MEMORANDUM

DISCUSSION:

The purpose of this memorandum is to introduce the new IM-1UA Application Supplement (IM-1UA SUPP) and to provide instruction for its use effective October 1, 2103 through December 31, 2013.

As introduced in Income Maintenance memorandum IM-86 MO HealthNet Single Streamlined Application dated September 27, 2013 and Email Memorandum # IM-63 dated October 2, 2013, the IM-1UA, APPLICATION FOR MO HEALTHNET FOR KIDS, PREGNANT WOMEN AND PARENTS, continues to be an acceptable form for FAM applications made through December 31, 2013. While the IM-1UA obtains information needed to make a current FAMIS determination, it does not gather sufficient information needed to process the MAGI-methodology redeterminations required as of January 1, 2014.

To assist in obtaining the information that will be needed to complete these redeterminations, we have created the IM-1UA SUPP. If an individual submits an IM-1UA between October 1, 2013 and December 31, 2013, request that the IM-1UA SUPP also be completed.

If the individual is in the office, the Eligibility Specialist (ES) should have the applicant complete the IM-1UA SUPP at that time. If the IM-1UA is received in any format other than in person, mail the IM-1UA SUPP to the applicant and request it be completed and returned.

DO NOT hold or reject any application for the return of the IM-1UA SUPP. If the applicant fails to return the completed form and the application is appropriate for referral to the Union Processing Center, Union staff will follow up with the household at the time of the redetermination.

Due to the limited applicable timeframe of the use of this supplemental document, it will not be made available in the Forms Manual. Please use the version attached to this memorandum, and print or make copies as needed.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.
• Begin using the effective October 1, 2013.

ATTACHMENT:

• IM-1UA SUPP

AC/mh