Department of Social Services
Family Support Division
PO Box 2320
Jefferson City, Missouri
TO: ALL FAMILY SUPPORT OFFICES
FROM: KIM EVANS, DIRECTOR
SUBJECT: COVID-19 MO HealthNet (MHN) Coverage for Positive COVID-19 Diagnosis
FSD will provide MO HealthNet coverage for individuals between the ages of 19 and 64 who have a positive COVID-19 diagnosis and meet current MHABD eligibility guidelines, including income and resources.
Applications for individuals who have a positive COVID-19 diagnosis will be accepted on a signed IM-1MA application form.
- To expedite the process, applications for individuals who have a positive COVID-19 diagnosis can be submitted to FSD.COVIDAPPS@dss.mo.gov.
- Submitting verification of the COVID-19 diagnosis with the application will allow for expedited processing. Verification of a positive COVID-19 diagnosis includes, but is not limited to, a letter signed by the physician, lab results, discharge summary, or hospital records that clearly state the diagnosis.
- NOTE: FSD must accept fillable applications from hospitals, providers, friends and/or family with an electronic signature that includes a statement from the applicant who is quarantined and wishing to apply for Missouri Medicaid.
If eligible, COVID-19 MHN coverage will begin the first day of the month of application in which a positive COVID-19 was performed and the determination of disability will be authorized for 90 days and reassessed moving forward. To authorize coverage for the month of a test completed prior to the month of application, indicate a request for prior quarter coverage on the REQUEST/FM0G screen and entering the date of the diagnosis on the DISABLED/FMMX screen with the COV code. When entering an approval ensure that only the appropriate months are authorized.
- Additional information will be released when available regarding participants that continue to have a positive COVID-19 diagnosis at the end of the 90 day time period.
- This coverage will remain in effect until the health emergency ends or the individual is no longer considered disabled whichever occurs last.
NOTE: Utilize prior quarter as needed for medical services that are related to a positive COVID-19 test but not prior to February 1, 2020. System updates allow for coverage based on a COVID-19 diagnosis to be authorized back to March 1, 2020. When applicable, staff must use the Worker Initiated Budget Calculation screen in order to authorize coverage for February 2020.
An application for COVID-19 coverage must be registered in the same manner as an MHABD-PTD application. These applications are a high priority.
- Use the standard income and resource limits for the MHABD-PTD program.
- Verification of a positive COVID-19 diagnosis is required.
- To be eligible, individuals must be between the ages of 19 and 64.
- Accept self-attestation of income and resources unless questionable, with the exception of trusts and annuities. Trusts and annuities must still be submitted to the Program and Policy unit for interpretation.
- Staff must explore all avenues available to FSD to verify citizenship and identity before requesting verification from the participant.
- The COVID-19 diagnosis will be captured in FAMIS on the DISABLED/FMMX screen using code “COV.”
- The begin date is the date of the test that resulted in a positive COVID-19 diagnosis.
- Only enter hard copy verification of the COV code if the individual is within the designated age range and has a positive COVID-19 diagnosis.
- Coverage will be displayed as Spend Down or Non-Spend Down coverage. A new ME code will not be created for this program and coverage will show as ME 13. If staff need to identify that coverage was authorized due to a positive COVID-19 test, this information can be located by checking the DISABLED/FMMX screen, or reviewing the technical details screen associated with the authorization.
- Programming is being completed to add specific information to the approval notice sent to eligible individuals who have a positive COVID-19 diagnosis.
- Enter a comment on the Eligibility Unit Member Role (EUMEMROL/FM3Z) screen with label “COVID-19 Application” on every case approved for coverage due to positive diagnosis.
- Include a comment on each income or resource entry that is verified with self-attestation with label “COVID-19 Self-Attestation” on every case approved for coverage due to positive diagnosis. The body of the comment should include the following statement: “Self-attestation accepted as verification due to special circumstances. 42 CFR §435.952(c)(3)”
NOTE: MAGI coverage should be explored if coverage could be offered through Family MHN programs
Questions regarding the entry of COVID-19 MHN coverage may be sent via email to Cole.MHNPolicy@dss.mo.gov.
- Review this memorandum with appropriate staff.