This is an archived document and does not contain the most current information for this topic. Use this document for reference only.
Medical Assistance for Hospitalized Incarcerated People
2.5.5.1.1 Applications (Archive)
A person who is incarcerated and applying for MA for hospitalized people who are incarcerated must apply using a paper application. Applying with a paper application ensures that eligibility dates for health care coverage are correct.
Health Care Application
The demographics of a person who is incarcerated determine which paper application they must complete. See the Minnesota Health Care Programs (MHCP) Application Forms policy for more information.
The Medical Assistance Payment for Inpatient Hospital Care for Incarcerated People (DHS-6696G) is also required.
A correctional facility staff member must help the person complete the application process.
The completed paper application and DHS-6696G must be submitted within three calendar months or:
-
after the person is discharged from the hospital or
-
when the preadmission screening (PAS) has been completed and the person has met institutional level-of-care (LOC) requirements for payment of long-term care.
The correctional facility is responsible for notifying the hospital or LTC facility of the person’s eligibility status and the person’s Person Master Index (PMI) number.
Legal Citations
Minnesota Statute 256B.055, subdivision 14