Participant FAQs for CSCs & RCs

• Review the budget with the participant and this will explain how the spend down amount is determined. 
• Always be sure the participant knows; they only have to meet/pay the spend down if they want to activate their Medicaid coverage.

• Would you like to review all the ways to meet your Spend Down?
  1. 3.8.1 MO HealthNet Non-Spend Down Coverage
  2. 3.8.8 Spend Down Pay-In Option 

1. Review the budget with the participant and make sure everything is correct. Reviewing Budget for Spend Down Clients SOP
2. What is the participants income on the budget? Do they qualify for HCB Waiver? 
   1. IF YES:
      1. Refer to Home and Community Based Services (HCB) Quick Reference Guide to determine if they meet other qualifications and the next steps.
      2. If they meet all qualifications complete the HCB Referral with the instructions in the above guide.

1. 1. IF NO:
      1. Discuss ways to meet or pay the spend down amount:
         1. 3.8.1 MO HealthNet Spend Down Coverage
         2. 3.8.8 Spend Down Pay-In Option 
      2. Worker should also complete a hand off to HCB regarding Miller Trust. or provide the HCB number to the participant to call and inquire about Miller Trust

1. Could you tell me what the papers you are referring to say so I know what you are receiving?
2. Referring to the invoices you receive in the mail from MO HealthNet. These are mailed monthly to give each participant the option to pay their premium to activate your coverage.
3. Would you like to set up paperless billing? If so, you can create a portal or log in to your MHN Portal to set up paperless billing so you do not get invoices in the mail.

1. Check EUMEMROL comments on the MA case for the month in question. If there is not a comment for that month, ask the participant if they submitted bills to be applied toward the Spend Down.
   1. If YES:
      1. Ask what date they submitted the bills. If it was within 2 days of the current date, it should still be in the process of being worked. If it is over 2 days since the client submitted the bills, check the ECM to see if the bills are there. If the bills are in the ECM, complete a handoff to the Spend Down Unit and they will pull the bills and work them.
      2. Let the client know they will get a letter in the mail from the Spend Down Unit on the outcome. 
   2. If NO: Ask participant if they paid in their premium/Spend Down amount?
      1. If NO: The worker will review ways to meet the Spend Down with the participant. 
         • 3.8.1 MO HealthNet Spend Down Coverage
         • 3.8.8 Spend Down Pay-In Option

2. 2. 2. If YES:
         1. Ask when the participant mailed the payment. If it was within the last 10 days, advise the client to give at least 10 business days if they mailed the premium, for it to be applied.
         2. If it was over 10 days ago, refer them to the Premium Collections Unit, 877-888-2811, to inquire about their payment. 
         3. If the participant paid it online:
            1. When paying by credit card, the web portal should update the invoiced status to show PAID immediately.
            2. When paying by e-check (bank account), it may take a day or two for the status to update to PAID

• Review the budget with the participant and this will explain how the spend down amount is determined. 
• Always be sure the participant knows; they only have to meet/pay the spend down if they want to activate their Medicaid coverage. 

1. As long as you return Annual Renewal forms when they are due, your MHN case will not close for not paying the premium (TWHA or MHSD) or meeting your Spend Down with approved medical bills.
2. For CHIP, you are required to pay the first premium to activate your coverage and then continuous eligibility will take place for 12 months. At the time of your renewal if you remain CHIP, you will have to pay the first premium the month following the renewal, or your case will close.

1. If you do not pay your MHSD or TWHA premium, coverage will not be activated.
2. If you paid your first CHIP premium, you will have continuous eligibility until your next annual renewal.
3. If you do not want to pay the MHSD premium you can submit bills to meet the Spend Down.
4. Would you like me to go over how to pay your premium?

• MO HealthNet Premium Payment FAQs | mydss.mo.gov
• Assisting Participants with MHN Portal Navigation and Online Payments

Reference:

• 10.1 Eligibility Requirements for TWHA
• It is good to go over Ticket to Work and Spend Down Comparison with the participant so they are able to make an informed decision.

• Reviewing the budget will help the participant understand why the spend down amount has increased.
• During the COVID19 Pandemic, the federal government declared a public health emergency (PHE), which ended 3/31/2023. Reviews resumed 4/1/2023, and updated information for participants was entered into the eligibility system, starting with 06/2023 reviews. During the PHE, spend down participant’s coverage was held at their current level of care (LOC), that the participant was eligible for when the PHE started.
  • EX: Jack was MHNS (Non-Spend Down) when the PHE began. Since then, his income has increased and he should have changed to a spend down amount of $50, but because of the PHE the system kept him at the best level of care, which was MHNS. 

• Review the budget with the participant and this will explain how the spend down amount is determined. 
• Always be sure the participant knows; they only have to meet/pay the spend down if they want to activate their Medicaid coverage. 

• 3.8.1 MO HealthNet Spend Down Coverage
• 3.8.8 Spend Down Pay-In Option

• MO Healthnet FAQs | mydss.mo.gov
• Spend Down FAQs | mydss.mo.gov

• mydss.mo.gov

• Print the application from the website and mail it to PO Box 2700, Jefferson City, MO 65102, fax the application to 573-526-9400

• FSD Upload Portal (mo.gov)

• RC staff can assist client in filling out their application or mail an application to the client.

• For MO HealthNet applications the client can apply on the phone at 855-373-9994

• FSD received your application. An interview is required for approval. We will call soon from 855-823-4908, please answer.

CSC/RC:

Check the ECM to see if the application/REIN/verification the participant is referring to is there.

1. If the document is not there, advise the participant to resubmit the documentation.
2. Refer the participant to https://mydss.mo.gov/ and advise them they can upload documents and apply for services from the home page.
3. If ITrackRS shows the document was received, but it cannot be located in the ECM report this issue at ECM/Sharepoint Support.
4. If the participant needs a form printed to resubmit, follow the chart below to view/print forms in FAMIS:
   • Generating, Editing and Printing FAMIS Documents, The Flow Chart

• Order/Enforcement: 866-313-9960
• Paternity Information: 855-454-8037
• Payment Information: 800-225-0530
• General Help: 800-859-7999

• https://dss.mo.gov/child-support/noncustodial-parent/

• Central: 877-770-8055;
• Eastern: 877-860-3052;
• Southeast: 877-603-4323;
• Western: 877-698-0760;
• Southwest: 877-839-4316.

• Subject line should be “Attorney Call”.
• Program & Policy Contacts ·
  • Eizabeth Roberts-Smith – MHABD, MAGI 
  • Alicia Mitchem – Food Stamps (SNAP) 
  • Detrice Hunter – Temporary Assistance/Child Care

• Eligibility Requirements
• How to Apply
• Approval Process
• Find an Application Assistant
• Participant Responsibilities
• Using Your Substitute Address
• Voter Registration
• Participant Newsletter

1. Inform them of the hours of operation for the call center and provide the interview phone number line for them to call 855-823-4908. Advise clients due to the heavy volume on this line, they may have to make several attempts and hold times may be long.
2. Advise them an interview is required to complete their case. If an interview is not completed before the due date the application will be rejected and the client will have to reapply.

• MOSB-1 In the Forms Manual
• Applications received after August 31,2024, will be used to determine eligibility for Summer 2025 benefits only.

• If you have multiple children in the home you only need to complete one application.
• Who MUST Apply:
  • Children who attend a Community Eligibility Provision (CEP) school which is a school that provides free breakfast or lunch for all kids.
  • Children who have not applied for National School Lunch Program (NSLP)/School Breakfast Program (SBP) at their school, and think they are income eligible. NSLP/SBP income standards are under 185% FPL.

