Family MO HealthNet (MAGI)
- Table of Contents

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1800.000.00 FAMILY MO HEALTHNET PROGRAMS
1800.005.00 LEGAL BASIS
1802.000.00 APPLICATIONS
1802.005.00 LEGAL BASIS
1802.010.00 REQUESTS FOR BENEFITS
802.010.10 Request in Person
1802.010.20 Request by Mail
1802.010.30On-line Application
1802.010.40 Request by Telephone
1802.010.50 Request for In Home Application
1802.010.60 Request Received Through Third Party
1802.010.70 MO HealthNet Requests at Federally Qualified Healthcare Centers (FQHC) and Disproportionate Share Hospitals (DSH)
1802.010.80 Specialized Application Procedures
1802.010.80.05 Adding a Person to an Existing Application
1802.010.80.10 Applications on a Closed Case
1802.020.00 SIGNING THE APPLICATION
1802.020.05 Application with No Signature
1802.020.10 Signing By Mark
1802.020.15 Electronic Signature
1802.020.20 Telephonic Signature
1802.020.25 Mail-in or Drop-off Application
1802.020.30 Signing by an Authorized Representative
1802.020.35 Signing By a Relative
1802.020.40 Signing By a Legal Guardian or Conservator
1802.020.45 Signing on Behalf of a Deceased Applicant
1802.020.45.05 Death after Application
1802.020.45.10 Application for Deceased Persons
1802.030.00 FILER CONSENT
1802.040.00 DATING THE APPLICATION
1802.050.00 APPLICATION TIMEFRAMES
1802.050.10 Cancel Rejections
1805.000.00 ELIGIBILITY AND VERIFICATION
1805.000.02 Federal Hub Calls
1805.000.05 Reasonable Opportunity
1805.000.05.05 Reapplication After 90-Day Reasonable Opportunity
1805.005.00 RESIDENT OF MISSOURI
1805.010.00 AGE AND DATE OF BIRTH
1805.015.00 SOCIAL SECURITY NUMBER
1805.015.05 Failure to Complete a SSN Application or Furnish a SSN
1805.020.00 CITIZENSHIP AND IMMIGRANT STATUS
1805.020.05 Citizenship
1805.020.05.05 Documents to Verify Citizenship
1805.020.10 Qualified Immigrant
1805.020.10.05 Qualified Immigrants Entering Prior To 8/22/96
1805.020.10.10 Qualified Immigrants Entering After 8/22/96
1805.020.10.10.05 Qualified Immigrants with No Waiting Period
1805.020.10.10.10 Qualified Immigrants with a Five-Year Period of Ineligibility
1805.020.10.15 Non-Qualified Immigrants
1805.020.10.20 Immigrants from Micronesia, Palau, and Marshall Islands
1805.020.15 Documentation and Verification of Alien or Immigrant Status
1805.025.00 PREGNANCY
1805.030.00 MODIFIED ADJUSTED GROSS INCOME (MAGI) METHODOLOGY
1805.030.05 Income Evidence
1805.030.10 MAGI Household Composition
1805.030.10.05 Legal Basis
1805.030.10.10 MAGI Household Composition for Tax Filers
1805.030.10.15 MAGI Household Composition for Non-Tax Filers
1805.030.10.20 Exceptions to MAGI Household Composition
1805.030.10.20.05 JOINT CUSTODY
1805.030.10.25 Caretakers Relatives
1805.030.15 Reasonable Compatibility
1805.030.20 Income, Deductions, and the Five Percent (5%) Disregard
1805.030.20.05 Income Included Under MAGI
1805.030.20.10 Income Excluded Under MAGI
1805.030.20.15 Allowable Deductions
1805.030.20.20 Five Percent Disregard - Legal Basis
1805.030.20.20.05 Calculation of the Five Percent Disregard
