*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016.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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07.20.35 - MinnesotaCare with Retroactive MA |
Archived: June 1, 2016 (Previous Versions) |
Applicants who request MinnesotaCare (MCRE) with retroactive coverage may be reviewed for retroactive MA. Applicants may request MinnesotaCare only on the HCAPP or with ApplyMN or may request all Minnesota Health Care Programs on any application. See Informed Choice. This section explains how to process retroactive MA with ongoing MinnesotaCare.
Follow policies governing MCRE and MA overlap. In most cases people cannot be covered by more than one program in the same month. Also see Shared and Transferred Applications.
Requests for MinnesotaCare Only and Retroactive Coverage.
Requests for All Minnesota Health Care Programs and Retroactive Coverage.
Requests for MinnesotaCare Only and Retroactive Coverage
Determine retroactive MinnesotaCare and ongoing MinnesotaCare eligibility if an applicant requests MinnesotaCare only and retroactive coverage, and is applying for MinnesotaCare within 30 days after MA closure. See Retroactive MinnesotaCare.
Contact applicants by phone or in writing if they do not meet the criteria for retroactive MinnesotaCare, and could potentially qualify for retroactive MA coverage.
l Ask if they want to apply for MA.
l Explain that they are not eligible for retroactive MinnesotaCare, that ongoing MinnesotaCare does not cover past medical expenses and that if they want coverage for past medical bills, they must apply for MA.
l Allow applicants to indicate either verbally or in writing if they want to apply for MA for the retroactive period only or if they want to apply for both retroactive and ongoing MA coverage. Document the applicant’s choice in case notes.
n Do not determine eligibility for retroactive MA if applicants indicate they do not want to apply for MA or fail to respond to attempted contact within 10 days. Determine ongoing MinnesotaCare eligibility only.
n Determine eligibility for retroactive and ongoing MA if applicants indicate either verbally or in writing they want to apply for both retroactive and ongoing MA.
m If necessary, transfer the application within five working days to the applicant’s county of residence for the MA eligibility determination. See How to Transfer and Receive an Application.
n Determine retroactive MA eligibility for the retroactive period and MinnesotaCare eligibility for future months if applicants indicate either verbally or in writing they want to apply for retroactive MA only.
m If necessary, transfer the application within five working days to the applicant’s county of residence for the retroactive MA eligibility determination. See How to Transfer and Receive an Application.
m Coordinate the retroactive MA closing date and the MinnesotaCare approval to avoid a lapse in coverage to the extent possible.
Requests for All Minnesota Health Care Programs and Retroactive Coverage
When an applicant requests all health care programs and retroactive coverage, first determine eligibility for both retroactive MA and ongoing MA.
l Determine ongoing MinnesotaCare eligibility if the applicant is eligible for retroactive MA, but ineligible for ongoing MA. Transfer the application to MinnesotaCare Operations within five working days if the county agency processing the MA is not a MinnesotaCare enrollment site. Coordinate the retroactive MA closing date and the MinnesotaCare approval to avoid a lapse in coverage to the extent possible.
l Determine ongoing MinnesotaCare eligibility if the applicant is ineligible for retroactive MA and ongoing MA. Transfer the application within five working days if necessary.
See Shared and Transferred Applications for information on when to transfer applications. Also see How to Transfer and Receive an Application.