Missouri Medicaid work requirement

Missouri Medicaid expansion adults ages 19–64 who are not otherwise exempt. Missouri has elected NOT to adopt optional short-term hardship exemptions. Members have a 35-day response period after receiving a notice of non-compliance.

• Work 80+ hours/month (paid or unpaid, including self-employment or work for goods/services)
• Community service / volunteering at a public or non-profit organization — 80+ hours/month
• Participation in an approved job training or workforce program — 80+ hours/month
• Enrollment in an educational program at least half-time (high school, GED, community college, vocational, or four-year college)
• Any combination of the above totaling 80+ hours/month
• Income ≥ $580/month (federal minimum wage × 80 hours) — regardless of hours tracked; seasonal workers may average $580/month over the prior 6 months

• Pregnant or less than 12 months postpartum (regardless of pregnancy outcome)
• Primary caregiver of a child 13 years old or younger
• Primary caregiver of a disabled individual
• Medically frail or living with a disability that significantly limits ability to work
• American Indian / Alaska Native (AI/AN)
• Former foster youth who aged out of foster care
• Veteran with total disability rating (VA)
• Household receiving TANF where work rules already apply
• Household receiving SNAP where SNAP work rules already apply
• Enrolled in or recently completed a substance use disorder (SUD) treatment program
• Currently incarcerated or released from incarceration within the prior 3 months

Caring for a child 13 or younger, or for a person with a disability, is usually an exemption. Caregiving hours are not counted toward the 80 hours.

Missouri FSD will check available state records. If records are insufficient, you will receive a notice with a 35-day response period. Respond promptly with documentation through mydss.mo.gov or by calling 855-373-4636.

• Visit dss.mo.gov/hr1/participant-resources for official Missouri participant resources
• Keep your contact information current with FSD (855-373-4636)
• Update your case at mydss.mo.gov
• Start tracking work, volunteer, education, or training hours each month now
• Note: Missouri is not adopting optional short-term hardship exemptions, so respond to notices promptly within the 35-day period

• Missouri DSS — H.R. 1 Participant Resources
• myDSS Portal

Sources: Missouri DSS FSD (dss.mo.gov). CMS IFC CMS-2454-IFC. Missouri not adopting optional short-term hardships; 35-day response period.

Last checked September 2026.