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MCHCP requires proof of eligibility for all dependents added to coverage. Include proof of eligibility with enrollment request. Enrollment of dependents is not complete until proof of eligibility is received by MCHCP. Include the subscriber’s MCHCPid or Social Security number on the documentation.

  • If proof of eligibility is not received, a letter will be sent requesting it. Documentation must be received by the specified due date, or dependents will not be added.
  • During Open Enrollment, proof of eligibility must be received by Nov. 20, or dependents will not be added for coverage effective Jan. 1.

Acceptable forms of proof of eligibility are listed below.

Action Circumstance Documentation
Enrollment Addition of biological child Government-issued birth certificate or other government-issued or legally certified proof of paternity listing subscriber as parent and child’s full name and birth date
Addition of child of a covered dependent Government-issued birth certificate or legally-certified proof of paternity for the child listing dependent as parent with child’s full name and birth date
Addition of foster child Order of placement
Addition of stepchild Marriage license to biological or legal parent/guardian of child; and government-issued birth certificate or other government-issued or legally certified proof of eligibility for child that names the subscriber’s spouse as a parent or guardian and child’s full name and birth date
Adoption of dependent Order of placement; or
Filed petition for adoption listing subscriber as adoptive parent (documentation must be received with the enrollment forms) and final adoption decree or a birth certificate issued (documentation must be received within 31 days of the date the court enters a final decree of adoption).
Legal guardianship or legal custody of dependent Court-documented guardianship or custody papers (Power of Attorney is not acceptable)
Loss of MO HealthNet or Medicaid Letter from MO HealthNet or Medicaid stating who is covered and the date coverage terminates
Loss of Prior Group Coverage Letter from previous insurance carrier or former employer stating date coverage terminated, length of coverage, reason for coverage termination, and list of persons covered
Marriage Marriage license or certificate recognized by Missouri law
MO HealthNet Premium Assistance Letter from MO HealthNet or Medicaid stating member is eligible for the premium assistance program
Qualified Medical Child Support Order Qualified Medical Child Support Order
TRICARE Supplemental Coverage Military ID Card
Termination Delete a dependent due to divorce If premiums are collected pre-tax through MoCAFE, coverage may only be cancelled at the time of divorce. If premiums are not collected pre-tax through MoCAFE, coverage on dependents may be cancelled during divorce or legal separation proceedings if spouse agrees to termination through a notarized letter.

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