IM-#48 March 27, 2003

On the second and third quarterly reports, caretakers report income and child care expenses for the second and third quarters of Transitional Medical Assistance eligibility. Accept the caretaker s statement of income and child care expense. Use the quarterly report to:

  1. determine average monthly earnings and average monthly child care expense,
  2. deduct the child care expense from earnings, and
  3. compare the remainder to 185% of the poverty level for the family size.

The assistance group for this budget includes all Transitional Medical Assistance eligible individuals, and any parent or dependent child in the household who is not an original assistance group member. If an individual moves into or out of a Transitional Medical Assistance household during the report quarter, include members in the assistance group based on the situation at the end of the quarter.

In determining if the assistance group meets the 185% test, consider the needs and gross EARNED income of every assistance group member. Consider earned income in the same manner as for MAF. In addition, deem the EARNED income of a stepparent or parent of a minor parent in the same manner as for MAF.

Allow as a deduction, unreimbursed childcare expenses paid for children. If the family receives Block Grant Childcare, allow any sliding fee or co-payment amounts.  If the remaining earned income (after the childcare expense deduction) is equal to or less than 185% of the poverty level, the family remains eligible for Transitional Medical Assistance.

If the remainder is greater than 185% of the poverty level, explore the children's eligibility under other MC+ programs.  The quarterly report form gives the family the opportunity to report if anyone is pregnant, blind or disabled so an IM-80 (PRE) is not required.  Complete a pre-closing review based on the information available.  An Adverse Action Notice (IM-80) is required when a family member is not eligible elsewhere.  Discontinue eligibility under TMA at the end of the seventh or tenth month, whichever is applicable if there is no request for appeal.  If the family requests an appeal, allow the TMA to continue pending the outcome of the appeal.


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

This policy was eliminated effective July 1, 2005 by Missouri House Bill 11.

Effective July 1, 2002, uninsured adults must have net income equal to or less than 100% of the federal poverty level to qualify for Extended Transitional Medical Assistance.

Because the conversion to ETMA is done by the system, it is necessary to have the most recent income information in the system at the time of conversion from TMA.  All TMA cases that are determined eligible for the final two months of TMA based on the third quarterly report must also have a 100% of FPL budget completed.  The income and deductions on this budget will be the same as what is shown on a MAF budget.  When an entry of “4” is made in field 38a of the IMU5, the system will require entry of a new 100% budget.  The information on the 100% FPL budget will be used to determine if the case should be converted to ETMA.