Supplemental Nursing Care

0620.000.00 MEDICAID COVERAGE

IM-#7 January 26, 2011,  IM-#30 April 4, 2008

Section 208.151 of the revised Statutes of Missouri, 1982 sets forth the legal basis for Title XIX coverage. Senate Bill 577 (2007) changed the name of Missouri Medicaid to MO HealthNet.

The participant’s eligibility for MO HealthNet coverage begins with the first day of the month of application, provided the participant is subsequently found eligible, and was not obviously ineligible for the entire month of application and any subsequent month prior to approval. If the participant was obviously ineligible for the entire month of application and any subsequent months prior to approval, the MO HealthNet eligibility date begins with the first day of the month in which eligibility was met. MO HealthNet eligibility does not necessarily mean SNC coverage; please see example number two below.

EXAMPLE: The participant applies 06-18. Participant is ineligible on resources until 07-03. MO HealthNet eligibility begins 07-01.

EXAMPLE #2: The participant is currently receiving benefits under the MHABD spend down program. The participant enters an SNC facility on the 15th of the month. The participant’s eligibility would be as follows: From the 1st of the month through the 14th of the month the participant would receive spend down coverage. From the 15th of the month forward the participant would receive SNC coverage.