Family Healthcare (FAMIS)

0950.070.00 MO HEALTHNET BENEFITS FOR PRESUMPTIVELY ELIGIBLE CHILDREN

Children determined presumptively eligible for MO HealthNet receive the same coverage (LOC 1) during the presumptive period. The children active under Presumptive Eligibility for Children are not enrolled in managed care. While the children must obtain their presumptive determination from a qualified entity, once eligible they can obtain covered services from any enrolled MO HealthNet fee-for-service provider. Coverage begins on the date the qualified entity makes the presumptive eligibility determination and coverage ends on the later of:

  1. 5th day after the Presumptive Eligibility for Children determination date,
  2. the day a MO HealthNet for Kids, Pregnant Women and Parents application is approved or rejected; or
  3. if the caretaker does not apply for MO HealthNet, coverage ends the last day of the month following the month of the presumptive eligibility determination.