This is an archived document and does not contain the most current information for this topic. Use this document for reference only.
Minnesota Health Care Programs
1.2.5 Retroactive Eligibility (Archive)
People may request retroactive eligibility for Medical Assistance (MA), Minnesota Family Planning Program (MFPP), and the Service Limited Medicare Beneficiary (SLMB), Qualified Individual (QI) and Qualified Working Disabled (QWD) Medicare Savings Programs (MSP) for up to three months prior to the month of application. Retroactive eligibility is not available under MinnesotaCare.
Medical Assistance and Minnesota Family Planning Program
The earliest possible begin date for MA and MFPP coverage is the first day of the month three months before the month of application. When a person enrolled in MinnesotaCare or another Insurance Affordability Program reports a change in circumstance that results in MA eligibility, the earliest possible begin date for MA is the first day of the month three months prior to the month the change was reported.
An applicant may be eligible for some, but not all months in the retroactive period. The person may be eligible for each retroactive month they meet the MA or MFPP eligibility requirements and has paid or unpaid medical expenses that would be covered by MA.
An applicant does not need to be eligible for MA or MFPP in the application month to qualify for coverage in the retroactive months.
Enrollees may add a request for retroactive MA or MFPP up to 12 months from the date of the original application. The original date of application determines the earliest possible date for MA and MFPP coverage.
Medicare Savings Programs
SLMB or QI benefits are available for the three months before the month of application for people who meet all eligibility requirements.
People eligible for Qualified Medicare Beneficiary (QMB) may receive SLMB for the three-month retroactive period and all processing months preceding the month QMB eligibility begins if all other eligibility requirements are met.
Legal Citations
Code of Federal Regulations, title 42, section 435.915
Code of Federal Regulations, title 42, section 435.1200
Code of Federal Regulations, title 45, section 155.410
Code of Federal Regulations, title 45, section 155.420
Minnesota Statutes, section 256L.05
Minnesota Statutes, section 256B.061