December 1973 Eligibility Requirements Manual

1000.005.00 Application for Other Benefits

IM-113 August 6, 2019; IM-35 April 26, 2018; IM-25 March 8, 2013; IM-32 March 28, 2012

Federal Regulation 42 CFR-435.608 stipulates applicants for and recipients of MO HealthNet for Aged, Blind, and Disabled (MHABD), and Supplemental Nursing Care (SNC) must take all necessary actions to acquire annuities, pensions, retirement, and disability benefits to which they may be entitled to receive, unless the participant can show good cause for not doing so.

Examples of these benefits include, but are not limited to, Veteran’s benefits, Social Security Disability or Retirement, Railroad Disability or Retirement, Workman’s Compensation, Supplemental Security Income, Qualified Medicare Beneficiary and Specified Low Income Beneficiary programs, and union, association, company, or government employee benefit programs.

If the applicant answers yes to the MO HealthNet Declaration question on the application; “I/we agree to apply for other benefits I/we may be able to get” (RSDI, SSI, VA, etc.), and is potentially eligible for other benefits, the MHABD, or SNC application may be processed using self-attestation as evidence of the agreement to apply. Self-attestation may also be used when the participant states he/she has applied for other benefits he/she may be eligible to receive, but has not yet been approved, and there is no evidence available to verify status of the application.

Example of how this rule applies to SSI/SSDI: Self-attestation is acceptable “at application for MHABD programs” to verify there is a current pending application for SSI or SSDI. Hard copy verification is not necessary when evidence of the application is not displayed on IIVE, and no other source of verification is available. Staff will review status of the SSI/SSDI application at annual review and verify via IIVE or documentation the participant received from the Social Security Administration (SSA).

As a condition of ongoing eligibility at annual review, “application for other benefits” must be verified. The Application for Other Benefits Letter must be mailed to the participant at annual review to request verification.  Refer to 0840.005.00.05 Application for Other Benefits at Annual Renewal, and the Application for Other Benefits training guide for processing instructions in the eligibility system.