- TO:
- ALL FAMILY SUPPORT DIVISION OFFICES
- FROM:
- PATRICK LUEBBERING, DIRECTOR
- SUBJECT:
- REVISION OF SHOW-ME HEALTHY BABIES (SMHB) MANUAL SECTION REGARDING HEALTHCARE COVERAGE
- MANUAL REVISION #100
1855.030.00
1855.030.05
DISCUSSION:
The purpose of this memorandum is to announce the policy revision regarding healthcare coverage for SMHB mothers of the unborn child(ren) and the child(ren) after their birth.
SMHB cases will be identified on MXIX with the following Medical Eligibility (ME) Codes:
- ME 62 - SMHB Newborn coverage for children of mothers previously approved for ME 96 with household income at or below 196% of FPL. This coverage will show on MXIX as Type of Coverage (TOC) “C” and Level of Care (LOC) 62. There will be a $0 premium.
- ME 74 - SMHB Newborn coverage for children of mothers previously approved for ME 96 with household income above 196% of FPL and up to and including 225% of FPL. This coverage will show on MXIX as Type of Coverage (TOC) “C” and Level of Care (LOC) 74. There will be a $0 premium.
- ME 75 - SMHB Newborn coverage for children of mothers previously approved for ME 96 with household income above 225% of FPL and up to and including 300% of FPL. This coverage will show on MXIX as Type of Coverage (TOC) “C” and Level of Care (LOC) 75. There will be a $0 premium.
- ME 94 – Show-Me Healthy Babies Presumptive Eligibility for pregnant women with household incomes above 196% of FPL up to and including 300% of FPL. This coverage will show on MXIX as Type of Coverage (TOC) “P” and Level of Care (LOC) 94.
- ME 95 – Prenatal, Labor, and Delivery for an unborn child, whose mother is a citizen or eligible alien and was denied on MPW for excessive income with household. Income above 196% of FPL and less than or equal to 300% of FPL. This coverage will show on MXIX as Type of Coverage (TOC) “C” and Level of Care (LOC) 95;
- ME 96 – Prenatal, Labor, and Delivery for an unborn child, whose mother was denied on MPW for citizenship or eligible alien status, and has income of 0% of FPL up to and including 300% of FPL. This coverage will show on MXIX as Type of Coverage (TOC) “C” and Level of Care (LOC) 96.
- ME 97 – SMHB Newborn coverage for children of mothers previously approved for ME 95. This coverage will show on MXIX as Type of Coverage (TOC) “C” and Level of Care (LOC) 97.
- ME 98 – Post-partum coverage for women approved for ME 95 immediately prior to the post-partum period. This coverage will show on MXIX as Type of Coverage (TOC) “C” and Level of Care (LOC) 98.
NOTE: Women approved immediately prior to post-partum period under ME 96 receive one post-partum visit.
NECESSARY ACTION:
- Review this memorandum with appropriate staff.
PL/df