Non-MAGI Household Determination

 

Guidance:

On the MO HealthNet Application Detail screen, each Supercase member is assigned a ‘Benefit Requested’ code for the MHABD application. You determine who is a part of the Household (EU) by identifying who is requesting benefits, who to include, and who to exclude in determining eligibility based on the discussion with the applicant.

    • M – OAA/PTD/AB MO HealthNet (No Cash) along with Supplemental Nursing Care (SNC) are explored. QMB/SLMB eligibility is also explored later in the controlled flow.
    • B – Supplemental Aid to the Blind (SAB)/Blind Pension (BP) and everything under ‘M’ are explored.
    • N – The individual is NOT requesting benefits, but his/her income and needs must be included in the eligibility determination
    • E – Exclude, not part of the MHABD eligibility unit. Eligibility Units for MHABD are either individuals or spouse, depending upon living arrangement.

Living Arrangement

Eligibility Unit
Client is a single person Individual Case
Client is married but separated and living apart from spouse
(NOTE: couples separated solely due to a medical condition are still considered a spouse case for MO HealthNet eligibility purposes.)		 Individual Case
Client is married and living with spouse who receives MO HealthNet coverage under SNC, SAB, or SP Individual Case for MHABD;
Spouse case for QMB/SLMB
Client is married and living with spouse who receives MO HealthNet coverage under MHF, MHK, Transitional MO HealthNet Assistance or BP Spouse Case (BP grant is excluded in MHABD determination)
Client is married and living with spouse who does not receive MO HealthNet Coverage under another program (one or both persons applying) Spouse Case

 

If the participant requests benefits for SAB/BP (‘B’), new driver question screens display in the application controlled flow to gather information specific to these benefits. The new screens only appear if there is a participant requesting benefits for SAB/BP. This also triggers the MO HealthNet Declarations (FMJ9) screen to display additional questions related to SAB/BP.

 

On the MO HealthNet Application Detail screen, function key (F15=DUEDATES) shows due dates and delay codes for the various programs under MO HealthNet for Adults.