*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016.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 |
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25.05.35 - Premium Exemption for Military Members and Their Families |
Archived: June 1, 2016 (Previous Versions) |
Military members who have completed a tour of active duty within 24 months of approval for MinnesotaCare coverage are exempt from paying MinnesotaCare premiums for up to 12 months. The exemption is also available to members of the military member’s household who are eligible for MinnesotaCare.
Determining Eligibility for the Premium Exemption.
Starting the Premium Exemption.
Resuming the Premium Exemption upon Reenrollment.
Changes in Household Composition.
Determining Eligibility for the Premium Exemption
A MinnesotaCare premium exemption is available if a military member’s most recent tour of active duty ended within 24 months prior to the date of application, renewal, or request for consideration for the premium exemption. All other MinnesotaCare eligibility requirements must be met.
Household members of a MinnesotaCare eligible member of the military are also eligible for the premium exemption for up to 12 months if:
l the military member is currently receiving MinnesotaCare, and
l the family member is or was part of the qualified military member’s MinnesotaCare household at the time the exemption was approved, and
l the family member meets all other MinnesotaCare eligibility requirements.
See Household Size for MinnesotaCare for more information.
Do not require verification of military status or of the dates of the most recent tour of duty.
Review the application to determine if anyone applying is a current or former member of the military or completed a tour of duty within the last 24 months.
Contact the applicant by phone or in writing if
n the applicant fails to answer the question.
n the applicant does not indicate the end date for the last tour of active duty.
n additional information is needed to determine whether a military member is part of the MinnesotaCare household.
Do not pend or deny eligibility while attempting to collect this information.
Accept and act on verbal and written requests to consider individuals and families for the military premium exemption.
Enter a case note in MMIS to document the name of the household member who is a military member and the date the member’s last tour of duty ended.
Starting the Premium Exemption
The premium exemption applies only to premiums for months following the approval of the exemption. The exemption does not apply retroactively to premiums owed in months prior to the approval of the exemption.
Complete and send a MinnesotaCare Premium Exemption Notice (DHS-5707) to applicants and enrollees qualified for the premium exemption. Keep a copy of this notice in the case file.
Check Financial Control in MMIS to determine when to begin the premium exemption.
l Contact the household if they have a credit equal to more than two monthly premiums to determine whether they want to start the exemption period immediately or use up their credit before starting the exemption period. If the household wants to use up their credit first, track the case and do not start the exemption period until the credit is within two monthly premiums of being exhausted.
l For households with a credit of two monthly premiums or less, assume the household wants to start the premium exemption period the month after the credit will be exhausted.
Contact the MMIS Help Desk for assistance if unsure of which dates to enter on the MinnesotaCare Premium Exemption Notice (DHS-5707).
Refer to the MinnesotaCare section of the MMIS User Manual for further instructions on starting the premium exemption.
Example:
Sara and her husband, Max, apply for MinnesotaCare in February. Sara returned from an active tour of duty with the Army in January. Sara and Max meet all other MinnesotaCare eligibility criteria when their case is processed in March. They qualify for the military premium exemption because Sara’s most recent tour of duty ended within 24 months prior to the date of application.
Action:
Approve Sara and Max as pending-awaiting payment in March for coverage to begin April 1. Their 12-month military premium exemption period begins April 1, 2009, and ends March 31, 2010. Sara and Max will start paying MinnesotaCare premiums beginning with the premium billing they receive in February 2010 for April 2010 coverage.
Example:
Adam is a MinnesotaCare enrollee. In March 2009 Adam informs his MinnesotaCare worker that he is a former member of the military. His tour of active duty ended in June 2008. Adam qualifies for the military premium exemption because his most recent tour of active duty ended within 24 months prior to his date of request for the premium exemption. Adam already paid his March premium and has a credit on his account that will pay for April and May. Adam wants to use the credit before starting the premium exemption period.
Action:
Adam is exempt from paying premiums beginning with the premium for June 2009 through the premium for May 2010. Adam will start paying premiums again beginning with the premium billing he receives in April 2010 for June 2010 coverage.
Track the premium exemption period for an individual or household.
Complete and send the MinnesotaCare Premium Exemption Ending Notice (DHS-5709) 60 days prior to the end of the premium exemption period. Keep a copy of this notice in the case file.
Refer to the MinnesotaCare section of the MMIS User Manual for further instructions on ending the premium exemption.
Resuming the Premium Exemption upon Reenrollment
Individuals and families who qualify for the military premium exemption and who disenroll from MinnesotaCare during the 12-month exemption period can resume the exemption period upon re-enrollment if no more than 24 months have passed since the military member’s last tour of duty ended and the full 12-month exemption period was not previously used.
Follow the instructions for starting the premium exemption. Include only the balance of the 12-month period when completing the MinnesotaCare Premium Exemption Notice (DHS-5707).
Note: Households that voluntarily disenroll from MinnesotaCare when a military member is called to active duty are not subject to a four-month penalty period. See Four-Month Penalty.
Example:
Victor returned from active military duty in October 2008. He is enrolled in MinnesotaCare and his premium exemption begins in March 2009. In December 2009, Victor reports that he is going back on active military duty and voluntarily disenrolls effective December 31, 2009. He reapplies for MinnesotaCare in April 2010 after his tour of duty ends.
Action:
Approve eligibility pending awaiting payment in April, with coverage to begin May 1, 2010. Victor’s military exemption period resumes May 1, 2010, and continues through June 30, 2010. He will start paying MinnesotaCare premiums beginning with the premium he receives in May for July 2010 coverage.
Changes in Household Composition
The premium exemption continues for the remainder of the 12 months for both the enrollee and any former household members who are already receiving the exemption if an individual’s or family’s household composition changes during the military exemption period, such as if the enrollee moves out or gets married. Individuals and families must continue to be eligible for and enrolled in MinnesotaCare to qualify for the military premium exemption.
Example:
Alexander's 12-month premium exemption began April 1, 2009, for himself, his wife Sylvia, and their two-year-old daughter Fiona. Alexander moves out of the household in June and is approved for MinnesotaCare on his own case.
Action:
Continue the exemption for Alexander, Sylvia, and Fiona through March 31, 2010, on both cases if they continue to meet all other MinnesotaCare eligibility criteria.
New enrollees who join a military member’s household during an exemption period receive a premium exemption for the remainder of the military member’s exemption period.
Example:
Nick returned from a tour of duty in August 2008. He and his son Julian were approved for MinnesotaCare in March 2009. Their premium exemption begins in April 2009. Nick subsequently marries Willow and she is approved for MinnesotaCare in August 2009.
Action:
Begin Willow’s premium exemption in September 2009 and end it on March 31, 2010.