Category: MoHealthNet Home

FROM:PATRICK LUEBBERING, DIRECTORSUBJECT:REVISION OF ACHIEVING BETTER LIFE EXPERIENCE (ABLE) MANUAL SECTIONSMANUAL REVISION #9
1025.015.17
0805.015.10

DISCUSSION:

The purpose of this memorandum is to announce a revision to the 1025.015.17 Achieving Better Life Experience (ABLE) Account section of the December 1973 Eligibility Requirements Manual and the 0805.015.10 Income Exclusions section of the Medical Assistance for the Aged, Blind, and Disabled manual.

The following information has been updated:

• contributions to ABLE accounts
• distributions from ABLE accounts
• resource values of ABLE accounts

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

PL/ers

FROM:  PATRICK LUEBBERING, DIRECTORSUBJECT:  REASONABLE COMPATIBILITY WITH MORE THAN ONE INCOME IN THE HOUSEHOLDMANUAL REVISION #7
1805.030.15.10

DISCUSSION:

The purpose of this memorandum is to clarify policy regarding reasonable compatibility when there is more than one income in a household.

EXAMPLE: Husband and wife apply for their children’s coverage. Mom has one source of income and dad has one source of income.

We have added manual section 1805.030.15.10 Reasonable Compatibility with More Than One Income in the Household to clarify what to do when comparing self-attested combined income and electronically obtained combined income (EOI) and:

• One statement of combined income (EOI or self-attested) is below the income guideline and one statement of combined income (EOI or self-attested) is above the guideline; and
• the difference between the two (2) statements of income is greater than 10%

NECESSARY ACTION:

• Review this memorandum and manual revision with appropriate staff.

PL/df

FROM:  PATRICK LUEBBERING, DIRECTOR

SUBJECT:  MAGI PRE-POPULATED ANNUAL RENEWAL FORM (IM-1U) TIMEFRAMEMANUAL REVISION #6
1880.005.00

DISCUSSION:

This memorandum provides an update to the MAGI Pre-populated Renewal Form 1880.005.00 section in the Annual Renewal policy.

Effective immediately the participant has 30 calendar days to return the pre-populated Annual Renewal form (IM-1U). Previously the participant had 45 days to return the IM-1U.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

PL/ks

FROM:  PATRICK LUEBBERING, DIRECTOR

SUBJECT:   BLIND PENSION MANUAL UPDATE DUE TO HOUSE BILL 2171

MANUAL REVISION #4
0505.025.00
0505.025.05
0505.025.10
0505.050.00
0505.060.00
0505.060.05

DISCUSSION:

House Bill 2171 (2018) revised Sections 209.030 and 209.040 RSMo and updated several eligibility factors for the Blind Pension (BP) program, see IM Memorandum #58 for further details. These changes are effective August 28, 2018. The BP manual has been updated to reflect these changes.

Changes include:

• The resource limit has increased from $20,000 to $30,000,
• $100,000 contributed to an ABLE account belonging to the blind individual is excluded from the resource calculation,
• All contributions made to an ABLE account belonging to the sighted spouse is excluded from resource calculations,
• A person who obtains, maintains, or renews a driver license in any state or territory is not eligible for BP,
• Applicants for BP must surrender their driver license within 60 days of approval for BP in order to continue to be eligible,
• A BP recipient who operates a motor vehicle, with or without a valid driver license is not eligible for BP,
• Sighted spouse income of 500% of the federal poverty level or greater will cause ineligibility,
• Participants must report changes in circumstances within 10 days of the change,
• Visual eligibility must be established in both eyes, the better eye must meet current eligibility requirements of 5/200 or visual field of 5 degrees tested on 5 millimeter target on perimeter, and must have lasted 12 months or be expected to last at least 12 months,
• The examining ophthalmologist, physician, or optometrist may indicate that a reexamination should be performed in less than 5 years, if the individual’s vision may reasonably be expected to improve within 5 years,
• FSD may require a visual reexamination before the date indicated by the examining ophthalmologist, physician, or optometrist, if there is reason to believe the BP participant is not eligible.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

PL/vb

FROM:  PATRICK LUEBBERING, DIRECTORSUBJECT:  UPDATED SIGNATURE REQUEST LETTERFORMS REVISION #1
IM-1SSL Signature Request Letter

DISCUSSION:

The IM-1SSL Signature Request letter has been updated with a new format. Staff should return any original unsigned IM-1SSL application with the IM-1SSL Signature Request Letter and an FSD addressed envelope to the customer within three business days.

Please refer to IM-#036, 04/30/2018 and section 1802.020.05 Application with No Signature of the Family MO HealthNet (MAGI) manual for more information on handling unsigned applications.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

PL/kp

FROM:  PATRICK LUEBBERING, DIRECTOR

SUBJECT:  QUALIFIED INCOME TRUST CONSIDERATION AS A RESOURCE OR INCOME

MANUAL REVISION #2
0805.015.10
0820.030.15
1025.015.04.01.02
1030.035.20.05

DISCUSSION:

42 UCS 1396p(d)(4)(B) created an avenue for individuals receiving or applying for MO HealthNet for the Aged, Blind or Disabled program under the Home and Community Based (HCB) waiver services, Program for All-Inclusive Care for the Elderly (PACE) and MO HealthNet for Children with Developmental Disabilities (MOCDD) to allocate a portion of their own earned or unearned income into a specified and excluded trust. This trust is referred to as a Qualified Income Trust (QIT) or Miller Trust.

The sole purpose of a Miller trust is to reduce the income consideration for an HCB, PACE, or MOCDD participant so that they can be budgetarily eligible for these hard income cap programs. It does not apply to programs that do not have a hard income cap, such as MO HealthNet Non-spend Down or Ticket to Work Health Assurance. If the trust is considered a valid Miller trust, all monies deposited into it are excluded as both income and resource for the participant. This exclusion applies only to the HCB, PACE and MOCDD determinations. It does not apply to any other MO HealthNet or Family Support Division (FSD) programs.

The hallmarks of a valid Miller Trust:

• Irrevocable
• Uses only the beneficiary’s income to create and maintain the trust
• Income must be deposited regularly
• The beneficiary must be disabled
• Missouri must be named as a beneficiary upon death of the participant
• The beneficiary cannot serve as Trustee
• Disbursements from the trust must be for the participant/beneficiary or the beneficiary’s spouse or disabled child if they reside in the home with the beneficiary
• The beneficiary must be applying for, or receiving HCB, PACE or MOCDD services

Example: Beth Jones receives $1380 gross in Social Security Disability benefits. She has applied for HCB. The current HCB maximum is $1311. She does have her SMI premium taken out of her Social Security, but HCB uses the gross income. Therefore she is $69 over the HCB maximum. She can create a Miller trust, and agree to deposit at least $69 each month into the trust. She decides to deposit $80 a month. Once this trust is set up, the $80 will no longer be counted as income for her HCB determination and she is found to be HCB eligible. Monies in the trust can be used to reimburse her for her SMI premium each month.

Until FAMIS programming is complete, the Poplar Bluff Processing Center, which is tasked with processing these cases with the exception of MOCDD, will employ a work-around to exclude the income from consideration for the appropriate programs without impacting other assistance groups.

The requirement to submit all trust documents to Program and Policy for determination of income and/or resource availability has not changed.

The relevant Income Maintenance Manual sections have been updated to reflect this change.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.
• Send all trusts to MO HealthNet Program and Policy for review.

PL/mah