*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016.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: July 1, 2008 |
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03.20.25.05 - Disabled Adults Without Children |
Archived: June 1, 2016 (Previous Versions) |
Disabled adults without children who apply for MinnesotaCare (MCRE) must also apply for Medical Assistance (MA) if they receive certain types of income based on disability or blindness. If they qualify for MA instead of MCRE, there are a number of advantages:
l They will be eligible for more health care benefits.
l Their MA eligibility would qualify for Federal Financial Participation (FFP).
MCRE applicants who must apply for MA include:
l People who receive Supplemental Security Income (SSI) based on disability or blindness. Refer SSI recipients regardless of whether they indicate they are disabled on the application.
l People who receive other benefits (including Retirement, Survivors, and Disability Insurance (RSDI) income) based on disability or blindness, if they are potentially eligible for MA-EPD (if they are working) or for MA without a spenddown (income is less than or equal to 100% FPG). Refer RSDI recipients ages 21 to 62 regardless of whether they indicate they are disabled on the application.
n Reported assets must be equal to or less than $3000 for a household of one, or $6000 for a household of two.
n Also refer them if the asset information on the application is missing or incomplete.
See Asset Limits.
If your agency is a county MCRE enrollment site, complete an MA determination concurrently with the MCRE determination. Otherwise, refer people who meet these criteria to their county of residence to apply for MA. They may request to have the HCAPP transferred or they may choose to contact the county directly. See Transfers From MCRE to MA/GAMC.
Approve MCRE for people who meet MCRE eligibility criteria while the MA application is pending.
l People may receive MCRE for up to 60 days beginning with the first day of the month coverage begins.
l People who have not cooperated with the MA determination by the end of the 60-day period must be canceled for the next available month.
l Send the Notice to Apply for Medical Assistance (DHS-3404) to the client.
At the end of the first month of MCRE eligibility, check MAXIS to determine if the client appears to be cooperating with or is eligible for MA.
Note: If you are unsure of the client's status after checking MAXIS, contact the county worker.
l For clients who have not yet been determined MA-eligible, send a letter reminding them that MCRE eligibility will end if they fail to cooperate with the MA determination and that, if eligible for MA without a spenddown, they must accept MA and MCRE will be closed.
l If the client has already been determined MA-eligible, cancel MCRE for the first available month.
For clients who have not yet been determined MA eligible at the end of the first month of MCRE eligibility, check MAXIS again at the end of the second month.
l If the client has been denied MA for non-cooperation, cancel MCRE effective the next available month following the end of the 60-day time period.
l If the client has been approved for MA, cancel MCRE for the first available month.
l If MA eligibility has not yet been determined and the client is cooperating, allow MCRE to continue until a determination is made.
Example:
Marcia, an adult without children, applies for MCRE on October 13. She indicates she is disabled and receives SSI.
Action:
Notify her that she must apply for MA.
Marcia indicates that she does not wish to have her application transferred, and that she will contact her county of residence to apply for MA. She is found eligible for MCRE and is enrolled effective November 1 after making her initial premium payment. The worker checks MAXIS at the end of November and finds that Marcia has not yet applied for MA.
Action:
Send a letter reminding Marcia that she must cooperate with the MA determination and that MCRE will end if she fails to cooperate. Continue MCRE eligibility for December.
At the end of December, the MCRE worker checks MAXIS and finds that Marcia has not yet submitted an application for MA.
Action:
Send Marcia a notice closing MCRE effective February 1.