MO Insurance Policy Details for External or Multiple Evidence

If a household member is covered by an insurance plan which is not employee sponsored, evidence is created on the MO Insurance Policy Details screen. The Federal Hub will be electronically called to obtain Medicare Part A information during the Eligibility Check.
Use the below guide to handle multiple MO Insurance Policy Details.

By policy, SMHB eligibility is granted as continuous coverage. However, if you enter a CiC that enrolls the participant in, or grants access to insurance that covers all three phases of maternity services, MEDES will end SMHB coverage. If this happens, follow the steps in Adding MO Override Eligibility Evidence to grant SMHB coverage through the applicable end date.

NOTE: This evidence will only exist after Check Eligibility is completed.

TO FIND EXTERNAL MO INSURANCE POLICY DETAILS

    1. Navigate to the Integrated Case > Evidence sub-tab > Dashboard folder
    2. Click on MO Insurance Policy Details
      1. If this evidence does not exist/you cannot click it, neither the applicant self-attested to non-employer sponsored coverage, nor was an H-31 Call successful.

IF THERE ARE ONE OR MORE MO INSURANCE POLICY DETAILS

    1. Toggle open the evidence
    2. Toggle open Change Summary Evidence
    3. Scroll down to the comments
    4. If Added from H31 Call is present, it is received from a Hub Call.
    5. If there is multiple Mo Insurance Policy Details evidence, confirm that the Policy Start Date and Policy End Date are the same for both the H-31 and self-attested evidence (for each participant).

NOTE: H -31 Evidence will have a Period for the evidence from the date of the call through the end of the policy year.

    1. If they are different, but the policy dates run concurrently, no action needs to be taken

NOTE: Medicare Part A insurance information is only an eligibility factor.  In all other cases, Mo Insurance Policy Details information is stored in MEDES

IF THE SELF-ATTESTED EVIDENCE AND H-31 EVIDENCE ARE DIFFERENT

    1. Generate an IM31A Request for Information form to verify the Self-Attested Evidence and the H-31Evidence are different
    2. Toggle Open the evidence with the oldest period
    3. Click the List Actions Menu
    4. Click Continue Editing
    5. Edit evidence according to the verification item(s)

NOTE: There should be no issues with having multiple pieces of evidence