MinnesotaCare
3.4.3 Renewals
MinnesotaCare enrollees must have their eligibility renewed annually.
Renewal Month
An enrollee’s renewal month is the month for which eligibility is redetermined when a renewal is conducted. The annual renewal month is January. The certification period is January 1 through December 31, regardless of when an enrollee is determined eligible. If an enrollee remains eligible after renewal, the new MinnesotaCare certification period is January 1 through December 31.
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 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 auto or ex parte renewal. When the enrollee’s eligibility cannot be auto renewed, the renewal must be completed using a prepopulated renewal form.
If eligibility for a MinnesotaCare enrollee is automatically renewed, the enrollee must receive a notice that includes their renewal outcome, and a summary of the 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 for the enrollee is inaccurate, the enrollee must report all corrections or changes to their county, tribal or state servicing agency.
Prepopulated Renewal Form
A MinnesotaCare enrollee whose eligibility cannot automatically be renewed must receive a prepopulated renewal form listing information the agency has about them. 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 review the form, make any changes or updates, sign and return the renewal form to their county, tribal or state servicing agency.
The county, tribal or state servicing agency must accept any renewal form returned by the enrollee in lieu of the prepopulated renewal and must accept renewal information by:
- mail,
- fax,
- telephone,
- document upload, and
- in person
When all required information has been gathered to redetermine eligibility for an enrollee, a renewal decision must not be delayed for that enrollee while additional information or proof is requested for other enrollees in the household.
Combined Renewal Results
In households with more than one enrollee due for a renewal, some enrollees may be automatically renewed while other enrollees will need to complete a renewal form. When this occurs, the household must receive a notice that indicates who was automatically renewed and who is required to return a renewal form. A prepopulated renewal form will be included with the notice.
Changes in Circumstances at Renewal
Changes in circumstances reported on the renewal form or collected in the renewal process may change an enrollee’s eligibility and the eligibility of previously renewed household members. When a renewal is processed, eligibility for all household members is redetermined.
If the enrollee is ineligible for MinnesotaCare, eligibility must be redetermined for other programs such as Advanced Premium Tax Credits or a Qualified Health Plan. Enrollees who lose MinnesotaCare eligibility due to changes must receive at least 10-day advance notice. Beneficial changes discovered during renewal may make an enrollee eligible for Medical Assistance (MA). See EPM 1.3.2.1, MHCP Change in Circumstance for more information.
Closure for Failure to Renew
MinnesotaCare 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 10-day advance notice of closure for failure to complete a renewal.
Legal Citations
Code of Federal Regulations, title 42, section 600.340
Minnesota Statutes, section 256L.05