*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016. Please refer to the EPM for current health care program policy information. ***
*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016. Please refer to the EPM for current health care program policy information. ***
Effective: November 1, 2008 |
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03.05 - MinnesotaCare Eligibility Groups |
Archived: June 1, 2016 (Previous Versions) |
All MinnesotaCare applicants and enrollees fit into an eligibility group made up of a set of factors: pregnancy status, age and household composition. The eligibility group determines the eligibility requirements that apply for each person (for example, residency, immigration status, income limits, asset limits). Assigning the eligibility group is the first step in determining eligibility; however, the person must meet all of the eligibility requirements associated with the eligibility group before they are eligible. MinnesotaCare has four eligibility groups.
The pregnant women eligibility group includes all pregnant women from the first day of the month of conception through the end of the 60-day postpartum period.
Note: Always consider pregnant children and pregnant women (with or without children) to be part of the pregnant women eligibility group.
See MinnesotaCare for Pregnant Women for information on the eligibility requirements associated with this group.
The eligibility group for children under age 21 includes all children from the month of birth through the month of their twenty-first birthday.
Note: For children from birth through age one whose mothers were enrolled in MinnesotaCare or Medical Assistance (MA) for the month of birth, see MinnesotaCare for Auto Newborns.
See MinnesotaCare for Children Under 21 for information on the eligibility requirements associated with this group.
The adults with children eligibility group includes people with children under age 21 in the household if they are:
l Parents. Consider stepparents to be parents regardless of whether the biological or adoptive parent lives in the household. Consider the husband of a pregnant woman to be a parent regardless of whether there are other children in the household.
l Relative caretakers, legal guardians, or foster parents residing with one or more children in their care and are including the children as family members on the application.
Note: Sometimes the ”adults with children” group is divided into two sub-groups: parents/relative caretakers and foster parents/legal guardians. This is done because eligibility requirements for these two sub-groups may vary.
See MinnesotaCare for Adults With Children for information on the eligibility requirements associated with this group.
The adults without children eligibility group includes people age 21 or older who meet the following:
l Are not pregnant.
l Are not married to a pregnant woman.
l Are not parents, stepparents, relative caretakers, legal guardians or foster parents of children under 21 in the household.
l Are relative caretakers, legal guardians, or foster parents of children under 21 in the household, but are not including the children as family members on their application.
See MinnesotaCare for Adults Without Children for information on the eligibility requirements associated with this group.