|
Effective: December 1, 2006 |
|
|
08.35ar1 - Six-Month Renewal (Archive) |
Archived: July 1, 2009 |
MA and GAMC enrollees, including the Medicare Savings Programs, are the only clients who must complete a six-month renewal.
Exception: GHO enrollees do not have renewals.
Six-Month Renewal Requirements.
Six-Month Asset Renewal Exemptions.
Six-Month Income Renewal Exemptions.
Six-Month Renewal Requirements
MA and GAMC enrollees must complete a six-month renewal unless a six-month income renewal exemption or asset renewal exemption is met.
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 If the six-month renewal is not received by the 16th of the sixth month of the certification period, the system will send the Notice of Late or Incomplete Household Report Form or Health Care Renewal (DHS-2414).
n If the renewal form is not received by, or it is incomplete at 10-day notice in the last month of the certification period, the system will automatically close the case.
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.
l Verify current income from the previous 30 days. Use the most accurate information available at the time of the six-month renewal.
Exception: For enrollees with an automatic monthly spenddown, require verification of income received in the fifth month of the certification period.
l Redetermine MA/GAMC eligibility.
n If the client is no longer eligible for MA due to excess income or assets determine eligibility for MCRE within five days. See Sharing and Transferring Applications for more information if your county agency is not a MCRE enrollment site.
The following forms may be used for the six-month renewal:
l Minnesota Health Care Programs Combined Six-Month Report (DHS-5576).
l The MA Renewal Form for Long-Term Care Elderly Waiver (DHS-2128).
The system will generate and attach instructions for the client 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 GAMC enrollees do not have six-month asset renewals.
Six-Month Income Renewal Exemptions
Some people are exempt from income renewals.
l When approving the new certification period for people exempt from the income renewal, base eligibility on information in the case record or available from other sources, such as BNDX and SDXS.
l People with spenddowns who are exempt from income renewals may be required to submit documentation of medical expenses if needed to determine continued eligibility for the next six-month budget period.
l Review eligibility for enrollees who are exempt from an income renewal when they report receipt of lump sums or additional assets.
The following people are exempt from completing an 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.
l People who receive MA or GAMC automatically with MSA, GRH or GA.
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 GHO 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.