If so, here’s what you need to know about new Medicaid work requirements.
If you have MO HealthNet (Missouri Medicaid), you may have heard about new “work requirements.” These changes can be confusing—especially when you are already dealing with cancer treatment.
First, know this:
Receiving a letter about Medicaid work requirements does NOT mean your Medicaid coverage is ending.
Missouri is beginning to send informational notices in August and September 2026. These notices explain changes that begin January 1, 2027. You do not need to respond to this informational notice or send proof of work hours right now. Keep the letter for your records and watch for future letters from Missouri’s Family Support Division (FSD).
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What are the new Medicaid work requirements?
Beginning January 1, 2027, some adults ages 19 through 64 who receive Medicaid through Missouri’s Adult Expansion Group (AEG) will have to meet a “Community Engagement Requirement” to keep their coverage.
You may meet the requirement in different ways. For example, you may:
- Work or be self-employed
- Complete qualifying community service or volunteer work
- Take part in certain work or job training programs
- Attend school or an education program
- Combine different qualifying activities
- Have enough qualifying income
If the requirements apply to you, 80 hours in one month may be one way to meet them.
You do not necessarily have to complete 80 hours every month. Missouri will review specific months based on your situation.
Missouri’s current income amount for 2026 is $580 in one month. This may change when the new requirements begin.
Not everyone with Medicaid will have to meet these requirements.
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What if I am receiving cancer treatment?
You may not have to meet the work requirement.
Missouri exempts people who are considered medically frail or who have special medical needs that greatly limit their ability to work, attend school, train, volunteer, or participate in a work program.
A cancer diagnosis does not automatically create an exemption. Missouri must determine whether your medical condition significantly limits your ability to meet the requirement.
If you are undergoing cancer treatment or have another serious medical condition that makes it difficult or impossible for you to work or participate in qualifying activities.
Talk with your Gateway to Hope navigator and your healthcare team to ask whether you may qualify for a medical exemption.
Keep documentation about your medical condition and treatment. Missouri may ask for information if it cannot verify your exemption through its existing records. Do not send medical records unless Missouri’s Family Support Division (FSD) asks you to do so.
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Who else may be exempt?
The new requirements do not apply to everyone. Examples of people who may not have to meet them include people who:
- Are pregnant or receiving postpartum Medicaid
- Have Medicare Part A or Part B
- Are age 65 or older
- Are parents, guardians, or caretakers of a child age 13 or younger
- Are a family caregiver for a person with a disability and meet Missouri’s requirements
- Have a medical condition or special medical needs that greatly limit ability to work, go to school, train, volunteer, or take part in a work program (if you have braest cancer, this could be you.)
- Are receiving certain drug or alcohol treatment
- Meet certain work requirements for SNAP or Temporary Assistance
- Meet certain other federal or Missouri exemptions
Missouri will review each person individually. Having a cancer diagnosis does not automatically mean you are exempt from the requirements.
However, some people with serious medical conditions may qualify for an exemption if their condition greatly limits their ability to participate.
If your health or treatment makes it difficult for you to work, attend school, volunteer, or take part in another qualifying activity, talk with your Gateway to Hope navigator and healthcare team.
Keep records about your medical care and treatment. Do not send medical records unless Missouri asks you to provide them.
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What happens when I renew my Medicaid?
Beginning in 2027, adults enrolled through Missouri’s Adult Expansion Group will have their eligibility reviewed every six months instead of once a year.
This means it is especially important to watch for letters from Missouri.
- Watch your mail and open the letter. Missouri’s Family Support Division will send you a renewal notice or letter.
- Read the entire letter. It will tell you whether Missouri needs information from you and what you need to do.
- Check your contact information. Make sure Missouri has your current address, phone number, and email.
- Follow the instructions in the letter. If Missouri asks you to provide information about your work, school, training, volunteer activities, income, or an exemptions, follow the instructions in the letter.
- Respond by the deadline on your notice. Do not ignore a Medicaid letter. If Missouri needs information from you and you do not respond by the deadline, you could lose your coverage.
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What should I do now?
You can prepare today.
- Keep your information current. Make sure Missouri Medicaid has your current mailing address, phone number, and email.
- Open every letter. Read letters and other notices from Missouri’s Family Support Division — do not assume it is junk. Some letters may require you to take action.
- Keep records. If you work, volunteer, attend school, participate in training, or have a medical condition that may qualify you for an exemption, keep documentation. Do not send records unless Missouri asks you to provide them.
- Talk to your care team. If cancer treatment or your medical condition makes it difficult for you to work or participate in other qualifying activities, talk with your GTH navigator and healthcare team. They can help you understand what information may be needed.
- Ask for help if you are confused. You do not have to figure this out alone. Gateway to Hope is here to assist you. Our goal is to support you, and ensure you maintain your healthcare coverage.
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Most importantly…
Do not ignore a letter from Missouri about your Medicaid coverage.
For people receiving cancer treatment, maintaining health coverage can be critical to continuing chemotherapy, radiation, surgery, medications, appointments, and other care.
If you receive a Medicaid notice that you do not understand, contact your Gateway to Hope navigator or care team.
We can help you understand what the notice means and what steps you may need to take.
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Learn more:
Missouri MO HealthNet Community Engagement Requirements
Missouri Medicaid Renewal Information
Gateway to Hope — Helping Missourians navigate breast cancer care, and the systems that make care possible.
Information current as of August 2026. Medicaid rules and implementation procedures may change. Your official Missouri Family Support Division notice is the final source of information about your individual coverage.