• healthytogether.co/onboarding/Missouri-sun-bucks.
• MOSB-1 In the Forms Manual

• Review the budget with the participant and this will explain how the spend down amount is determined. 
• Always be sure the participant understands; the Spend Down Pay-In amount may vary monthly based on family size and income.

1. Check the ECM to make sure the bills are there. 
2. • If the bills are not in the ECM, advise participant to email, fax, or mail copies of the documents again. 
   • Email: sesd@ip.sp.mo.gov
   • Fax: 855-600-3754
   • Mail: Spend Down Unit 16798 Oak Hill Dr Suite 600 Houston, MO 65483
   • If the participant says they mailed them to the Spend Down Unit, complete a Spend Down Inquiry Handoff. Let the participant know a staff member will contact them as soon as possible. 
3. Review EUMEMROL on the MA case to view comments from the Spend Down Unit, this will help assist in explaining the outcome of the participant's bills.
4. Advise participant the bills have been received; once it is processed the participant will receive a letter in the mail with the outcome.
5. If there is a high volume of bills to be processed AND if the bills are in the ECM, reassure the participant the Spend Down Unit has received the information and it will be processed as quickly as possible.

1. Review EUMEMROL on the MA case to view comments from the Spend Down Unit. This will help assist in explaining the outcome of the participants bills.
2. Search the ECM to view the IM-29 that was sent to the participant. Review the IM-29 and EUMEMROL comments with the participant.

• 3.8.1 MO HealthNet Spend Down Coverage
• 3.8.8 Spend Down Pay-In Option

• What is the name of the provider you are calling for?
• What is the DCN of the individual you are calling about?
  • (Name) has not received Presumptive (PC) or BCCT (M2) coverage in the last 12 months
  • OR
  • (Name) received Presumptive (PC) or BCCT (M2) coverage from mm/dd/yyyy to mm/dd/yyyy
• View MXIX to obtain dates of coverage and Presumptive Eligibility coverage
• Presumptive Eligibility coverage = PC
• BCCT coverage =M2
• Give coverage information from the last 12 months.
• For any service coverage questions refer the provider to Provider Relations at: 573-751-2896 or https://emomed.com

• What is the name of the provider you are calling for?
• What is the DCN of the individual you are calling about?
  • (Name) has not received Presumptive (PC) or BCCT (M2) coverage in the last 12 months
  • OR
  • (Name) received Presumptive (PC) or BCCT (M2) coverage from mm/dd/yyyy to mm/dd/yyyy
• View MXIX to obtain dates of coverage and Presumptive Eligibility coverage
• Presumptive Eligibility coverage = PC
• BCCT coverage =M2
• Give coverage information from the last 12 months.
• For any service coverage questions refer the provider to Provider Relations at: 573-751-2896 or https://emomed.com

• If yes: You will need to submit your inquiry by email to FSD.HospitalApplications@dss.mo.gov
• If no OR if caller indicates there are extenuating circumstances: What is the DCN of the person you are calling about?
  • If caller indicates there are extenuating circumstances or that the client they are calling about is not on their communication log, complete the call as normal.

• AUTHREP Check to see if the caller is an authorized rep.
• EUMEMROL Review comments
• FAMISPAR Check the status of the application
• PAYHIST Check to see if a check has been sent to the participant.
• MEDHIST Check for the date each type of coverage began
• SCMBR/PRSNDTL Check to verify current mailing address.

• Open Adobe Document:
• List sorted in the order of County, Specialty Name and Provider Name
• Right Click Mouse
• Choose Find
• Enter Name of provider Once located
• View MEDHIST to obtain dates of eligibility
• MPNI AF DCN minus two 0’s fo the DCN.
• If MPNI is showing spend down met, go to MSPI to see the start date of coverage
• For BCCT, TEMP MPW or PE coverage press F23 from MEDHIST to view the MXIX screen.

• Open Adobe Document:
• List sorted in the order of County, Specialty Name and Provider Name
• Right Click Mouse
• Choose Find
• Enter Name of provider
• Once located MPNI AF minus first two 0's of DCN to check if Spend Down has been met.
• If more than two 2 days since bills have been submitted send email to sesd@ip.sp.mo.gov

• I can see the application is still pending because ____________.
• Or
• I can see the application has been approved. Let me check the start date and tell you the surplus amount.
• Or
• It appears the application has been rejected.

• North Region (Chillicothe): 660-646-5770 or 660-240-6460
• South Region (Gainesville): 417-255-1563
• St. Louis Area (Fredericktown): 573-783-5596
• KC Area (Lexington): 660-259-8013

• AUTHREP: Check to see if the caller is an authorized representative.
• EUMEMROL (ADM case): Check to see if the nursing home has an authorization form on file, in a comment titled Nursing Facility Authorization Form.
• MEDHIST: Check to see if the program coverage is active.

• North Region (Chillicothe): 660-646-5770 or 660-240-6460
• South Region (Gainesville): 417-255-1563
• St. Louis Area (Fredericktown): 573-783-5596
• KC Area (Lexington): 660-259-8013

• I see the participant had active coverage at the time of the procedure. You will need to contact Provider Relations Unit at 573 751 2896. This is an interactive system but does eventually connect you with a live representative.

• It looks like there is a discrepancy in the participants coverage period. I will need to contact our policy unit to correct this issue. In order for the policy unit to respond to you directly I will need your name and contact information.

• If the change is something that can be done within 10 minutes complete the change.
• If it is something that will be over 10 minutes give the participant the option to stay in the office or on the phone to go on the statewide lobby OR provide a change report to them or instruct them how to report a change online.

• North Region (Chillicothe): 660-646-5770 or 660-240-6460
•  South Region (Gainesville): 417-255-1563
• St. Louis Area (Fredericktown): 573-783-5596
• KC Area (Lexington): 660-259-8013

• What is the name of the provider you are calling for?
• What is the first and last name of the individual?
• Please verify the date of birth and the gender.
• I can also screen for receipt of Presumptive Coverage for the past 12 months.
• SNME
  • If individual is shown, provide the DCN number to the provider 
  • If individual is not shown and needs to be assigned a DCN, assign the DCN
• View MEDHIST to obtain dates of coverage
• View MXIX to obtain dates of coverage and Presumptive Eligibility coverage. Share PE coverage with provider.
• Presumptive Eligibility coverage = PC
• BCCT coverage =M2
• Check coverage information from the last 12 months.
• For any service coverage questions refer the provider to Provider Relations at: 573-751-2896 or https://emomed.com

• • If they have never used the IM Portal follow the IM Benefits Portal Guide to assist the participant.
  • If the participant has no access to the portal, staff will assist the participant in checking the status of their case in FAMIS.
    • • BPT can send a copy of this information in the mail.
        
        • • Prior to mailing this information to the participant, BPT must verify name, DOB and SSN or DCN and the mailing address the participant wants this sent to.
          • These cannot be faxed to participants.
  • Non-MAGI specific: 
    • • If active: At the current time you are active on:
      • If application status: Your application is still pending. Your application timeframe is (insert timeframe applicable to application) but in some circumstances the timeframe may extend past that if disability needs to be determined when an individual is not receiving SSA or SSI as a disabled person, or there are resources that need to be verified.
      • If case is BP/SAB: You will need to contact our Blind Pension unit at 866-877-8155
      • If case is not BP/SAB: Have you been to the hospital or emergency room since you have applied?
        
