Family MO HealthNet (MAGI) Manual – Table of Contents

1805.000.05 – Reasonable Opportunity

IM-#146, November 27, 2017IM-#71, June 15, 2017IM-#43, May 11, 2017IM-#13, February 1, 2017

Reasonable opportunity applies to the 90 day period participants are given to provide:

  • Citizenship verification or proof of qualified immigrant status
  • Social Security Number
  • NOTE: Section 6036 of the Deficit Reduction Act of 2005 (DRA) states that when documentation of citizenship includes proof of identity, the application may be approved pending documentation of citizenship even when proof of identity has not been provided. Do not provide a reasonable opportunity period for verification of identity only.

Section 1902(a) of the Social Security Act requires individuals to apply for and provide a Social Security Number (SSN) as a condition of eligibility for MO HealthNet. See 1805.015.00 SOCIAL SECURITY NUMBER for exceptions.

Allow reasonable opportunity for persons requesting benefits who do not have citizenship documents/proof of qualified immigrant status or a SSN at the time of application.

Reasonable opportunity for SSN is only allowed when proof of application for a SSN is provided. Reasonable opportunity for SSN is not given if:

  • Proof/documentation of applying for a SSN is not provided; or

    NOTE: If the application for SSN is for employment authorization only, they may receive the RO period.

  • The person already has a SSN, but refuses to provide it to FSD.

When an applicant does not already have a SSN at the time of the Family MO HealthNet application:

    1. Send the participant a Request for Information to provide proof of application for SSN. Self-attestation of application for a SSN is not acceptable; documentation must be provided.

NOTE: Under 42 CFR 435.910, FSD staff must assist applicants in obtaining a SSN. Refer to 1805.015.00 SOCIAL SECURITY NUMBER for more information.

    1. When proof of application for a SSN is received, and all other eligibility criteria are met, approve the Family MO HealthNet application. Do not deny or delay the approval pending the issuance of a SSN once the application for SSN has been verified.
    2. Allow a 90 day reasonable opportunity period for the participant to provide his or her SSN.

NOTE: The 90 day reasonable opportunity period begins the day the MO Health Net application is approved.

    1. Close coverage for individuals who fail to provide a SSN by the end of the 90 day reasonable opportunity period, (see manual section 1805.015.05 Failure to Complete a SSN Application or Furnish a SSN).

Example: Ms. Jones states on her Family MO HealthNet application that she does not have a SSN. A Request for Information notice is sent to Ms. Jones to request proof of application for a SSN. Ms. Jones submits verification that she has filed for a SSN. She is eligible on all other factors and is approved for coverage. She is given a 90 day reasonable opportunity period to provide the SSN.

Section 6036 of the DRA requires individuals claiming U.S. citizenship or qualified immigrant status to provide satisfactory documentary evidence of citizenship or nationality when applying for MO HealthNet. Refer to MAGI Manual section 1805.020.05.05 Documents to Verify Citizenship for information on acceptable citizenship documentation. Refer to MAGI Manual section 1805.020.10 Qualified Immigrant for information on persons with qualified immigrant status.

    1. Applicants for Family MO HealthNet must declare under penalty of perjury that they are citizens or qualified immigrants on a document that explains the penalties under state law for obtaining public assistance benefits fraudulently. The signed application serves as this declaration. RSMo. 208.009 states that an applicant who cannot provide proof of citizenship or qualified immigrant status at the time of application may be given a reasonable opportunity to provide the information if:

      • The signed application contains the individual’s Social Security Number or any applicable federal identification number; or
      • FSD receives a signed statement of attestation to either United States citizenship or classification by the United States as an alien lawfully admitted for permanent residence which contains the individual’s Social Security Number or any applicable federal identification number.

NOTE: Social Security Numbers issued to non-citizens are allowable since the individual may have qualified immigrant status. If a participant provides a SSN, but does NOT claim citizenship or qualified immigrant status, do NOT pend the application for citizenship/qualified immigrant status and do NOT provide a 90 day reasonable opportunity period.

      1.  

    An applicant who has provided a sworn statement of citizenship or qualified immigrant status, and provided a Social Security number (or provided proof of application for a SSN), or applicable federal identification number is eligible to receive MO HealthNet for Families program coverage as follows:

      • For ninety (90) days or until such time that it is determined that the applicant is not lawfully present in the United States, whichever is earlier; or
      • Indefinitely if the applicant provides a copy of a completed application for a birth certificate that is pending in Missouri or some other state. An extension of the reasonable opportunity period for a birth certificate ends when FSD receives a copy of the applicant’s birth certificate or a determination that a birth certificate does not exist because the applicant is not a United States citizen.

