When it is reported that a household member is leaving action should be taken to remove the person from the home.
Review the tax filing status and relationships. Determine the following:
- Will the tax filing status and relationships remain the same?
- Will coverage for anyone else in the household be affected?
- Is person leaving the only one affected?
- Is the person going on coverage somewhere else such as another household, Children’s Division, etc.?
When the head of the household is the individual being removed from the home, coverage ends for the entire household. Another individual must reapply for the household.
EXAMPLE: Steven and Melissa are actively receiving MHF with their two children. Melissa reported that Steven has moved out of state and no longer in the home. Melissa attests that Steven intends to continue to claim their children as tax dependents; however, she is exercising more than 50% physical custody and care of the children.
Outcome: The children are being claimed by a non-custodial parent and therefore fall under tax non-filer rules. Melissa can continue to receive MHF with the children as she is the custodial parent (exercising more than 50% physical custody and care of the children). Melissa’s household consists of herself and her two children. Since the children now fall under non-filer rules, their household composition will consist of themselves, their sibling and Melissa. Steven is ineligible because he is not a Missouri Resident/out of the home and the non-custodial parent.
If the individual being removed is the only MO HealthNet for Families (MHF) eligible child in the home, MHF ends for the parent/caretakers as well. This applies regardless of the tax filing status. The parent/caretaker no longer meets an eligible living arrangement. Refer to MAGI Manual section 1805.030.10.20 Exceptions to MAGI Household Composition.
NOTE: When the individual being removed is not the only MHF eligible child in the home, coverage may not end for the other household members. Depending on the intended tax filing status and other qualifying criteria, the individual may continue to be included in someone’s household regardless of whether or not they reside in the home. However, an individual may not receive benefits in two homes at the same time.
Inform the household from which the individual is being removed prior to the action to remove the person takes effect. Send an action notice (IM-33C) to the household from which the individual is being removed.
NOTE: If the request to remove a person is received in writing, the 10-day adverse action (IM-80) period does not need to be given. Send the action notice (IM-33C) to inform the household that the individual has been removed.