IM-66 JANUARY 2025 COLA ADJUSTMENT OF SSA/SSI/VA/RR INCOME FOR ALL INCOME MAINTENANCE PROGRAMS EXCEPT MAGI MO HEALTHNET

FROM: KIM EVANS, DIRECTOR

SUBJECT: JANUARY 2025 COLA ADJUSTMENT OF SSA/SSI/VA/RR INCOME FOR ALL INCOME MAINTENANCE PROGRAMS EXCEPT MAGI MO HEALTHNET

MANUAL REVISION #
APPENDIX B
APPENDIX D
APPENDIX E
APPENDIX J
APPENDIX K

 

DISCUSSION:

In January 2025, all Social Security Administration (SSA), Supplemental Security Income (SSI), Veterans Administration (VA), and Railroad Retirement (RR) participants will receive a 2.5% Cost of Living Adjustment (COLA).

The weekend of December 14, 2024, a mass adjustment will be completed in the eligibility system for Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance (TA), and Non-MAGI MO HealthNet cases. Income increases for SSA, SSI, VA, and/or RR and other adjustments will be completed. Medicare Premium amounts and federal eligibility standards will also be updated.

Note: The 2025 COLA will have the following effect on SNAP cases:

  • Increase in SNAP benefit reductions for January 2025.
  • Increase in SNAP closures for December 2024.

SSI Increases

SSI Table 2024 AMOUNT 2025 AMOUNT INCREASE
SSI Individual maximum (in own household)  $943  $967  $24
SSI Couple maximum (in own household)  $1415  $1450  $35
SSI Individual in household of another  $629  $645  $16
SSI Couple in household of another  $943  $967  $24
SSI Essential person/own home  $472  $484  $12

Non-MAGI Standards Adjustments

NON-MAGI STANDARDS 2024 AMOUNT 2025 AMOUNT
Maximum Allotment of Community Spouse  $3,854  $3,948
Minimum Maintenance Standard for Allotments  $2,465  $2,555
Maximum Allocation to a child  $472  $483
Maximum Allotment to a child  $821  $852
Minimum Spousal Share  $30,828  $31,584
Maximum Spousal Share  $154,140  $157,920
Maximum Home Equity  $713,000  $730,000
HCB Maximum  $1,649  $1,690
SAB Standard  $1,019  $1,044

Supplementary Medical Insurance (SMI) Premium Adjustment

The standard SMI, commonly known as Medicare Part B, premium will increase for 2025 to $185.00. Premiums for Medicare participants who pay less than the standard premium amount will not have an increase of more than the amount of the increase in Social Security benefit the individual received.

Additional Non-MAGI Program Increases

Resource Limits for Medicare Savings Programs (QMB/SLMB/QI-1)

For a single individual, the resource limit increases to $9,660. For a married couple, the resource limit increases to $14,470. There is no change in policy regarding how to determine available resources.

Minimum and Maximum Spousal Share

The 2025 minimum spousal share is $31,584. The new maximum spousal share is $157,920. Both amounts become effective for any Division of Assets completed on or after January 1, 2025.

Substantial Gainful Activity (SGA)

The SGA monthly amounts increase and are as follows:

  • $2,700 for statutorily blind individuals
  • $1,620 for non-blind individuals

Appendices Updates

The following appendices were updated to show the new amounts:

Note: Appendix J and Appendix K were updated to reference Resource Limits, instead of Asset Limits. Appendix K was updated to correct the Blind Pension and Supplemental Aid to the Blind grant amount to $828, as it was increased in 7/2024.

  • December 1973 Eligibility Requirements Manual
    • Appendix D – Substantial Gainful Activity

 

Adjustments by Program and Mass Adjustment Process

All programs will be adjusted according to program. Review FAMIS Resources for further information about the mass adjustment process.

Senate Bill 577 (2007) authorized the disregard for Social Security COLA increases for certain MO HealthNet (MHN) programs with income eligibility based on federal poverty level (FPL) until the next FPL adjustment in April. All SSA, SSI, VA, and RR income sources will be updated with the new income amount and verification code “CO” for COLA adjustment.

Note: For budget months prior to January 2025, do not use the “CO” – COLA verification code.

Reports with Actions Needed

Reports with action needed will be distributed to the SNAP, TA, and MHN Program Managers for assignment. Follow the instructions in FAMIS Resources on how to process each type of report.

Request for Hearing/Continued Benefits

When a fair hearing is requested, follow current fair hearing request procedures.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Search “COLA” or “Adjustment” in FAMIS Resources for processing guidance.
  • State Office will provide the SSA/SSI/VA/RR Needing Review report to designated staff.
  • Allow MHN Policy for “CO” income verification to disregard SSA and SSI COLA Adjustments until the Federal Poverty Level (FPL) Adjustment in April.

