*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016.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: September 1, 2012 |
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08.35 - Six-Month Renewals |
Archived: June 1, 2016 (Previous Versions) |
MA enrollees, including Medicare Savings Program enrollees, are the only clients who must complete a six-month renewal.
Six-Month Renewal Requirements.
Six-Month Asset Renewal Exemptions.
Six-Month Income Renewal Exemptions.
Six-Month Renewal Requirements
MA enrollees must provide information about their income and assets every six months unless a six-month income renewal exemption or a six-month asset renewal exemption is met.
Note: Enrollees who are exempt from completing a six-month income renewal are also exempt from completing a six-month asset renewal.
l The six-month renewal determines eligibility for the next certification period.
l Begin the first six-month period with the month of initial eligibility for all enrollees.
Note: The six-month renewal will alternate every six months with the annual renewal.
l The completed six-month renewal form is due by the eighth day of the sixth month of the certification period.
n The system will send a termination notice if the six-month renewal is not received by the 16th of the sixth month of the certification period.
n The system will automatically close the case if the six-month renewal form is not received, or it is incomplete on the last day of the last month of the certification period.
n Reinstate coverage if the six-month renewal form is received by the end of the sixth month and the household remains eligible.
l Verify all countable assets and their encumbrances for enrollees required to report assets.
Note: Some enrollees are not required to report assets at the six-month renewal. See Six-Month Asset Renewal Exemptions.
l Verify current income from the previous 30 days. Use the most accurate information available at the time of the six-month renewal.
l Redetermine MA eligibility.
n Counties that are MinnesotaCare enrollment sites must determine MinnesotaCare eligibility if the client is no longer eligible for MA, unless the case was closed for failure to return the renewal or failure to provide verifications or requested information.
A renewal is late if it is returned after the end of the certification period.
Process the renewal as a new application if the complete renewal is received in the renewal month. For MA, approve coverage back to the first day of the renewal month or the date all eligibility factors are met.
Unless the household meets an exception under Application Not Required, require a new application if the enrollee submits:
l a renewal after the renewal month.
l an incomplete renewal before the end of the certification period, but submits missing information/verifications after the end of the renewal month.
Note: If the client is cooperating with obtaining verifications, do not require a new application.
l an incomplete renewal during the renewal month and the missing information is returned after the renewal month.
Example:
Marty’s certification period is February through July. The six-month renewal form is due in July. The agency receives Marty’s six-month renewal on August 10, 2009.
Action:
Process the six-month renewal as a new application because the agency received it in the renewal month of August. If Marty had sent in the six-month renewal in September, a new application would be required unless he met an exception.
Exception: Safe at Home participants may request and be granted good cause for late submission or completion of renewals. See Data Privacy or the Minnesota Secretary of State’s Web site for further information.
The following forms may be used for the six-month renewal:
l Combined Six-Month Report (DHS-5576).
l Renewal for People Receiving Long-Term Care Services (DHS-2128).
l Household Report Form (HRF) (DHS-2120). The HRF may be sent to some enrollees required to report monthly and can be used as the six-month renewal form.
The system will generate and attach instructions to the appropriate six-month renewal form.
Six-Month Asset Renewal Exemptions
The following people are exempt from a six-month asset renewal:
l People noted as exempt in Exemptions from Asset Limits.
Reminder: A client who is exempt from the asset limit may still need to provide asset verifications if their assets are deemed to another household member.
l Enrollees who are exempt from completing a six-month income renewal.
Note: Update the case as needed, but do not deny coverage or require verification based on whether an enrollee who is exempt from six-month asset renewals answers or does not answer the asset questions on the Combined Six-Month Renewal Form.
Six-Month Income Renewal Exemptions
The following people are exempt from completing a six-month income renewal:
l People who complete monthly renewals for MA, Food Support, or a cash program. Use the information on the monthly reports to complete the MA six-month income renewal if a client submits the monthly form. Request information and verifications as necessary if the monthly report does not contain enough information to determine MA eligibility.
l People who receive MA automatically with MSA or GRH.
l People who meet an annual renewal exemption.
l People who receive only unvarying unearned income, such as:
n RSDI.
n Private pensions.
n Veterans’ benefits.
n MFIP.
n Other unvarying payments that are expected to continue indefinitely.
Example:
Seth receives SSI and RSDI each month. The amount is the same each month, and he has no other income.
Action:
Do not require Seth to submit six-month income renewals.
l People whose only source of income is from an excluded income source such as SSI.
l RMA enrollees.
l People who report no income.
Example:
Mario and Louise receive MA. Louise is employed and Mario receives SSI. Louise’s income is considered in determining Mario’s SSI eligibility and benefit level.
Action:
Mario is exempt from an income renewal because he receives only unvarying income.
Louise is required to complete income and asset renewals to determine her continued eligibility.
Base eligibility on information in the case record or available from other sources, such as BNDX and SDXS, when approving the new certification period for people exempt from the income renewal.
Require people with spenddowns who are exempt from income renewals to submit documentation of medical expenses if needed to determine continued eligibility for the next six-month budget period.
Review eligibility for enrollees who are exempt from an income renewal when they report receipt of lump sums or additional assets.