Mo 886 3846 7 15-2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering your personal information in the 'Applicant Name' section, including your first, middle, and last name.
  3. Fill in your address details accurately, ensuring to include house number, street or rural route, and city, state, and ZIP code.
  4. Provide your home and work phone numbers in the designated fields for easy contact.
  5. In the section regarding household members, list all individuals living with you along with their names, relationships, and other required details.
  6. Answer eligibility questions regarding citizenship status and residency in Missouri by selecting 'YES' or 'NO' as applicable.
  7. Complete the income sections by detailing employment status for yourself and others in your household. Include amounts earned before deductions.
  8. Review all entries for accuracy before signing at the bottom of the form to certify that all information is true and complete.

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Apply through the online portal. Apply by phone at 855-373-9994.
When applying, you will need the following items: Identification (ID) that includes your name, photo, and date of birth. Proof of all income (example: wage stubs, Social Security award letter, tax returns) Information or the insurance cards on health insurance you or your family already have.
Create an account with the Health Insurance Marketplace and fill out an application. If it looks like anyone in your household qualifies for Medicaid, your information will be sent to your state agency. They will contact you about enrollment.

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