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500.15 Financial Eligibility for MinnesotaCare |
Effective: January 1, 2014 |
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500.15.15 Income Verification for MinnesotaCare |
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The income for all household members whose income counts must be verified for MinnesotaCare. For applicants who currently report monthly income that is within the MinnesotaCare income limits, the individual's attested income is compared to available electronic income sources. For individual applicants who attest to income above the MinnesotaCare income limits see APTC/CSR manual sections.
The new eligibility system verifies income for the household as follows:
The applicant must attest to projected annual household income for the benefit year for which coverage is requested at application, renewal or when reporting a change.
The applicant’s attested income is verified using electronic sources.
Income is considered verified and financial eligibility is determined or redetermined if:
the applicant's attested income and the electronic data both indicate income is below the MinnesotaCare income standard;
the applicant's attested income is at or below the MinnesotaCare income limit and the electronic data indicates income above the MinnesotaCare limit, but they are reasonably compatible.
If information provided by an applicant is not reasonably compatible with electronic data sources, the applicant is approved for MinnesotaCare based on attested income and then given a reasonable opportunity to provide:
a reasonable explanation of the discrepancy, or
paper documentation be sent to the lead agency within 95 days.
A case-by-case exception to the income verification requirement may be granted by the lead agency when both the agency and client are unable to obtain paper documentation.
Whose Income Counts for MinnesotaCare
Code of Federal Regulations, title 42, section 435.945
Code of Federal Regulations, title 42, section 435.952
Code of Federal Regulations, title 45, section 155.320