Frequently Asked Questions

If you are a DMH Agency or Facility and have any questions please email DMH.MedicaidEligibility@dmh.mo.gov.

With COVID-19 causing the need to self-quarantine and increased awareness of social distancing as an effective tool to help prevent the spread of disease there have been a number of questions as to how this will impact DMH consumers. We have tried to address the most common questions and concerns here, but if you have further questions please email us at DMH.MedicaidEligibility@dmh.mo.gov. This email address will continued to be monitored daily.

Are Annual Reviews still required during the COVID-19 Public Health Emergency?

No. Do not submit MO HealthNet Annual Reviews at this time.

Annual Reviews Post Public Health Emergency

The following is NOT a finalized plan. The annual review process, forms and due dates will likely be the same as prior to the PHE. This means client would be given 10 days to return the form and then be sent a 10 day advance notice of closing if the form is not returned. Once FSD resumes doing the annual reviews, DMH plans to resume sending CMHCs and other DMH agencies/providers the list of their clients due for a review in the next two months.

FSD has indicated they will spread out doing the annual reviews over several months (possibly 12). Some reviews will be completed without the need to contact the client if FSD has the needed information. Examples might be clients that have a SNAP case or recently had an adjustment to their Medicaid case.

Since we do not know how or when FSD will do a review on individual clients, a review form should NOT submitted until the client receives a request.

When will the Federal COVID-19 Public Health Emergency (PHE) end?

The federal Department of Health and Human Services (HHS) has been assured State governments that they will be given at least 60 days advance notice before allowing the PHE to lapse.

When we have more concrete information about the date the PHE will lapse, we will update this section.

What will happen when the Federal COVID-19 Public Health Emergency (PHE) ends?

When the PHE ends Missouri will implement their plan to "unwind" the changes to Medicaid. The unwinding plan will include:

resuming annual reviews/redeterminations,
closing cases when a client is determined ineligible,
ending coverage on spend down cases unless bills are submitted to FSD or the spend down is paid to MHD,
ending coverage on TWHA cases unless a premium is paid,
taking action on changes that occurred during the PHE but were put on hold to prevent adverse case actions

It is likely that these changes will not be done immediately upon the end of the PHE but instead be rolled out over time, but we do not have any details on the specifics of the unwinding plan at this time.

Medicaid cases cannot be closed for any reason without FSD sending the client a 10 day advance notice letter with appeal rights.

Once we have more specifics about the details of the PHE unwinding plan this section will be updated.

I have questions about Medicaid Expansion

The Missouri Department of Social Services has a comprehensive FAQ document available for providers, and that can be found here: Frequently Asked Questions: Adult Expansion for Providers

They have also put together a Frequently Asked Question document for participants, which can be found here: Frequently Asked Questions: Adult Expansion for Participants

Does my client need to pay the Spend Down in order to have coverage?

Maybe. Please email us at DMH.MedicaidEligibility@dmh.mo.gov if you have any questions on whether a spend down payment is needed and we can research the consumers case for you.

Beginning with March 2020 and any months after this during the emergency:

if the spend down is met with bills for medical services for which the client is personally responsible (or which are billable to DMH) or
with a check, money order, or cashiers check

Family Support division will not end coverage if the spend down is not met. The spend down will not need to be paid at a later date. Coverage will begin with the first month the spend down is met and continue each month with no end date while the emergency is in place.

The spend down is still due, but coverage will not end if the spend down is not met. If the spend down is paid, it will not be refunded. If a client is enrolled in automatic withdrawal, payment will continue to come out each month. The client can opt out of automatic payments, but will have to re-enroll again later.

Example: Kim meets her spend down using bills on March 12th. FSD still will enter the bills for March and then at the first of each month FSD will manually enter spend down met with bills through the emergency period.
Example: Wally is enrolled in automatic withdrawal. He automatically pays the spend down for March (which meets April spend down) and April (which meets May spend down), and cancels his automatic withdrawal in late April. His spend down will be considered met beginning in May and extending for the duration of the emergency. He will need to fill out the paperwork to re-enroll again after the emergency, and may need to pay in with a check while the auto-withdrawal is set up again.

