Changes in a household’s circumstances may cause a family to be eligible for a different premium amount or level of care (LOC).
Occasionally, a change in household composition could result in an increase or decrease in the premium amount. The premium may increase in situations where a person is added to an existing household, but the income and federal poverty level percentage remain in the same category.
CHIP premiums are also updated every July 1st. Refer to the MO HealthNet for Kids – CHIP Premium Chart at Appendix E, Section 1800.000.00.
NOTE: Whenever a premium increases, the participant must be sent an Adverse Action Notice (IM-80) and an Action Notice (IM-33C) to advise the participants that the premium is changing.
The following are the procedures to use when a change in eligibility is reported or discovered.