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Effective: July 1, 2009 |
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07.05.10ar4 - Application Required (Archive) |
Archived: April 1, 2010 |
There are specific situations when a new application is required. This section discusses the requirements for all programs and those that apply to specific programs only.
For information on when a new application is not required, see Application Not Required.
Application Required for All Minnesota Health Care Programs (MHCP).
Application Required for MinnesotaCare.
Application Required for MA or GAMC.
Application Required for Transitional MinnesotaCare.
Application Required for All MHCP
Require an application in the following situations:
l An individual or household applies for health care for the first time.
l An MHCP enrollee submits a renewal after the renewal month. See Processing MinnesotaCare Renewals, Processing MA/GAMC Annual Renewals, and Six-Month Renewals.
l An individual or household applies on the same application as another household, but is not considered part of that household for MA/GAMC or MinnesotaCare, and has not signed the application 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. James and Judy both sign the application.
Action:
The 22-year-old is not part of his parents’ household due to his age. Send the son an application with instructions to return it as soon as possible. Use the same application date on the returned application as on the application from James and Judy.
l An individual is removed from an MHCP household and requests MHCP on his or her own case, but has not signed the original application.
Example:
Rose and Robert live with their 17-year-old son Anthony. They all apply for MA. Rose and Robert both sign the application. Since Anthony is only 17, he is not required to sign. A few months after being approved for MA, Anthony reports that he was emancipated by a court and has moved out of his parent’s home. He wants to keep his MA.
Action: Require Anthony to complete a new application.
Note: Request a signature from the new primary applicant if the primary applicant left the household and the new primary applicant has not signed the application. See Application Signature for more information.
l The household asks to add members when the only household member is an auto newborn and the most recent application or renewal is:
n 12 months or older for MA/GAMC, or
n 11 months or older for MinnesotaCare. See Adding a Household Member.
l Individuals active on an MHCP request a different MHCP, unless they meet one of the exceptions listed in Application Not Required.
Example:
Require an application when a MCRE enrollee requests MA/GAMC and it has been more than 45 days since the most recent application or renewal.
Application Required for MinnesotaCare
Require an application in the following situations:
l The client applies for all MHCP. All MHCP are denied. The client requests MinnesotaCare 11 months or more from the last completed application or renewal.
l The client applies for MinnesotaCare only. MinnesotaCare is denied. The client requests MinnesotaCare 11 months or more from the last completed application or renewal form.
l The client’s MA/GAMC is closed. The client requests MinnesotaCare 11 months or more from the last completed application or renewal form.
Note: In some situations, MinnesotaCare eligibility must be determined when MA or GAMC is closed. Neither a request from the client nor a new application is required. See Application Not Required and Processing MA/GAMC Annual Renewals.
l The client’s MinnesotaCare is closed. The client requests MinnesotaCare 11 months or more from the last completed application or renewal form.
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.
Application Required for MA and GAMC
Require an application in the following situations:
l The client applies for all MHCP. All MHCP are denied. The client requests MA/GAMC more than 45 days from the date of the last completed application or renewal.
l The client applies for MinnesotaCare only. MinnesotaCare is denied. The client requests MA/GAMC more than 45 days from the date of the last completed application.
l The client’s MA/GAMC is closed. The client requests MA/GAMC after the effective date of MA/GAMC termination.
l The client’s MinnesotaCare is closed. The client requests MA/GAMC more than 45 days from the date of the last completed application or renewal.
Note: In some situations, MA/GAMC eligibility must be determined when MinnesotaCare is closed. Neither a request from the client nor a new application is required. See Application Not Required and Applications after Nonpayment of MinnesotaCare Premium.
l A previously enrolled GHO client is re-hospitalized more than six months from the date of the most recent application.
l People receiving cash or Food Support (FS) 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 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.
l A client’s MinnesotaCare closes for nonpayment of premiums and the client either:
n Did not receive the MinnesotaCare Programs Option letter, or
n Returned their MinnesotaCare Premium Options letter after the due date stated on the letter.
See Applications after Nonpayment of MinnesotaCare Premium for more information.
l An incarcerated individual or the individual’s authorized representative requests MA to be reopened more than 10 days after the date of release. See MHCP and Incarcerated Individuals.
Application Required for Transitional MinnesotaCare
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.