If other eligibility cannot be established from the record, third party verification, or the participant fails to return the necessary paperwork, send the Pre-Closing Review Notice (IM-80PRE) to inquire about pregnancy, blindness, disability, and changes in income.
If the individual responds to the Pre-Closing Review Notice within the ten (10) days indicating other possible eligibility, register the proper application and allow the current benefits to remain open pending the eligibility determination for the other category. A new signed application from the individual is not required to switch categories. If a participant claims disability or blindness, use the IM-1ABDS when determining eligibility under MHABD/MHDC. Do not end one category of coverage before approval in the other category or until the participant is determined ineligible for any coverage.
If there is no response from the participant within ten (10) days indicating any other possible eligibility, initiate an Adverse Action Notice (IM-80) explaining:
- Reason for the loss of eligibility for the current program;
- Reason ineligible for any MO HealthNet program; and
- Statement that we do not have information that indicates eligibility for any other MO HealthNet programs.
NOTE: If the participant did not respond prior to the expiration of the Pre-Closing Review Notice but does respond indicating other possible eligibility prior to the expiration of the Adverse Action Notice, follow the instructions above for individuals who respond to the Pre-Closing Review Notice.
NOTE: There are no appeal rights with the Pre-Closing Review Notice since this is not an adverse action notice. If the final decision results in an adverse action, the IM-80 is required and normal hearing rights are allowed.