*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016. Please refer to the EPM for current health care program policy information. ***
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Effective: February 1, 2013 |
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03.20.25 - MinnesotaCare for Adults Without Children |
Archived: June 1, 2016 (Previous Versions) |
MinnesotaCare (MCRE) adults without children include people age 21 or older who meet the following:
l Are not pregnant.
l Are not married to a pregnant woman.
Note: If a pregnant MinnesotaCare enrollee is married, her husband is also considered to be a parent of a child under 21. See Enrollee Becomes Pregnant for more information.
l Are not parents, stepparents, relative caretakers, legal guardians, or foster parents of children under 21 in the household.
l Are relative caretakers, legal guardians, or foster parents of children under 21 in the household, but are not including the children as family members on their MinnesotaCare application.
l Are not eligible for Medical Assistance (MA) for adults without children.
Eligibility factors and links to standard program guidelines are provided below.
Citizenship/Immigration Status.
Insurance and Benefit Recovery.
MinnesotaCare Major Program and Eligibility Types (MPETs).
Relationship to Other Groups/Bases.
Application Process (standard guidelines)
Follow standard MinnesotaCare guidelines.
Follow standard MinnesotaCare guidelines.
Renewals (standard guidelines)
Follow standard MinnesotaCare guidelines.
Follow standard MinnesotaCare guidelines.
Social Security Number (standard guidelines)
Follow standard MinnesotaCare guidelines.
Adults without children must follow citizenship verification requirements if they are U.S. citizen or immigration status requirements if they are a noncitizen.
Use the Systematic Alien Verification for Entitlements (SAVE) system to validate the immigration status of eligible noncitizen applicants and enrollees.
Note: Applicants and enrollees who are otherwise eligible for MA or federally funded MinnesotaCare but fail to document their citizenship and identity, or immigration status are not eligible for state-funded MinnesotaCare as an adult without children.
Noncitizen adults without children may qualify for state or federally funded MinnesotaCare depending on their immigration status and household income. Refer to MinnesotaCare Major Program Eligibility Types (MPET) and Citizenship and Immigration Status for more information about determining eligibility for noncitizens.
Residency (standard guidelines)
Follow standard MinnesotaCare guidelines.
Follow standard MinnesotaCare guidelines.
Household Composition (standard guidelines)
Follow standard MinnesotaCare guidelines.
See MinnesotaCare Major Program Eligibility Type (MPET) for information on determining an adult's MPET.
Asset Guidelines (standard guidelines)
The asset limit for non-pregnant adults is:
l $10,000 for a household of one.
l $20,000 for a household of two or more.
Adults without children must have income less than 200% FPG to be eligible for MinnesotaCare.
Adults without children who have income equal to or greater than 200% FPG, less than or equal to 250% FPG may be eligible for the Healthy Minnesota Contribution Program.
Adults without children who have income at or below 75% FPG are not eligible for MinnesotaCare if they qualify for MA. See Relationships to Other Groups Basis.
Deductions/Disregards (standard guidelines)
Follow standard MinnesotaCare guidelines.
Follow standard MinnesotaCare guidelines.
Covered Services (Prepaid MHCP Manual)
MinnesotaCare adults without children have the Basic Plus One benefit set.
Service Delivery (Prepaid MHCP Manual)
Follow standard MinnesotaCare guidelines.
Certain disabled adults without children must apply for MA. See that section for more information.
When adults gain parent or caretaker status, change eligibility effective the month after the change. See Change in MinnesotaCare Eligibility.
When a MinnesotaCare enrollee reports an increase in income equal to or greater than 200% FPG, but less than or equal to 250% FPG, determine eligibility for the Healthy Minnesota Contribution Program. MinnesotaCare enrollees are eligible for an extra month of MinnesotaCare coverage. Close MinnesotaCare effective the last day of the month after the month the increase in income is reported.
People who are eligible for MA for adults without children are not eligible for MinnesotaCare for adults without children.
Determine MA eligibility for MinnesotaCare enrollees who report changes at renewal or between renewals that may result in eligibility for MA for adults without children. Follow current policy to determine eligibility for MA or to transfer the application to the appropriate agency for a complete MA determination. Send Notice to Apply for Medical Assistance (DHS-3404).
MinnesotaCare enrollees may remain enrolled in MinnesotaCare for up to 60 days from the first day of the month following the referral for MA. MinnesotaCare can also continue if the enrollee is cooperating with the process, but the MA determination takes longer than 60 days or if the enrollee is ineligible for MA. Close MinnesotaCare for the next available month for enrollees who fail to submit an application for MA or are denied MA for adults without children due to failure to complete or cooperate with the MA determination process.
MinnesotaCare applicants who do not cooperate with the MA determination process are not eligible for MinnesotaCare until they cooperate. Applicants who reapply for MinnesotaCare after failing to cooperate with an MA determination must complete the MA determination before they can enroll in MinnesotaCare, unless they no longer appear to qualify for MA for adults without children.
Adults without children who have income equal to or greater than 200% FPG, but less than or equal to 250% FPG, are not eligible for MinnesotaCare. These individuals may be eligible for the Healthy Minnesota Contribution Program.