MinnesotaCare

3.3.4 Income Verification (Archive)

MinnesotaCare requires verification of a person’s attested Projected Annual Income (PAI). PAI must be verified through an available electronic data source or by paper proof, if electronic data sources are unsuccessful or unavailable.

The PAI is determined using the MinnesotaCare Income Methodology policy.

Household PAI includes the PAI of everyone in the household composition whose income counts. See the MinnesotaCare Household Composition and Family Size policy for more information.

Eligibility is approved for applicants who meet all other eligibility criteria who attest to PAI within the MinnesotaCare limit. If verification of PAI is required, the person or people whose MinnesotaCare eligibility depends on the verification are given a reasonable opportunity period of 90 days to provide appropriate proof of PAI. The 90 days begins on the date the notice is mailed informing the household of the requirement to verify. The 90 day reasonable opportunity period can be extended if the household is making a good faith effort to attain the needed information. Eligibility must end with 10 day notice when PAI is not verified using electronic or paper verification as stated below.

If someone appears to be newly eligible for MinnesotaCare after reporting a change in circumstances, verification of PAI must be provided prior to the approval of MinnesotaCare eligibility. See EPM 1.3.2.1 MHCP Change in Circumstance for full policy.

An individual who reports having no income is not required to provide verification or an explanation, unless electronic sources or other information the agency has indicate there is inconsistent information. See EPM 1.3.2.4 MHCP Inconsistent Information for full policy.

Electronic Verification

Electronic sources verify PAI when:

1. The attested household PAI is at or below the MinnesotaCare income limit and electronic sources indicate the household PAI is at or below the limit.

2. The attested household PAI is at or below the MinnesotaCare income limit and electronic sources indicates the household PAI is above the limit but is reasonably compatible.

Paper Verification

When self-attestation of PAI is below the MinnesotaCare income limit and electronic sources indicate the person’s household PAI is above the limit, and the amounts are not reasonably compatible, the person must provide paper proof to verify PAI. Paper proof is also required when electronic sources are unavailable.

The person must provide a complete copy of their most recently filed federal tax return if they have filed a federal tax return in the last three years. This includes people who currently do not expect to file a tax return for the next tax year. A complete federal tax return includes all forms and schedules. If a person expects their PAI will be different from what their most recently filed tax return shows, the person must explain why and include proof. Examples of types of proofs for income and income tax adjustments are located in the Medical Assistance for Families With Children and Adults Income Verification policy.

The county, tribal or state servicing agency must review the federal tax return and proofs to confirm that the person has reported all sources of income listed on the tax return or has explained why an income source has ended.

Federal Tax Return Only

When the person submits a federal tax return as the only proof of PAI and:

• The modified adjusted gross income derived from the tax return is less than or equal to the PAI attested on the application or renewal, the attested PAI is verified.

• The modified adjusted gross income derived from the tax return is more than the PAI attested on the application or renewal, the new amount is the PAI used to determine health care eligibility.

Federal Tax Return and Other Paper Proof

When the person submits a federal tax return and other paper proof, the modified adjusted gross income derived from the tax return information and paper proof of any changes, the new amount is the PAI used to determine health care eligibility.

Other Paper Proof

When the person has not filed a federal tax return within the last three years, and modified adjusted gross income is derived from other paper proof, the new amount is the PAI used to determine health care eligibility.

Partial or No Other Paper Proof

A signed Yearly Income Statement (DHS-7117) can verify PAI for a person who is unable to provide other proof. The Yearly Income Statement can be used on its own, or it may be used in conjunction with other paper proof if the person is able to provide only partial proof of PAI. The person must provide a copy of their most recently filed federal tax return if they have filed a federal tax return in the last three years. The Yearly Income Statement must indicate the total amount of PAI, even if paper proof exists for some of the PAI amount. The Yearly Income Statement verifies PAI only if a person has no other proof.

A person can also submit a signed affidavit to the county, tribal or state servicing agency including any partial proof and a copy of their most recently filed federal tax return if they have filed a federal tax return in the last three years.

Legal Citations

Code of Federal Regulations, title 42, section 600.345

Code of Federal Regulations, title 45, section 155.315

Code of Federal Regulations, title 45, section 155.320

Minnesota Statutes, section 256L.05, subdivision 2

Published:  April 1, 2018

Archived: June 1, 2019