MinnesotaCare

3.4.1 Begin and End Dates

Eligibility and coverage are separate concepts for MinnesotaCare:

Eligibility refers to when a person meets the MinnesotaCare eligibility rules.
Coverage refers to when a person can receive MinnesotaCare benefits.

MinnesotaCare eligibility and coverage begin dates can be different dates. When a person is determined eligible for MinnesotaCare, coverage can begin no earlier than the first of the month following the determination. Once a person has been determined eligible for MinnesotaCare, that person remains eligible for MinnesotaCare for the rest of the certification period, unless a change in circumstances makes the person ineligible during the certification period. A person may still be eligible for MinnesotaCare even if they fail to pay a premium. A person required to pay a premium has coverage for only those months for which a premium is paid, subject to the grace month policy.

See MinnesotaCare Premiums and Cost Sharing for more information.

MinnesotaCare eligibility and coverage end dates can be different dates as well. For example, a person can remain eligible for MinnesotaCare but have coverage end due to nonpayment of their premium.

When a MinnesotaCare enrollee received coverage for a month they were not eligible for MinnesotaCare, an overpayment may exist. See the MHCP Overpayment policy for more information.

Eligibility Begin Date

MinnesotaCare eligibility begins the first day of the month that a person meets the eligibility requirements. Eligibility can begin no earlier than the first day of the month of application. If a request for an eligibility determination does not require a new application, the eligibility begin date can begin no earlier than the first day of the month the request for coverage is received.

Generally, people who meet all eligibility requirements at any time during a month are eligible for the entire month. The eligibility begin date exceptions are:

When a person is born, eligibility can begin no earlier than the date the person was born.
When a person moves to Minnesota, eligibility can begin no earlier than the date the person became a Minnesota resident.

Coverage Begin Date

The coverage begin date for a person newly eligible for MinnesotaCare is the first day of the month after the month in which eligibility is approved and a first premium payment is received, if the person is required to pay a premium.

The coverage begin date for a person who is not required to pay a premium is the first day of the month after eligibility is approved. This is true even if the person is a member of a household with others who are required to pay a premium.

The coverage begin date for a person who is newly eligible for MinnesotaCare in a household with existing MinnesotaCare enrollees who are subject to premium payments and have coverage, is the month after the determination of eligibility.

The effective date of coverage for a person who is required to pay a premium and is added to an existing MinnesotaCare household whose members are exempt from paying a premium, or is newly determined eligible for MinnesotaCare as an existing member of a household whose other members are exempt from paying a premium, is the first day of the month after the month in which the premium is received.

There is no individual activation of MinnesotaCare coverage for premium-paying members within a household. A household must pay the entire premium due to start coverage for those members required to pay a premium.

Eligibility End Date

When a MinnesotaCare enrollee no longer meets the MinnesotaCare eligibility requirements, eligibility generally ends on the last day of the month in which the change occurred. The exceptions are:

When a MinnesotaCare enrollee dies, eligibility ends the date the person died.
When the change occurred too late in the month to send a 10-day advance notice, MinnesotaCare eligibility ends the last day of the month following the month in which the change occurred.
When a MinnesotaCare enrollee becomes newly eligible for MA, MinnesotaCare eligibility ends the day before MA eligibility begins.

Coverage End Date

MinnesotaCare coverage ends if a MinnesotaCare enrollee no longer meets the eligibility requirements or fails to pay the MinnesotaCare premium.

Coverage End Date due to Ineligibility

When a MinnesotaCare enrollee no longer meets the MinnesotaCare eligibility requirements, MinnesotaCare coverage ends the last day of the month for which 10-day advance notice can be given.

Generally, 10-day advance notice is needed to end MinnesotaCare coverage. See the MHCP Notices policy for specific situations that require less than 10-day advance notice.

Coverage End Date due to Non-Payment of Premium

The monthly household premium must be paid to maintain coverage for a MinnesotaCare enrollee. See the MinnesotaCare Cost Sharing and Premiums policy for more information about the coverage end date due to nonpayment of premiums.

Households that are exempt from premiums and household members who are not required to pay premiums remain covered regardless of whether premiums are paid.

Legal Citations

Minnesota Statutes, section 256L.05

Minnesota Statutes, section 256L.15