        • • If yes: What is the name of the hospital and the name of the doctor that treated you? We are asking for this information so we know where to request additional medical records to help us in determining eligibility.
          • If no: Thank you. If you have to go to the hospital or emergency room before a determination has been made on the case, please contact us with the name of the hospital and the name of the doctor who treated you. We ask for this information so we know where to request additional medical records from to help us in determining eligibility.
      • If there are changes in their condition & they want to submit additional medical records: I will notify our processing team of the situation. You will receive a letter in the mail if changes are made to your case. You can also contact us back in two business days for an update.

• • • • If application is past 90 days: I will review your case. Review SharePoint site. If participant had a doctor appointment scheduled: I see you had an appointment on (date), were you able to go to that appointment?
        • • If yes: We need the medical records from that appointment. The doctor is allowed 45 days to submit records. If at the end of 45 days we have not gotten the records we will request them again from the doctor. You may contact the doctor in the meantime and ask for the records to be sent so a decision can be made on your application.
          • If no: Please summarize the reason the appointment was not able to be kept. I will send this information to our Medical Review Team. If the participant indicates they need to reschedule because of a hospitalization: Please provide me with the name of the facility and the dates you were hospitalized. They will determine if your appointment can be rescheduled. You may call us back in 48 hours for the determination.

• • EUMEMROL: Check current comments.
  • OUTVERF: Check if the case is pending. If so, what verification is needed? If participant states they have already provided the information, check all scanning systems for receipt. 
  • EULOG: Displays benefit amounts and adverse actions.
  • Evaluating FAMIS Results-FS, and TA

• • Non-MAGI specific: 
    • • OUTVERF: If MRT packet has been provided but there is no indication the packet has been received by MRT, use the MRT Hand off, unless case is BP/SAB. For BP/SAB, participants will need to be referred to BP/SAB Unit at 866-877-8155
      • CONFLOWS: For SNAP/Non-MAGI combo cases, check CONFLOWS screen to see if the application is still in the flow awaiting an interview. If yes, then transfer to Application/Interview team to complete the controlled flow. Follow end of date procedures. 
      • DISALBED: PMR with CS Reason Code means FSD is waiting on MRT Decision. Press F18 for comments
        • • Select the case and press F15 MRTINFO, F12MRT to MEDINFO for MRT details. 
      • Non-MAGI App Detail: Check due dates (On REQUEST, select Non-MAGI app and press F14 APPDETL
        • • If application is past 90 days, or if there are changes in their condition and they want to submit additional medical records, use MRT Hand off. Once submission is sent to MRT staff will review and add comment in EUMEMROL within 2 business day. 
          • If participant provides hospital or doctor information or needs to reschedule their appointment use MRT hand off. If the participant indicated, they need to reschedule because of a hospitalization include that information in the add notes field in Current. 

• • Client Contact: Check all tabs to the left once in the Client Contact tab.
  • Evidence: Check for incoming evidence.

1. 1. Check the ECM to see if the change/verification the participant is referring to is there.
2.  FAMIS:
   • Check EUMEMROL in FAMIS to see if there are any comments regarding the change/verification.
3.  MEDES:
   • Check the “Client Contact” tab for notes regarding the change/verification.
4.  If the document is not there, advise the participant to fill out and resubmit the change report online.

• 10.12 Resource Deeming

• Discuss SkillUp with the participant by reviewing the IM-4 SkillUp flyer.
• If the participant chooses to participate in the SkillUp program complete the SkillUp HandOff to refer the participant to the nearest Missouri Job Center.
• Make a comment in EUMEMROL regarding the SkillUp referral.

CSC/RC:

Refer the participant to:

• feedingmissouri.org

• Be a Missouri resident
• Be a US citizen (or have been legally admitted for permanent residence) *
• Be responsible for paying the utilities for your home *
• Have less than $3,000 in your bank accounts, retirement accounts, or investments
• Be at or below the income guidelines for your household size

CSC/RC:

LIHEAP DSS Internet

LIHEAP Contracted Agencies

LIHEAP application and additional information can be found at: https://mydss.mo.gov/utility-assistance

Applications are processed by their local contracted agency. Contracted agencies are listed by county at LIHEAP Contract Agencies & Energy Suppliers (mo.gov)

The Family Support Division does not issue the phones; you will need to contact Safe Link Wireless.

 For all issues with your free phone, you need to contact technical support. The hours for the technical support line are 7:30am to 5:30pm.

CSC/RC:

Refer participant to:

• Safe Link Wireless:
• Enroll/Change Plan 1-800-723-3546

OR

• safelinkwireless.com
• Technical Support at 800-378-1684

CSC/RC:

Review the following with the participant:

• Review Budget Summary
• Maximum Allowable Income Limits
• Review Resource Summary

• Review Expense Summary

Explain to the participant:

CSC/RC:

EBT Card Replacement Request use:

• EBT Card Replacement Handoff

MO Healthnet Replacement:

• (MXIX coded AC for Alternative Care)
• If your case is active through Youth Services or the Children’s Division you will need to contact them for a new card. Children’s Division contact info per county can be found at: http://dss.mo.gov/cd/office/
  
  Youth Services contact: 573-751-3324

CSC/RC:

Participants can request a new card by calling:

1. If your EBT card has been lost, stolen, or damaged, please call 800-997-7777 to ask for a replacement EBT card. You can also call the FSD Information Center at 855-FSD-INFO (855-373-4636)
2. If you need a new MO HealthNet ID card, please call 855-FSD-INFO (855-373-4636)
3. If you need a new Managed Care health plan card, please reach out to your health plan directly.

• Healthy Blue 833-388-1407
• United Healthcare  866-292-0359
• Home State Health  855-694-4663
• Show Me Healthy Kids 877-236-1020

CSC/RC:

• United Way 211
• HUD Housing Assistance 800-955-2232

Medicare Questions:

1. I want to apply for Medicare, can you tell me how?
2. What is Medicare RX open enrollment?
3. Who can help me pick a Medicare supplement?
4. What is a Medicare Advantage Plan?
5. What is the best plan for Part D?

CSC/RC:

Refer participant to Missouri SHIP, if they do not have access to a computer, they can call 800-390-3330.

MO RX: 800-375-1406

CSC/RC:

At age 65 participants age-out for all MAGI-based healthcare programs and MEDES completes ex-parte (eligibility review) to explore eligibility for MHABD. We review the participant’s circumstances to determine continued eligibility for benefits.

• An IM-80PRE is generated 20 days prior to the participant’s 65th birthday.

SkillUP, is a free employment and training program for SNAP participants. This program offers the support you need to find a job, such as training, work experience, and other services. This free help can lead you to a career and a plan for your family’s future.

SkillUP providers are at schools and job centers throughout Missouri. They can help you:

• Connect with resources such as childcare and housing assistance
• Get free job and skills training that can be completed in a few weeks
• Get a high school diploma or equivalent if needed, and real work experience and
• Create a resume and search for a job

The program can also help you with transportation and other expenses such as clothes and tools needed for a job or training.

To get started with SkillUP, go online to https://mydss.mo.gov/skillup-program on.mo.gov/SkillUP and click on the SkillUP provider links at the bottom of the page.

NOTE: Temporary Assistance participants who receive SNAP are not allowed to volunteer for the SkillUP and should be referred to Missouri Work Assistance Program (MWA

SkillUP is not mandatory for ABAWDs. However it is a convenient method to meet the required hours for SNAP. SkillUP can work with participants through training and job search to reach their required 80 hours for the month.

