*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016.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, 2011 |
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08.20.05 - Processing MinnesotaCare Renewals |
Archived: June 1, 2016 (Previous Versions) |
This section provides information on processing a MinnesotaCare renewal.
MinnesotaCare Renewal Processing Steps.
A complete renewal includes all of the following:
l A completed annual renewal form. For more information on acceptable renewal forms, see Renewal Forms.
l A signature for everyone who is required to sign. See Renewal Signature for specific policy on who must sign the renewal form.
l Required verifications and any information needed to redetermine eligibility.
Exception: Participants in the Safe at Home (SAH) Address Confidentiality Program are not required to provide their actual address.
For more information on the Safe at Home Program:
r See Data Privacy.
r See the Minnesota Secretary of State’s Web site.
r Call (651) 201-1399 or (866) 723-3035 or TTY (800) 627-3529 or 711.
MinnesotaCare Renewal Processing Steps
Follow these steps to process a MinnesotaCare renewal:
1. Process renewals in the order they are received. Give priority to processing renewals to avoid a gap in coverage.
l If possible, process the renewal before MinnesotaCare billing (cutoff) to ensure continuous coverage and allow the client time to pay the new premium amount.
l Do not require an in-person interview as part of the renewal process for MinnesotaCare.
2. Review the renewal form.
l Review the renewal for missing data, verifications and the following:
n Address changes.
n Household member changes. See Adding a Household Member and Removing a Household Member.
n Pregnancy reported. Request verification. Consider the woman to be pregnant upon reporting.
n Insurance changes.
m Request new insurance information.
m Request verification of access to Employer-Subsidized Insurance (ESI) for each employer as required.
Note: This may include changes in eligibility for household members based on insurance already on file, or new insurance being reported.
n Assets.
n Income. Request verifications.
Note: For households previously determined to have excess income for MinnesotaCare, determine if the household continues to have excess income. If the household continues to have excess income, see Excess Income - MinnesotaCare for more details on how to process eligibility.
n Changes in parental status and medical support. Follow required steps.
l Contact the enrollee to obtain any missing information or verifications.
l The household has until the redetermination date to provide the necessary information to ensure continuous coverage for renewals pending additional information.
3. Enter the date the renewal was received on MMIS as soon as it is received and reviewed.
Note: Once the renewal received date is entered into MMIS it sets a new redetermination date. Be sure to process the renewal to completion (do not leave it incomplete). The system cannot automatically close a case that has had the redetermination date updated.
4. Redetermine MinnesotaCare eligibility.
l If the household has completed the renewal and sent in all required information and verifications timely and:
n the household is eligible, approve the renewal.
n the household is not eligible, close the household for the end of the month before the renewal month using the appropriate closing code. Determine eligibility for MA if the renewal is being processed at the county.
Note: Contact MMIS User Services to extend the renewal for an additional month at the old premium rate if there is not time to process the renewal. The household may be reinstated.
l Close the household with an incomplete code (C48) if information and verifications are incomplete.
l MMIS will automatically generate a closing notice if the renewal has not been processed (approved or closed) by the MinnesotaCare billing (cutoff) prior to the renewal month.
Renewals are late if they are received after the redetermination date. Depending on when the renewals are received at the agency, process late renewals as follows:
l Renewal is received in the renewal month: consider it a new application.
Example:
The Hogans’ renewal month is August. The renewal is sent to them in June, 45 days before the redetermination date. The renewal must be received by July 31 for continued eligibility in August. The Hogans do not return the renewal form until August 15.
Action:
Process the renewal as a new application. The application date is August 15. The first month the Hogans can possibly receive MinnesotaCare coverage is September, if the renewal is complete and the premium is paid. They will not have coverage for August.
Reminder: The Hogans may request retroactive MA for August if they have medical expenses for that month.
l Renewal is received after the renewal month: require a new application unless the household meets an exception under Application Not Required.
Exception: Safe at Home participants may request and be granted good cause for late submission or completion of renewals. See Data Privacy.