local Eligibility Specialist.
  • Call the MO HealthNet Managed Care Enrollment Helpline at 1-800-348-6627 for more information on changing health plans.
  • When you enroll in a MO HealthNet Managed Care health plan or change your MO HealthNet Managed Care health plan, you will receive a confirmation letter in the mail with your new MO HealthNet Managed Care health plan choice telling you the date you can begin getting services with your new MO HealthNet Managed Care health plan.

Applications may also be obtained at local hospitals and local public health agencies.

12/03/08