Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability
2.3.4.2 Renewals
Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) enrollees must have their eligibility renewed annually.
Certain MA-ABD enrollees with a medical spenddown must also complete a six-month income review. See 2.3.3.4 Medical Spenddowns for more information.
Renewal Month
An enrollee’s renewal month is the month for which eligibility is redetermined when a renewal is conducted. The renewal month is the first month in the enrollee’s new certification period. The first annual renewal month after application is 12 months from the month of application, and renewals occur annually thereafter as long as the enrollee remains eligible for MA.
Eligibility for retroactive MA does not affect when an enrollee’s annual renewal month occurs.
A renewal is conducted individually for each enrollee in a household. If there are multiple enrollees due for renewal within a household, a renewal must not be delayed if all required information is available to determine the enrollee’s eligibility, even if additional information or proof is needed for other enrollees in the household.
Ex Parte Renewals
When it is time for an enrollee’s annual renewal, the agency must attempt to confirm an enrollee’s eligibility using information in the case file and from trusted electronic data sources before sending a renewal form and requesting information from the enrollee. When the enrollee’s eligibility cannot be renewed on an ex parte basis, the renewal must be completed using a paper renewal form.
If eligibility for an enrollee is renewed on an ex parte basis, the enrollee must receive a notice that includes the renewal outcome and a summary of the information used to renew their eligibility. If the information is correct, the enrollee does not need to do anything. If any of the information on the notice is inaccurate, the enrollee must report corrections or changes to their county or tribal servicing agency.
Paper Renewal Forms
Enrollees whose eligibility is not renewed on an ex parte basis receive a renewal form. The enrollee must be given until the end of the certification period, but no less than 30 days from the issuance date on the renewal notice to respond. The enrollee must complete, sign, and return the renewal form to their county or tribal servicing agency.
The county or tribal servicing agency must accept a renewal form and any renewal-related verifications received electronically or by mail, fax, telephone, or in person.
Combined Ex Parte and Paper Renewals
In households with more than one MA enrollee, some enrollees may be renewed on an ex parte basis while other enrollees may need to complete a renewal form. When this occurs, the household must receive a notice that indicates who was renewed on an ex parte basis and who is required to return a renewal form. A paper renewal form will be included with the notice.
Changes in Circumstance at Renewal
Changes reported on the renewal form or collected in the renewal process may change an enrollee’s eligibility. An enrollee who is no longer eligible under one basis of eligibility must be redetermined for all other potential MA bases of eligibility, without interruption in their coverage.
If the enrollee is ineligible for MA under any basis, eligibility must be redetermined for other programs such as MinnesotaCare, Advanced Premium Tax Credits, or a Qualified Health Plan. An enrollee must receive at least 10-day advance notice of any adverse change to their MA eligibility. See EPM 1.3.2.1 MHCP Change in Circumstance for more information.
Closure for Failure to Renew
MA-ABD eligibility ends for an enrollee who does not complete their renewal or submit required proofs by the last day of the certification period, regardless of whether other enrollees in their household were renewed. The enrollee must receive at least10-day advance notice of closure for failure to renew.
Legal Citations
Code of Federal Regulations, title 42, section 435.916
Code of Federal Regulations, title 42, section 435.930(b)
Minnesota Statutes, section 256.01
Minnesota Statutes, section 256B.056