| 0800.000.00 |
Medical Assistance for the Aged, Blind, and Disabled |
| 0800.000.05 |
Related Special Eligibility Groups |
| 0800.005.00 |
Legal Basis |
| 0805.000.00 |
Eligibility |
| 0805.005.00 |
December 1973 Eligibility Requirements |
| 0805.010.00 |
MA/GR Dual Eligibility |
| 0805.015.00 |
Financial Need |
| 0805.015.05 |
Persons Whose Income And Needs Are Considered |
| 0805.015.05.05 |
Couple Cases In The IMU5 System |
| 0805.015.10 |
Income Exclusions |
| 0805.015.10.05 |
Social Security Cost of Living Adjustment (COLA) Disregard |
| 0805.015.15 |
Overhead Expense Of Producing Income |
| 0805.015.20 |
Determination Of Gross Earned Income |
| 0805.015.25 |
Standard Deductions From Gross Earned Income |
| 0805.015.30 |
Non-Earned Income |
| 0805.015.35 |
Income Exemptions/Deductions |
| 0805.015.40 |
Types Of Need Determination |
| 0805.015.45 |
Income Maximum |
| 0805.020.00 |
Medical Assistance For Disabled Children (MADC) |
| 0805.020.05 |
Definition Of Living With A Parent |
| 0805.020.10 |
Deeming Parental Resources |
| 0805.020.15 |
Deeming Parental Income |
| 0810.000.00 |
Medicaid Coverage |
| 0810.005.00 |
Medicaid Non-Spenddown Coverage |
| 0810.010.00 |
Medicaid Spenddown Coverage |
| 0810.010.05 |
Processing Spenddown Medicaid Cases |
| 0810.010.10 |
Notification Of Spenddown Amount |
| 0810.010.10.05 |
Notification Of Spenddown On New Approvals |
| 0810.010.15 |
Meeting Spenddown With Incurred Expenses |
| 0810.010.15.01 |
Documentation of Incurred Medical Expenses |
| 0810.010.15.02 |
Determining Patient Responsibility After Third Party Liability |
| 0810.010.15.05 |
Countable Medical Expenses For Spenddown |
| 0810.010.15.10 |
Authorizing Spenddown Coverage Based On Incurred Expenses |
| 0810.010.15.15 |
Preventing Medicaid Payment Of Expenses Used To Meet Spenddown |
| 0810.010.15.15.05 |
Allowable Third Party Payment from State Funded Programs |
| 0810.010.15.15.10 |
Identifying DMH Medical Services Allowable For Spend Down |
| 0810.010.15.15.15 |
Identifying DHSS NME CDS Participants |
| 0810.010.15.15.20 |
Verification of DMH Medical Expenses |
| 0810.010.15.15.25 |
Verification of DHSS Medical Expenses |
| 0810.010.20 |
Spenddown Pay-In Option |
| 0810.010.20.05 |
Pay-in option for new approvals |
| 0810.010.20.10 |
Pay-in by automatic withdrawal |
| 0810.010.20.15 |
Pay-in by other agencies |
| 0810.010.20.17 |
Combination of Incurred Medical Expenses and Pay-In |
| 0810.010.20.20 |
Out-of-Pocket Expenses for Spenddown Cases |
| 0810.015.00 |
Prior Quarter Coverage |
| 0810.015.05 |
Prior Quarter Non-Spenddown |
| 0810.015.10 |
Prior Quarter Spenddown |
| 0810.020.00 |
Medicaid Coverage End Date On Closings |
| 0810.025.00 |
Eligibility For Buy-In (SMI Premium) For Medicare |
| 0810.030.00 |
Early Periodic Screening, Diagnosis, And Treatment (EPSDT) |
| 0810.035.00 |
Personal Care Services Program |
| 0810.035.05 |
Legal Reference (Personal Care Services) |
| 0810.035.10 |
Basic Eligibility Guidelines For Personal Care Services |
| 0810.035.15 |
Eligibility Determination (Division Of Senior Services) |
| 0810.035.20 |
Family Support Division Responsibilities |
| 0810.035.25 |
Division Of Medical Services Responsibilities |
| 0810.035.30 |
Personal Care Service Provider Responsibilities |
| 0810.040.00 |
The Respite Care Program (In-Home And Institutional) |
| 0810.040.05 |
