0810.000.00 MO HealthNet Coverage

0810.010.10 Notification of Spend Down Amount

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

The MO HealthNet Division (MHD) mails a monthly invoice to active spend down cases on the second working day of each month. The invoice is for the next month’s spend down amount, for example, the 10/02/02 invoice is for the November 2002 spend down. The invoice gives the participant the option of paying in their spend down amount to MHD or submitting bills to the eligibility specialist. The invoice instructs the participant to call the MHD Premium Collections Unit at 877-888-2811 for questions about a payment.

NOTE:  The MPNI inquiry screen provides information regarding invoices for MHK CHIP premium, Ticket to Work Health Assurance Program (TWHA) premium and MO HealthNet Spend down cases. Refer to memorandum IM-28 February 19, 2003 for instructions on the MPNI screen. Since conversion to FAMIS, the identifier for spend down cases on MPNI is AF.

MHD will stop mailing monthly invoices if the participant does not meet spend down for 6 consecutive months.  An invoice is still created in the system and can be viewed on the MPNI screen.  The system will continue to create invoices as long as the case remains open as spend down.  A case cannot be closed simply because the participant has not met spend down for 6 or more months.  MHD will resume mailing invoices the month following the month in which the participant meets spend down by bills or pay-in for one of the preceding 6 months. The procedure for authorizing spend down coverage based on incurred expenses is the same whether or not the participant was mailed an invoice (refer to 0810.010.15.10 Authorizing Spend Down Coverage Based on Incurred Expenses).