Family MO HealthNet (MAGI) Manual

1840.025.10 Failure to Pay Premium After Coverage Begins

Active participants in a Reduced Premium Group (CHIP73 or CHIP74) who fail to pay a premium are not subject to any penalty period, however, coverage stops until the premium payment is received. The MO HealthNet for Kid’s case remains open unless the case is closed for other reasons (examples: failure to cooperate, no longer age-eligible child in home).

Child(ren) active in a Full Premium Group (CHIP75) whose coverage is closed for non-payment of premium any time after the coverage begins are subject to a ninety (90) day penalty for non-payment of the premium. The MO HealthNet for Kid’s case closes and coverage for the child(ren) stops.

NOTE: Whenever a Full Premium Group household reapplies for MO HealthNet for Kids within the ninety (90) day penalty period, enter the application in MEDES and review the MCII screen to determine when the case was previously closed for failure to pay the premium. Review the eligibility check in MEDES to confirm the determination. If the household is eligible for any another MO HealthNet program, the penalty will not apply. If the household is eligible for CHIP 75 deny the application.