Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability

2.3.4.2.1 Ex Parte Renewals

When it is time for an enrollee’s annual renewal, the agency must attempt to confirm eligibility using information in the case file and from trusted electronic data sources before sending a renewal form and requesting information from the enrollee. This is called an ex parte renewal. If the agency is able to confirm an enrollee’s eligibility using information in the case file and from trusted electronic data sources, the enrollee’s MA eligibility is renewed without the enrollee having to complete a renewal form. When the enrollee’s eligibility cannot be confirmed via the ex parte process, a renewal form must be completed by the enrollee and processed by the agency to renew eligibility.

If eligibility for an MA-ABD enrollee is renewed with the ex parte process, the enrollee must receive a notice that includes their eligibility determination, the basis of their eligibility, and information used to renew their eligibility. If all the information is correct, the enrollee does not need to do anything. If any of the information about the enrollee is inaccurate, the enrollee must report corrections or changes to their county, tribal or state servicing agency.

Enrollees whose eligibility must be reviewed for an ex parte renewal

The following MA-ABD and MSP enrollees may have their eligibility renewed through the ex parte process. Agencies must attempt to confirm eligibility through the ex parte process before sending a renewal form to:

Supplemental Security Income (SSI) beneficiaries who do not receive Veteran’s Administration (VA) Aid and Attendance benefits or VA unusual medical expense payments.
TEFRA Option enrollees
Enrollees with 1619(a) or 1619(b) status
Enrollees whose only income is one or a combination of the following:
- SSI (even if the benefit amount is zero),
- Retirement, Survivors, and Disability Insurance (RSDI)
- Railroad Retirement Benefits (RRB)
Enrollees who are also SNAP, MFIP, or Tribal TANF recipients. To confirm income eligibility for ex parte renewal, their SNAP, MFIP or Tribal TANF net income must be at or below 100% FPG and the income must have been verified as part of the SNAP, MFIP, or Tribal TANF determination.
Enrollees with zero income reported and verified at application or their most recent eligibility determination. Income eligibility for renewal is confirmed when any of the following occurs:
- No income data is returned from any electronic data source.
- New income data is returned from trusted electronic data sources, and the income is at or below the MA-ABD income limit of 100% FPG.
- New income data is found and was verified as part of the SNAP, MFIP, or Tribal TANF determination, and the income is at or below the MA-ABD income limit of 100% FPG.
MSP enrollees who are eligible only for a Medicare Savings Program (MSP), which includes Qualified Medicare Beneficiary (QMB), Service Limited Medicare Beneficiary (SLMB), Qualified Individual (QI), and Qualified Working Disabled (QWD) when any of the following are true:
- Their only source(s) of income are SSI, RSDI, or RRB.
- They reported and verified having zero income at application or their most recent eligibility determination. Income eligibility for renewal is confirmed if any of the following occur:

No income data is returned from any electronic data source.
New income data is returned from trusted electronic data sources, and the income is at or below the MSP income limit.
New income data is found and was verified as part of the SNAP, MFIP, or Tribal TANF determination, and the income is at or below the MA-ABD income limit of 100% FPG.

They are a SNAP, MFIP, or Tribal TANF recipient whose net income is at or below 100% FPG. The income must have been verified as part of the SNAP, MFIP, or Tribal TANF determination.

MA-ABD enrollees with an MSP and whose MA eligibility was renewed through the ex parte process will also have their MSP eligibility renewed through the ex parte process. If during the ex parte process, the enrollee is determined eligible for a different type of MSP than the one the enrollee is enrolled in, the enrollee’s MSP must be changed. The enrollee must be sent a 10-day advance notice if the enrollee moves to an MSP with fewer benefits.

Enrollees receiving Medical Assistance for Long-Term Care Services

Agencies must attempt to renew MA eligibility through the ex parte process for enrollees who have an MA-ABD basis of eligibility and are receiving Medical Assistance for Long-Term Care Services (MA-LTC) if they have any of the income listed above that can be verified using information in the case file and from trusted electronic data sources, and meet the following criteria.

Enrollees who use a community income calculation

For MA-LTC enrollees with an MA-ABD basis of eligibility who use a community income calculation, agencies must attempt to renew MA eligibility through the ex parte process if they use the remedial care expense and bills for waiver services that are received during the certification period to meet a spenddown. These expenses can be verified without obtaining additional information from the enrollee.

Enrollees who use a long-term care income calculation

For MA-LTC enrollees with an MA-ABD basis of eligibility who use a long-term care income calculation, agencies must attempt to renew MA eligibility through the ex parte process if the person has post-eligibility deductions from income that can be verified electronically or are generally unchanging. The following types of deductions may be verified electronically or are generally unchanging:

Special SSI
Minnesota Supplemental Aid (MSA)
Medicare premiums paid by the enrollee
Personal needs allowance (PNA)
Veteran’s Improved Pension
Special Income Standard-Elderly Waiver (SIS-EW) maintenance needs allowance
Fees paid to a guardian, conservator, or representative payee
Court-ordered child support and court-ordered spousal maintenance
Medicare co-payments and deductible
Remedial care expense

Certain post-eligibility deductions cannot be verified without requiring additional information from the enrollee. Enrollees with these deductions must not have their eligibility renewed using the ex parte process:

Community spouse income allocation
Family allocation
Health insurance premiums, co-payments and deductibles that cannot be verified without requiring information from the enrollee
Medical expenses

Enrollees with certain types of assets

Assets must be verified for MHCP enrollees who have an asset limit. Agencies must attempt to renew MA and MSP eligibility through the ex parte process for MA-ABD and MSP enrollees listed above if they have any of the following:

No assets
Assets that can be verified through the Asset Verification Service (AVS), including:

Savings accounts
Checking accounts
Money market accounts
Certificates of deposit (CD)

Assets unlikely to increase in value:

Vehicles, including but not limited to cars, trucks, vans, campers, motorcycles, trailers, boats, and off-road vehicles
Tools and equipment that are not used in the home

Excluded or unavailable assets unless the asset becomes countable or becomes available

MA-ABD and MSP enrollees with other types of countable assets cannot be renewed through the ex parte process, except for certain SSI beneficiaries. Agencies must attempt an ex parte renewal for SSI beneficiaries even if they have other countable assets, because SSA has already verified these assets.

For SSI beneficiaries, agencies must also attempt ex parte renewal if they have the following excluded assets, if these assets remain excluded:

Life insurance-funded burial arrangements
Special needs trusts
Pooled trusts

Enrollees whose eligibility cannot be renewed through the ex parte process

Some MA-ABD enrollees cannot have their MA eligibility renewed through the ex parte process, because there is not sufficient information in their case file and via electronic data sources to confirm their continued eligibility or their premium, if a premium applies. This includes the following:

Medical Assistance for Employed Persons with Disabilities (MA-EPD) enrollees
MA-ABD and MSP enrollees with earned income, who are not:

SSI beneficiaries
Enrollees with 1619(a) or 1619(b) status
SNAP, MFIP, or Tribal TANF recipients with net income at or below 100% FPG verified as part of that determination if they meet the asset requirements

MA-ABD enrollees who receive both SSI and VA Aid and Attendance benefits or VA unusual medical expense payments
MA-ABD enrollees whose eligibility is reviewed for ex parte renewal, but who do not meet the income or asset criteria above, or who have one or more other eligibility factors that cannot be confirmed using information in the case file and data from trusted electronic data sources.

Legal Citations

Code of Federal Regulations, title 42, section 435.916

Minnesota Statutes, section 256B.056

Laws of Minnesota 2023, chapter 22