0810.000.00 MO HealthNet Coverage

0810.010.05 Processing Spend Down MO HealthNet Cases

IM-08 January 24, 2012; IM-126 October 3, 2002; IM-106 September 10, 2002

Once a participant is determined eligible on all factors, except having met the spend down, the case must be approved and will remain active until a change in the participant’s situation causes ineligibility on a factor other than meeting spend down.  Any proposed closing, increase in spend down, or change from non-spend down to spend down requires normal adverse action procedures to be followed.

As of October 1, 2002 eligible spend down participants’ MO HealthNet coverage dates will be shown on the MSPI screen. The MSPI screen is an inquiry screen that displays spend down coverage periods.  This is the only screen that will show coverage dates for spend down participants.   The screen also displays the participant’s remaining liability for the first date of coverage in a month.  For participant’s meeting spend down with incurred expenses the liability amount is the amount of the spend down met on the coverage start date, not the total spend down amount.  Participant’s meeting spend down by paying-in will have a zero liability on the screen.