0820.035.00  HCB and QMB

If a spend down individual has previously declined QMB due to its effect on the spend down amount and is now eligible under HCB waiver criteria, approve a QMB application at the same time the HCB application is approved. There will be no adverse effect to this action. It is not necessary to have the individual sign a new application form, although an application for QMB must be entered through IAPP.

0820.040.00  MO HealthNet Eligibility Date

Eligibility for MO HealthNet based on HCB criteria cannot be prior to the date of the DHSS/DSDS determination that the individual qualifies for HCB waiver services. Individuals may qualify for MHABD spend down prior to the DHSS/DSDS determination.

EXAMPLE: Mr. and Mrs. Bledsoe apply for MHABD on 8/15/07. Mr. Bledsoe, age 68, receives Social Security of $900 per month. Mrs. Bledsoe, age 65, receives Social Security of $500 per month, and a private pension of $300 per month. Due to a recent illness and hospitalization, Mr. Bledsoe has medical expenses in May, June and July. Mr. Bledsoe is referred to DHSS/DSDS for a determination of eligibility for HCB waiver services. Neither Mr. nor Mrs. Bledsoe has any countable available resources. Both meet all other eligibility requirements for MHABD. On 09/01/07, DHSS/DSDS determines that Mr. Bledsoe is in need of NF level of care, and that he is in need of HCB waiver services.

Individuals found eligible under HCB criteria in the prior quarter may be approved for prior quarter coverage using those criteria IF the DHSS/DSDS determination includes the prior quarter.

0820.050.00  Entering an HCB Case into IMU5

Enter the HCB into IMU5 in the same manner as a regular MHABD case, except enter the HCB income limit in Field 33. This entry will identify the case as HCB.