*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016.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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13.25 - County Residence |
Archived: June 1, 2016 (Previous Versions) |
Medical Assistance (MA) has rules about county residence. County residence rules do not apply to MinnesotaCare or the Minnesota Family Planning Program. County residence rules determine:
l County of financial responsibility.
l County of service.
l The County of Financial Responsibility is responsible for paying the county share of MA services.
l The County of Service is responsible for administering the case, including, but not limited to:
n Processing applications.
n Mailing and processing renewals and income reports.
n Gathering verifications and documentation.
n Issuing notices.
n Creating case notes.
Counties must not delay processing applicants’ eligibility because there is a dispute about the county of financial responsibility or the county of service. If there is a dispute, the county of service is the county where the applicant submits the application until the dispute is settled. See County Residence Disputes for the dispute resolution procedures.
See County Transfers for procedures to follow when a client moves to another county.
State residency rules apply when applicants move to Minnesota from another state and apply for health care. See State Residence for MA and MinnesotaCare.
Financially Responsible County.
Cash Enrollee with Automatic MA Moves.
Financially Responsible County
The county of financial responsibility is the county where the applicant lives on the day the county receives a written request for assistance.
Exception: The applicant lives in an excluded time facility or receives excluded time services. The county of financial responsibility is the county in which the person lived immediately before the excluded time started.
County residence rules still apply when an applicant or enrollee is temporarily absent from their home.
Example:
Jane, age 18, lives on campus in County A during the school year while she attends college. She returns to her mother’s home in County B for school holidays and in the summer. Jane’s mother claims her as a dependent on her income tax. Recently, Jane applied for MA in County A.
Action:
County B is the county of financial responsibility. County A is the servicing county unless there is already a case open in County B for Jane’s mother.
If an applicant moves to another county (County B), the first county (County A) is financially responsible, whether or not the first county (County A) has acted on the application. The new county (County B) becomes financially responsible when the applicant has lived in the new county (County B) for two full calendar months.
Exception: If the applicant is ineligible between the date of the application in the first county (County A) and the time the applicant moves, the new county (County B) is financially responsible effective the date eligibility begins.
Example:
Sheila applies for MA in County A on April 10. County A worker reviews the application and provides a list of information needed to process the application. Sheila calls on April 25 to report that she moved to County B on April 20.
Sheila has not turned in the required information. County A transfers the application to County B for processing. They instruct Sheila to give the required information to County B.
Action:
On May 10, County B determines that Sheila is eligible for MA retroactive to March 1. County A is financially responsible until July 1. May and June are the two full calendar months.
If Sheila had submitted the information before reporting the move, County A would have processed the application before transferring the active case to County B.
Example:
John applies for MA in County A on October 4. On October 20, he submits all required information to County A and reports that he moved to County B on October 20. County A determines that he is ineligible for October but will become eligible on November 1.
Action:
County A transfers the application to County B to approve MA effective November 1. County B is financially responsible.
If a former client reapplies in a new county within 30 days of termination by another county, the former county continues financial responsibility. The new county becomes financially responsible two full calendar months after the move date.
If a former county of residence closed the case more than 30 days ago, the new county is financially responsible even if the applicant requests retroactive coverage.
Enrollee Moves to Another County
When an active MA enrollee moves to a new county, the new county becomes financially responsible when the enrollee has lived in the new county for two full calendar months.
Exception: Do not count time spent in excluded time facilities or receiving excluded time services toward the two calendar months.
Do not count the month of the move, even if the move takes place on the first day of the month.
Example:
The Olson family receives MA in County A. They move to County B on March 1.
Action:
County A remains responsible for April and May.
Example:
Jennifer receives MA with her mother in County A. On August 5, she moves in with her aunt in County B. Jennifer does not intend to return to live with her mother. Her aunt receives MA in County B.
Action:
County A remains financially responsible for Jennifer's MA through October 31st. County B becomes responsible on November 1st.
If the client does not live in the new county outside of excluded time for two full calendar months, the new county does not become financially responsible. The first county is responsible until the client lives in non-excluded time in another county for two full calendar months.
Example:
Cecilia and her daughter receive MA in County A. They enter an excluded time facility in County B on March 12. They leave the facility on April 4 and move to non-excluded time in County C.
Action:
County A remains responsible through June 30th. May and June are the two full calendar months of residence in County C. County C is responsible starting July 1.
If the enrollee is temporarily absent from a household in the previous county, the previous county remains the financially responsible county.
Example:
Judy is receiving MA in County A as part of her mother’s household. In September, Judy moves to County B to attend college.
Action:
County A remains the county of financial responsibility as long as Judy intends to return to live in her mother’s household when she has finished school.
Cash Enrollee With Automatic MA Moves
When an enrollee who receives automatic MA with cash assistance moves, the county responsible for the cash assistance is also responsible for MA. Follow the policies of the cash program when determining and transferring financial responsibility for MA.
Note: If an active MA enrollee applies for cash assistance in the new county, the new county is responsible for the cash assistance. The former county retains responsibility for the MA until the enrollee has lived in the new county for two full calendar months.
Example:
Rufus receives MA from County A. He moves to County B on May 1. He applies for MSA in County B on May 5. County B approves his application on May 20.
Action:
County A remains responsible for the MA through July 31st. County B is responsible for MSA starting in May, and MA starting August 1st.