 

 

 

KE/cj

IM-61 CLARIFICATION OF MAGI ZERO INCOME POLICY RELATED TO QUARTERLY INCOME ON IMES

FROM: KIM EVANS, DIRECTOR

SUBJECT: CLARIFICATION OF MAGI ZERO INCOME POLICY RELATED TO QUARTERLY INCOME ON IMES

MANUAL REVISION #
1805.030.05

 

DISCUSSION:

The Zero Income section of 1805.030.05 Income Evidence has been updated to clarify:

  • Use reasonable compatibility to determine if the participant’s statement of zero income and the Electronically Obtained Income (EOI) result in eligibility in the same threshold.
  • Quarterly wage information from IMES may not be current enough to cause a participant’s statement of zero income to be questionable.

Remember that the goal is to use Electronically Obtained Information (EOI) to confirm the participant’s stated income. Only send a request for information after all other options have been exhausted.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

 

 

KE/rc

IM-52 UPDATED REVISION DATE FOR ONLINE AGED, BLIND, AND DISABLED SUPPLEMENT (IM-1ABDS)

FROM: KIM EVANS, DIRECTOR

SUBJECT: UPDATED REVISION DATE FOR ONLINE AGED, BLIND, AND DISABLED SUPPLEMENT (IM-1ABDS)

 

DISCUSSION:

The Aged, Blind, and Disabled Supplement (IM-1ABDS) was updated in 10/2023, but the revision date was not initially updated on the online form. The online form is now updated and will show the correct 10/2023 revision date for forms submitted after 9/11/2024.

FSD will accept the IM-1ABDS with the 8/2022 revision date as a valid form. Disregard the statement in Memo IM-89 OCTOBER 2023 – QUARTERLY FORMS UPDATE that the obsolete form may not be accepted.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

 

 

KE/cj

IM-43 UPDATE TO THE DOCUMENTATION OF INCURRED MEDICAL EXPENSES IN THE MO HEALTHNET FOR THE AGED, BLIND, AND DISABLED (MHABD) MANUAL

FROM: KIM EVANS, DIRECTOR

SUBJECT: UPDATE TO THE DOCUMENTATION OF INCURRED MEDICAL EXPENSES IN THE MO HEALTHNET FOR THE AGED, BLIND, AND DISABLED (MHABD) MANUAL

MANUAL REVISION #
0810.010.15.01

 

DISCUSSION:

MHABD Manual section 0810.010.15.01 Documentation of Incurred Medical Expenses is revised to state:

FSD processes documentation of medical expenses in a timely manner to ensure correct coverage and sends a Spend Down Notice to notify the participant:

  • When the spend down liability was met;
  • When documentation of incurred medical expenses did not meet the spend down liability; and
  • When the documentation of incurred medical expenses was not allowed to meet the spend down and why the documentation was insufficient.

 

NECESSARY ACTION:

  •  Review this memorandum with appropriate staff.

 

 

 

KE/sh

IM-35 2024 MO HEALTHNET CHILDREN’S HEALTH INSURANCE PROGRAM (CHIP) PREMIUM ADJUSTMENT

FROM: KIM EVANS, DIRECTOR

SUBJECT: 2024 MO HEALTHNET CHILDREN’S HEALTH INSURANCE PROGRAM (CHIP) PREMIUM ADJUSTMENT

MANUAL REVISION #
Appendix A
Appendix E

 

DISCUSSION:

CHIP premiums will be adjusted July 1, 2024. Premiums are required for families with income above 150% of the Federal Poverty Level (FPL). Each year, as required by state statute, the MO HealthNet Division (MHD) establishes the new premium amounts. The new premiums range from a minimum of $18 to a maximum based on family size and gross income, not to exceed 5% of the family’s gross income. A premium chart with an effective date of July 1, 2024 is attached.

For CHIP cases active prior to July 1, 2024

The MHD Premium Collections Unit is including an advance notice of the upcoming change to premiums with invoices mailed July 2024 to all eligible premium group families. Premiums paid in June for July coverage will not change. Premiums invoiced in July for August coverage will reflect the new premiums.

For CHIP cases starting on or after July 1, 2024

Premiums for CHIP cases beginning on or after July 1, 2024 will immediately reflect the new amounts.

Questions about premiums

Refer any questions concerning premiums to the Premium Collections Unit at (877) 888-2811.

Hearing Requests

Hearings requested as a result of the premium change will be conducted by the MO HealthNet Division (MHD) using normal hearing procedures. Refer participants to the MHD Participant Services number: (800) 392-2161.

Hearings requested as a result of a change in income or household composition that affect the premium will be conducted by the Family Support Division (FSD). Reference Email Memo #22 dated 04/29/2021 for guidance on submitting a hearing request.

Evidence presented at the hearing must include a copy of the invoice from the Premium Collections Unit, a copy of the budget used to arrive at the monthly gross income, and the IM-4(PRM) reflecting the premium amounts based on income.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

ATTACHMENTS

IM-4(PRM)

 

 

 

KE/rc

IM-34 REVISIONS TO TICKET TO WORK HEALTH ASSURANCE (TWHA) FLYER

FROM: KIM EVANS, DIRECTOR

SUBJECT: REVISIONS TO TICKET TO WORK HEALTH ASSURANCE (TWHA) FLYER

FORM REVISION #
IM-4TWHA
IM-4TWHA (SPANISH)

 

DISCUSSION:

The IM-4TWHA was updated to provide information for how participants eligible for the TWHA program can make their premium payments.

