The Consolidated Appropriations Act, 2023, requires Medicaid and Children’s Health Insurance Programs (CHIP) to implement 12 months of Continuous Eligibility for Children (CEC).
Effective January 1, 2024 all children active on MO HealthNet (MHN) have continuous eligibility at their current level of care (LOC) or better until the household is due for an annual renewal. At the annual renewal, staff will make a new eligibility determination and a new CEC period will begin if the child remains eligible. Children are defined as being under 19 years of age. A child’s CEC period ends at 11:59 pm the day before the child’s 19th birthday.
CEC Period
Once an initial application is approved for MHN benefits, the CEC period begins. Children granted a Reasonable Opportunity period are the exception, please see 1805.000.05 Reasonable Opportunity (RO) for more information.
CEC periods last 12 months and prevent children from closing and/or eligibility from reducing. At the end of the CEC period, Family Support Division (FSD) must complete an annual renewal to determine eligibility. MHN eligibility may only be closed prior to the end of the CEC period if the child:
- Turns 19,
- Is no longer a Missouri resident,
- Child or child’s representative requests a voluntary termination of eligibility,
- Child dies,
- Eligibility was incorrectly granted at the most recent determination, redetermination, or renewal due to agency error or fraud, abuse, or perjury attributed to the child or child’s representative.
Change in Circumstance
In addition to preventing eligibility from closing, except when required, CEC also requires that benefits cannot be negatively affected due to changes reported by the household or discovered by FSD during the CEC period. Changes reported are entered into the eligibility system during the CEC period but can only be acted on if there is a valid closing reason (listed above) or the determination results in a better LOC.