Family MO HealthNet (MAGI) Manual

1820.015.00 TMH Definitions

IM-19 February 7, 2018

The following definitions apply to Transitional MO HealthNet:

  1. Parent or Caretaker Relative – a relative by blood, adoption, or marriage who assumes primary responsibility for a child living in their home, and who is one of the following:
    • The child’s father, mother, grandfather, grandmother, brother, sister, stepfather, stepmother, stepbrother, stepsister, uncle, aunt, first cousin, nephew, or niece
    • The spouse of such parent or relative, even after the marriage is terminated by death or divorce. The parent or caretaker relative may claim the child as a dependent on income taxes, but is not required to do so
  2. Eligible Household Member – an individual who was member of the MHF household at the time the coverage was changed to TMH. If a parent/caretaker relative or dependent child who is not an original household member moves into the household during the Transitional MO HealthNet eligibility period, that person is not eligible for TMH (even though their needs and earned income are used to complete the budget in the second six months).

    NOTE: If a household member receiving TMH gives birth during the Transitional MO HealthNet period, that member’s child is eligible for automatic newborn coverage.

  3. Good Cause – when a Parent/Caretaker Relative states an acceptable reason for why something occurred. If a parent/caretaker relative contacts FSD claiming good cause, allow whenever possible. Good Cause must be claimed within 30 days of the notice due date. Below are two uses of Good Cause with TMH and the acceptable reasons:
    • Good cause for failure to return a Quarterly Report timely is limited to:
      • serious illness or death of the participant or a member of the participant’s household
      • a household emergency or household disaster, such as a fire, flood, or tornado
      • other good cause beyond the participant’s control (discuss such cases with the supervisor to determine if a participant has good cause and if unable to decide, obtain clearance through normal supervisory channels); or
      • The participant did not receive a quarterly report form for a reason not attributable to the participant (failure to furnish Family Support Division (FSD) with a current address is attributable to the participant)
    • Good cause when the parent/caretaker relative had no earnings in one or more of the three report months (on the second or third quarterly reports only), and lack of earnings resulted from:
      • The parent/caretaker relative personally provides care for a child under age six and their employer requires them to work more hours than they are able
      • Childcare is necessary for the parent/caretaker relative to continue employment and is not available
      • Self-employment income which results in the family experiencing a net loss of cash income. (i.e., if the claimant reports self-employment expenses higher than the self-employment income); or
      • Circumstances occur beyond the parent/caretaker relative’s control such as a serious illness, hospitalization, or a natural disaster