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Eligibility Factor Self- Attestation Accepted without Additional Verification (Y/N) Self- Attestation Accepted with Post- Eligibility Verification (Y/N) Electronic Data SourceUsed (Y/N) Reasonable CompatibilityStandard Used Specify Reasonable Compatibility Standardfor Income Ask for a Reasonable Explanation from the Individual (Y/N) Paper Documentation Required from the Individual (Y/N) Comments Pregnancy *** YES NO NO N/A N/A YES YES Self- attestation is accepted as a rule. However, if information deemed discrepant by the state is received indicating a participant is not pregnant and eligibility is affected, after reviewing available resources, the state may seek a reasonable explanation from the participant. The state may require paper documentation as a last resort. Caretaker Relative YES NO NO N/A N/A YES YES Self- attestation is accepted as a rule. However, if information deemed discrepant by the state is received indicating a caretaker relative relationship does not exist and eligibility is affected, after reviewing available resources, the state may seek a reasonable explanation from the participant. The state may require paper documentation as a last resort. Medicare NO NO YES N/A N/A YES YES The state will rely on electronic data sources as a rule. However, if information deemed discrepant by the state is received, the state may seek a reasonable explanation from the participant. The state may require paper documentation as a last resort. Application for OtherBenefits YES YES YES N/A N/A YES YES There is currently no available electronic source that can be used to verify a person has applied for other benefits such as short or long-term disability or a pension. For those benefits for which there is a source, such as referral form received from Social Security Administration when participant has applied for benefits, Missouri uses that source pre and post enrollment. Other: (Please describe anyother eligibility factors in the space below) N/A N/A * States must check electronic data sources determined useful to verify income in accordance with 42 CFR 435.948 but can be done post-enrollment. If the information obtained from electronic data sources and the information provided by or on behalf of the individual are both above, at or below the applicable income standard, the State must determine the applicant eligible or ineligible for Medicaid/CHIP. (NOTE: this option is prepopulated for the state and is not an option that can be changed). ** States must follow statute, regulations, and guidance for verification of SSN, citizenship and immigration status including obtaining such information through the federal data services hub if available. *** States must accept self-attestation of pregnancy unless they have information that is not reasonably compatible with such attestation. MAGI-BASED ELIGIBILITY VERIFICATION PLAN SECTION A - Verification Procedures for Factors of Eligibility 2