End MO Insurance Self Attestation Evidence

If a pregnant family member becomes enrolled or gains access to maternity insurance, MO Insurance Self-Attestation evidence must be ended prior to entering MO Covered Member evidence. This is for instances where MPW was denied and a SMHB decision is necessary.

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.

Related Evidence: MO Covered Member Evidence

TO END MO INSURANCE SELF ATTESTATION EVIDENCE

    1. Navigate to the Integrated Case > Evidence sub-tab > Dashboard folder
    2. Click the MO Insurance Self Attestation hyperlinks
    3. Enter the End Date. End Date should be the day before the date the participant enrolled in maternity Insurance or gained access to maternity insurance
    4. Click Save
    5. Verify all Outstanding Evidence
    6. Apply Changes, Check Proposed Determination, Finalize Proposed Determination

NOTE: MEDES may generate an additional proposed determination, especially in cases with income changes, adding a person, or removing a person. If the system generated an additional proposed determination, you must run the Finalize Proposed Determination again

    1. Make a comment on the HoH Person Page to include:
      1. All actions taken
      2. Participant with override entered
    2. Review Notice Queue to make sure appropriate forms generated
      1. IM-80PRE: Generates in the event of coverage changes that result in a complete loss of coverage
      2. IM-80: Generates in the event of negative coverage changes
      3. IM-33C: Case Action Notice