Family Healthcare (FAMIS)

0950.030.10 PRESUMPTIVELY INELIGIBLE

Qualified entities should submit Presumptive Eligibility determinations completed that reflect ineligibility to the local FSD county office for entry in the IMU5 system. The FSD county office staff will register a Presumptive Eligibility for Children application and enter a rejection in the system. It is necessary to enter the qualified entity number in field 15b when entering the rejection.

The system will only accept the following reason codes in field 7 of a Presumptive Eligibility rejection:

  • 01     Income exceeds limits
  • 38     Non-resident
  • 75     Received within last 12 months

Keep all denial PC-1 forms in the file with the MO HealthNet case file.

The qualified entity is required to send the IM-1UA even if the child is found ineligible for Presumptive Eligibility for Children. Upon receipt, register and process the MO HealthNet for Kids, Pregnant Women and Parents (IM-1UA) application submitted with the Presumptive Eligibility for Children denial.