The flyer has been updated in English and Spanish and is available in the public and internal forms manuals.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

 

 

KE/cj

 

 

IM-32 JULY 2024 ANNUAL NON-MAGI PROGRAM ADJUSTMENTS AND BLIND PENSION (BP) SUPPLEMENTAL AID TO THE BLIND (SAB) GRANT ADJUSTMENT

FROM: KIM EVANS, DIRECTOR

SUBJECT: JULY 2024 ANNUAL NON-MAGI PROGRAM ADJUSTMENTS AND BLIND PENSION (BP) SUPPLEMENTAL AID TO THE BLIND (SAB) GRANT ADJUSTMENT

MANUAL REVISION #

APPENDIX A
APPENDIX B
APPENDIX J
APPENDIX K

 

DISCUSSION:

Supplemental Aid to the Blind (SAB) and Blind Pension (BP)

Effective July 1, 2024, SAB and BP grants increase from $789 to $828.

The appendices listed above have been updated with July 2024 data.

Resource Limit

As a result of HB1565 (2016), resource limits for Non-MAGI programs, except BP and Medicare Savings Programs, increase July 1, 2024. Appendices J and K have been updated with the new amounts.

The weekend of June 8, 2024, all Non-MAGI cases are adjusted in the eligibility system. The Individual Resource Limit and Couple Resource Limit will be updated for actions effective the month of July 2024 and thereafter.

Effective July 1, 2024:

  • Individual Resource Limit: $5,909.25
  • Couple Resource Limit: $11,818.45

Minimum Monthly Maintenance Needs Allowance (MMMNA) and Shelter Standard

Effective July 1, 2024, the MMMNA and Shelter Standard are increased for Vendor cases.

The weekend of June 8, 2024, all Vendor cases are adjusted in the eligibility system. Allotments for community spouses, minor children, and eligible dependents and the MMMNA and Shelter Standard are updated for actions effective the month of July 2024 and later.

Effective July 1, 2024:

  • Minimum Maintenance Standard: $2,555
  • Shelter Standard: $767

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

 

 

KE/mc

IM-31 DOCUMENTS ADDED THAT VERIFY BOTH CITIZENSHIP AND IDENTITY FOR ALL MO HEALTHNET (MHN) PROGRAMS

FROM: KIM EVANS, DIRECTOR

SUBJECT: DOCUMENTS ADDED THAT VERIFY BOTH CITIZENSHIP AND IDENTITY FOR ALL MO HEALTHNET (MHN) PROGRAMS

MANUAL REVISION #
1805.020.05.05

 

DISCUSSION:

Effective June 3, 2024, due to requirements in the 2024 Centers for Medicaid and Medicare Services (CMS) Final Rule, verification of birth using Department Health-Birth Name Inquiry (IBTH) or verification of citizenship using Systematic Alien Verification for Entitlements (SAVE) now verifies both citizenship and identity.

Family MO HealthNet (MAGI) manual section 1805.020.05.05 Documents to Verify Citizenship has been updated to include both IBTH and SAVE as acceptable documents that verify both citizenship and identity.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

 

 

KE/sh

IM-30 EXTENSION OF THE TEMPORARY RECONSIDERATION PERIOD POLICY FOR ALL MO HEALTHNET (MHN) PROGRAMS

FROM: KIM EVANS, DIRECTOR

SUBJECT: EXTENSION OF THE TEMPORARY RECONSIDERATION PERIOD POLICY FOR ALL MO HEALTHNET (MHN) PROGRAMS

MANUAL REVISION #
0840.005.05
1880.020.00

 

DISCUSSION:

Temporary reconsideration period policy for all MHN programs introduced in IM-28 RECONSIDERATION PERIOD DURING THE TRANSITION PERIOD FOR ALL MO HEALTHNET (MHN) PROGRAMS has been extended. Continue to follow the instructions outlined in the memorandum until further notice.

MO HealthNet for the Aged, Blind, and Disabled (MHABD) manual section 0840.005.05 Reconsideration Period and Family MO HealthNet (MAGI) manual section 1880.020.00 Reconsideration Period have been updated to remove the end date for the temporary policy.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

 

 

KE/sh

IM-29 UPDATES TO 1619 POLICY

FROM: KIM EVANS, DIRECTOR

SUBJECT: UPDATES TO 1619 POLICY

MANUAL REVISION #
0850.000.00
0850.005.00
0850.005.05
0850.005.10
0850.005.15
0850.005.20
0850.010.00
0850.020.00

 

DISCUSSION:

Updates have been made to 1619 policy in the MO HealthNet for the Aged, Blind, and Disabled (MHABD) Manual. Updates include revisions to remove outdated information, including verifying 1619 status and processes, and update terminology.

MHABD Manual section 0850.010.00 Case Processing Procedures Section 1619 Status Cases, is now obsolete.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

 

 

KE/st