IM-22 April 11, 2024; IM-148 November 27, 2017; IM-90 July 11, 2017
An individual may be added to an existing MAGI MO HealthNet case without the need for a new application. A request to add a person can be received through all current acceptable reporting methods; the request does not have to be in writing.
The request to add a person may be received:
- Online
- By telephone
- In person
- Electronic data sources
The request to add a person to an existing case can be received at any time: as part of the Annual Renewal, or any time a household reports a new person in the home.
Note: The addition of a Newborn (a child born to a women who is receiving or eligible to receive Title XIX coverage at the date of birth including when the birth is during the prior quarter period or when the MPW application is made after the birth) to a household is treated the same as adding an individual to another MO HealthNet program. The birth of the child must be reported prior to adding the child to a case.
Requests to add a person may also be a request to change the status of a person already in the household from included to active.
If sufficient information is already present in the case record to establish eligibility for the person the addition is being requested, add the person. If there is not enough information to establish eligibility for the person being added, request the needed information.
Note: It is not necessary to re-verify income of persons currently included in the assistance group unless an income change is reported that is not reasonably compatible with the previously verified income.
If a person has MO HealthNet coverage in another household, or is included in another household, the tax filing status, relationships and custody arrangements must be gathered when adding the individual to the new household. If adding a child that is in their Continuous Eligibility (CEC) period, the child must continue at the same or better Level of Care (LOC). Refer to 1805.070.00 Continuous Eligibility for Children (CEC).
Note: If a child moves to a new household where they are not eligible, but a portion of the CEC period remains, the child must remain at the current LOC and the CEC period continues. Eligibility is re-determined at annual renewal.
The individual being added can be included in multiple households; however, they cannot receive benefits in more than one household at a time.
Example: Sandy receives CHIP 75for her child, Patrick. On May 1, Sandy completed a change report and reported she is pregnant and married Bob on April 25. Bob and his daughter, Bailey, moved in with Sandy and Patrick. Prior to reporting the change, Bob and Bailey received MHF in another household with Bailey’s mother, Karen. Sandy and Bob intend to file taxes jointly and to claim Patrick as a tax dependent. Karen will claim Bailey as a dependent.
Outcome: Due to CiC, the MAGI households will change for all individuals and level of coverage will change for some household members. Bailey will be included in both households, but can only receive benefits in Sandy’s. After all changes are complete:
- Sandy’s MAGI household includes 5 people: herself, her unborn child, Bob, Patrick and Bailey.
- She is now eligible for MPW effective May 1.
- Bob’s MAGI household includes 4 people: himself, Sandy, Patrick, and Bailey.
- He is not eligible for MAGI benefits in Sandy’s household and is no longer eligible for benefits after his adverse action period. Sandy will receive a notice that Bob is not eligible. Karen will receive a notice that Bob has been removed from her household.
- Patrick’s MAGI household includes 4 people: himself, Sandy, Bob and Bailey.
- He is no longer eligible for CHIP 75, but is now eligible for CHIP 74, effective May 1.
- Bailey’s MAGI household includes 4 people: herself, Sandy, Bob, and Patrick.
- She is no longer eligible for MHF based on her current household and income, but as she is in the middle of her CEC period, she will remain MHF until her next annual renewal.
- Karen’s MAGI household includes 2 people: herself and Bailey (her tax dependent).
- Even though Bailey is still included in her MAGI household as a tax dependent, she is not living in her home. As Karen no longer has an eligible child in the home, she can no longer receive MHF. After an adverse action period, she is now eligible for AEG.
Note: For more information regarding joint custody situations and household composition, refer to MAGI Manual sections 1805.030.10.20.05 Joint Custody and 1805.030.10 MAGI Household Composition.
When applicable, request information for medical support cooperation. Refer to MAGI Manual section, 1805.040.00 Cooperation in Pursuit of Medical Support.