In-Home Respite Care |
| 0810.040.10 |
Institutional Respite Care |
| 0810.040.15 |
Basic Eligibility Guidelines For Respite Care |
| 0810.040.20 |
Eligibility Determination (Division Of Senior Services) |
| 0810.040.25 |
Family Support Division Responsibilities |
| 0810.040.30 |
Respite Care Provider Responsibilities |
| 0815.000.00 |
Vendor Eligibility |
| 0815.000.05 |
Missouri Care Options |
| 0815.000.10 |
Definitions for Vendor Coverage |
| 0815.005.00 |
Eligibility for Vendor Payments |
| 0815.005.05 |
December 1973 Eligibility Requirements |
| 0815.005.10 |
Medicaid Certified Beds in Nursing Facilities |
| 0815.010.00 |
Applications for Claimants Not Currently Receiving Medicaid |
| 0815.010.05 |
Application Processing Time Frames |
| 0815.015.00 |
Claimants Currently Receiving Medical Assistance or SNC to Vendor |
| 0815.015.05 |
Claimant Returns to Vendor Facility |
| 0815.015.10 |
Tracking MA and SNC to Vendor Requests |
| 0815.020.00 |
Initial Assessment and Medical Certification |
| 0815.020.05 |
Verification of Medical Certification |
| 0815.020.10 |
Claimant Not Medically Certified |
| 0815.020.15 |
Medical Re-certifications (Utilization Reviews) |
| 0815.025.00 |
Preadmission Screening for Entry into Nursing Facilities |
| 0815.025.05 |
Preadmission Screening Process |
| 0815.025.10 |
Verification of Preadmission Screening |
| 0815.030.00 |
Vendor Surplus Computation |
| 0815.030.05 |
Determining Adjusted Gross Income |
| 0815.030.10 |
Determining Total Allowable Deductions |
| 0815.030.10.05 |
Personal Needs Allowance |
| 0815.030.10.05.05 |
Increasing the Personal Needs Allowance Due to Child Support Payments |
| 0815.030.10.10 |
Allotments |
| 0815.030.10.10.05 |
Maintenance Standards for Allotments |
| 0815.030.10.10.10 |
Determining the Allotment to the Community Spouse |
| 0815.030.10.10.15 |
Hearing Officer or Court of Law Sets Allotment Amount |
| 0815.030.10.10.20 |
Allotments for Minors and Dependents Living with the Community Spouse |
| 0815.030.10.10.25 |
Allotments for Minors Not Living With Community Spouse |
| 0815.030.10.15 |
Medical Deductions (Health Insurance Premiums) |
| 0815.030.10.20 |
Other Deductions |
| 0815.030.15 |
Effective Date of Surplus |
| 0815.030.20 |
Changes in Surplus Amount |
| 0815.035.00 |
Effective Date of Vendor Coverage for Claimants in a Nursing Facility |
| 0815.035.05 |
Effective Date of Vendor Coverage for Claimants in a Nursing Facility When No Level II Screening is Required |
| 0815.035.10 |
Effective Date of Vendor Coverage for Claimants in a Nursing Facility When Level II Screening is Required and Claimant is not found to be MR, MI or DD |
| 0815.035.15 |
Effective Date of Vendor Coverage for Claimants in a Nursing Facility When Level II Screening is Required and the Claimant is found to be MR, MI or DD |
| 0815.040.00 |
Effective Date of Vendor Coverage for MHC or IMR Level of Care |
| 0815.045.00 |
Prior Quarter Vendor |
| 0815.050.00 |
Claimant Not in Vendor Facility on the First Day of the Month of Application |
| 0815.050.05 |
Claimant Not in Vendor Facility in the Prior Quarter Has Medical Expenses in the Prior Quarter |
| 0815.055.00 |
Inpatient Psychiatric Services for Individuals Under Age 21 |
| 0815.055.05 |
Claimants Under Age 18 Receiving Inpatient Psychiatric Services |
| 0815.055.10 |
Claimants Ages 18 to 21 Receiving Inpatient Psychiatric Services |