SkillUp Providers can be located at https://mydss.mo.gov/food-assistance/missouri-employment-training-program

EMPLOY: 24 or 22 in the Code fields indicate the participant has volunteered for this program. Prompt out in the code field for explanation of other fields.

SkillUP Pamphlet: IM-4 SkillUP Brochure (mo.gov)

Flyer: SkillUP- (mo.gov)

CSC/RC:

Refer participant to:

CSC/RC:

Search “Select Authorization” in IM resources to view:

• FAMIS Authorization Codes
• FAMIS Reason Codes

Search “Supercase Eligibility Unit Summary FINAL” to view:

CSC/RC:

CSC/RC:

• Medicare is federal health insurance for anyone age 65 and older, and some people under 65 with certain disabilities or conditions.
• Medicaid is a joint federal and state program that provides health coverage for some people with limited income and resources.

CSC/RC:

Refer the participant to:

CSC/RC:

CSC/RC:

CSC/RC:

CSC/RC:

To check for Authorized representatives for:

• SNAP/TA fastpath to AUTHREP.

CSC/RC:

Review the budget with the participant:

• Evaluating FAMIS Results-FS and TA
• Evaluating FAMIS Results-MHABD

I lost my form; can you print me a new one?

I got a letter and don’t know what it means. (Participant does not have letter with them)

CSC/RC:

Follow the chart below to view/print forms in FAMIS:

• Generating, Editing and Printing FAMIS Documents, The Flow Chart
• Review DOQUE for instructions on how to view letters printed within the last 30 days.
• Review Retrieving Archived Documents in FAMIS for instructions to view letters printed over 30 days ago.

CSC/RC:

CSC/RC:

CSC/RC:

Participants can obtain a copy of their birth certificate through their local public health agency:

• Local Agency Listing: https://health.mo.gov/living/lpha/pdf/printablelisting.pdf

OR

Participants can request a copy by phone or online:

• Call VitalChek at 1-877-817-7363, toll free 24 hours a day, 7 days a week or order online now through VitalChek. 

OR

Participants can request a copy from the Department of Health and Senior Services through the mail by mailing Application for a Vital Record - Birth/Death/Fetal/Stillbirth to:

Who does home health?

CSC/RC:

If a participant has Medicare, refer them to medicare.gov:

• At the top right there is a tab that says, “Providers & Services”, this will allow the participant to search for home health providers near them.

Missouri Alliance for Home Care is also a very good place for participants to search for in home care and private pay care as well. There is a tab at the top left, “Find a Local Provider”.

CSC/RC:

Participants may request a copy of verification they previously submitted such as: driver’s license, divorce decree, paystubs, lease agreement, etc. 

• The participant must provide a written statement, signed, and dated, requesting the specific verification they want a copy of. 
• Staff must scan the written statement into the ECM.
• If the participant is requesting a copy of verification that was submitted by a different agency, a copy of the verification cannot be provided to the participant.
• EX: The participants Life Insurance company sent verification of the policy directly to FSD, we cannot provide a copy of this to the participant. 

CSC/RC:

Participants can file an unemployment claim online as soon as they are separated from their employer. UInteract, the online claim filing system, is mobile friendly and available 24 hours a day.

uinteract.labor.mo.gov

Division of Employment Security: 800-320-2519

CSC/RC:

Refer participant to health.mo.gov then have them select the “Senior and Disability Services” tab. Once they are redirected, they will select the “Area Agencies on Aging” tab to the right of the page. There will be a “Click Here” pdf that is a chart of all the agencies with contacts and addresses.

• https://health.mo.gov/seniors/pdf/AAARegion.pdf

OR

 Participants can call:  Senior Resource Line at 1-800-235-5503

health.mo.gov

Senior Resource Line at 1-800-235-5503

CSC/RC:

Refer participant to:

I need a tax paper for my Medicaid. How do I show proof that I had Medicaid insurance when I file my taxes?

CSC/RC:

Refer participant to:

• mo.gov/mhd

• If it is for a Family Services claim, Check OVCI IDCN, enter.
• If there is an “A” under Status refer to Claims and Restitution Unit.
• If it is for child support transfer to Child Support Call Center.

Claims and Restitution Unit: 800-877-1379

Child Support Call Center: 866 313 9960.

• If it is for a Family Services claim, Check OVCI IDCN, enter.
• If there is an “A” under Status refer to Claims and Restitution Unit.
• There are many different reasons why money could be deducted from a person’s social security check. Call Center staff should be sure to research if the participant is on QMB/SLMB and to provide status of that benefit. If the participant wants more information regarding QMB/SLMB being withheld from their benefits refer them to the Social Security Office.
• If it is for child support transfer to Child Support Call Center.

Claims and Restitution Unit: 800-877-1379

Social Security Office: 800-772-1213

Child Support Call Center: 866 313 9960.

• If it is for a Family Services claim, Check OVCI IDCN, enter.
• If there is an “A” under Status refer to Claims and Restitution Unit.

CSC/RC:

Refer participant to:

• doc.mo.gov

doc.mo.gov

 Access http://dss.mo.gov/offices.htm

• Type in city and click Submit Available resource centers in the area are listed on the left.
• If there is more than one option, provide all the options to the participant and ask which one they would prefer to go to.
• Click on the chosen resource center for hour information.
• If they would like the hour’s information for a different resource center in the list, click Submit on the left again to get the list back.

Advise the participant they can drop off information in their local office at any time during these hours.

We have a formal process for complaints. You can fill out our survey at mydss.mo.gov/survey or I will be happy to mail you a form.

This is a Federal Program of assistance and services to refugees resettling in the United States during their first 8 months of entry, who are not eligible for Temporary Assistance, Family MO HealthNet programs or MO HealthNet for Aged, Blind and Disabled.

Persons who wish to apply for this program should contact the International Institute of St. Louis at 314-773-9090 ext. 150.

You can apply for any benefit at any time. There are fillable application forms on our website. You can apply online at mydss.mo.gov, through mail to PO Box 2700, Jefferson City, MO 65102, fax the application to 573-526-9400 or upload the application to FSD Upload Portal (mo.gov) and for MO HealthNet for Families you can apply online at mydss.mo.gov or over the phone at 855 373 9994.

If you are not eligible for services through FSD, you may be eligible for assistance through the Federal Program of assistance and services to refugees resettling in the United States during their first 8 months of entry.

Applications for refugee households found in ECM or Current should be sent to FSDREFUGEE@ip.sp.mo.gov FSDREFUGEE@ip.sp.mo.gov and transfer them in FAMIS to caseload 004716.

Applications for all other immigrant types are processed using normal procedures.

Some of the programs FSD has to offer are: Food Stamps, Temporary Assistance, Child Care benefits, and MO HealthNet coverage. You can apply for any benefit at any time. There are fillable application forms on our website. You can apply online at mydss.mo.gov, through mail to PO Box 2700, Jefferson City, MO 65102, fax the application to 573-526-9400 or upload the application to FSD Upload Portal (mo.gov) and for MO HealthNet for Families you can apply online at mydss.mo.gov or over the phone at 855 373 9994.

General:  Can you talk to my _(insert name) so they can explain the information to me. 
Can I give verbal permission to speak with them over  speaker or 3 way calling?

If the third caller is not with you, you can connect them using three-way calling (if you have that feature) to get the customer on the phone. Please give me verbal permission to speak with the caller. If the third caller is with you, you can give me verbal permission and put your phone on speaker phone. If you do not have a speaker phone or three- way calling, I can send you this form or call us back when is with you.

