Transitional MO HealthNet Basic Eligibility

Reference Tools: Constructing a MAGI Household

ELIGIBILITY FACTOR

REQUIREMENT

SOCIAL SECURITY NUMBER

All eligible members of the household must provide a number.*

CITIZENSHIP AND IDENTITY
Must be a U.S. citizen or a qualified alien.

RESIDENCE

Must reside in Missouri.

HOUSEHOLD COMPOSITION

Household composition is based on Federal tax filing rules.

Tax filer households: intend to file a federal income tax return for the year coverage is requested. Households consists 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

INELIGIBILITY FOR MO
HEALTHNET FOR FAMILIES

The family must be eligible and received MHF for at least 3 out of the last six months immediately preceding the month in which they are no longer eligible

INCOME INELIGIBILITY

Ineligible must be caused by employment or increased earned income of the parent/caretaker relative

CHILD IN THE HOME

An eligible child must remain in the household for eligibility.

FIRST SIX MONTHS OF TMH

Household remains eligible for the first 6 months unless: Household no longer resides in Missouri; or there is no longer a Transitional MO HealthNet eligible child in the home

SECOND SIX MONTHS

Transitional MO HealthNet eligibility continues during the second six months unless:

  • parent/caretaker relative fails to complete and return the second or third quarterly reports
  • Modified Adjusted Gross Income (MAGI) exceeds 196% of the federal poverty level for the household size.
  • For the second or third quarterly reports, the parent/caretaker relative had no earnings in one or more of the three report months, unless earner claims Good Cause

*Social Security number is not a requirement for other members of the household, however, their Social Security numbers should be requested.