IM-#54 June 2, 2005IM-#70 June 14, 2002

When a Medical Assistance for Families (MAF) family becomes ineligible for MAF (with or without cash) because of employment, increased earnings, or loss of earned income disregards, and the family meets certain other requirements, the family qualifies for Transitional Medical Assistance (TMA). This program provides MC+ healthcare coverage for the family for six months following MAF ineligibility, and if other requirements are met, the family may be eligible for an additional six months. Families must meet eligibility criteria at MAF closing, certain requirements during the first six months, and additional requirements during the second six months. Transitional Medical Assistance ends 12 months after MAF ineligibility.

A Transitional Medical Assistance eligible family must complete quarterly reports of earned income and child care expenses in the fourth, seventh, and tenth months of eligibility. Failure to return a complete report in the fourth month results in ineligibility at the end of the sixth month. Failure to return a complete report in the seventh or tenth months results in suspension at the end of those months until completed reports are submitted, if prior to the 12th month.

Additionally, if gross earned income less child care expenses from the second or third quarterly reports exceeds 185% of the poverty level, Transitional Medical Assistance eligibility ends.

0910.005.00  LEGAL BASIS (TMA)

IM-#54 June 2, 2005,  IM-#70 June 14, 2002

Federal law at 42 U.S.C. 1396r-6 makes Transitional Medical Assistance mandatory for states. Section 208.151.3 (RSMo 1990) provides for Transitional Medical Assistance as follows.

After April 1, 1990, any family receiving aid pursuant to 42 U.S.C. 601 et seq, as amended, in at least three of the six months immediately preceding the month in which such family becomes ineligible for such aid, because of hours of employment or income from the caretaker relative’s employment, remains eligible for medical assistance for six calendar months following the month of ineligibility as long as such family includes a child as provided in 42 U.S.C. 1396r-6. Each family receiving such medical assistance during the entire six-month period described in this section and that meets reporting requirements and income tests established by the division and continues to include a child as provided in 42 U.S.C. 1396r-6 receives medical assistance without a fee for an additional six months. DMS may provide by rule the scope of medical assistance coverage granted to such families.

Effective February 1, 1999 Missouri began providing two years of extended TXIX coverage to uninsured adults who successfully complete the 12 months of Transitional Medical Assistance (TMA) on or after January 31, 1999. A Medicaid waiver under Section 1115 of the Social Security Act authorizes this coverage.

Effective July 1, 2002 Missouri House Bill 1111 reduced the extended TXIX coverage for uninsured adults to 12 months.

Effective July 1, 2005 Missouri House Bill 11 eliminated the extended TXIX coverage for uninsured adults.

In June of 1999 Missouri began referring to the Medicaid program for all family eligibility groups MC+.