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Effective: October 1, 2007 |
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07.05.10ar2 - Application Required (Archive) |
Archived: March 1, 2009 |
There are specific situations when a new application is required. This can be based on program and other additional factors.
For information on when an application is not required, see Application Not Required.
Required Application for All Programs.
MinnesotaCare (MCRE) Application Required.
MA and GAMC Application Required.
Transitional MinnesotaCare Application Required.
Application Required for All Programs
An application is required when an individual or household applies for health care for the first time and is not requesting cash or Food Support.
Require a health care application in the following situations:
l A person or household reapplies 11 or more months after they last completed an application or renewal form, regardless if they were an enrollee or a denied applicant.
Note: If the person or household reapplies within 11 months of the date of the last application or renewal, contact the applicant to update the application.
Example:
Pam applies for MCRE on June 15 and is enrolled effective August 1. Her coverage is canceled effective March 1 of the following year. She calls on July 20 of that same year to request coverage.
Action:
Require a new HCAPP since it has been 13 months since she last completed an application and no renewal is on file.
l A person who applied for and was denied MA/GAMC and requests the application be transferred to MCRE 11 months or more after the MA/GAMC application date.
l People leaving an existing MCRE household who are requesting MCRE for themselves.
l A person or household who applies on the same HCAPP as another household, but is not considered part of that household composition, and the person or household has not signed the application and/or provided enough information to determine eligibility.
n Send an application to the second household.
n Request the signed and completed application be returned as soon as possible to the worker processing the original application.
n Consider the date of application to be the date the original application was received.
Example:
James and Judy apply for health care on March 5. They are applying for themselves and their three sons, ages 16, 17 and 22. The application is signed by James and Judy.
Action:
The 22-year old is not part of his parent’s household due to his age. Send the son an application with instructions to return it as soon as possible. The returned application will have the same date as the application filed by James and Judy.
MA and GAMC Application Required
Require a health care application in the following situations:
l An individual or household previously denied MA or GAMC reapplies more than 45 days after the date of the previous application.
Note: If the individual or household reapplies for MA or GAMC within 45 days, an application is not required.
l A previously enrolled individual or household reapplies after the effective date of MA or GAMC termination.
l A previously enrolled GHO client is re-hospitalized more than six months from the date of the most recent application.
l People active on a MHCP request a different health care program listed in Application Not Required.
l People receiving cash or Food Support request MA or GAMC after the agency has acted on the CAF.
Note: If pending cash or food support applicants request MA or GAMC in addition to or instead of the programs they originally requested, allow them to amend the pending CAF to include MA or GAMC.
l A person is removed from a household and request MA/GAMC for themselves.
Note: If the primary applicant leaves the household, request a new application signed by the new primary applicant who remains in the household.
l The household asks to add members when the only household member is an auto-newborn and an application or renewal form has not been completed within the past 12 months.
l A MCRE enrollee requests MA/GAMC and it has been more than 45 days since the most recent application or renewal.
l GAMC enrollees acquire an MA basis and they do not meet a condition listed in Application Not Required, GAMC to MA Program Change.
l MA enrollees lose their MA basis of eligibility and do not meet a condition listed in Application Not Required, MA to GAMC Program Change.
Transitional MinnesotaCare – Application Required
There are additional considerations for Transitional MinnesotaCare applicants and former enrollees who are applying or reapplying for health care programs. For more information, see:
l Transitional MinnesotaCare – Application Process.