FROM: KIM EVANS, DIRECTOR
SUBJECT: INTRODUCING AGED, BLIND, AND DISABLED SUPPLEMENT (IM-1ABDS) AND OBSOLETING APPLICATION FOR MO HEALTHNET (MEDICAID) (IM-1MA)
FORM REVISION #
The Aged, Blind, and Disabled Supplement (IM-1ABDS) has been created for use with the Application for Health Coverage & Help Paying Costs (IM-1SSL) which is currently used for Family MO HealthNet (MAGI) programs. The Aged, Blind, and Disabled Supplement (IM-1ABDS) collects program specific information and asset information for the MO HealthNet for the Aged, Blind and Disabled (MHABD) programs. Spanish and Large Print forms are also available. This change simplifies the application process for participants who want to apply for Medicaid benefits and provides Family Support Division (FSD) with the information to explore all potential Medicaid coverage.
Effective July 6, 2021 when a participant applies for MO HealthNet (MHN), they must complete the IM-1SSL to collect address, household members, income, and other basic MHN eligibility information. If the participant is disabled, blind, over the age of 65, or in need of long-term care, then they will also complete the IM-1ABDS to collect information regarding program specific questions, assets, and other expenses required for the MHABD programs.
The IM-1ABDS CANNOT be accepted as an application without the signed IM-1SSL. If an IM-1ABDS is received without a signed application, FSD staff must contact the participant to advise that they did not submit a valid application and provide information about applying online or by phone, or offer to mail an application to the participant. The application date is the date a signed IM-1SSL is received.
Staff should complete the IM-1ABDS if the required information cannot be collected from the participant by phone or in person.
The IM-1ABDS CAN be used by a participant to request a referral for an active MAGI participant who is requesting MHABD benefits. Staff must follow current procedures for exploring MHABD coverage.
As of 7/6/2021, the IM-1MA is obsolete and should not be distributed by FSD staff. Unused applications should be discarded and the IM-1SSL and IM-1ABDS should be used for all MHABD applicants. Staff who work with community partners and other stakeholders should advise of the new application process.
FSD will honor IM-1MA’s received between 7/6/2021 and 12/31/2021 as applications. An IM-1MA received prior to 12/31/2021 MUST be processed as a valid application.
NOTE: If an IM-1MA is received after 12/31/21, FSD staff must send an IM-1SSL and IM-1ABDS to the participant. If the IM-1SSL is returned, the date of application would be the date the IM-1MA was first received.
- Review this memorandum with appropriate staff.
- FSD staff should address any questions or concerns regarding this change through normal supervisory channels.
- FSD staff should order IM-1ABDS forms from the e-store.
- Access and print IM-1SSL and IM-1ABDS form from DSS Forms Manual.
- Discard any unused IM-1MA forms.