NOTE: When waiting on a birth certificate, staff must still review the case in ninety (90) days and then provide 30 day extensions of the reasonable opportunity period as needed.

When an applicant does not provide a SSN, other federal identification number, or citizenship documents/proof of qualified immigrant status at the time of the Family MO HealthNet application:

      1. Send the participant a Request for Information to provide the SSN (or proof of application for a SSN), applicable federal identification number, and citizenship verification documents/proof of qualified immigrant status.

NOTE: Self-attestation of SSN or applicable federal identification number is acceptable to provide the reasonable opportunity period. If an applicant declares citizenship status, but does not have a SSN or citizenship documentation, FSD must assist the participant in applying for a SSN (see 1805.015.00 SOCIAL SECURITY NUMBER). If the participant is submitting a birth certificate, they must provide verification that they have applied for it in order to receive reasonable opportunity.

      1. When the SSN/proof of application for a SSN or applicable federal identification number is received, or the participant has submitted proof they have ordered a birth certificate, and all other eligibility criteria are met, approve the Family MO HealthNet application. Do not deny or delay the approval pending the citizenship/proof of qualified immigrant status documents.
      2. Allow a 90 day reasonable opportunity period for the participant to provide his or her citizenship documents/proof of qualified immigrant status or birth certificate.

Example: Ms. Jones applies for Family MO HealthNet coverage as a qualified immigrant, but does not include a SSN or applicable federal identification number on her application. A Request for Information notice is sent to Ms. Jones to request SSN, applicable federal identification number, and qualified immigrant documents. Ms. Jones submits her alien identification number, but not her supporting documents. She is eligible on all other factors and is approved for coverage. She is given a 90 day reasonable opportunity period to provide the qualified immigrant documents.

NOTE: The 90 day reasonable opportunity period begins the day the MO Health Net application is approved. If proof of application for SSN is received, staff may approve the application and provide a 90 day reasonable opportunity period for both citizenship and SSN concurrently.

      1. Close coverage for individuals who fail to provide citizenship or qualified immigrant documents by the end of the reasonable opportunity period.

NOTE: The reasonable opportunity period may be extended beyond the 90 day period if a participant is making a good faith effort to provide verification of citizenship or qualified immigration status.

If documentation has not been provided within 90 days:

      • Send an Adverse Action Notice (IM-80) to discontinue MO HealthNet coverage for all members for whom citizenship documentation has not been provided, and
      • Once the Adverse Action Notice (IM-80) expires, discontinue coverage for all participants for whom documentation of citizenship or qualified immigrant has not been provided.

If the participant responds before the expiration of the Adverse Action Notice, but does not have citizenship documentation or proof of qualified immigrant status:

      • Determine whether the participant is making a good faith effort to provide documentation.
      • If the participant is making a good faith effort to provide documentation, staff may provide a 30 day extension of the reasonable opportunity period with supervisor approval. If the participant is continuing to make a good faith effort, but more time is required, staff will need to submit a Request for Interpretation of Policy (IM-14) with supporting documents through proper supervisory channels. Staff should follow-up on good faith efforts until FSD receives the requested information or a determination that the documentation does not exist because the applicant is not a United States citizen or qualified immigrant.
      • If the participant is not making a good faith effort to provide documentation, discontinue MO HealthNet coverage for all members for whom citizenship documentation or proof of qualified immigrant status has not been provided once the Adverse Action Notice (IM-80) expires.

EXAMPLE: Ms. Jenkins did not provide documentation of qualified immigrant status when she applied for Family MO HealthNet. She supplied her applicable federal identification number, was found eligible on all other factors, was approved for coverage, and was given 90 days to provide verification of qualified immigrant status on 8/10/2016. The 90 reasonable opportunity period ends in November 2016.

Ms. Jenkins fails to provide documentation of qualified immigrant status by November. The Eligibility Specialist sends Ms. Jenkins an Adverse Action Notice (IM-80) to discontinue MO HealthNet coverage. Before the expiration of the Adverse Action Notice, Ms. Jenkins provides a letter from the United States Citizenship and Immigration Services (USCIS) explaining the paperwork delay. The Eligibility Specialist, with supervisor approval, voids the adverse action, and sends a new Request for Information providing Ms. Jenkins with a 30 day extension of the reasonable opportunity period.

Approval notices for Family MO HealthNet benefits approved with a reasonable period must state that the participant’s continued eligibility is contingent on the provision of SSN or verification of citizenship/qualified immigrant status.>