Family MO HealthNet (MAGI)

1820.040.10 Budgeting For Income Eligibility

IM-#19, February 07, 2018

On the second and third quarterly reports, parent/caretaker relatives report income for the second and third quarters of Transitional MO HealthNet eligibility. Accept the parent/caretaker relative’s self-attestation of income. Use the quarterly report to:

  • determine the MAGI for the household; and
  • compare the MAGI to 196% of the federal poverty level for the household size.

Income should be considered in the same manner shown in manual section 1805.030.00 Modified Adjusted Gross Income (MAGI) Methodology.

The household for this budget includes:

  • All Transitional MO HealthNet eligible individuals; and
  • Any parent or dependent child in the household who is not an original household member.

NOTE: If an individual moves into or out of a Transitional MO HealthNet household during the report quarter, include members in the household based on the situation at the end of the quarter.

If MAGI is greater than 196% of the poverty level, explore the children’s eligibility under other MO HealthNet programs. The quarterly report form gives the household the opportunity to report if anyone is pregnant, blind or disabled. Complete a review based on the information available. An Adverse Action Notice (IM-80) is required when a household member:

  • Is not eligible for equal coverage in another MO HealthNet program; or
  • Is not eligible for any other MO HealthNet coverage.

If the household requests, prior to expiration of the IM-80, to keep coverage open until a hearing decision is made, allow the TMH to continue, pending the outcome of the hearing. Discontinue eligibility under TMH at the end of the seventh or tenth month, whichever is applicable if there is no request for a hearing.