The spend down will not need to be paid at a later date. Coverage will begin with the first month the spend down is met and continue each month with no end date while the emergency is in place. Invoices are still generated but if the spend down or premium is not paid there will be no adverse action to the client's coverage.

How can we help our consumers apply when we are not seeing them in person?

We strongly encourage all DMH agencies and providers to have the consumers they are assisting sign an authorized representative form designating the agency as the authorized representative for MO HealthNet eligibility.

Once this form is completed and signed by both the client and the authorized representative, the application can be completed with the client over the phone and submitted online, or printed and signed by the authorized representative.

The IM-6AR Appointing an Authorized Representative form should be used if the application has already been submitted and the "Appendix C" was not included with the application.
The agency will receive copies of all letters and requests for information sent to the client for Medicaid cases based on disability, blindness or being over age 65 as those letters are system generated.
The agency should receive copies of all letters requests for information sent to the client for Family Medicaid cases (children, parents, pregnant women). However, the although the Family MO HealthNet letters are system generated, copies to the authorized representative have to be sent manually, so some may be missed.
The authorized representative may sign applications for the client.

FSD will provide MO HealthNet coverage for individuals between the ages of 19 and 64 who have a positive COVID-19 diagnosis and meet current MHABD eligibility guidelines, including income and resources.

Questions regarding the entry of COVID-19 MHN coverage may be sent via email to Cole.MHNPolicy@dss.mo.gov.

If an individual age 22-65 in a State Mental Hospital is diagnosed with COVID-19 and moved to a hospital outside of the of the SMH can they qualify for MO HealthNet?

No. Regardless of admission to a hospital the individual will be considered residents of the SMH. In order to qualify for MO HealthNet they must be officially discharged.

How can we submit applications without going to a local FSD resource center?

Apply using the DSS online portal for all applications. If you cannot apply online the next best option is to scan and upload the application using the FSD Upload Portal.

How can we submit verification without going to a resource center?

Submit documents or applications along with the client's date of birth and SSN or DCN by:

Fax: 573-526-9400

Mail: Family Support Division

Jefferson City, MO 65102

What should we do about forms which require the client's signature, such as the Authorization for Release of Medical Records form for the MRT Packet?

These forms should be mailed to the client on or around the time you complete the application with them over the phone. Marking the areas in highlighter or with a pen which need to be signed can be helpful as well. Once signed, the client can return the forms to you or mail them directly to:

FSD Greene County Office

101 Park Central Square

Springfield MO 65806

Is there any danger of cases closing due COVID-19?

No. Due to the Families First Coronavirus Response Act, any adverse actions or closings are on “pause” indefinitely until the federal emergency COVID-19 declaration ends.

If you or the consumer receive an adverse action stating that a case is closing, or if you have any concerns, please email us at DMH.MedicaidEligibility@dmh.mo.gov and we can research the case for you.

I need to speak to someone at FSD. How do I reach them?

You can call 1-855-FSD-INFO but we strongly encourage you to email us at DMH.MedicaidEligibility@dmh.mo.gov. We do have a FSD worker at Central Office and typically can assist you with questions about DMH consumers quicker than calling the call center.

My client is applying for Food Stamps, how do we complete an interview?

Family Support Division will call the client within 3 days of receiving the application at the phone number listed on the application. If possible the interview will be completed during this phone call. If this call is missed or the interview cannot be completed, the client can call back at 855-823-4908 to complete the interview.

Can my client buy groceries online using Food Stamps?

Yes. On 05/14/2020 Family Support Division confirmed in a press release that households are now able to use an Electronic Benefit Transfer (EBT) card to purchase eligible foods online.

As of 05/14/2020, the United States Department of Agriculture, Food and Nutrition Service has approved two retailers, Amazon and Walmart for online purchasing.

More information can be found at the Family Support Division Food Stamp FAQ page.

Will the stimulus money being provided to the American public have any impact on client's coverage?

Payments are excluded as income.
Payments are excluded as a resource for the first 12 months from receipt.

Any money left from the EIP 12 months after receipt will be counted as a resource.