Family MO HealthNet (MAGI) Manual – Table of Contents

1840.015.00 BEGIN AND END DATES FOR CHIP COVERAGE

IM-#153, November 30, 2017IM-#9 January 22, 2015

MO HealthNet eligibility and coverage for children in the No-Cost group (CHIP71 and CHIP72) begins with the first day of the month of application or first day of the month in which eligibility is met.

NOTE: Children in the No-Cost group are eligible for prior quarter determination.

For children in the Reduced Premium group (CHIP73 and CHIP74) MO HealthNet eligibility begins on the date of application, or first day of the month determined eligible. Coverage begins on the date of application or first day of the month determined eligible, or the date the premium is paid, whichever is later.

NOTE: Children in the Reduced Premium group are not eligible for prior quarter coverage.

For eligible children in the Full Premium group (CHIP75), eligibility and coverage can begin no earlier than 30 days from the date of application, or on the date the premium is paid, whichever is later. For eligible (CHIP 75) premium group child(ren) determined to have special healthcare needs, eligibility begins on the date of application and coverage begins on the date of application or the date the premium is paid, whichever is later. The exception to the 30-day waiting period only applies to the child(ren) with special healthcare needs; other children in the household who do not have a special healthcare need are subject to the 30-day waiting period from the date of application.

EXAMPLE: Mrs. Wilson applies for MO HealthNet for her one child, Jan, on September 1. She meets all eligibility requirements for the Full Premium Group (Level of Care 3, CHIP75). Mrs. Wilson attests that Jan has special healthcare needs. The eligibility specialist approves the case September 10. As Jan has special healthcare needs, there is no 30-day waiting period for eligibility from date of application, eligibility begins September 1.

An invoice is mailed to Mrs. Wilson on September 11, the day after the approval. Mrs. Wilson’s payment is received by the MHD Stakeholder Services Unit on September 15. Jan’s coverage begins September 15.

NOTE: Children in the Full Premium group are not eligible for prior quarter coverage.

MO HealthNet coverage for all CHIP children is date specific at the time of closing. An adverse action notice must be sent. Close the coverage on the first business day following the expiration of the adverse action.