IM-22 April 11, 2024; IM-45 May 3, 2023; IM-193 December 28, 2000
Once an individual is determined eligible for MO HealthNet (MHN), eligibility must continue, uninterrupted, until the individual is determined ineligible for every category of MHN.
Do not terminate coverage without reviewing the case to see if eligibility exists in another MHN category. Reviews for ongoing eligibility must be conducted without the involvement of the recipient, if possible. This is known as an ex parte review.
Continuous Eligibility for Children (CEC)
Once an initial application is approved for MHN benefits, a CEC period begins for children under the age of 19. The CEC period lasts 12 months and prevents cases from closing and benefits from reducing. At the end of the CEC period, Family Support Division (FSD) must complete an annual renewal to determine continued eligibility. A new CEC period begins after each annual renewal.
- During the CEC period, an adverse action is authorized and eligibility terminated after adverse action period only in these circumstances:
- child turns 19
- child ceases to be a resident of the state of Missouri
- child or child’s representative requests a voluntary termination of eligibility
- child dies
- eligibility was erroneously granted at the most recent determination, redetermination or renewal due to agency error or fraud, abuse, or perjury attributed to the child or the child’s representative
Note: Refer to section 1805.070.00 Continuous Eligibility for Children (CEC) located in the MAGI Manual.