| 0815.060.00 |
Claimants Between the Ages of 21 and 65 in State Mental Hospital |
| 0815.065.00 |
Individuals Under Age 18 in an Institution for the Intellectually Disabled or Nursing Facility |
| 0815.070.00 |
Claimant Leaves the Vendor Facility |
| 0815.070.05 |
Vendor Facility to SNC Facility |
| 0815.070.10 |
Vendor Facility to Private Home, not receiving HCB |
| 0815.070.15 |
Vendor Facility to Private Home, receiving HCB |
| 0815.075.00 |
Claimant Moves from One Type of Vendor Facility to Another |
| 0815.075.05 |
Claimant Moves to a Nursing Facility from Another Type of Vendor Facility |
| 0815.075.10 |
Nursing Facility or Institution for the Intellectually Disabled to Mental Hospital |
| 0815.075.10.05 |
Claimant Age 22 to 65 Goes from NF or IMR to State Mental Hospital |
| 0815.075.10.10 |
Claimant Age 65 or Older Goes from NF or IMR to State Mental Hospital |
| 0815.075.15 |
Nursing Facility or Mental Hospital to Institution for the Intellectually Disabled |
| 0815.080.00 |
Entering a Vendor Case Into IMU5 |
| Appendix A |
Accessing Vendor Numbers for Licensed Nursing Homes |
| Appendix B |
Maintenance Standards For Allotments |
| Appendix C |
JCAHO Facilities |
| Appendix D |
July 1996 Percentage Of Need Standard |
| 0820.000.00 |
Eligibility Based On Receipt Of HCB Waiver Services |
| 0820.010.00 |
Overview of Eligibility Criteria |
| 0820.020.00 |
Application Process |
| 0820.020.05 |
Application Processing Timeframes |
| 0820.030.00 |
Eligibility Requirements |
| 0820.030.05 |
Age |
| 0820.030.05.05 |
Permanent and Total Disability |
| 0820.030.10 |
Medical Need and Authorization for HCB Waiver Services |
| 0820.030.10.05 |
Referrals to DHSS/DSDS |
| 0820.030.15 |
Income and Budgeting |
| 0820.030.15.05 |
HCB with Non-HCB Spouse |
| 0820.030.15.05.05 |
Income of HCB Spouse When Non-HCB Spouse Applies for MO HealthNet |
| 0820.030.15.05.10 |
Spouse of HCB is MHABD Spenddown |
| 0820.030.20 |
Available Resources |
| 0820.030.20.05 |
Division of Assets |
| 0820.030.20.05.05 |
Month of Institutionalization |
| 0820.030.20.05.10 |
Entry Into a MO HealthNet Certified Bed |
| 0820.030.25.00 |
Transfer of Property |
| 0820.030.30.00 |
Social Security Number |
| 0820.030.35.00 |
Citizenship |
| 0820.030.40.00 |
Residence |
| 0820.035.00 |
HCB and QMB |
| 0820.040.00 |
MO HealthNet Eligibility Date |
| 0820.050.00 |
Entering an HCB Case into IMU5 |
| Appendix E |
HCB Income Maximums |
| 0825.000.00 |
Eligibility Based on Receipt of Missouri's Children with Developmenta Disabilities (MOCDD) Waiver Services |
| 0825.010.00 |
Overview of Eligibility Criteria |
| 0825.020.00 |
Application Process |
| 0825.020.05 |
Application Processing Timeframes |
| 0825.030.00 |
Eligibility Requirements |
| 0825.030.05 |
Age |
| 0825.030.10 |
Social Security Number |
| 0825.030.15 |
Citizenship |
| 0825.030.20 |
Residence |
| 0825.030.25 |
Disability |
| 0825.030.30 |
Medical Need and Authorization for MOCDD Waiver Services |
| 0825.030.35 |
Income and Budgeting |
| 0825.030.40 |
Available Resources |
| 0825.030.45 |
Transfer of Property |
| 0825.030.50 |
MO HealthNet Eligibility under Other Categories |
| 0825.040.00 |
MO HealthNet Eligibility Date |
| 0825.040.05 |
Reinvestigations |
| 0830.000.00 |
Program of All-Inclusive Care for the Elderly (PACE) |
| 0835.000.00 |
Prompt Disposition |
| 0840.000.00 |
