IM-25 March 23, 2023; IM-137 November 20, 2017
When an annual renewal is completed, send case action notices within 10 days of receiving the necessary information to determine continued eligibility.
- If the annual renewal produces no change or a higher level of care –
- Send an action notice notifying the household of the action
- If the annual renewal produces a lower level of care –
- Send an adverse action notice notifying the household 10 days prior to the change taking effect;
- Once the 10-day adverse action period expires, take action on the case; and
- Send an action notice notifying the household of the action
- If the annual renewal produces an outcome of ineligibility –
- Send a pre-closing notice asking the household to notify FSD if they are pregnant, disabled, or have other changes.
- Once the pre-closing notice expires, send an adverse action notice notifying the participant/household that the agency will take action to close in 10 days. A participant cannot request a hearing until the adverse action notice is sent.
NOTE: A pre-closing notice is not required when the case is closing for failure to respond to a request for information.
- Once the adverse action period expires, take action on the case, and
- Send an action notice notifying the household of the action taken on the case as a result of the annual renewal.
When the annual renewal results in ineligibility for reasons other than failure to cooperate, evaluate eligibility for all other applicable categories of MO HealthNet (MHN) prior to taking action to close the case. If the participant/household is not eligible for any other MHN program, the case information is sent to the Federally Facilitated Marketplace (FFM) for an eligibility determination.
NOTE: An ex parte review is not required when the case is closed for failure to respond to the annual renewal or failure to provide requested information.
If a participant indicates a disability or blindness, complete a Non-MAGI determination. Do not close MAGI coverage until the Non-MAGI determination is complete.