*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016.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: June 1, 2012 |
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07.15 - Who May Apply |
Archived: June 1, 2016 (Previous Versions) |
Determining who may apply for health care is a key part of the application process. This section will provide the details on who may apply as an individual and who may apply on behalf of another person.
Referrals to County Social Services.
MinnesotaCare Minor Caretakers.
Medical Assistance (MA) Minor Caretakers.
The following rules apply to clients of all ages:
l Authorized representatives may apply on behalf of clients who have designated them for this function.
l Minnesota Community Application Agents (MNCAAs) and application assistors may help clients with the application process but cannot sign for applicants unless they are designated as authorized representatives.
l A guardian is the authorized representative unless the court has appointed a conservator. Require the guardian to provide a copy of the letters of guardianship issued by the court as evidence of authority to act on behalf of the ward.
l A conservator is the authorized representative. Require the conservator to provide a copy of the letters of conservatorship issued by the court as evidence of authority to act on behalf of the protected or incapacitated person. An incapacitated person is someone who a court has determined lacks understanding or capacity to make reasonable personal decisions and is not able to meet his or her own needs for medical care, nutrition, clothing, shelter or safety.
Follow these rules when determining who must apply for themselves or on behalf of another person:
l Clients age 18 and older may apply on their own behalf.
l A spouse may apply on behalf of his or her spouse.
l Emancipated minors may apply on their own behalf, for their spouse, and children.
l When people under 18 without children live with parents, other relative caretakers, or guardians, the adult parent, relative caretaker or guardian must apply on the minor’s behalf.
Note: For MA, when parents have joint custody, the parent with whom the child spends the most amount of time must apply for the child.
Example:
Desmond, age 15, has lived with his grandmother Shirley for several years. His father, Ken, moves in with the household and two days later Shirley applies for health care for Desmond.
Action:
Although Ken is not required to sign the application, he must provide other information, such as income and health insurance availability.
Example:
Kristin, age 15, lives with her grandmother, Lana.
Action:
Lana must apply for health care on Kristin’s behalf.
l People under age 18 who do not live with a parent, another relative caretaker, foster parent, or guardian may apply on their own behalf.
Exception: If the child under age 18 does not live with parents, other relative caretakers, guardians, or in a formal placement arrangement, and is unable to apply (for example, the child is too young to understand the questions), the person or agency legally responsible for the child must apply.
Note: The child’s parents may be liable for medical support or parental fees if the child is determined eligible for health care.
Example:
Abe, age 17, lives in an apartment with an unrelated 19-year-old friend.
Action:
Abe may apply for health care on his own behalf. If he is eligible, determine if either parent is liable for medical support or parental fees.
Example:
Elizabeth, age 16, has been declared legally emancipated by a court. She lives on her own.
Action:
Elizabeth may apply for health care for herself. If she is eligible, determine if Elizabeth’s parents are liable for medical support or parental fees.
Example:
Julia attends school out of state. She has an informal arrangement with a friend of hers to care for her daughter, Talia, age 10, while she is gone.
Action:
Julia is temporarily absent. She must apply on her daughter’s behalf or designate an authorized representative for Talia.
l MA and MCRE: Foster parents may apply for health care on behalf of foster children.
n In most cases, the county social service agency will apply on the child’s behalf.
n See Household Composition for foster parents who wish to include the foster child in their household.
Referrals to County Social Services
Make a referral to the county social service agency if a child under 18 appears to be abused or neglected.
n Local agencies should develop their own procedures for social service referrals.
n The social service agency will determine what action, if any, is appropriate.
n Do not delay or deny eligibility pending social services action.
MinnesotaCare Minor Caretakers
Minor caretakers have different rules from other people under age 18 regarding whether they may apply on their own behalf or someone must apply for them.
l When a minor caretaker lives with one or both parents, require a parent to apply on behalf of the minor and the minor's child.
Exception: A minor caretaker may only apply for his or her child if:
r the minor caretaker’s parents applied and the child is ineligible due to the parent’s income, or
r the minor caretaker’s parents refuse to apply.
The parents must still apply for the minor caretaker.
Example:
Lauren, age 17, and her two-year-old daughter Sierra live with Lauren's mother, Joanne. Lauren would like to apply for MCRE for Sierra.
Action:
Joanne must file the application. If Joanne's income causes ineligibility for Sierra or Joanne refuses to provide the necessary information, Lauren may then apply for MCRE for only Sierra. Lauren may not receive MCRE for herself separately from Joanne.
l Minor caretakers who do not live with one or both parents may apply on their own behalf.
Exception: When minor caretakers live with guardians or non-parent relative caretakers who choose to include the minor caretaker and minor caretaker's child in their own household, the guardian or non-parent relative caretaker must apply.
Minor caretakers have different rules from other people under age 18 regarding whether they may apply on their own behalf or someone must apply for them.
l Minor caretakers may apply on behalf of themselves and their children, even if they live with one or more parents. The parent may also apply on their behalf.
Note: Although minor caretakers may apply for themselves, deeming rules continue to apply to minor caretakers who live with one or more parents.
Example:
Lauren, age 17, and her two-year-old daughter Sierra live with Lauren's mother Joanne. Lauren is requesting MA for herself and Sierra.
Action:
Lauren may apply on her own behalf. Joanne needs to provide income verification since her income must be deemed to Lauren. Joanne’s income will not be deemed to Sierra.
l Minor caretakers who do not live with a parent but do live with a non-parent relative caretaker or a guardian may apply on their own behalf, and that of their child. The guardian or non-parent relative caretaker may also apply on their behalf.
MA enrollees who are incarcerated for less than 12 months can request to have MA reopened using a shortened process. See MHCP and Incarcerated Individuals for more information.