*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016.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 |
|
07.20.55 - Informed Choice |
Archived: June 1, 2016 (Previous Versions) |
Informed choice allows applicants who complete the Minnesota Health Care Programs Application (HCAPP) (DHS-3417) or ApplyMN application to specify one of two options for health care program eligibility. Both the HCAPP and ApplyMN allow the client to apply for all health care programs or for MinnesotaCare only. Determine eligibility for only the option that the client requests. Determine eligibility in the order listed below. This may require transferring the application to another agency for the eligibility determination. See Shared and Transferred Applications for information on when to transfer these applications.
Note: Other applications, such as the Combined Application Form (CAF) and pre-1/09 versions of the HCAPP, do not ask applicants to specify a choice of health care program. Follow policy in Where to Apply for more information on applications that do not include the informed choice question.
Request for All Programs or No Choice.
Request for MinnesotaCare Only and No Retroactive Coverage.
Request for MinnesotaCare Only and Retroactive Coverage.
Request for MA by an Active MinnesotaCare Enrollee.
Request for MA and Medicare Savings Programs (MSP) through Extra Help Application.
Request for All Programs or No Choice
Determine health care eligibility as follows if a client completes the HCAPP or ApplyMN application and requests ”All programs” or if no choice is selected:
Note: It may be necessary to transfer the application to another agency for the eligibility determination. See Shared and Transferred Applications.
l First, determine MA eligibility.
l Determine MinnesotaCare eligibility for clients who are not eligible for MA.
Exception: Do not determine MinnesotaCare eligibility if MA is denied for failure to provide verification or requested information, unless
r The applicant contacts the agency after receiving the MA denial notice and specifically asks to have MinnesotaCare eligibility determined. Explain that the client will need to provide the requested verifications or information before MinnesotaCare eligibility can be determined.
r MinnesotaCare does not need the missing information.
Note: Do not determine MinnesotaCare eligibility for adults without children if MA is denied for failure to verify assets and the policy in MA Asset Verification Denial/Closure applies.
Note: People who are eligible for MA for adults without children are not eligible for MinnesotaCare for adults without children. Require these people to enroll in MA for adults without children.
Request for MinnesotaCare Only and No Retroactive Coverage
Determine MinnesotaCare eligibility if the client applies on the current HCAPP and requests MinnesotaCare only with no indication of retroactive coverage. Do not determine MA eligibility if MinnesotaCare is denied.
Exception: People who are eligible for MA for adults without children are not eligible for MinnesotaCare for adults without children. Require these people to enroll in MA for adults without children.
Follow these steps if the client applies on the current HCAPP and requests MinnesotaCare only with an indication of retroactive coverage:
Note: It may be necessary to transfer the application to another agency for the eligibility determination. See Shared and Transferred Applications.
l Determine retroactive and ongoing MinnesotaCare eligibility according to policy as outlined in Retroactive MinnesotaCare if an applicant is applying for MinnesotaCare within 30 days after MA closure.
l Follow the policy in MinnesotaCare with Retroactive MA if an applicant does not meet the criteria for retroactive MinnesotaCare.
Exception: People who are eligible for MA for adults without children are not eligible for MinnesotaCare for adults without children. Require these people to enroll in MA for adults without children.
Request for MA by an Active MinnesotaCare Enrollee
An active MinnesotaCare enrollee may request a determination of MA eligibility at any time. The request may be made in person, via phone or in writing. Follow the policies in Application Required, Application Not Required, Date of Application, and Applications.
Clients who apply for Extra Help with Medicare Part D costs through the Social Security Administration (SSA) can have their Extra Help application data transmitted by SSA to initiate an application for MA or MSP eligibility. See Applications for Minnesota Health Care Programs (MHCP) - SSA Data as a Request for MHCP for more information.