Customer must be PRESENT on call if the Authorized Rep forms or releases are not on file.

NOTE: This does pertain to customers who do not speak English and are needing interpreter services.

Send the form based on need:

• If it’s a non-medical provider wanting access to information only, send the IM-6 Authorization for Release of Information
• If it’s a provider of medical services (nursing home, etc) requesting access to information only, send the IM-6NF Nursing Facility Authorization form.

What can I help you with today?

Public administrator must be established as the guardian/conservator AUTHREP to review if authorized rep Check scanning systems for court appointed letter.

Check EUMEMROL notes on MHABD and FS cases on PA designation.

Check case.net at https://www.courts.mo.gov/, search the participant’s name and look for PR Guardian/Conserv-Adult under Case Type Location.

If PA needs to complete a FS interview transfer to Application/Interview Team. Follow end of day procedures.

For more information regarding PA see Participant Screening SOP

General:  What is the Emergency Broadband  Benefit program?

Can I get help paying my internet bill?

If I am on food stamps, can I get free internet?

The Emergency Broadband Benefit program is a temporary program to help households reduce their internet bill. An eligible household could get up to $50 per month off their internet bill. Your internet provider will sign up eligible household while funding lasts.

To see eligibility requirements and a list of internet providers, you can visit ded.mo.gov/GETCONNECTED for more information you can contact the Office of Broadband Development.

Office of Broadband Development: (833) 511-0311 from 8am -7pm daily.

My benefits have been stolen! How can I get these back?

(note this is for if the actual money was stolen, NOT if the card was stolen.)

• I apologize this has happened to you.
• Send caller IM-111 Electronically Stolen Benefit Replacement Request
• dssmanuals.mo.gov/wp-content/uploads/2023/09/im-111.pd
• If the signed form is returned timely, FSD will explore eligibility for replacement benefits.
• Call center staff should NOT reissue benefits.

• TA benefits cannot be replaced unless ordered to do so via a hearing or legal decision. staff should NOT reissue benefits.

SNAP:  What is the double up Food Bucks program?

This program is administered by the Fair Food network. It is a national model for health food incentives and allows low income families to bring home healthier food while supporting farmers and growing local economies.

Double Up matches the value of SNAP when spent on fruits and vegetables

SNAP:  My Food Stamp application was rejected due to Quality Control sanction but I participated with QC.

Let me get the contact information for you.

Check comments for IM311Q

I was approved for a program that would pay my Medicare premium, but it is still being withheld from my check. What’s taking

so long? (QMB or SLMB)

Let me review your case to see your current type of coverage.

If determination date is not over 90 days:

• It can take 90 days from (insert date) for information to be updated. In the meantime the premium will be taken out of your social security check. Once 90 days has passed and the QMB/SLMB benefit has taken effect, you will need to discuss any reimbursement with Social Security.

If determination date is over 90 days and IIVE shows it has not taken effect yet:

• I will contact our unit that handles these issues.
• MEDHIST Check the date that the client was approved for QMB or SLMB. The Determination date is the date they were approved, not the start date.
• IIVE to see if QMB/SLMB has taken effect.

If it has been more than 90 days from determination date and IIVE shows it has not taken effect yet, use QMB/SLMB-“Buy In”/Over 90 Days Hand Off

• Provide participant with Social Security phone number 1-800-633-4227 if asked.
• Let me get the contact information for you.

Social Security: 800-633-4227

I need to reschedule my appointment with MRT (Medical Review Team)

I can contact them with your request. What is the reason for rescheduling?

If the participant indicates they need to reschedule because of a hospitalization:

Please provide me with the name of the facility and the dates you were hospitalized. If your appointment is rescheduled you will be notified by mail of the new appointment date and time. You can also call us back in two business days for an update.

Use MRT Handoff.

If participant provides hospital or doctor information or needs to reschedule their appointment use MRT Handoff. If the participant indicated they need to reschedule because of a hospitalization include that information in the add notes field in Current.

I’m calling to complete my disability questionnaire.

Have you returned the MRT packet to us?

• If yes: I can take your contact information and ask our processing team to return your call. What is the best time of day to reach you and what is your phone number?
• If no: We will need you to return the packet to us before completing your disability questionnaire over the phone. Once we receive it we can help you with completing the questionnaire.

I have questions about the Estate Recovery Program.

You will need to contact the MO HealthNet Division, Cost Recovery Unit.

Cost Recovery Unit: 573-751-2005

When a claimant dies, the state may attempt to recover some of its cost from the claimant’s estate. The Missouri Attorney General’s website  for general information.

What is the Rehabilitation Services for the Blind Program?

More Information: http://dss.mo.gov/fsd/rsb/

Rehabilitation Services for the Blind: 800-592-6004.

Can you  send me a application/foms in large print and/or Braille?

If participant wants bp/sab:

• You can apply online at mydss.mo.gov, through mail to PO Box 2700, Jefferson City, MO 65102, fax the application to 573-526-9400 or email the application to FSD.Documents@dss.mo.gov.

If participant wants HCB services

• I can send that request to our processing team. I just need to gather some information from you first.
• If participant is moving to a nursing home and need Vendor coverage:
• I will report this information to our Vendor team. They will contact you for more information.
• Use the HCB Hand Off

If participant is moving to a nursing home and need Vendor coverage:

• I will report this information to our Vendor team. They will contact you for more information.
  
  

If participant wants a different category

• I can help you with this
• If participant would like to add BP/SAB categories a new application is needed. Send client IM-1MAC
• If participant is age 65 OR age 63 and disabled, and would like HCB services-

Map of Vendor Counties https://dssmanuals.mo.gov/wp-content/uploads/2021/08/map-regional-nursing-home-offices.pdf

I’m on disability and I need information about Property Tax Credit

• records you have on file.

• If there is a signed release “Individuals Request for Access to Protected Health Information” form is found:
  I will contact the unit that handles these requests. It typically takes 2-3 weeks for these files to be located, copied and returned to the address listed on the form.
• If there is no signed release form on file:
  Due to HIPPA regulations we will need to have a signed release on file before you request can be processed. I can mail you the form that must be filled in order to process your request. This form will need to be returned to:    Greene County FSD 101 Park Central Square Springfield, MO 65806

• BPT should mail the caller the release form (links above)
  Participant will need to sign and return INDIVIDUAL’S REQUEST FOR ACCESS TO PROTECTED HEALTH INFORMATION Form MO 886-4451 (4-11)   

If signed release is on file, BPT Use MRT Handoff.

• The submission should include the head of household name, DCN, caller’s name, where the signed release was found (ecm, vfr, eumemrol comments, etc) contact phone number for person requesting the records and the best time of day to reach the caller. ”

A lock in restricts who you can use for your pharmacy, physician/clinic or sometimes both.

To make changes to who you are locked in to, you will need to contact the Missouri Medicaid Audit and Compliance Unit (MMAC)

A lock in restricts who you can use for your pharmacy, physician/clinic or sometimes both.

To make changes to who you are locked in to, you will need to contact the Missouri Medicaid Audit and Compliance Unit (MMAC)  https://mmac.mo.gov/contact-us/ 

Qualified Income Trust
Miller Trust

What is a Qualified Income Trust 

If calling for general information, or how to set up a Miller trust, or about a pending Miller trust contact HCB Unit 877-304-7939

If calling about a pending Miller trust, participants can contact the HCB Unit at 877-304-7939.

I received a letter that my medical coverage is closing or was rejected because I am in alternative care. I am no longer in alternative/foster care.

