MO HealthNet for the Aged, Blind, and Disabled (MHABD) Manual

If a claimant is determined eligible for Medicaid under 1619 criteria, the worker will:

1. Record the information obtained about SSA 1619 status, income and resource verification in the case record.
2. Complete the MA budget worksheet (IM-30A).  Enter the threshold amount on Line 15 of the IM-30A.  Enter the claimant’s gross earned income (or $1 less than the threshold amount) on Line 14 of the IM-30A.  1619 claimants are NOT entitled to any deductions from gross income.
3. Enter an IMU5 transaction indicating:
   • A “T” level of care and a reason code of “O” in field 13G2.  Enter a new Title XIX begin date when changing an active MA case to Section 1619 Status.
   • The threshold amount in Field 33 (Line 15 of the IM-30A).
   • The gross earned income (or $1 less than the threshold amount) in Field 34 (Line 14 of the IM-30A).
   • The deficit in Field 35.
   • The gross income in Field 41.
4. Send the claimant a Notice of Case Action (IM-33) indicating s/he is eligible under 1619 criteria.
5. Notify the IM Program and Policy Unit that the individual is receiving Title XIX under 1619 criteria.