1865.030.00 Begin and End Dates for Coverage – DSS Manuals

IM-95 September 21, 2021

If eligible, the begin date for Adult Expansion Group (AEG) coverage is the first day of the month of application.

Note : AEG coverage, for any participant found eligible, will not begin prior to July 1, 2021 and will only be explored if the application is dated on or after July 1, 2021.

Example : John applies for MO HealthNet coverage on July 15th and is found eligible for AEG coverage. John’s AEG coverage will begin July 1st.

Example : Mary applies for MO HealthNet on June 30, 2021. A determination is made after July 1, 2021. Eligibility for AEG is not explored as the application is dated prior to July 1, 2021. Eligibility will be explored for all other MO HealthNet programs, except AEG, and she will be approved if eligibility exists under another program.

NOTE : AEG is not explored as Mary is not already receiving another MO HealthNet program. If someone is already receiving on or after July 1, 2021, then, Ex Parte rules (see 1890.000.00 Ex Parte Review Process and subsections) are used to explore eligibility for all other MO HealthNet programs including AEG.

Example : Jane made application at the end of May and her application was rejected June 15th because she failed to return income verification. Jane turns in the requested income verification on July 2nd. Cancel reject actions are taken on July 12th. Jane’s eligibility will be explored under All MO HealthNet programs, except AEG, as the application is dated prior to July 1, 2021. If Jane is found eligible under another MO HealthNet program, she will be approved.

The end date of AEG coverage is the day the Adverse Action (AA) period expires or the date of the action when Advance Notice requirements are exempt (see 0130.015.20 Exceptions to Advance Notice of Adverse Action ).

Example : Mary is receiving AEG coverage. She reports an increase in her income, making her ineligible for AEG. Mary is provided an adverse action period for her loss in eligibility, which expires on September 19th. The last day of AEG coverage for Mary is September 19th.