1805.030.25 Determining MAGI
1805.030.25.05 Projection of MAGI
1805.030.25.10 Patterns of Income
1805.030.25.15 Specific Types of Income
1805.035.00 ADDING INCOME COMMENTS TO EVIDENCE
1805.040.00 COOPERATION IN PURSUIT OF MEDICAL SUPPORT
1805.040.05 Referral to FSD-CS
1805.040.10 Notice/Good Cause for Refusal to Cooperate
1805.040.10.05 Areas of Cooperation
1805.040.10.10 Refusal to Cooperate/Claiming Good Cause
1805.040.10.15 Good Cause Defined
1805.040.10.15.05 Determining Good Cause
1805.040.10.15.10 Types of Evidence to Support Good Cause
1805.040.10.20 Sanctions for Non-cooperation
1805.040.10.25 Cooperation and Referral to Child Support When Adding Children to an Active Case
1805.050.00 Former Foster Care Youth
1810.000.00 MO HEALTHNET FOR FAMILIES (MHF)
1810.010.00 LEGAL BASIS
1810.020.00 ELIGIBILITY REQUIREMENTS
1810.020.10 Income Maximums/Need
1810.020.20 Construction of MAGI Household for MHF
1810.020.20.10 Relationship Of Child to Parent or Caretaker Relative
1810.020.20.20 Eligibility for 18-year-olds
1810.030.00 BEGIN AND END DATES FOR COVERAGE
1810.030.10 Prior Quarter (PQ)
1810.030.20 Transitional MO HealthNet
1810.040.00 HEALTHCARE COVERAGE
1830.000.00 MO HEALTHNET FOR KIDS (MHK) - NON-CHIP COVERAGE
1830.005.00 LEGAL BASIS
1830.010.00 ELIGIBILITY REQUIREMENTS
1830.010.05 Income Maximums / Need
1830.010.10 Budget Procedure
1830.010.15 Referral to Family Support Division – Child Support (FSD-CS)
1830.015.00 HEALTHCARE COVERAGE BEGIN AND END DATES
1830.020.00 PRIOR QUARTER
1840.000.00 MO HEALTHNET CHILDREN´S HEALTH INSURANCE PROGRAM
1840.005.00 LEGAL BASIS (CHIP)
1840.010.00 ELIGIBILITY REQUIREMENTS
1840.010.05 Need
1840.010.10 Uninsured
1840.010.10.05 HIPP Effect on Uninsured Status
1840.010.15 Access To Affordable Health Insurance
1840.010.15.05 Affordable Insurance Definition
1840.010.15.08 Affordability Test
1840.010.15.10 Employer Sponsored Insurance
1840.010.15.12 State Employee Health Insurance
1840.010.15.15 Private Insurance
1840.010.15.20 Special Healthcare Needs
1840.015.00 BEGIN AND END DATES FOR CHIP COVERAGE
1840.020.00 INTERIM CHANGES
1840.020.05 From no premium to premium
1840.020.10 From premium to no premium
1840.020.15 Other level of care changes
1840.020.20 Adding A Person
1840.025.00 PAYMENT OF PREMIUM
1840.025.05 Failure to Pay Initial Premium
1840.025.10 Failure to Pay Premium After Coverage Begins
1840.030.00 MO HEALTHNET DIVISION NOTICES FOR NON-PAYMENT OF PREMIUM
1840.030.05 Initial and Recurring Invoices
1840.030.10 Failure to Pay Notice
1840.030.15 Notice of Case Action
1840.030.20 Closing Letter
1850.000.00 MO HEALTHNET FOR PREGNANT WOMEN
1850.010.00 LEGAL BASIS
1850.020.00 ELIGIBILITY REQUIREMENTS
1850.020.10 Pregnant
1850.020.20 Income Maximum/Need
1850.020.20.10 Income Limits
1850.030.00 PRIOR QUARTER (PQ) AND MONTH OF APPLICATION ELIGIBILITY
1850.040.00 HEALTHCARE COVERAGE
1850.040.10 Continuous Eligibility for Pregnant Women
1850.040.20 Postpartum Benefit
1850.040.20.10 Correction of Postpartum Ending Date
