MO HealthNet for Kids Basic Eligibility Requirements

Reference Tools: Constructing a MAGI Household

HOUSEHOLD COMPOSITION (applies to all MHK categories)	Household composition is based on Federal tax filing rules. A household is established for each person requesting benefits, and must include an eligible child. NOTE: The parent/caretaker relative must have an eligible child in the home and qualify as an eligible parent/caretaker relative to receive MO HealthNet for Families (MHF). The individual may be a parent/caretaker relative who files taxes but does not claim the child as a dependent. Tax filer households: intend to file a federal income tax return for the year coverage is requested. Households consist of the tax filer and individuals to be claimed as dependents: Parents / Stepparents Children and their siblings including stepchildren Children over age 19 (when claimed as dependents) Note: some exceptions apply for individuals who expect to be claimed as dependents The parents of a person under age 19 must be included in the household composition and the parents’ income is counted even if the child claims he is a non-dependent tax filer. These individuals fall under non-filer rules because they are children who are not claimed as tax dependents Non-filer households: do not plan to file a federal income tax return nor expect to be claimed as a tax dependent for the year coverage is requested. Households include the family members who live with the individual: The individual requesting coverage His/her spouse His/her Children and stepchildren For children, include: parents / stepparents dependent siblings / stepsiblings under age 19
ELIGIBILITY FACTOR	CHIP NO COST GROUP (CHIP 71 & 72)	CHIP REDUCED PREMIUM GROUP (CHIP 73 & 74)	CHIP FULL PREMIUM GROUP (CHIP 75)	MHK/MHK Under 1 (Title XIX) and CHIP 4M
MAGI ELIGIBILITY Federal income tax rules determine how income is counted.	Modified Adjusted Gross Income above 148%, up to and including 150% of FPL	Modified Adjusted Gross Income over 150%, up to and including 225% of FPL	Modified Adjusted Gross Income over 225%, up to (but not including) 300% of FPL	Modified Adjusted Gross Income up to and including 196% of FPL for MHK under 1; up to and including 148% of FPL for MHK and CHIP 4M kids ages 1-18
SOCIAL SECURITY NUMBER*	SSN or application for number required for everyone requesting benefits	SSN or application for number required for everyone requesting benefits	SSN or application for number required for everyone requesting benefits	SSN or application for number required for everyone requesting benefits
CITIZENSHIP	Must be U.S. citizen or eligible qualified alien	Must be U.S. citizen or eligible qualified alien	Must be U.S. citizen or eligible qualified alien	Must be U.S. citizen or eligible qualified alien
RESIDENCE	Must reside in Missouri	Must reside in Missouri	Must reside in Missouri	Must reside in Missouri
ASSIGNMENT OF MEDICAL SUPPORT RIGHTS	No Assignment of Medical Support Rights	No Assignment of Medical Support Right	No Assignment of Medical Support Right	Payee assigns rights for medical support to FSD Child Support
COOPERATION IN OBTAINING MEDICAL SUPPORT	No cooperation requirement	No cooperation requirement	No cooperation requirement	Payee must cooperate with FSD Child Support in obtaining medical support
UNINSURED	Child must not currently have health insurance.	Child must not currently have health insurance or access to affordable health insurance.	Child must not currently have health insurance or access to affordable health insurance.	A child may be insured, but payee must provide insurance information. MO HealthNet is the payer of last resort. CHIP 4M children must be uninsured.
PAYMENT OF PREMIUM	N/A Eligibility and coverage begins with the first day of the month of application or first day of the month in which eligibility is met.	Must pay a monthly premium based on household size and income. Coverage begins the date the initial premium is received. Appendix E: CHIP Premium Chart	Must pay a monthly premium based on household size and income. Eligibility begins 30 days from the date of application. If the premium is paid within 30 days from the date of application, coverage is effective on the 30th day after application. If the premium is not paid within the 30-day period, coverage is effective the date of receipt of the premium. For children with special healthcare needs, the eligibility start date is the date of application and coverage starts on the date the premium is paid. Appendix E: CHIP Premium Chart Children whose coverage is closed for non-payment of premium any time after coverage begins are subject to a ninety (90) day penalty for non-payment of the premium.	N/A Eligibility and coverage begin with the first day of the month of application or first day of the month in which eligibility is met.

*Social Security number is not a requirement for other members of the household; however, their Social Security numbers should be requested as they may be needed to verify income.