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2.5.4 Program for People Living in Institutions for Mental Diseases (Archive)

Minnesota provides health care for people living in an Institution for Mental Diseases (IMD) who would be eligible for Medical Assistance (MA) if they were not living in an IMD. This health care is also known as Program IM and is state-funded.

An IMD is a hospital, nursing facility, or other institution of 17 beds or more that primarily provides diagnosis and treatment for people with mental illness or chemical dependency. See Appendix E Institutions for Mental Diseases for more information.

The following people continue to be eligible for MA while living in an IMD and do not need Program IM:

  • People age 65 or older

  • Children younger than 21 in an accredited licensed inpatient psychiatric hospital

  • People residing in an IMD that is an accredited, licensed inpatient psychiatric hospital who received MA covered services prior to their 21st birthday. Enrollees, who continue to receive these services in the same facility after age 21, are covered by MA until they turn age 22.

  • People who receive MA via managed care, and were placed in an IMD by the managed care plan, or for whom the plan was court-ordered to pay for treatment in the IMD.

  • People enrolled in Refugee Medical Assistance

Program IM uses the same MA bases of eligibility and people must meet all of the MA eligibility requirements associated with their basis. People are in one of the following eligibility groups:

When an MA enrollee moves into an IMD, they do not need to file a new application for Program IM.

Program IM is only available on days the person is living in an IMD. Program IM eligibility and coverage ends the day before the person is discharged from the IMD. Health care coverage can continue under MA, without a new application, if the person continues to meet all MA eligibility requirements.

This subchapter includes policies that apply to Program IM and links to policies that apply to all MA and all Minnesota Health Care Programs (MHCP) programs.

  1. IMD General Requirements

    1. MA-ABD General Requirements

    2. MA-EPD General Requirements

    3. MA-FCA General Requirements

  2. Program IM Non-Financial Eligibility

    1. MA-ABD Bases of Eligibility

    2. MA-ABD Certification of Disability

    3. MA-FCA Bases of Eligibility

    4. MA Citizenship and Immigration Status

    5. MA County Residency

    6. MA Social Security Number

    7. MHCP State Residency

  3. Program IM Financial Eligibility

    1. MA-ABD Financial Eligibility

    2. MA-EPD Financial Eligibility

    3. MA-FCA Financial Eligibility

  4. Program IM Post-Eligibility

    1. MA Begin and End Dates

    2. MA Benefit Recovery

    3. MHCP Change in Circumstances

    4. MA Cooperation

    5. Program IM Cost Effective Insurance

    6. MA Cost Sharing

    7. MHCP Fraud

    8. Program IM Health Care Delivery

    9. MHCP Inconsistent Information

    10. Program IM Leave Days

    11. MA-EPD Premiums and Cost Sharing

    12. MA Qualifying Health Coverage

    13. MA Referral for Other Benefits

    14. MA-ABD Renewals

    15. MA-FCA Renewals