IM-140 PRESUMPTIVE ELIGIBILITY (PE) FORM REVISIONS FOR MAGI

Department of Social Services
Family Support Division
PO Box 2320
Jefferson City, Missouri

TO:  ALL FAMILY SUPPORT OFFICES

FROM:  REGINALD E. McELHANNON, ACTING DIRECTOR

SUBJECT:  PRESUMPTIVE ELIGIBILITY (PE) FORM REVISIONS FOR MAGI

FORM REVISION #33

PE-2 WORKSHEET

PE-2 Worksheet Instructions

PE-3

PE-3TEMP

 

DISCUSSION:

The purpose of this memorandum is to share revisions to the following three (3) Presumptive Eligibility (PE) forms:

  • Qualified Entity Presumptive Eligibility Determination Worksheet (PE-2 Worksheet)
    • Clarification of:
      • What can be provided if DCN for head of household or applicant cannot be located;
      • Calculation of Household Size
      • Questions A-G
    • Addition of checkboxes for PE Programs
  • MO HealthNet Presumptive Eligibility Authorization (PE-3) and MO HealthNet TEMP/SMHB-PE Authorization (PE-3TEMP)
    • Addition of check boxes indicating for what program each individual is eligible

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

RM/df