0865.025.00 Annual Renewal – DSS Manuals
IM-24 March 22, 2023
Annual renewals are required for QMB cases to confirm the participants remain eligible for coverage on all eligibility factors, such as state residency, income and resources.
Ex Parte Renewals An ex parte renewal is a renewal completed using reliable information available to the agency, without requiring information from the individual. Attempt to verify necessary eligibility factors, such as income and resources, by accessing available electronic data sources.
Annual Renewal Form
When an ex parte renewal cannot be completed because of insufficient information available to the agency, the eligibility system sends a paper annual renewal form to request additional information from the participant. The participant has at least 30 days to complete, sign, and return the annual renewal form. Participants can return the annual renewal form or can complete the annual renewal telephonically or online. Do not consider an annual renewal form as received unless it is signed.
If information required to determine eligibility is missing, inconsistent, or incomplete, check other sources of information including the electronic record and other available data sources.
If verification or clarification is required, send a Request for Information to the participant and allow 10 days for the participant to respond. If the participant provides the information, complete the eligibility determination. If the participant is eligible, renew the coverage for 12 months. If the participant is ineligible, complete an ex parte review to determine if eligibility exists in another MO HealthNet program. If not eligible, send an adverse action notice to inform the participant the case will be closed and an action notice after the case is closed. If the participant fails to respond, send an adverse action notice to inform the household the case will be closed and an action notice after the case is closed. An ex parte review to explore eligibility in another MHN program is not required.