IM-144 December 7, 2022; IM-25 April 8, 2015
If the individual is not currently receiving MO HealthNet (MHN) benefits, to explore Home and Community Based (HCB) Services waiver, FSD must:
- Obtain a valid MHN application.
Note: Participants requesting vendor coverage would follow all MHN application policies regarding requesting benefits and signing the application. These policies are outlined in the MAGI Manual, beginning with section 1802.000.00 Applications.
- Determine that the individual is age 63 or older.
- If the individual is at least age 63 but is under age 65, determine that the individual meets Permanently and Totally Disabled (PTD) requirements.
- Determine that the individual’s gross income is at or below the HCB maximum, see MHABD Appendix J.
- Complete the eligibility determination for all other eligibility factors:
- Approve the MHN application if individual is eligible for MHABD spend down or non-spend down.
- If the applicant cannot be approved for MHABD due to excess resources, but has a spouse with whom they live and the individual is not obviously ineligible for HCB, begin the division of assets.
- Using the Home and Community Based Referral (IM-54A) form, refer the individual to Department of Health and Senior Services, Division of Senior and Disability Services (DHSS/DSDS) to determine medical need and authorization for HCB services within 2 days of approval for MHABD coverage or decision that a division of assets will be required.
Note: FSD staff should follow established procedures to begin a DHSS/DSDS referral.