Department of Social Services
Family Support Division
PO Box 2320
Jefferson City, Missouri
TO: ALL FAMILY SUPPORT OFFICES
FROM: KIM EVANS, DIRECTOR
SUBJECT: 2021 UPDATE OF POVERTY INCOME GUIDELINES FOR FAMILY MO HEALTHNET (MAGI) PROGRAMS
MANUAL REVISION #
FORM REVISION #
DISCUSSION:
Effective April 1, 2021, the Federal Poverty Level (FPL) income guidelines are increased for:
- MO HealthNet for Kids (MHK);
- Children’s Health Insurance Program (CHIP);
- MO HealthNet for Pregnant Women (MPW);
- Show-Me Healthy Babies (SMHB);
- Uninsured Women’s Health Services (UWHS); and
- All Presumptive Eligibility programs:
- Temporary MO HealthNet During Pregnancy (TEMP);
- Show-Me Health Babies Presumptive Eligibility (SMHB-PE);
- Presumptive Eligibility for Children (PC); and
- Presumptive Eligibility for Parents/Caretaker Relatives (MHF-PE).
NOTE: New poverty income guidelines for Presumptive Eligibility programs will be provided to Qualified Entities by Income Maintenance Program and Policy.
MAGI cases will be adjusted in April 2021 based on the new FPL income guidelines; however, due to the Public Health Emergency (PHE), no cases will have coverage closed or reduced to a lower level of care due to FPL adjustments until after the PHE has ended.
PREMIUM REFUNDS
Premiums paid for April coverage will be refunded to the participant if the FPL causes the case to:
- become eligible as a non-premium case;
- go from CHIP75 to CHIP74; or
- go from CHIP74 to CHIP73.
The refund process will take approximately 8 weeks to complete.
REQUEST FOR HEARING/CONTINUED BENEFITS
After the PHE expires, any household receiving an IM-80 Adverse Action Notice may request a hearing on the adjustment action within 10 days from the date of the notice.
If a household receiving an IM-80 Adverse Action Notice requests a hearing on the adjustment within 10 days of the notice, the household benefits continue at the level before the FPL adjustment until the hearing decision is made. Staff should inform the household that if continued benefits are issued and the agency is determined to be correct, a claim will be established for any overpayment.
MAGI MANUAL, PROGRAM DESCRIPTIONS AND OTHER RESOURCES
MAGI Manual section 1805.030.20.10 Income Excluded Under MAGI has been updated to reflect an increase in the tax filer threshold for earned income from a child to $12,400 based on the 2020 IRS Publication 501.
NOTE: The tax filer threshold for unearned income from a child has not increased and remains the same.
The internet pages MHK/MHF/TA Income Chart and Do Your Children Need Health Coverage are updated to include the change in FPL income limits.
NECESSARY ACTION:
- Begin using the new federal poverty level income guidelines effective for April 2021 and later.
- Review this memorandum with appropriate staff.
KE/al