*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016.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: March 1, 2014 |
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03.30.35 - Medical Assistance for People Receiving Minnesota Supplemental Aid (MSA) |
Archived: June 1, 2016 (Previous Versions) |
MSA is a state-funded program that provides cash assistance to people who are:
l Supplemental Security Income (SSI) recipients; or
l age 65 or older; or
l blind; or
l age 18 or older and disabled.
MSA recipients are automatically eligible for Medical Assistance (MA) without a separate application or eligibility determination. MSA recipients may decline MA coverage; however, they may not choose to receive coverage under state-funded MinnesotaCare.
See the Combined Manual for more information on MSA eligibility requirements.
Most MSA recipients also receive Supplemental Security Income (SSI) and/or Retirement, Survivors, and Disability Insurance (RSDI) .
Note: Some MA enrollees who live in long-term care facilities or receive services through a home and community-based waiver program also receive MSA. A separate eligibility determination for payment of LTC services is required.
Eligibility factors and links to standard program guidelines are provided below.
Citizenship/Immigration Status.
Insurance and Benefit Recovery.
Relationship to Other Groups/Bases.
Application Process (standard guidelines)
No separate application is needed because MA is automatic with MSA eligibility.
Automatic MA eligibility is available effective the first of the month in which MSA is approved unless the client moved to Minnesota after the first of the month. MA eligibility begins the date the applicant moved to Minnesota, even though eligibility for MSA may begin the first of that month.
Note: MSA applicants can request up to three months of retroactive MA coverage without a separate health care application. They must meet all MA eligibility requirements in the retroactive months.
Six-month renewals are not required for people who receive MA automatically with MSA.
MSA recipients are not subject to mandatory MA verification requirements.
Exceptions:
n MSA recipients who request retroactive MA coverage for months in which they did not receive an MSA cash payment are subject to mandatory MA verification requirements for those months.
n MSA recipients who request MA payment of LTC services are required to provide necessary verifications to determine eligibility for MA payment of LTC services.
An enrollee’s Social Security Number is verified by the Social Security Administration for a person eligible for MSA with automatic MA.
An enrollee’s citizenship or immigration status is verified through the MSA determination for a person eligible for MSA with automatic MA..
Follow standard MA residency guidelines.
Insurance and Benefit Recovery (standard guidelines)
Follow standard MA guidelines.
Refer MSA recipients who are age 65 or older, and who receive only SSI benefits to the Social Security Administration (SSA) to apply for Medicare if they are not currently enrolled. Send the client the Medicare Buy-In Referral Letter (DHS-3439) and a county-addressed return envelope requesting the client apply within 60 days. Once you receive the confirmation portion of the referral letter or otherwise confirm Medicare eligibility with the SSA, enroll the person in the appropriate Medicare Savings Program.
DHS pays Medicare Part B premiums for MSA recipients who receive Retirement, Survivors, and Disability Insurance (RSDI) benefits and are enrolled in Medicare through the Medicare Buy-In.
Household composition is determined with the MSA approval for a person eligible for MSA with automatic MA.
Not applicable.
Asset Guidelines (standard guidelines)
Assets are verified through the MSA determination for a person eligible for MSA with automatic MA.
Income is verified through the MSA determination for a person eligible for MSA with automatic MA.
There are no deductions or disregards applied for a person eligible for MSA with automatic MA.
Not applicable.
Covered Services (Prepaid MHCP Manual)
Follow standard MA guidelines.
People who are not enrolled in a managed care plan receive services through fee-for-service .
MSA recipients under age 65 who are automatically eligible for MA are excluded from mandatory managed care enrollment. However, people may voluntarily enroll in Special Needs BasicCare (SNBC) if they are:
l ages 18-64 and are eligible for MA with or without Medicare Parts A and B, and
l certified disabled by SSA or SMRT.
MSA recipients age 65 or older who are not enrolled in a managed care plan receive services through fee-for-service.
People age 65 or older, including people who receive services through the Elderly Waiver (EW), who are not subject to a managed care exclusion will be enrolled in Minnesota Senior Care or Minnesota Senior Care Plus, depending on their county of residence. Most seniors may voluntarily enroll in Minnesota Senior Health Options (MSHO) if they so choose.
MSA recipients must comply with MA requirements to assign rights to medical support to maintain automatic eligibility for MA.
Automatic MA eligibility ends when MSA eligibility ends. Redetermine the person’s eligibility for health care and Medicare Savings Programs. See Eligibility Groups and Bases of Eligibility.
MSA recipients who are enrolled in Medicare are automatically accreted to the Medicare Buy-In, so have no need for Medicare Savings Programs eligibility.