1850.040.30 Coverage When Application Is Made After The Birth
1850.040.40 Extended Women's Health Services
1850.040.40.10 Eligibility for Other MO HealthNet Programs
1850.040.40.20 No Longer in Need of Family Planning Services
1850.040.40.30 Notification of Ineligibility for Extension Due To Insurance
1850.050.00 REVIEWS
1855.000.00 SHOW-ME HEALTHY BABIES (SMHB)
1855.010.00 LEGAL BASIS
1855.020.00 ELIGIBILITY
1855.020.10 Unborn Child
1855.020.20 Resident of Missouri
1855.020.30 Need
1855.020.40 Uninsured
1855.020.50 Employer Sponsored Insurance
1855.020.60 Private Insurance
1855.020.70 Ineligible for any other MO HealthNet Programs
1855.020.80 Application Processing Timeframe
1855.030.00 HEALTHCARE COVERAGE
1855.030.05 Coverage for the Child After Birth
1855.030.10 Labor and Delivery Coverage for the Mother
1855.030.15 Coverage for the Mother after Birth of the Child
1860.000.00 NEWBORN -AUTOMATIC MO HEALTHNET ELIGIBILITY
1860.005.00 LEGAL BASIS
1860.010.00 ELIGIBILITY
1860.010.05 Adding the Newborn
1860.010.10 Assignment of DCN
1860.010.15 Verification Of Birth
1860.010.20 Eligibility Dates
1860.015.00 NEWBORN’S ELIGIBILTIY FOR OTHER PROGRAMS
1860.020.00 REINVESTIGATIONS (NEWBORNS)
1870.000.00 UNINSURED WOMEN'S HEALTH SERVICES PROGRAM (UWHS)
1870.005.00 LEGAL BASIS
1870.010.00 ELIGIBILITY REQUIREMENTS (UWHS)
1870.010.05 Age (UWHS)
1870.010.10 Social Security Number (UWHS)
1870.010.15 Residence (UWHS)
1870.010.20 Citizenship and Alien Status (UWHS)
1870.010.25 Need (UWHS)
1870.010.25.05 Income Limits (UWHS)
1870.010.25.10 Household (UWHS)
1870.010.30 Uninsured (UWHS)
1870.010.30.05 HIPP Effect on Uninsured Status (UWHS)
1870.010.30.10 Health Insurance Definition (UWHS)
1870.010.40 Ineligible for Any Other MO HealthNet Program (UWHS)
1870.015.00 HEALTHCARE COVERAGE (UWHS)
1870.015.05 UWHS HealthCare Coverage End Date
1870.020.00 PROMPT DISPOSITION (UWHS)
1870.025.00 REVIEWS (UWHS)
1870.030.00 EX-PARTE PROCESS
1870.035.00 EXPLORING UWHS ELIGIBILITY FOR AGE ELIGIBLE WOMEN WHEN NO LONGER ELIGIBLE FOR ANY OTHER MO HEALTHNET PROGRAM
1880.000.00 ANNUAL RENEWALS
1880.005.00 PRE-POPULATED RENEWAL FORM
1880.010.00 FLOATING RENEWAL
1880.015.00 CHILDREN’S HEALTH INSURANCE PROGRAM (CHIP) ANNUAL RENEWAL
1880.020.00 RECONSIDERATION PERIOD
1880.025.00 ANNUAL RENEWAL CASE ACTION NOTIFICATIONS
1885.000.00 INTERIM CHANGES FOR MAGI CASES
1885.005.00 AGE OUT
1885.010.00 ADDING A PERSON
1885.015.00 REMOVING A PERSON
1885.020.00 UNABLE TO LOCATE
1885.025.00 MOVED OUT OF STATE
1885.030.00 REOPENING CLOSED CASES
1890.000.00 EX PARTE REVIEW PROCESS
1890.010.00 PRE-CLOSING ACTIONS
1890.010.10 Eligibility Exists Under Another Category
1890.010.20 No Other Eligibility Exists
Appendix A MAGI income with 5% of FPL included and CHIP premium amounts pdf
Appendix B Reasonable Compatability Calculator Excel
Appendix D Poverty Guidelines pdf
Appendix E MO HealthNet for Kids - CHIP Premium Chart pdf
Appendix F CHIP Affordability Test Calculator Instructions pdf
Appendix G CHIP Affordability Test Calculator pdf