As provided in 42 CFR 435.907, all MO HealthNet (MHN) applications are signed under penalty of perjury regardless of application method.
Acceptable paper MHN applications can be found in the DSSManuals Forms Manual.
The following individuals may apply for MO HealthNet Programs on behalf of a participant:
- The participant
- The participant’s spouse
- An adult (age 18 or over) who is part of the participant’s tax-filing or non-filing household. Reference 26 U.S.C. 36B(d)(1) and 42 CFR 435.603(f)(1).
EXAMPLE: Carlos is a disabled individual. He is 23 years old, but lives with his mom, Andrea. Andrea claims Carlos as a tax dependent and can sign the application for MHN for Carlos.
EXAMPLE: Tyanna is 15 years old and is living with her mother, Dinah. Dinah does not expect to file taxes or claim Tyanna as a dependent on taxes next year, but Tyanna is living with her and will continue living with her. Dinah can sign the MHN application for Tyanna as she is part of her non-filing household.
- An individual with a valid power of attorney to act on behalf of the participant
- An authorized representative of the participant
- If the participant is a minor or incapacitated person only the following people may apply on their behalf:
- A parent, including minor parents on behalf of their minor children or any child in his or her legal custody
- An authorized representative
- A guardian or conservator
- Someone acting responsibly for the applicant. This person must be age 18 or older and have the capacity to enter into a contract and who:
- Is related to the applicant by blood, marriage, or adoption; OR
- Is a person who the division reasonably determines has sufficient knowledge of the applicant’s circumstances to accurately complete the application, and has an obligation to act in the best interests of the applicant.
NOTE: Acting responsibly and signing an application does NOT qualify the person as an authorized representative. Their authority is limited to making the application valid.
- A minor, regardless of age, can sign the application, if any of the following conditions apply:
- lawfully married
- a parent
- legally emancipated
- A minor who is homeless and/or a victim of domestic violence meeting the criteria below (per RSMo 431.056(1)):
- age 16 or 17 years old
- homeless (per RSMo 167.020(1))
- sharing housing (couch surfing and/or temporary sharing)
- living in motels, hotels, or campgrounds
- living in emergency or transitional shelters
- living in cars, parks, abandoned building, bus or train stations
- other night time residences that are not designed for or ordinarily used as a regular sleeping accommodation for people
- self-supporting (parents and/or guardians are not providing physical or financial support)
- a parent and/or guardian is unwilling or unable to provide care for the minor. This may be explicit statements or implied by:
- making statements (written or verbal) that the minor may live independently.
- barring the minor from the home or otherwise indicating they are not welcome to stay.
- refusing to provide any financial support.
- abusing or neglecting the minor or committing acts of domestic violence against the minor.
NOTE: Although minors may apply on their own behalf in certain circumstances, their household composition must still follow the household composition rules in MAGI policy sections 1805.030.10 MAGI Household Composition through 1805.030.10.25 Caretaker Relatives.
Explore a Children’s Division Referral
If the participant is an unaccompanied minor age fifteen (15) or under and applying without a responsible adult, explore the following:
- Where is the child living?
- Who does the child live with?
- Is there a responsible adult living in the child’s household?
If the child is not living with a responsible adult, report this to Children’s Division through the Mandated Online Reporting site found at https://dss.mo.gov/cd/can.htm. FSD staff must complete the online referral with all known information.