Reviews And Interim Activities |
| 0840.005.00 |
Annual Reinvestigation |
| 0840.010.00 |
Changes In Circumstances |
| 0840.010.05 |
Adding A Spouse |
| 0840.010.10 |
Non-Spenddown To Spenddown |
| 0840.010.15 |
Spenddown To Non-Spenddown Or MA-WD Non-Premium |
| 0840.010.20 |
Change To MA-WD Premium |
| 0840.010.25 |
Increase In Spenddown Amount |
| 0840.010.30 |
Decrease In Spenddown Amount |
| 0840.015.00 |
Closing Of Cases |
| 0840.015.05 |
Pre-Closing Ex-Parte Review |
| 0845.000.00 |
Location Of Case Records |
| 0845.005.00 |
Separation Of Spouse Cases |
| 0850.000.00 |
Individuals Qualifying Under Section 1619 Of The Social Security Act |
| 0850.005.00 |
Eligibility Requirements For MA Based On Section 1619 Status |
| 0850.005.05 |
SSA 1619 Status |
| 0850.005.10 |
Title XIX Eligibility In The Month Prior To Attaining SSA 1619 Status |
| 0850.005.15 |
Resources |
| 0850.005.20 |
Financial Need |
| 0850.010.00 |
Case Processing Procedures Section 1619 Status Cases |
| 0850.015.00 |
Reviews (Section 1619 Status Cases) |
| 0850.020.00 |
Individuals Losing SSA 1619 Status |
| 0855.000.00 |
Ticket to Work Health Assurance (TWHA) Program |
| 0855.005.00 |
Eligibility Requirements for Ticket to Work Health Assurance (TWHA) Program |
| 0855.005.05 |
Age |
| 0855.005.10 |
Citizenship/Alien Status |
| 0855.005.15 |
Social Security Number |
| 0855.005.20 |
Residence |
| 0855.005.25 |
Disability |
| 0855.005.30 |
Employment |
| 0855.005.35 |
Available Resources |
| 0855.005.40 |
Income Limit |
| 0855.005.40.01 |
Social Security Cost of Living Adjustment (COLA) Disregard |
| 0855.005.40.05 |
Gross Income Limit |
| 0855.005.40.10 |
Net Income Limit |
| 0855.005.45 |
Premium Payment |
| 0855.005.45.05 |
Premium Collection Process |
| 0855.010.00 |
Case Processing Procedures |
| 0855.010.05 |
Approval Notice |
| 0855.015.00 |
Reviews and Interim Changes |
| 0855.015.05 |
Medicaid Coverage End Dates On Closings |
| 0855.020.00 |
TWHA Couple Cases |
| 0855.025.00 |
HIPP |
| 0860.000.00 |
Qualified Disabled Working Individuals (QDWI) |
| 0860.005.00 |
Eligibility Requirements |
| 0860.005.05 |
SSA QDWI Status |
| 0860.005.10 |
Enrollment in Part A Medicare (Hospital Insurance) |
| 0860.005.15 |
Need |
| 0860.005.15.05 |
QDWI Income Standard |
| 0860.005.15.10 |
Budgeting Procedures (QDWI) |
| 0860.005.20 |
Resources |
| 0860.005.25 |
Eligibility for Other Assistance |
| 0860.005.30 |
Citizenship |
| 0860.005.35 |
Residency |
| 0860.005.40 |
Social Security Number |
| 0860.010.00 |
Application Processing (QDWI) |
| 0865.000.00 |
Qualified Medicare Beneficiaries (QMB) |
| 0865.005.00 |
Legal Basis |
| 0865.010.00 |
Eligibility Requirements |
| 0865.010.05 |
Enrollment In Part A Medicare |
| 0865.010.05.05 |
Verification of Part A |
| 0865.010.05.10 |
Part A Eligibility and Enrollment Process |
| 0865.010.05.15 |
Part A Conditional Enrollment |
| 0865.010.05.20 |
Buy-In eligibility for persons in Alternative Care |
| 0865.010.10 |
Financial Need (QMB) |
| 0865.010.10.05 |
Assistance Group |
| 0865.010.10.10 |
QMB Income Standard |
| 0865.010.10.15 |
Income Considered |
| 0865.010.10.20 |
Income Exemptions/Deductions |
| 0865.010.10.25 |
Completion of the QMB budget |
| 0865.010.15 |
Resources (QMB) |
| 0865.010.20 |
Citizenship/Alien Status |
| 0865.010.25 |
Residency |
| 0865.010.30 |
Social Security Number |
| 0865.015.00 |
