Department of Social Services
Family Support Division
PO Box 2320
Jefferson City, Missouri
TO: ALL FAMILY SUPPORT OFFICES
FROM: KIM EVANS, DIRECTOR
SUBJECT: UPDATE OF POVERTY INCOME GUIDELINES FOR MO HEALTHNET NON-MAGI PROGRAMS
MANUAL REVISION #
Appendix J
Appendix K
DISCUSSION:
Effective April 1, 2023, the Federal Poverty Level (FPL) income guidelines increase for the following programs:
- MO HealthNet Non-Spend Down (MHNS)
- MO HealthNet Spend Down (MHSD)
- 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)
- Blind Pension (BP)
On the weekend of March 11, 2023, programs with income eligibility based on the federal poverty level will be adjusted in the eligibility system.
Note: All MO HealthNet cases will be adjusted based on the new FPL income guidelines. However, due to the continuous enrollment condition, participants will not have coverage reduced to a lower level of care or cases closed until after their next annual review is completed.
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 in the MHABD Policy Manual is updated to include the change in FPL income limits. Appendix K is now named, MO HealthNet Eligibility for Non-MAGI Programs.
Income Standards
Appendix J in the MHABD Policy Manual is updated with the updated FPL income limits. Appendix J is now named, Non-MAGI Eligibility Standards.
All FPL income guidelines are effective from April 1, 2023 through March 31, 2024. 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 | $1033 | $1215 |
| 2 | $1397 | $1644 |
QDWI income standards
| Assistance Group Size | QDWI (200% of FPL) | |
| 1 | $2430 | |
| 2 | $3287 | |
Medicare Savings Programs income standards
| Assistance Group Size | QMB (100% FPL) | SLMB1 (120% FPL) | SLMB2 (135% FPL) |
| 1 | $1215 | $1458 | $1641 |
| 2 | $1644 | $1972 | $2219 |
| 3 | $2072 | $2486 | $2797 |
Blind Pension sighted spouse monthly income maximum
| Sighted Spouse (500% FPL) |
$8217 |
TWHA Income Standards and Premiums
| Percent of FPL | Type of Case | Monthly Income | Premium Amount |
| Less than 100% FPL | Single | $1215.00 or less | non premium |
| Couple | $1644.00 or less | non premium | |
| 100% FPL up to but not including 150% FPL | Single | $1215.01-1822.99 | $42 |
| Couple | $1644.01-2464.99 | $56 | |
| 150% FPL up to but not including 200% FPL | Single | $1823.00-2429.99 | $62 |
| Couple | $2465.00-3286.99 | $85 | |
|
200% FPL up to but not including 250% FPL |
Single | $2430.00-3037.99 | $104 |
| Couple | $3287.00-4108.99 | $141 | |
| 250% FPL up to 300% FPL | Single | $3038.00-3645.00 | $156 |
| Couple | $4109.00-4930.00 | $211 |
NECESSARY ACTION:
- Begin using the new FPL income guidelines for eligibility determinations effective April 2023 and ongoing.
- Follow the staff user guides in FAMIS Resources to resolve conflicting actions related to FPL.
- Review this memorandum with appropriate staff.
KE/cj