|
Effective: November 1, 2009 |
|
|
03.50.05ar5 - GAMC (Archive) |
Archived: June 1, 2011 |
To be eligible for GAMC an individual must not have a basis of eligibility for Medical Assistance (MA).
People do not have a basis of eligibility for MA if they are adults between ages 21 and 65 who are not blind or disabled and who:
l have no children currently living in the home, or
l are parents or relative caretakers whose only children living in the home are ages 18, 19, or 20, or
l are stepparents with no biological or adoptive children in the home.
Note: A parent or relative caretaker has an MA basis of eligibility if their child living in the home is 18 years old and a full-time student who is expected to graduate by age 19.
In addition to not having a basis of eligibility for MA, to be eligible for GAMC an individual must meet one of the following three factors:
1. Receive General Assistance (GA) benefits.
2. Receive Group Residential Housing (GRH) benefits.
3. Meet all other GAMC eligibility factors.
Eligibility factors and links to standard program guidelines are provided below.
Citizenship/Immigration Status.
Insurance and Benefit Recovery.
Relationship to Other Groups/Bases.
Application Process (standard guidelines)
GAMC applicants must answer certain questions that are not on the HCAPP. See Legal Factors for more information about this requirement.
The earliest possible begin date for GAMC is the date of application or the date all eligibility factors are met, whichever is later. Retroactive coverage is not available for GAMC.
When a GAMC enrollee obtains a SMRT or SSA disability status that is effective prior to the date of their GAMC application, evaluate eligibility for MA (or eligibility under program IM for residents of Institutions for the Treatment of Mental Diseases (IMD) when appropriate) for the retroactive months.
Note: People do not have to be eligible in the month of application. Eligibility may begin at a later date if the applicant meets all eligibility factors by the end of the processing period.
Renewals (standard guidelines)
People who receive GAMC automatically due to being eligible for General Assistance (GA) or Group Residential Housing (GRH) benefits are not required to complete six-month renewals.
Follow guidelines in Chapter 9.
Note: GAMC is not available for applicants or enrollees who are otherwise eligible for MA, but fail to verify their assets.
Follow standard guidelines.
Follow guidelines in Chapter 11.
GAMC applicants and enrollees who are U.S. citizens are not required to document their citizenship and identity.
Note: Applicants and enrollees who are otherwise eligible for MA or federally funded MinnesotaCare but fail to document their citizenship and identity are not eligible for GAMC.
Noncitizens who meet the citizenship and immigration status requirements for MA (program MA or program NMED) but do not have an MA basis of eligibility may be eligible for GAMC. Undocumented and nonimmigrant people are not eligible for GAMC.
Follow GAMC residency requirements.
Follow guidelines in Chapter 15.
Follow guidelines in Chapter 17.
Follow MA Method B to determine asset and income exclusions.
The asset limit is $1,000 per household regardless of the number of people in the household or the number of people requesting GAMC.
Exception: Do not apply the GAMC asset limit to people applying for or receiving GAMC automatically with GA or GRH. GA or GRH recipients are subject to the asset limit for the applicable cash program.
Asset transfers without adequate compensation or for the purpose of obtaining or maintaining eligibility for GAMC may result in a period of ineligibility for GAMC. See Transfers for more information.
Income Guidelines (standard guidelines)
Income limit is 75% FPG.
Exception: Do not apply the income limit to people applying for or receiving GAMC automatically with GA or GRH.
No deductions or disregards are allowed for GAMC. Income eligibility is determined using gross countable income.
There are no spenddown provisions for GAMC.
Enrollees are eligible for full GAMC benefits.
GAMC enrollees receive health care services through a managed care organization (MCO) unless they meet a managed care exclusion. See the Prepaid Minnesota Health Care Programs Manual, section 04.03 for more information.
None applicable.
Follow Change in Basis of Eligibility when GAMC ends.
General Assistance (GA) recipients with no MA basis do not have to accept automatic GAMC. They may decline health care coverage. They may apply for MinnesotaCare although they are not required to do so.
The father of the pregnant woman’s child does not have a parent/caretaker basis for MA until the child is born, unless he is already a parent to another child in this household. Determine GAMC eligibility until the birth of the child. The father of the child gains a parent/caretaker basis effective the first day of the child’s birth month if he is living with the mother.
Also, consider MinnesotaCare for Adults With Children.