Let me take a look at your case to see why it is closing. I did see that it is closing or was rejected because we still have you as being in alternative care. I will send a request to have your coverage through Children’s Division closed. Our processing team will contact you if they need more information.

• MXIX
• Check for active medical coverage ME-38.

Review for closing/rejection reason. If case is closing or rejecting for alternative care only, send an email to cole.mhnpolicy@dss.mo.gov to close AC case. The subject line will be “AC ME 38 Needs to be Closed” and include the applicant’s name, DCN and current address

If other factors are causing ineligibility (i.e. excessive resources, not disabled), allow the case to close or reject.

Review policy for MO Healthnet Eligibility for Persons Age 19-26 Who Have Previously been in Foster Care

• 3.4 Former Foster Care Youth (FFCY)

Can I have my premium for ticket to work auto withdraw from my bank account?

Yes. You must file an auto withdrawal form with the MOHealthNet Division. This process can take up to 30 days to be completed.

Withdrawals are made on the 15th of each month. The effective begin date is dependent on the day the form is received and when the financial institution puts the withdrawal in place. Therefore, participants must send a check or money order to Stakeholder Services Unit to pay for the prior, current and possibly the month after sending in the form. You will receive a monthly confirmation of withdrawal from MO HealthNet Division.

MEDHIST to verify coverage type.

The form can be found at http://dss.mo.gov/mhd/participants/pdf/ttw-ha.pdf

This form is to be used if participanclient wants to start, change or stop auto withdraw for ticket to work.

 Is Non-Emergency Medical Transportation service free or does it cost? (NEMT) What happens if I can’t pay?

You can obtain this information online from the agency's Benefit Center: www.mydss.mo.gov

If you do not have access to this information online I can send you a copy of this information in the mail.

Prior to mailing this information to the participant. Benefit Program Technician must verify name, DOB and SSN or DCN and the mailing address the participant wants this sent to.

These cannot be faxed to participants

I called for a ride to my Dr.’s appointment and they have not arrived yet, or did not show up at all

Please contact Where's my Ride “Where’s My Ride” (This is to be called by MHD participants if their ride is more than 15 minutes late.)

General/Reservations/Cancellations: 1-866-269-5927

Where’s My Ride: 866-269-944

I want my AEG coverage to be backdated (Prior Quarter}.

Eligibility for PQ coverage will begin the first day of the month in which you received medical services and was eligible at any time during that month.

Explore PQ coverage if requested at time of application or if requested within 12 months of application. The eligibility for PQ months should be treated as if the person had applied in that month. Determine income for PQ months using the same methodology as the month of application. These guidelines are in manual section

3.6.2 Modified Adjusted Gross Income (MAGI) Methodology and 3.6.1 Eligibility Requirements.

NOTE: PQ coverage shall not start prior to the implementation month of July 2021.

I don’t think I can afford to be screened for Breast and Cervical Cancer Treatment (BCCT). Is there help for that?

I can refer you to a provider and they can assist you will that. https://health.mo.gov/living/healthcondiseases/chronic/showmehealthywomen/providermap.php

*NOTE*

Currently, if the participant received diagnosis out of state and did not have MO HealthNet benefits when diagnosed. The participant will not qualify.

The link shows the providers by County. Ask the participant for their County information.

What is alternative care?

Alternative care is MO HealthNet coverage provided to children who have an open case with the State of Missouri’s Children’s Division.

If an individual’s MO HealthNet benefit is being closed, and that individual was under the age of 26 and in Foster Care on the date he or she turned 18 or within 30 days prior, that individual may be eligible for MO HealthNet coverage through the Children’s Division. Please call the MO HealthNet open enrollment broker at 1 (800) 348-6627 to find out if the individual is eligible for this coverage. You may also contact the Children’s Division at  or call 1 (573) 522-8024.

3.4 Former Foster Care Youth (FFCY)

Please call the MO HealthNet open enrollment broker at 1 (800) 348-6627 to find out if the individual is eligible for this coverage.

You may also contact the Children’s Division at http://dss.mo.gov/cd/ or call 1 (573) 522-8024.

I have been sanctioned on my medical coverage for not cooperating with child support enforcement and I would like to cooperate

Please let me transfer you to Child Support to better determine what is needed to cooperate. If you are disconnected during the transfer please call (866) 313-9960.

Notes on Client Contact tab in Person Page for notes regarding sanction.

Child Support: 866-313-9960

My child is American Indian or Native Alaskan, do I still have to pay a premium?

If your child is a member of a federally-recognized American Indian or Native Alaskan tribe, you will not have to pay a premium for your child’s health care coverage. To stop owing a premium, send a copy of the proof of your child’s tribal membership to the Stakeholder Services Unit by mail, fax, or e-mail. Be sure to include your child’s name and MO HealthNet identification number with your proof.

Mail:

• MO HealthNet Division Stakeholder Services Unit
• PO Box 6500
• Jefferson City, MO 65102-6500
• Fax: (573) 526-2471 Email:
• Scan your records and e-mail to Ask.MHD@dss.mo.gov Ask.MHD@dss.mo.gov Type the Words “ Stakeholder Services Unit” in the subject line of your e-mail.

Proof of membership can be a copy of a tribal membership card or letter issued by the tribe that is recognized by the United States Department of the Interior, Bureau of Indian Affairs.

Go to the Head of Household Person Page, Go to the Client Contact Tab, Review Notes

Also Go to PDC, Review determinations for Premium Amount Review MXIX for current coverage

I’m trying to complete a MO Healthnet application online, but am having technical difficulties. (password reset, etc.)

To apply online you first have to create an account with our Citizen Portal.

Go to mydss.mo.gov/healthcare/apply

Click on Apply Online. For new customers you must create an account before applying. Click on the Apply for Health Benefits button to begin setting up your account or sign in to your existing account.

If participant states they already set up their account and are having technical difficulties OR they are attempting to set up an account and are getting an error message

I can transfer you to our technical team to resolve your issue.

Will I be receiving a tax form for my Blind Pension or Temporary Assistance Benefits?

No. The Family Support Division does not provide tax statements for Blind Pension or Temporary Assistance benefit.

Let me review your case.

Check all scanning systems and case notes If information is found and FAMIS has not been updated Use TA Follow Up Request Handoff

TA exemptions are handled on a case by case basis. Additional and continuing verification may be needed to continue the exemption. I will contact the team that processes these requests and they will contact you if additional information is needed.

Use TA Follow up Request

I am calling to check on the hardship request that I made to extend my lifetime limit.

If it has not been 10 days since requested Hardship request can take up to 10 days to process. Please allow more time for processing.

If it has been longer than 10 days since requested, I will reach out to the team that processes these request for an update.

If request is greater than 10 days use TA Follow Up Request Handoff

There two ways to resolve this issue:

• You can search “EBT Payment” and the choice should show: “Shop our SNAP EBT eligible groceries” when they choose that they get an option to add their EBT card, or
• You can go to your account:
• Choose “Your Account”
• Scroll down to “Payments”
• Choose “Your Payments”
• Scroll down and choose “Add a payment Method”
• Scroll down to bottom and choose “Add an EBT card”

EBT Edge can’t issue a new card because they have the wrong address.

Let me verify both your physical and mailing address and see whether or not the card was mailed to the correct address.

Note: If there is a mailing address shown on the PRSNDTL (FM01) Screen the EBT card will be sent there.

Update address as necessary.

Use EBT Card Replacement Request

Use the link below to search if the card has been requested in the last 10 days through the worksite.

