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:
- 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.
The individual being added can be included in multiple households; however, s/he cannot receive benefits in more than one household at a time.
EXAMPLE: Billy is the custodial father of Claire (10). Claire currently receives MHK with Billy as the head of the household. Recently, Billy reported that his son, Andy (3), moved into the home with him and Claire on a part-time basis. Andy already receives MHK benefits in his mother’s household. Andy’s mother continues to be his custodial parent, by exercising more than 50% physical custody. Billy will continue to claim Claire and Andy as tax dependents.
Outcome: Billy is included in one MAGI household (Claire’s), Claire is included in one MAGI household (her own), and Andy is included in two MAGI households (his own and Claire’s).
- Andy cannot receive MHN in Billy’s household since his mother is his custodial parent. Andy’s mother must apply for MHN on his behalf. Since Andy is claimed as a tax dependent by someone who resides outside of his home, Andy’s MAGI household composition is based on non-tax filer rules. Andy’s household consists of two: himself and his mother.
- Billy must apply for Claire since he is her custodial parent. Claire’s MAGI household consists of three; herself, Billy and Andy.
NOTE: Andy is included in Claire’s MAGI household since they are both Billy’s tax dependents even though he does not reside with them more than 50% of the time.
EXAMPLE: Sandy receives MHF with her child, Patrick. Sandy reported she married Bob on April 25th. Prior to Sandy reporting the change, Bob received MHF in another MAGI household with his child, Bailey. Bailey’s mother, Karen, remains the custodial parent as she practices more than 50% physical care and control of Bailey. Karen also receives MHF with Bailey as a member of her MAGI household. Sandy and Bob intend to file taxes jointly and to claim Patrick and Bailey as tax dependents.
Outcome: Bob is included in three MAGI households (his own, Sandy’s and Patrick’s), Sandy is included in three MAGI households (her own, Bob’s and Patrick’s), Patrick is included in three household compositions (his own, Sandy’s and Bob’s), and Bailey is included in five MAGI households (her own, Bob’s, Sandy’s, Patrick’s and Karen’s).
- As a parent caretaker, Bob can only receive MHF benefits if he resides in the home of an eligible child regardless of whether or not he claims an eligible child as a tax dependent. Since Bob is the stepfather to, and resides with Patrick, an eligible child, Bob can also receive MHF. Bob’s MAGI household composition consists of four members: himself, Sandy, Patrick and Bailey.
- Sandy’s MAGI household will consist of four members: herself, Bob, Patrick and Bailey.
- Patrick’s MAGI household composition will consist of four members: himself, Sandy, Bob and Bailey.
NOTE: Since Patrick is the tax dependent of Sandy and Bob, all of their tax dependents will be included in Patrick’s MAGI household composition. In this case, Bailey should be included in Patrick’s MAGI household composition since she is Sandy and Bob’s tax dependent, even though she does not reside in their home more than 50% of the time.
- Bailey cannot receive MHN in Bob’s household since her mother is her custodial parent. Bailey’s mother must apply for MHN on behalf of Bailey. Since Bailey is claimed as a tax dependent by someone residing outside of her home, she falls under non-tax filer rules when determining her MAGI household composition. Bailey’s MAGI household consists of two members: herself and her mother.
- Karen’s MAGI household consists of herself and Bailey.
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.
Enter a comment to explain the addition of the new individual to the household
When applicable, request information for medical support cooperation. Refer to MAGI Manual section, 1805.040.00 Cooperation in Pursuit of Medical Support.