Program IM

2.5.4.4.1 Medicare

Medicare Eligibility

People who reside in an Institution for Mental Diseases (IMD) and who would otherwise qualify for Medical Assistance (MA) if they did not reside in an IMD must enroll in Medicare, if eligible, to be eligible for Program IM.

If a person eligible for Medicare is not enrolled in the program at the time they are placed in an IMD, they must apply for Medicare during the next available general enrollment period (January through March of each year).

Medicare Reimbursement

People who are enrolled in federally funded MA who reside in an IMD may be eligible for Medicare Savings Programs (MSP). See EPM 2.5.4 Program for People Living in Institutions for Mental Diseases for more information. If an enrollee is eligible for an MSP, they must apply for Medicare immediately. They do not have to wait for the next general enrollment period.

People who are enrolled in state-funded MA (Program IM) are not eligible to receive MSP benefits while living in an IMD. People who would receive MSP benefits if they did not reside in an IMD may be eligible to have their Medicare premiums manually reimbursed by their county or tribal servicing agency. See EPM 1.7.2 MHCP Direct Reimbursement of Medicare Premiums for more information.

Legal Citations

Minnesota Rules, part 9505.0430

Minnesota Statutes, section 256B.0625, subdivision 15