MedicaidAdministrativeLow impact
Pharmacy Services for Participants with Presumptive Eligibility
Missouri Medicaid (MO HealthNet)·MO·Pharmacy
Effective date
Dec 22, 2021
We identified it
Jun 20, 2026
Summary
MO HealthNet will reimburse pharmacy services for participants with presumptive eligibility during their active eligibility period. Pharmacy providers must verify eligibility dates on PE-3 or SMHB-PE authorization forms and maintain photocopies for documentation.
Action Required
For Missouri practices with pharmacy services: Verify eligibility dates on MO HealthNet PE-3 and SMHB-PE authorization forms before dispensing medications. Maintain photocopies of authorization forms in pharmacy files for eligibility documentation. Contact Pharmacy Administration at (573) 751-6963 with questions.