IM-25 2022 UPDATE OF POVERTY INCOME GUIDELINES FOR MO HEALTHNET FOR THE AGED, BLIND, AND DISABLED (MHABD) PROGRAMS

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

TO:  ALL FAMILY SUPPORT OFFICES

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  2022 UPDATE OF POVERTY INCOME GUIDELINES FOR MO HEALTHNET FOR THE AGED, BLIND, AND DISABLED (MHABD) PROGRAMS

MANUAL REVISION #
Appendix J
Appendix K

DISCUSSION:

Effective April 1, 2022, the Federal Poverty Level (FPL) income guidelines increase for the following programs:

  • MO HealthNet for the Aged, Blind and Disabled (MHABD)
  • Ticket to Work Health Assurance (TWHA)
  • Qualified Medicare Beneficiary (QMB)
  • Specified Low Income Medicare Beneficiary (SLMB and SLMB2)
  • Qualified Disabled Working Individuals (QDWI)
  • MO HealthNet for Disabled Children (MHDC)
  • Gateway to Better Health (GTBH)
  • Blind Pension (BP)

The weekend of March 12, 2022, programs with income eligibility based on the FPL will be adjusted in the eligibility system.

MO HealthNet cases will be adjusted based on the new FPL income guidelines; however, due to the COVID-19 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. The refund process will take approximately 8 weeks to complete.

Program Descriptions

Appendix K: MO HealthNet eligibility for people who are Aged (65 or older), Blind, Disabled, or need treatment for Breast or Cervical Cancer in the MHABD Policy Manual has been updated to include the change in FPL income limits.

Income Standards

Appendix J: Eligibility Standards for MHABD has been updated in the MHABD Policy Manual to show the updated FPL income limits.

All FPL income guidelines are effective from April 1, 2022 through March 31, 2023. These standards may be referenced as needed for historical purposes.

 

MHABD income standards

Assistance Group Size

Non-Spend Down OAA/PTD

(85% FPL)

Non-Spend Down AB

(100% FPL)

1

$963

$1,133

2

$1,297

$1,526

 

QDWI income standards

Assistance Group Size

QDWI (200% of FPL)

1

$2,265

2

$3,052

 

Medicare Savings Plan Program income standards

Assistance Group Size

QMB (100% FPL)

SLMB1 (120% FPL)

SLMB2 (135% FPL)

1

$1,133

$1,359

$1,529

2

$1,526

$1,831

$2,060

3

$1,920

$2,303

$2,591

 

Blind Pension sighted spouse monthly income maximum

Sighted Spouse

(500% FPL)

$7,630

 

TWHA Income Standards and Premiums

Percent of FPL

Type of Case

Monthly Income

Premium Amount

Less than 100% FPL

Single

$1132.99 or less

non premium

 

Couple

$1525.99 or less

non premium

100% FPL up to but not including 150% FPL

Single

$1133.00 – $1698.99

$42

 

Couple

$1,526.00 – $2288.99

$56

150% FPL up to but not including 200% FPL

Single

$1699.00 – $2264.99

$62

 

Couple

$2289.00 – $3051.99

$85

200% FPL up to but not including 250% FPL

Single

$2265.00 – $2831.99

$104

 

Couple

$3052.00 – $3814.99

$141

250% FPL up to 300% FPL

Single

$2832.00 – $3398.00

$156

 

Couple

$3815.00 – $4578.00

$211

 

NECESSARY ACTION:

  • Begin using the new federal poverty level income guidelines for eligibility determinations effective April 2022 and ongoing.
  • Follow the FAMIS Changes Due to FPL Adjustments user guide to resolve conflicting actions.
  • Review this memorandum with appropriate staff.

 

KE/cj