Add a Person to an Integrated Case

When a person moves into a MAGI household, it may be necessary to add the individual to the integrated case.

Is this person already a part of the MAGI Household?

Is this person returning to the MAGI household?

If yes, see Add/ReAdd Eligibility for a Person on an Integrated Case

If you see the Gray Avatar on the Integrated Case when trying to add a person, stop what you are doing as you will not be able to add the person. Submit this on a MEDES Incident Ticket.

NOTE: If the person you are adding was receiving Newborn LOC or is a child and both parents are not in the home, remember to complete the CS-201 Child Support Referral form. See the Cooperation In Pursuit Of Medical Support resource page.

TO ADD A PERSON TO AN INTEGRATED CASE

NOTE: The participant you add to the Integrated Case must have a DCN before being added. Follow the steps in the DCN Search Guide to see if the participant already has a DCN. If the participant does not have a DCN (determined after conducting a thorough search following each step) assign a DCN.

1. Navigate to the Integrated Case >Page Actions menu
  1. Hover over Guided Change
  2. Select the Add A Member… The Add A Member Wizard opens
2. Enter Participant Details
  1. Date Reported and Enter the date on which this person joined the household or coverage has been requested. Must be the date the change was reported to FSD.
  2. If the participant being added is new to this household (does not appear in the Integrated Case (IC)) in MEDES:
    1. Click Next.
  3. If the participant being added is a child between the ages of 0 – 18 and has active CEC in another HH.
    1. Click the dropdown in the Active Applicant (CEC transfer only) – Participant has active CEC period in another household (Only for children ages 0 – 18) field.
    2. Select the participant being added.
    3. Click Next.
    4. Proceed to Step 12
  4. If the participant being added is an inactive case participant (previous HH member, no active app details):
    1. Click the dropdown in the Inactive Case Participant (Previous HH member, no active app details) field.
    2. Select the participant being added.
    3. Click Next.
    4. Proceed to Step 12
  5. If the participant being added is an active non-applicant (no open Yes segment of Application Details evidence):
    1. Click the dropdown in the Active non-applicant participant (Currently included in the HH now requesting coverage) field.
    2. Select the participant being added.
    3. Click Next.
    4. Proceed to Step 12
3. Participant Details:
  1. Date Reported and Enter the date on which this person joined the household or coverage has been requested. Must be the date the change was reported to FSD.
  2. If the participant being added is known to MEDES, click on the magnifying glass to perform a search.
  3. If the participant is NOT known to MEDES, enter the participant detail information. This acts the same as Registering a Person in MEDES.
  4. Address Details click the dropdown and select appropriate response.
  5. If the answer to Address Details is yes, the Address Information question appears. Click the dropdown and select the appropriate response.
  6. Select the reason for this person joining the household click the dropdown and select appropriate reason.
  7. Is this person applying for assistance click the dropdown and select the appropriate response.
4. Select Next
5. Enter Personal Information details
6. Select Next
7. Enter Relationship details
  1. 1. Note: If the relationship is unknown and the participant cannot be reached by phone, mark the relationship(s) as unknown between the person(s) being added and the household members. Once the remaining information has been entered, pend the action and send an IM-31A for correct relationship information.
8. Select Next
9. Enter Tax Information details. If not known, see Unknown Tax Filing Status and/or Tax Relationship

1. Select Next
2. Enter Income details. Once you’ve entered new Income evidence, select Add New Income.
3. Once you’ve entered all Income evidence, select Next
4. Are you transferring CEC eligibility for this individual from another IC popup box.
  1. If the participant being added is receiving Continuous Eligibility for Children (CEC) coverage in another IC, you must transfer that coverage to the IC.
    1. Select the radio button next to the IC they are being transferred from.
    2. Click Next.
  2. If you do not want to transfer CEC benefits for the participant being added.
    1. Select the checkbox next to Check if you do not want to transfer CEC benefits from existing IC.
    2. Click Next.
5. Review the Summary and select Finish

Complete the Guided Change

1. Select the toggle next to Add a Member to add evidence.
  1. Insurance
  2. Disability
  3. Medical Bills
  4. Pregnancy
  5. Benefit
  6. Deductions
2. Select the List Actions menu.
3. Select Mark Complete.
4. Select Yes .

Add any additional evidence if applicable

1. Navigate to the Integrated Case (If necessary, refresh the screen to view the new member) > Dashboard folder.
2. Hover the cursor over the MO Medicare Self-Attestation evidence.
3. Select the Add Evidence icon.
4. Complete the MO Medicare Self-Attestation evidence for the new participant.
5. Select Save.
6. Hover the mouse cursor over the Demographics hyperlink.
7. Select the Add Evidence icon.
8. Complete New Demographics required fields for the new participant.
  1. Received Date and Start Date: Enter current date.
9. Select Save .
10. Hover cursor over the Address hyperlink >click the Add Evidence.
11. Complete the New Addresses required fields.
  1. The Received Date and From Date should match and be the date the participant was reported in the home.
  2. Select only the new participant being added from the Case Participant.
  3. Select Mailing from the Type drop-down box.
12. Select Save .

NOTE: The above listed evidence is required; however, there may be additional evidence, such as Tax Filer status and Tax Relationships, that may need to be updated/added based on the household circumstances.

Update the new participants Application Details with the application ID found in the Application Filer evidence.

1. Navigate to the Integrated Case > Evidence sub-tab> Dashboard folder > Application Filer hyperlink.
2. Retrieve the Application ID.
3. Close the Application Filer page to return to the Evidence Dashboard.
4. Select the Application Details hyperlink.
5. Toggle open new participant.
6. Select the List Actions menu.
  1. Select Continue Edit.
7. Enter the Application ID.
8. Select Save .

NOTE: If you are requesting coverage for a participant who had an open No segment of Application Details, MEDES will automatically end the No segment as of the date of request and open a Yes segment.

Search and Assign DCN to new participant

1. Navigate to the Person Tab of the person being added and see if the DCN has brokered from the Common Area to MEDES. If it hasn’t, follow the directions in the DCN ASSIGNMENT/TRANSFER FROM COMMON AREA guide
2. Close the Person Page Tab and return to the Integrated Case
3. Verify All Outstanding Evidence

NOTE: If verifications cannot be completed, LOC evidence should not be applied and a 31A should be sent. Once 31A is sent, move on to step 43. If all Verifications can be completed and additional information is not needed move to step 42.

1. 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. Person added
  2. Any coverage changes
2. Review notice queue to make sure appropriate forms generated
  1. See Notice Triggers Document