Benefits Available To QMB Recipients |
| 0865.015.05 |
Buy-in for QMB |
| 0865.015.10 |
Payment of Medicare Coinsurance and Deductibles |
| 0865.015.15 |
Services not covered under QMB |
| 0865.020.00 |
Application Processing (QMB) |
| 0865.020.05 |
Begin Date for QMB Eligibility |
| 0865.020.10 |
Filing a QMB Application |
| 0865.020.15 |
Application Procedures |
| 0865.020.15.05 |
QMB-only Approvals |
| 0865.020.15.10 |
Approval of QMB and another type of assistance |
| 0865.020.15.15 |
Requests for QMB Coverage on Active Cases |
| 0865.020.15.20 |
Exploration for QMB eligibility with other types of assistance |
| 0865.025.00 |
Reinvestigations (QMB) |
| 0865.030.00 |
Special Procedures For System Opening And Closing Of QMB Cases |
| 0865.030.05 |
“QMB-only” Is Approved For Another TOA |
| 0865.030.10 |
“QMB-only” Is Approved For Another TOA, And Is No Longer Eligible For QMB |
| 0865.030.15 |
QMB Eligibility Continues When Another TOA Stops |
| 0865.030.20 |
Both QMB And Another TOA Are Closed |
| 0865.035.00 |
QMB In Conjunction With Spenddown |
| 0865.035.05 |
Non-spenddown May Become Spenddown When Adding QMB |
| 0865.035.10 |
Special Procedures For QMB/Spenddown Combination approvals |
| 0865.035.15 |
Budgeting Procedure When MA and QMB Applications
Are Approved In The Same Month |
| 0865.035.20 |
Medical Expenses Allowed In QMB/Spenddown Budgeting |
| 0865.035.25 |
QMB Benefits Guide |
| 0870.000.00 |
Specified Low-Income Medicare Beneficiaries (SLMB) And Qualifying Individuals (QI) |
| 0870.005.00 |
Legal Basis |
| 0870.010.00 |
Eligibility Requirements |
| 0870.010.05 |
SLMB Income Standard |
| 0870.010.10 |
Budgeting Procedures (SLMB) |
| 0870.010.15 |
Buy-In eligibility for persons in Alternative Care |
| 0870.015.00 |
Benefits Available to SLMB Recipients |
| 0870.020.00 |
Application Processing (SLMB) |
| 0870.020.05 |
Beginning Date Of SLMB Coverage |
| 0870.020.10 |
Processing SLMB Applications |
| 0870.020.10.05 |
SLMB Only |
| 0870.020.10.10 |
Approvals of SLMB in Combination With Other Type of Assistance |
| 0870.020.15 |
IMU5 Completion |
| 0870.025.00 |
Reinvestigations (SLMB) |
| 0870.030.00 |
System Approvals And Closings Of SLMB Cases |
| 0870.030.05 |
SLMB Group 1 Is Approved for Another Type of Assistance |
| 0870.030.10 |
SLMB Recipient is Determined Ineligible at Approval of Another Type of Assistance |
| 0870.030.15 |
QMB Recipient is Determined SLMB Eligible at Approval for Another Type of Assistance |
| 0870.030.20 |
SLMB Eligibility Continues, Other Type of Assistance Closes |
| 0870.030.25 |
Both SLMB and Another Type of Assistance Close |
| 0870.035.00 |
SLMB In Combination With Spenddown Cases |
| 0870.040.00 |
QMB To SLMB Cases |
| 0870.045.00 |
Effect of COLA Increases On SLMB Cases |
| 0875.000.00 |
Former Foster Care Youth
|
| Appendix A |
Changing a Facility Address |
| Appendix B |
Maintenance Standards for Allotments |
| Appendix C |
JCAHO Facilities |
| Appendix D |
July 1996 Percentage of Need Standard |
| Appendix E |
HCB Income Maximums |
| Appendix G |
Spend Down Calculator |
| Appendix H |
Spend Down Calculator and Expense Log Instructions |
| Appendix I |
Setting Up a New Calculator |
| Appendix J |
Adult Standards |
| Appendix K |
MHABD Program Description |
| Appendix L |
Aged, Blind, Disabled Income Chart |
| Appendix M |
Medicare Cost Savings Programs |