EBT Card Replacement Request

Verify card has not already been issued in EBTedge

Verify old card has been deactivated in EBTedge

14 ELECTRONIC BENEFITS TRANSFER (EBT)

I received this letter that says something about EBT card being used out of state and that I might not be living in Missouri and that I need to contact the Welfare Fraud Investigations, what is this about?

• Eastern Region 877-860-3052
• Western Region 877-698-0760

Check EBTedge to verify old card is de-activated:

If this is the first time that you have been issued benefits or if it has been at least 1 full year since you last received or used benefits, you will be issued a new EBT card and should receive it by mail within 5-7 business days of approval. When you receive the card you can call the 800 number listed on the card to set up a 4 digit PIN.

If card is not deactivated on EBTedge

I can reissue the card to you. You will receive your EBT card within 5-7 business days.

EULOG for approval action. PAYHIST for issuance date. If no issuance date is listed, advise the client to allow 7 days from the approval date on EULOG if payment is going to EBT card. If payment is direct deposit, the benefits will be available on the 4^th of the month or the next business day if the 4^th of the month is on a weekend.

Review the issuance number, the first letter will indicate the type of payment method.

• Y – direct deposit regular payroll
• X – Direct Deposit Daily
• D – EBT regular
• C – EBT Daily
• K – Regular monthly payroll, paper check
• M – Daily Paper check (i.e. Deficiency or retroactive.)
• A – Check issued to replace an outlawed check

If I use my EBT card at an ATM or get cashback at a register, is there a fee?

There is no fee for the first withdrawal, but there is an $0.85 charge for each additional cash withdrawal. There may be additional surcharges from the retailor.

What is frozen used for on my EBT app?

If you misplace your EBT card you can temporarily freeze you card until you locate it.

When the card is in frozen status it cannot be used. You can unfreeze the card using the same steps taken to the freeze it.

I would like to set up an Optional ID for my EBT card.

I can submit your request to our processing team. The optional ID must be 5-10 characters and can be numbers or letters. What would you like for the Optional ID to be?

14 ELECTRONIC BENEFITS TRANSFER (EBT)

EBTCardReplaceRequest (state.mo.us)

In the comment say the request is for an optional ID and what the caller’s chosen ID is.

My card is being mailed to the local office. Can you tell me if it has been received?

One moment while I review your case

If the EBT card is not in ItrackR

We have not received your EBT card yet. Our records show the card was mailed on ____. Your card will arrive within 5-7 business days.

EBTI

Paste DCN minus two beginning 0’s

Review card mailed field

Open ITRACKR

The reason for visit field will read “Documentation Mailed.”

The office name will show the specific office. Click on the view button to be sure it was an EBT card. The sub-reason will state “EBT Card Received” The address to each specific local office can be found at https://dss.mo.gov/dss_map/?locationString=65101&submit=Submit If the card has not been received and it is past 10 days, email the supervisor the participant’s name, dcn and the date the EBT card was ordered. The supervisor will contact the manager for further review.

I am in the state of California or Nevada trying to use my EBT card but it’s not working. My card was declined Because something is wrong with my PIN.

For Frozen cards:

•  You can download the ebtEDGE app or use ebtedge.com participant portal to attempt to unfreeze your card. You must change your PIN number once your card is unfrozen.

If the participant is unable to unfreeze their card:

•  One moment while I submit request for your EBT card to be unlocked.
• Your card should be unlocked within 24 to 48 hours (This will vary depending on the day of day the week or holiday etc)

 For PIN errors:

•  Please call the EBT vendor at 800-997-7777, use ebeEDGE app or ebtEDGE.com to choose a new PIN.
• Look at EUMEMROL for any comments about the EBT card. If the card status in ebtEDGE shows “frozen”, advise the participant their card may have been reported as possibly comprised.

All staff should submit the request for the EBT card to be unlocked. Email policy at FSD.IMProgramandPolicy@dss.mo.gov. Include name, DCN and phone number in the email. Make a comment in EUMEMROL regarding the request.

When you are approved for MO HealthNet, you may be required to participate in a managed healthcare plan depending on where you live and the type of MO HealthNet you receive. You will also receive a welcome packet with important information about your coverage from your managed care plan. I can give you a number to call for information regarding the health plans 1-800-348-6627.

Review: MXIX for current coverage information. MCII for managed care information

I have misplaced my open enrollment plan form. What do I do now? How do I get a new form?

When you are approved for MO HealthNet, you may be required to participate in a managed healthcare plan depending on where you live and the type of MO HealthNet you receive. You will also receive a welcome packet with important information about your coverage from your managed care plan. I can give you a number to call for information regarding the health plans 1-800-348-6627.

Review: MXIX for current coverage information. MCII for managed care information

You will need to contact your Managed Care Provider to request a card.

MCII for managed care information. For contact information go to https://dss.mo.gov/mhd/participants/mc/managed-care-health-plan-options.htm

I need a new card for:

• United Healthcare
• Healthy Blue
• Show Me Healthy Kids
• Home State Health

You will need to contact your Managed Care Provider to request a card.

MCII for managed care information. For contact information go to https://dss.mo.gov/mhd/participants/mc/managed-care-health-plan-options.htm

When can I change my MO HealthNet managed care plan? (participant may say their "insurance") Where can I find their number?

You have the right to change your health plan if:

• It has been less than 90 days since you were assigned a health plan
• It is your annual open enrollment period and you do not want to stay with the same health plan
• You have “just cause” and the state approves your request.

You will need to submit the request for each family member’s health plan you would like to change. If you are enrolled in Show Me Healthy Kids you are not able to change health plans.

You can change your plan:

• Online- you will need your PIN number and MO Healthnet ID
• Phone -1-800-348-6627 7am-6pm
• Mail- MO Healthnet Division PO Box 104928 Jefferson City MO 65110

MCII for managed care information. Web Link to other general Managed Care Info: http://dss.mo.gov/mhd/mc/

For contact information go to https://dss.mo.gov/mhd/participants/mc/managed-care-health-plan-options.htmYou will need to contact your Managed Care Provider to request a card.

MCII for managed care information. For contact information go to https://dss.mo.gov/mhd/participants/mc/managed-care-health-plan-options.htm 

How can I change my MO HealthNet managed care plan primary care provider?

Where can I find that number?

To change your primary care provider or to find out more about your MO HealthNet managed care health plan, call the membership services number on your managed care health insurance card. The number for your managed care plan should be listed on your health plan card. If the card is not available: Who is your provider? That number is ------

Managed Care:

800-348-6627

Hours 7am-6pm

MCII for managed care information. Web Link to general Managed Care Info: http://dss.mo.gov/mhd/mc/

For contact information go to https://dss.mo.gov/mhd/participants/mc/managed-care-health-plan-options.htm

Medicaid denied a claim and I don’t think it should be denied, what can I do?

If you are enrolled in a MO HealthNet managed care health plan you must contact the membership services number on your health plan card to file an appeal.

You must pay $2 for each trip unless:

• You have Managed Care
• Are under 19, pregnant, blind, or if you live in a nursing home
• Use public transportation, bus tokens, or if you receive help to pay for gas.
• The $2 includes trips that are one-way or round trip. It also includes if you have more than one stop to make.

Your ride cannot be denied if you cannot pay.

I am on managed care and need to get prescriptions can I just use my managed care card?

 I received a SkillUP Volunteer Agreement in the mail, what do I do with it?

Why does it say volunteer? I dont want to volunteer anywhere.

