Create Ongoing Income on an Integrated Case

When an Integrated Case participant reports a new income source, income evidence is added for ongoing income AFTER adding actual income evidence for the month the income started.

By policy, SMHB eligibility is granted as continuous coverage. However, if you enter a CiC that increases the household income to greater than 305% FPL, 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.

All income sources must be entered whether the income is a countable income source for Family Healthcare programs or not.

See: 10.17 Income Disregards and Deductions and 10.17.1 MAGI MO HealthNet 5% Income Disregard; 10.16.2 Projecting Income; 10.14 Determining Countable Income

Related Evidence: Income, Application Details

TO CREATE ONGOING INCOME FOR A PARTICIPANT ON AN INTEGRATED CASE

If completing this task as part of a returned IM-1U, or if the case is Under Renewal, you must first follow steps to To Create a Manual Renewal and To Complete Manual Renewal.

      1. Navigate to the Integrated Case> Evidence sub-tab> Dashboard folder
      2. Hover cursor over Income hyperlink> Click Add Evidence
      3. Complete all required fields see Related Evidence above
        1. Received Date > The date the change was reported to FSD
        2. Start Date > The date the participant started the job being reported or the first day of the month in which ongoing income needs to be budgeted

    2. Example: The participant called on 08/20 and reported his/her job began on 06/03. The Received Date would be 08/20 and the Start Date would be 06/03/2020.

      NOTE: If the participant reports new income in the same month it starts, the Start Date will be different on the actual budget for the month started vs. the on-going budget. In this situation, the Received Date for the actual budget would be the date reported and the Start Date would be the date the income started. For the on-going budget, the Received Date would be the date reported and the Start Date must be the first day of that month of the ongoing budget. See example below:

      Example: Participant reports a new job on 08/13 that started on 08/10. For the actual budget for August, the Received Date would be 08/13 and the Start Date would be 08/10. For the on-going budget, the Received Date would be 08/13 and the Start Date would be 09/01.

        1. Case Participant > Click Drop-down menu > Select participant whom you want to add the inome
        2. Income Type > Click Drop-down menu > Select type from the drop down box
        3. Source > Click Drop-down menu > Select how the change was reported to FSD
          1. The applicant reports a change of income. The Source is Applicant.
          2. ES receives a document from IRS of a change of income for case. The Source is IRS System.
          3. ES receives change of income from Web Server systems. The Source is External System.
          4. ES receives pay stubs in the mail. The Source is Manual if provided not provided by the applicant.
        4. Employer Name > Enter the Employer name
        5. Amount > Enter the total average income received each pay period
        6. Frequency > Click the Drop Down menu > Select the appropriate pay frequency

NOTE: If unable to use the participant’s statement to verify income and you must request paystubs, you will need to average the paystubs before entering the average pay per check.

EXAMPLE: The participant is paid weekly and provides the following paystubs to verify income:

    • Check dated December 20 for 249.00
    • Check dated December 27 for 242.00
    • Check dated January 3 for 257.00
    • Check dated January 10 for 247.00

Add all four checks together for a total of 995.00. Divide this by 4 (as using 4 checks in the average) to get 248.75 per check average. The 248.75 is entered in the amount field and the frequency code would be Weekly.

NOTE: If the participant is reporting Social Security Adult (SSA/SSD), Social Security Adult (retirement) or Social Security Child (SSA/SSD), follow the direction in the Entering Claim Number on SSA/SSD Income Evidence to correctly enter the claim number.

    1. Click Save
    2. Verify all Outstanding Evidence
    3. 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. Enter Income Verification Comments in either the HoH Person Page > Client Contact sub-tab > Notes folder or on the Income Evidence. The Income Evidence comment should state:
      1. Start and/or stop dates (if applicable)
      2. What was used to verify Income Evidence:
        1. Reasonable Compatibility
        2. Hard Copy
        3. Data Source
        4. If verification is from an employer list:
          1. the employers name
          2. frequency of pay
          3. rate of pay
          4. when the income started
      3. Include how the Amount field was calculated:
        1. was the amount manually calculated
        2. participant’s self-attestation
      4. If Reasonable Compatibility was used to verify the participant’s self-attestation of income
        1. state why used
        2. percentage difference in the participant’s self-attestation of income and EOIs
        3. state a copy of the calculator is filed in the ECM/VFR
    2. Review Notice Queue to make sure appropriate forms generated
      1. IM-80PRE: Generates in the event of coverage changes
      2. IM-80: Generates in the event of coverage changes
      3. IM-33C: Case Action Notice