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Effective: December 1, 2006 |
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07.15ar1 - Who May Apply (Archive) |
Archived: February 1, 2008 |
Determining who may apply for health care - whether it is for themselves or others - is a key part of the application process. This section will provide the details on who may apply for themselves or on another's behalf.
Who May Apply - Age 18 and Older.
MinnesotaCare (MCRE) Minor Caretakers.
The following rules apply to clients of all ages:
l Authorized representatives may apply on behalf of clients who have designated them for this function.
l Medical providers may request health care coverage in order to set the date of application for clients who are unable to apply on their own behalf at the time services are being provided.
Note: The minimum information needed to set the application date is the client’s name, address, signature of provider representative, and date.
Who May Apply - Age 18 and Older
Follow these rules when determining who must apply for themselves or on behalf of another person:
l Clients age 18 and older may apply on their own behalf.
l Spouses may apply on the spouse’s behalf, if the other spouse is unable to do so.
l Emancipated minors may apply on their own behalf, for their spouse, and children.
l When people under 18 without children live with parents, relative caretakers, or legal guardians, the adult parent, caretaker or guardian must apply on the minor’s behalf.
Note: For MA, when parents have joint custody, the parent with whom the child spends the most amount of time must apply for the child.
Example:
Desmond, age 15, has lived with his grandmother Shirley for several years. His father, Ken, moves in with the household and two days later Shirley applies for health care for Desmond.
Action:
Although Ken is not required to sign the application, other information, such as income and health insurance availability must be provided.
Example:
Kristin, age 15, lives with her grandmother, Lana.
Action:
Lana must apply for health care on Kristin’s behalf.
l People under age 18 who do not live with a parent, relative caretaker, foster parent, or legal guardian may apply on their own behalf.
If the child under age 18 does not live with parents, guardians, relative caretakers, or in a formal placement arrangement, and is unable to sign for themselves due to age or other circumstance, the person or agency legally responsible for the child must apply.
Note: The child’s parents may be liable for medical support or parental fees if the child is determined eligible for health care.
Make a referral to the county social service agency if a child under 18 appears to be abused or neglected.
n Local agencies should develop their own procedures for social service referrals.
n The social service agency will determine what action, if any, is appropriate.
n Do not delay or deny eligibility pending social services action.
Example:
Abe, age 17, lives in an apartment with an unrelated 19-year-old friend.
Action:
Abe may apply for health care on his own behalf. If he is eligible, determine if either parent is liable for medical support or parental fees.
Example:
Elizabeth, age 16, lives on her own with her infant son, Jeremy.
Action:
Elizabeth may apply for health care for herself and Jeremy. If they are eligible, determine if Elizabeth’s parents are liable for medical support or parental fees. Also make a medical support referral for Jeremy’s father, if applicable.
Example:
Julia attends school out of state. While she is gone a friend she has an informal arrangement with a friend of hers to care for her daughter, Talia, age 10.
Action:
Julia remains Talia’s legal guardian and must apply on her daughter’s behalf or designate an authorized representative for Talia.
l MCRE only: Foster parents may apply for health care on behalf of foster children.
n In most cases, the county social service agency will apply on the child’s behalf.
n See Determining MCRE Household Size for foster parents who wish to include the foster child in their MCRE household.
Minor caretakers have different rules from other people under age 18 regarding whether they may apply on their own behalf or someone must apply for them.
l When a minor caretaker lives with one or both parents, require a parent to apply on behalf of the minor and the minor's child.
Exception: If the parents' income causes ineligibility for the minor caretaker's child or the parents refuse to apply, the minor caretaker may apply for his or her child only. The parents must still apply for the minor caretaker.
Example:
Lauren, age 17, and her two-year-old daughter Sierra live with Lauren's mother, Joanne. Lauren would like to apply for MCRE for Sierra.
Action:
Joanne must file the application. If Joanne's income causes ineligibility for Sierra or Joanne refuses to provide the necessary information, Lauren may then apply for MCRE for only Sierra. Lauren may not receive MCRE for herself separately from Joanne.
l Minor caretakers applying as separate households may apply on their own behalf.
Exception: When minor caretakers live with legal guardians or relative caretakers who choose to include the minor caretaker and minor caretaker's child in their own household, the guardian or caretaker must apply.
Minor Caretakers have different rules from other people under age 18 regarding whether they may apply on their own behalf or someone must apply for them.
l Minor caretakers may apply on behalf of themselves and their children, even if they live with one or more parents. The parent may also apply on their behalf.
Note: Although the minor caretaker may apply for themselves, deeming rules continue to apply.
Example:
Lauren, age 17, and her two-year-old daughter Sierra live with Lauren's mother Joanne. Lauren is requesting MA for herself and Sierra.
Action:
Lauren may apply on her own behalf. Joanne will need to provide income verification since her income must be deemed to Lauren. Joanne’s income will not be deemed to Sierra.
l Minor caretakers who live with legal guardians or relative caretakers, may apply on their own behalf, and that of their child. The guardian or relative caretaker may also apply on their behalf.