IM-57 May 19, 2022; IM-95 July 3, 2019; IM-21 February 7, 2019
When determining gross monthly income, follow the policy outlined in 0805.015.00 Financial Need.
When the gross monthly income of the MOCDD waiver individual is at or below the HCB income standard listed in Appendix E – HCB Income Maximums, he/she meets the income criteria for MOCDD eligibility. Only the income of that individual is considered. The HCB income standard is absolute. Individuals cannot spend down to become eligible under MOCDD waiver criteria.
The income and needs of parents and siblings are not included on the MOCDD budget; however, the income and needs of the parents and siblings must be evaluated to determine if the applying child should receive coverage as an MHDC non-spend down participant prior to the date found eligible for the MOCDD waiver.
A Qualifying Income Trust (QIT), also known as a Miller Trust, may be utilized to lower the budgeted income of an individual applying for HCB, or MOCDD Waiver programs. A QIT may be established by the individual, their spouse, parent, grandparent, guardian, conservator, or a court. The purpose of the QIT is to decrease the income of the individual below the absolute HCB/MOCDD limit. See 1025.015.04.01.02 Qualified Income Trusts.
NOTE: If the individual is participating in a valid Qualified Income Trust (QIT)/Miller Trust under 42 U.S.C. 1396p(d)(4)(B), the amount of income being deposited into the trust is excluded from income consideration for the HCB participant’s determinations. It is not excluded from consideration for any coverage other than the QIT programs.
All trust documents are to be sent through normal supervisory channels using the current Request for Interpretation (IM-14) process to determine availability of the income held in the trust to the participant. Include a copy of the entire original trust and any amendments.
Persons with income above the HCB income standard may be eligible for MO HealthNet using regular MHDC procedures.