MEMORANDUM

DISCUSSION:

This memorandum is to notify staff of a change in the age eligibility requirement for the Uninsured Women's Health Services policy and updates to the Family Assistance Management Information System (FAMIS). The Uninsured Women's Health Services Program (UWHS) provides women's health services for uninsured women from age 18 up to but not including age 56 who are in need of family planning services and have family income up to and including 185% of the federal poverty level for their household size. Formerly, this coverage was only available for women up to age 55. Effective 01/13/2013 FAMIS was updated to allow participants to receive UWHS services up to but not including age 56.

It is necessary to explain the benefits and services available under the Uninsured Women's Health Services program at application for the program. To be in need of family planning services the woman must be of the child bearing ages of 18 up to but not including age 56 and is not sterilized. Women who are not in need of family planning services are determined ineligible based on program eligibility factors. The only, healthcare services under the program covered by MO HealthNet are family planning and family planning related services. The MO HealthNet Division provides guidance to MO HealthNet providers of services covered by the various Medicaid eligibility (ME) codes. Refer to the benefit matrix located under "Covered Services" on the About The MO HealthNet Division webpage for listing of covered services for all programs. Clarification was added to manual sections: 0927.000.00; and 0927.005.00.

Women ages 18 up to but not including age 56 who have access to employer-sponsored insurance that covers family planning services are ineligible for UWHS. Clarification was added to manual sections: 0927.010.00; 0927.010.05; and 0927.010.35. 

Women ages18 up to but not including age 56 are ineligible for UWHS if they qualify for any other MO HealthNet program, including the MHABD Spend down or non-spend down programs.

Women in the Uninsured Women's Health Services program who are in need of family planning services are eligible for the same services as women in the Extended Women's Health Services (EWHS) program. Clarification was added to manual section 0927.015.00.

A UWHS reinvestigation is to be completed every 12 months. The reinvestigation can be completed using current information in FAMIS from an application or recertification from another program. For example, a review is completed by a Food Stamp application initial approval or recertification when all members of the UWHS Eligibility Unit are in the Food Stamp Eligibility Unit or by a Temporary Assistance application approval when all members of the UWHS Eligibility Unit are in the Temporary Assistance Eligibility Unit. When a reinvestigation of this type occurs, completion of the reinvestigation form is not required.

When a UWHS review form (FA402) is received within the same month that the case closed due to failure to complete and return a review form, take appropriate action to cancel close the case and process the review using current procedures. Refer to FAMIS User Guide, "Completing a Temporary Assistance/Medical Assistance Reinvestigation in FAMIS" for instructions on how to complete a review in FAMIS. Clarification was added to manual section 0927.025.00.

NECESSARY ACTION:

• Review this memorandum with all appropriate staff.

AC/mks