MO Healthnet Children’s Health Insurance Program

Changes in income and household composition may cause a family to be eligible for a different level of care (LOC). The following are the procedures to use when a change in eligibility is reported or discovered.

 

Tools:

 

Copy the CHIP Affordability Calculator and paste into Notes on the Head of Household Page and scan a copy to the ECM.

 

MO HEALTHNET CHILDREN’S HEALTH INSURANCE PROGRAM (CHIP)

From no premium to premium

  1. Make all appropriate entries in MEDES
  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. Make a comment on the HoH Person Page to include
    1. Any information on the CiC
    2. Any change in coverage
  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

 

For a quick guide to eligibility and coverage start dates please see. Medicaid Categories/Coverage Type w/ME Codes and Processing Timeframes