The Volunteer Agreement does not imply you are signing up to become a volunteer. It means you are volunteering to comply with the SkillUP program. This agreement was sent to you as an option to comply with the work and training requirements to continue receiving food stamps as an abled-bodied adult without dependents (ABAWD). If you are working or participating in training that is not administered through a SkillUP provider, please sign and have the employer or agency complete the form with a valid signature. If this is a new employer, you need to provide verification of employment with paystubs or a  statement from the employer. This can be dropped off at any FSD Resource Center.

If participant wishes to sign up, complete a SkillUP Referral Form on the Hand Off menu

 I want a hearing!
I would like to request an administrative hearing. 

I can submit that request for you. Once the request is submitted you will receive a letter, scheduling the hearing with the Division of Legal Services, within approximately 10 days. This letter will provide with further instruction on how to participate in your hearing.

• Review case to determine reason for hearing. If BPT can solve the issue advise the participant of this and then ask if they would still like to request a hearing. If yes, follow instructions below:
• Click on Hearing Request. Complete a hand-off referral based on the information the customer has shared when requesting a hearing and the information available in the system of record. Additional resource information regarding submitting a hearing hand-off is available on the site. If participant requests to continue receiving benefits, BPT staff member taking the hearing request must complete the entry to hold the adverse action on ACTRES in FAMIS. BPTES should be sure to document the participants choice in EUMEMROL.

Representatives with Application Only (APO) role

1. Update the hearing field to Y on the FMNG screen and
2. Remove the AR end date if application was not cancel rejected.

Field User Guide for Hand-off button

For Spend Down hearings specific to bills not being allowed, incorrect doctor statements, no itemized bill, or unsigned Provider form- send email to SpendDown.Unit@dss.mo.gov.

For LIHEAP hearing requests, the customer should be referred to the contracted LIHEAP provider for their county to request a hearing. The listing of these providers is located at this site:

• https://dss.mo.gov/fsd/energy-assistance/pdf/liheap-contracted-agencies.pdf

If the customer states they have already made contact with the provider requesting a hearing or to have the issue resolved but have not received any satisfaction, field staff should email the LIHEAP Unit directly at FSD.LIHEAP@dss.mo.gov with identifying information for the customer (name, address, DCN, SS#, etc.) regarding the customer’s request for a hearing.

I requested a hearing, but I forgot when it is scheduled. When is my hearing?

Your hearing is currently scheduled for _________.

FAMIS Instructions: EUMEMROL Review notes regarding hearing.

MEDES Instructions: Client contact, Notes tab Review notes regarding hearing.

Can I Reschedule my hearing?

Only the Division of Legal Services, Administrative Hearings Unit can reschedule your hearing. You will need to contact the hearings unit directly. The hearing’s unit number is on your letter, or I can look up that number for you. Which county do you reside in?

https://dss.mo.gov/fsd/iman/admin/counties-served-per-regional-administrative-hearings-office.pdf to provide correct telephone number.Your hearing is currently scheduled for _________.

FAMIS Instructions: EUMEMROL Review notes regarding hearing.
MEDES Instructions: Client contact, Notes tab Review notes regarding hearing.

I recently had a hearing. Has a decision been made?

Let me review your case….

I see the hearing decision was _______.

(If no notes)

You will be notified of the hearing decision by mail from the Hearings Unit.

Review virtual file room for decision information

FAMIS Instructions: EUMEMROL Review notes regarding hearing.

MEDES instructions: Client contact tab, Notes tab Review notes regarding hearing

I see the hearing decision was received on _______; the change should be made within 10 days of the office receiving this decision and will be effective the month the adverse action was initiated or the date reflected on your decision.

•  “More time is needed to make the adjustments on your case. You will be notified of the change in writing.”

•  I will have someone follow up on this for you. Please continue to check our automated system or our website mydss.mo.gov for updates.
• BPT should send an email to   name, DCN, Date hearing held and participant’s question. BPT or Supervisor should contact participant back once a response is received.

FAMIS Instructions: EUMEMROL Review notes regarding hearing.

MEDES instructions: Client contact tab, Notes tab Review notes regarding hearing

• I would like to withdraw my hearing request

You will need to complete a Withdrawal of Request for Hearing Form. I will have one sent to you, what is your current mailing address?

Generate an IM-90. Advise the participant client they will need to return the IM-90 to their local FSD office.

• See Voluntary Withdraw from Hearing for additional instructions
  
  17.3.3 Withdrawing a Hearing Request
  
  

I am not sure where to go for my hearing.

Did you receive a notice in the mail with the time and location information already?

• Just one moment while I look into your case.

• When did you request your hearing?

Review EUMEMROL comments and/or MEDES notes thoroughly for notes regarding time and location of hearing. If found, relay information to caller.

• If not found and participant says they did receive a notice, transfer participant to DLS. Refer to https://dss.mo.gov/fsd/iman/admin/counties-served-per-regional-administrative-hearings-office.pdf
• If not found and participant says they have not received a notice, review comments, notes, and search the hearings SharePoint site to ensure hearing request was submitted.

Hearings SharePoint site https://moteam13.state.mo.us/dss-fsd02/SitePages/Hearings/HearingsSearch.aspx

Search participant’s 8-digit DCN in the Customer DCN field.

I received my hearing decision and would like to appeal the decision.

The bottom of your decision letter explains your appeal rights. You will need to contact the Administrative Hearings Unit and request and affidavit for appeal.

FAMIS Instructions: EUMEMROL Review notes regarding hearing.

MEDES instructions: Client contact tab, Notes tab Review notes regarding hearing

Administrative Hearings Unit: 573-751-0335

or

800-473-0302

My Child receives free and reduced lunches at school, why have we not received our benefit?

Children are categorically eligible if they:

Participate in SNAP, or Temporary Assistance (TA),

Children who are in foster care,

A migrant child

A child or youth who made a qualifying move in the preceding 36 months as a migratory agriculture worker or migratory fisher; or, to join a parent or spouse who is a migratory agricultural worker or a migratory fisher.

A runaway child

A child identified as a runaway receiving assistance under a program under the Runaway and Homeless Youth Act by the local educational liaison, or other individual in accordance with guidance issued by FNS.

A homeless child

A child identified as lacking a fixed, regular, and adequate nighttime residence.

 A Head Start child

A child enrolled as a participant in a Head Start program.

Categorically eligible children must meet another guideline to qualify for Missouri SuN Bucks. Children eligible for Summer EBT include those who, at any time during the period of eligibility, are:

School aged (7-17) and receiving assistance under SNAP, TA a foster child,

Enrolled in an NSLP/SBP-participating school and either categorically eligible, meeting the requirements to receive free or reduced-price meals, are otherwise determined eligible to receive a free or reduced-price meals or determined eligible through a Summer EBT application, or;

Enrolled in a special provision school and either categorically eligible, otherwise meeting the requirements to receive free or reduced-price meals as determined through an NSLP/SBP application or determined eligible through a summer EBT application.

Questions regarding Missouri SuN Bucks and all other case related inquiries should be directed to the Family Support Division (FSD):

Chat Online: Visit mydss.mo.gov and select “DSS Chat” to get answers about your case or general information.

Visit mydss.mo.gov to apply for benefits, check your status, report a change or to learn more about our programs.

Text: For answers to basic questions that are not case-specific you can text 855-684-9242 where team members are available Monday-Friday 8am-5pm for assistance

Call us on the FSD Info Line 855-373-4636

Do not refer participants to DESE.

For additional resources and information please visit https://fsdimresources.mo.gov/?docs=missouri-sun-bucks