Department of Social Services
Family Support Division
PO Box 2320
Jefferson City, Missouri
TO: ALL FAMILY SUPPORT OFFICES
FROM: KIM EVANS, DIRECTOR
SUBJECT: MO HEALTHNET FOR THE AGED, BLIND AND DISABLED (MHABD) MANUAL AND FORM REVISION- MEDICAL DEDUCTIONS WHEN DETERMINING SURPLUS
MANUAL REVISION #47
DISCUSSION:
MHABD manual section 0815.030.10.15 Medical Expenses When Determining Surplus, has been revised.
Health Insurance Premiums: Health insurance premiums for the institutionalized participant paid by the participant or his/her community spouse may be allowed as medical deductions. The manual has been revised to clarify that if it cannot be determined what portion of the insurance premium is for the institutionalized participant, allow the total premium.
Post Eligibility Medical Expenses: Requests for a reduction in surplus affect the participant’s budgeted expenses and these requests must be made by the participant or their Authorized Representative. Requests for reduction in surplus are not required to be in writing.
If the participant prefers that the nursing home or other provider make this request on their behalf, the participant or their Authorized Representative can sign the Post Eligibility Medical Expense Budgeting Request form (IM-63 PEME) giving FSD permission to accept this request from the provider.
New forms have been created for the Post Eligibility Medical Expense (PEME) reduction in surplus determination.
- IM-62 PEME Notice of Post Eligibility Medical Expense Reduction in Surplus
- PEME Facility Notification- Approval
- PEME Facility Notification- Denial
- IM-63 PEME Post Eligibility Medical Expense Budgeting Request
NECESSARY ACTION:
- Review this memorandum with appropriate staff.
KE/rr