*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016.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, 2012 |
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07.05.10 - Application Required |
Archived: June 1, 2016 (Previous Versions) |
There are specific situations when a new application is required. This section discusses the requirements for all programs and those that apply to specific programs only.
For information on when a new application is not required, see Application Not Required.
Application Required for All Minnesota Health Care Programs (MHCP).
Application Required for MinnesotaCare.
Application Required for All MHCP
Require an application in the following situations:
l An individual or household applies for health care for the first time.
l An MHCP enrollee submits a renewal after the renewal month. See Processing MinnesotaCare Renewals, Processing MA Annual Renewals, and Six-Month Renewals.
l The county agency receives SSA Data as a Request for MHCP. Consider the SSA data a request for coverage to initiate an application and set the application date. The client’s application date is the date he or she applied to SSA for Extra Help. DHS automatically mails a Minnesota Health Care Programs Application (HCAPP) (DHS-3417) to each client referred from SSA who has a verified address. Require the client submit a completed application to approve eligibility. Deny coverage if the applicant does not submit a completed application by the end of the processing period.
Note: SSA will send separate records for each person, even if they are transmitting information for a married couple. Compare records to determine if a person is married to another applicant and they should be on the same case. Only require a married couple to return one HCAPP, even though DHS will send a HCAPP to each of them.
Example:
Tim, age 67, and Betty, age 65, apply for Extra Help by submitting an application to SSA on January 10. SSA transmits their application data to Minnesota on February 3. DHS mails a HCAPP to each of them on February 4 and provides the clients’ information to their county of residence via an online MAXIS report.
Action:
Compare the records received to determine they are a married couple and should be on the same case. Their MHCP application date is January 10, but they must return a HCAPP before eligibility can be approved for either of them for Medicare Savings Programs (MSP) or Medical Assistance (MA).
l An individual or household applies on the same application as another household, but is not considered part of that household for MA or MinnesotaCare, and has not signed the application or provided enough information to determine eligibility.
n Send an application to the second household.
n Request applicant(s) to return the signed and completed application as soon as possible.
n Consider the date of application to be the date the original application was received.
Example:
James and Judy apply for health care on March 5. They are applying for themselves and their three sons, ages 16, 17 and 22. James and Judy both sign the application.
Action:
The 22-year-old is not part of his parents’ household due to his age. Send the son an application with instructions to return it as soon as possible. Use the same application date on the returned application as on the application from James and Judy.
l An individual is removed from an MHCP household and requests MHCP on his or her own case, but has not signed the original application.
Example:
Rose and Robert live with their 17-year-old son Anthony. They all apply for MA. Rose and Robert both sign the application. Since Anthony is only 17, he is not required to sign. A few months after being approved for MA, Anthony reports that he was emancipated by a court and has moved out of his parent’s home. He wants to keep his MA.
Action:
Require Anthony to complete a new application.
Note: Request a signature from the new primary applicant if the primary applicant left the household and the new primary applicant has not signed the application. See Application Signature for more information.
l The household asks to add members when the only household member is an auto newborn and the most recent application or renewal is:
n 12 months or older for MA, or
n 11 months or older for MinnesotaCare. See Adding a Household Member.
l Individuals active on an MHCP request a different MHCP, unless they meet one of the exceptions listed in Application Not Required.
Example:
Require an application when a MCRE enrollee requests MA and it has been more than 45 days since the most recent application or renewal.
Application Required for MinnesotaCare
Require an application in the following situations:
l The client applies for all MHCP. All MHCP are denied. The client requests MinnesotaCare 11 months or more from the last completed application or renewal.
l The client applies for MinnesotaCare only. MinnesotaCare is denied. The client requests MinnesotaCare 11 months or more from the last completed application or renewal form.
l The client’s MA is closed. The client requests MinnesotaCare 11 months or more from the last completed application or renewal form.
Note: In some situations, MinnesotaCare eligibility must be determined when MA is closed. Neither a request from the client nor a new application is required. See Application Not Required and Processing MA Annual Renewals.
l The client’s MinnesotaCare is closed. The client requests MinnesotaCare 11 months or more from the last completed application or renewal form.
Example:
Pam applies for MCRE on June 15 and is enrolled effective August 1. Her coverage is canceled effective March 1 of the following year. She calls on July 20 of that same year to request coverage.
Action:
Require a new HCAPP since it has been 13 months since she last completed an application and no renewal is on file.
Exception: Do not require children previously enrolled in MinnesotaCare for Certain Children Exiting Foster Care or a Juvenile Residential Correctional Facility to complete an application even if the original application is more than 11 months old. See Application Not Required.
Require an application in the following situations:
l The client applies for all MHCP. All MHCP are denied. The client requests MA more than 45 days from the date of the last completed application or renewal.
l The client applies for MinnesotaCare only. MinnesotaCare is denied. The client requests MA more than 45 days from the date of the last completed application.
l The client’s MA is closed. The client requests MA after the effective date of MA termination.
l The client’s MinnesotaCare is closed. The client requests MA more than 45 days from the date of the last completed application or renewal.
Note: In some situations, MA eligibility must be determined when MinnesotaCare is closed. Neither a request from the client nor a new application is required. See Application Not Required and Applications after Nonpayment of MinnesotaCare Premium.
l People receiving cash or Supplemental Nutrition Assistance Program (SNAP) request MA after the agency has acted on the request for cash or SNAP submitted on a CAF or with ApplyMN.
Note: People who apply for cash or SNAP may request health care program eligibility while the application is still pending by amending a paper application or by calling or writing the agency where they applied. Document the request in case notes.
l A client’s MinnesotaCare closes for nonpayment of premiums and the client either:
n Did not receive the MinnesotaCare Programs Option letter, or
n Returned their MinnesotaCare Premium Options letter after the due date stated on the letter.
See Applications after Nonpayment of MinnesotaCare Premium for more information.
l An incarcerated individual or the individual’s authorized representative requests MA to be reopened more than 10 days after the date of release. See MHCP and Incarcerated Individuals.