Minnesota Health Care Programs

1.3.2.1.1 Death of an Applicant or Enrollee

Minnesota Health Care Programs (MHCP) applicants and enrollees must report changes that may affect their eligibility. County, tribal and state servicing agencies must act on reported changes. Death of an applicant, enrollee or household member is one of the changes that must be reported. Eligibility and coverage end for the deceased enrollee through the end of the day the person died. When an agency receives a substantiated report that an applicant, enrollee or other household member has died, they must redetermine eligibility for the surviving household members.

Substantiated Report of Death

There are three ways a report of death can be substantiated:

Information received from an acceptable electronic data source

Information that an MHCP applicant, enrollee or household member has died received directly from the Social Security Administration (SSA), the Minnesota Department of Health (MDH) Office of Vital Records, or the MDH Minnesota Death Search is considered substantiated.
Report from a “first party”

Information that an MHCP applicant, enrollee or household member has died received from a “first party” is considered substantiated. A first party is a competent adult family member, or agent, such as a former power of attorney, or an authorized representative.
Report from a “third party” confirmed by an electronic data source or first party

Information that an MHCP applicant, enrollee or household member has died received from a “third party” must be confirmed by an acceptable electronic data source or a first party to be considered substantiated. A “third party” is anyone who is not a “first party.”

Confirmation is required before the agency acts on a report of death from a third party. If no record of death is available from an accepted electronic data source, the agency must confirm the death with a first party before acting on the information.

If a person’s MHCP is closed based on information from a first party or an electronic data source, and the agency later learns that the person has not died, eligibility must be redetermined and coverage restored for any partial or full months which the person was eligible.

Legal Citations

Code of Federal Regulations, title 42, section 431.231

Code of Federal Regulations, title 42, section 435.916

Minnesota Statutes, section 144.225