IM-04 January 11, 2024; IM-29 March 29, 2017
If continued MO HealthNet (MHN) eligibility cannot be established from the record, third-party verification, or the participant fails to provide the necessary information, send the Pre-closing Review Notice (IM-80PRE) to inquire about pregnancy, blindness, disability, and changes in income.
If the participant responds to the Pre-closing Review Notice within the ten (10) days indicating other possible eligibility, register the proper application and allow the current benefits to remain open pending the eligibility determination for the other category.
A new, signed application from the individual is not required to switch categories. Do not end one category of coverage before approval in the other category, or until the participant is determined ineligible for all MHN programs.
If a participant claims disability or blindness, the Aged, Blind, and Disabled Supplement (IM-1ABDS) may be required when determining eligibility for Non-MAGI programs.
If there is no response from the participant within ten (10) days indicating any other possible eligibility, initiate an Adverse Action Notice (IM-80) explaining:
- Reason for the loss of eligibility for the current program
- Reason ineligible for any MO HealthNet program
- Statement that we do not have information that indicates eligibility for any other MO HealthNet programs
NOTE: If the participant did not respond prior to the expiration of the IM-80PRE but does respond indicating other possible eligibility prior to the expiration of the IM-80, follow the instructions above for individuals who respond to the IM-80PRE.
NOTE: There are no appeal rights with the IM-80PRE since this is not an adverse action notice. If the final decision results in an adverse action, the IM-80 is required and hearing rights are provided.