Minnesota Health Care Programs
1.7.2 Direct Reimbursement of Medicare Premiums
Certain Medical Assistance (MA) enrollees are eligible for direct reimbursement of their Medicare Part A and/or Part B premiums. The county or tribal agency reimburses the enrollee for their Medicare premium to ensure that Medicare benefits are not interrupted. See 1.7.1 Medicare Buy-In for more information about the Medicare Buy-In.
Medical Assistance for Employed Persons with Disabilities (MA-EPD)
Medical Assistance for Employed Persons with Disabilities (MA-EPD) enrollees may be eligible for direct reimbursement of their Part B premiums. Reimbursement is effective the date of MA-EPD eligibility for enrollees who meet both of the following: have income at or below 200% FPG and are not eligible for the Qualified Medicare Beneficiary (QMB) or Service Limited Medicare Beneficiary (SLMB) programs. See EPM 2.3.5.4.1 MA-EPD Medicare for more information.
People Residing in an Institution for Mental Diseases (IMD)
Certain individuals are eligible for direct reimbursement of their Medicare Part A and/or Part B premiums from the agency:
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MA enrollees who are enrolled in an MSP and lose that coverage due to residing in an Institution for Mental Disease (IMD), or
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MA applicants who would be eligible for an MSP if they did not reside in an IMD.
See EPM 2.5.4.4.1 Program IM Medicare for more information.
If an enrollee meets the requirements above, the enrollee must be reimbursed the full Medicare Part A and/or Part B premium amount for any month(s) they are eligible for the reimbursement. There is no time limit for the processing of an agency reimbursement for such premiums.
The Late Request for Medicare Reimbursement (DHS-3918) form is used to request reimbursement of the Medicare Part A and/or Part B premium paid to the enrollee from the Department of Human Services if it is submitted 12 months or more after the Medicare Part A and/or Part B premium was paid.
Legal Citations
Minnesota Statutes, section 256B.057
Minnesota Rules, part 9505.0430