Medical Assistance
2.1.2.4 Living Arrangement
Medical Assistance (MA) enrollees live in a variety of community and facility (or institutional) living arrangements. A person’s living arrangement may affect MA eligibility and covered services. This chapter discusses living arrangements.
Community Living Arrangement
Community living arrangements have no impact on MA eligibility. See Appendix D Community Living Arrangements for more information.
Facility Living Arrangement
People who live in the following settings have a facility living arrangement. People in facility settings may be subject to special eligibility rules related to the living arrangement.
Institutions for Mental Diseases
An Institution for Mental Diseases (IMD) is a hospital, nursing facility, or other institution or residential program that has 17 or more beds and is primarily engaged in providing diagnosis, treatment or care of people with mental diseases. An IMD provides treatment for people with mental illness or chemical dependency (CD). See the Appendix E Institute for Mental Diseases for more information.
Long-Term Care Facilities
Policies regarding payment of long-term care facility services are different for different types of MA. See the MA for Long-Term Care Services chapter for more information.
Long-term care facilities (LTCFs) include:
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Nursing facilities
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Intermediate Care Facilities for Persons with Developmental Disabilities (ICF/DDs)
Correctional Facilities
In general, people of any age who are incarcerated in a state prison, county detention facility, or city jail are not eligible for Minnesota Health Care Program (MHCP) coverage. Correctional facilities include:
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City, county, state and federal correctional and detention facilities for adults, including inmates who are:
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in a work release program that requires they return to the facility during non-work hours.
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sent by the court or penal institution to a chemical dependency residential treatment program while serving a sentence and are required to return to the correctional facility after completing treatment.
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Juvenile facilities licensed by the Department of Corrections (DOC) that are for holding, evaluation and detention purposes
Exceptions
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People who are incarcerated may qualify for MA payment of inpatient hospital care. See the MA for Hospitalized Incarcerated People chapter for more information.
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People residing in a correctional setting voluntarily may be eligible for MA. This includes, but is not limited to the following:
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The person voluntarily enrolled in a program at the correctional facility, and was not placed there through the action of law enforcement authorities
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The person is free to leave, but living in the correctional facility for a temporary period pending other arrangements
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People on home confinement are eligible for MA because they are not considered to be residing in a correctional facility.
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People in a halfway house are eligible for MA, as long as they have freedom of movement. Freedom of movement means:
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Residents can work in the community, in jobs that are available to people who are not part of the justice system
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Residents can use community resources, such as grocery stores and libraries, at will.
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Residents can access health care treatment in the community, to the same extent as people who are not part of the justice system.
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People residing in a correctional facility may apply for Minnesota Health Care Programs 45 days prior to their release. See the MHCP Applications for Incarcerated People Preparing for Release policy for more information.
Title IV-E Certified Facilities
The IV-E program certifies different types of programs for children as Title IV-E eligible facilities. These settings include residential treatment programs, foster homes or group foster homes licensed by DHS and/or Department of Corrections and out-of-state residential treatment programs approved as Title IV-E eligible by their home state.
See MA Northstar Care for Children chapter for more information about MA eligibility rules for children who reside in foster care settings.
Legal Citations
Code of Federal Regulations, title 42, section 435.1010
Minnesota Statutes, section 256B.055, subdivisions 11 to 14