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Effective: April 1, 2010 |
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07.20.55ar2 - Informed Choice (Archive) |
Archived: June 1, 2011 |
Informed choice allows applicants who complete the Minnesota Health Care Programs Application (HCAPP) (DHS-3417) to specify one of two options for health care program eligibility. The HCAPP allows the client to apply for all health care programs or for MinnesotaCare only. Determine eligibility for only the option that the client requests. Determine eligibility in the order listed below. This may require transferring the application to another agency for the eligibility determination. See Shared and Transferred Applications for information on when to transfer these applications.
Note: Other applications, such as the Combined Application Form (CAF) and pre-1/09 versions of the HCAPP, do not ask applicants to specify a choice of health care program. Follow policy in Where to Apply for more information on applications that do not include the informed choice question.
Request for All Programs or No Choice.
Request for MinnesotaCare Only and No Retroactive Coverage.
Request for MinnesotaCare Only and Retroactive Coverage.
Request for MA/GAMC by an Active MinnesotaCare Enrollee.
Request for MA and Medicare Savings Programs (MSP) through Extra Help Application.
Request for All Programs or No Choice
Determine health care eligibility as follows, if a client completes the HCAPP and requests ”All programs” or if no choice is selected:
Note: It may be necessary to transfer the application to another agency for the eligibility determination. See Shared and Transferred Applications.
l First, determine MA and GAMC eligibility.
Exception: Do not determine GAMC eligibility if MA is denied for failure to provide verification or requested information, unless:
r The applicant contacts the agency after receiving the denial notice and specifically asks to have GAMC determined. Explain that the client will need to provide the requested verifications or information before GAMC eligibility can be determined.
r The information is not needed for GAMC.
Note: Do not determine GAMC eligibility if MA is denied for failure to verify assets and the policy in MA Asset Verification Denial/Closure applies.
l Determine MinnesotaCare eligibility for clients who are not eligible for either MA or GAMC.
Exception: Do not determine MinnesotaCare eligibility if MA or GAMC is denied for failure to provide verification or requested information, unless
r The applicant contacts the agency after receiving the MA or GAMC denial notice and specifically asks to have MinnesotaCare eligibility determined. Explain that the client will need to provide the requested verifications or information before MinnesotaCare eligibility can be determined.
r MinnesotaCare does not need the missing information.
Note: Do not determine MinnesotaCare eligibility for adults without children if MA is denied for failure to verify assets and the policy in MA Asset Verification Denial/Closure applies.
Request for MinnesotaCare Only and No Retroactive Coverage
Determine MinnesotaCare eligibility if the client applies on the current HCAPP and requests MinnesotaCare only with no indication of retroactive coverage. Do not determine MA or GAMC eligibility if MinnesotaCare is denied.
Follow these steps if the client applies on the current HCAPP and requests MinnesotaCare only with an indication of retroactive coverage:
Note: It may be necessary to transfer the application to another agency for the eligibility determination. See Shared and Transferred Applications.
l Determine retroactive and ongoing MinnesotaCare eligibility according to policy as outlined in Retroactive MinnesotaCare if an applicant is applying for MinnesotaCare within 30 days after MA or GAMC closure.
l Follow the policy in MinnesotaCare with Retroactive MA if an applicant does not meet the criteria for retroactive MinnesotaCare.
Request for MA/GAMC by an Active MinnesotaCare Enrollee
An active MinnesotaCare enrollee may request a determination of MA eligibility at any time. The request may be made in person, via phone or in writing. Follow the policies in Application Required, Application Not Required, Date of Application, and Applications.
Clients who apply for Extra Help with Medicare Part D costs through the Social Security Administration (SSA) can have their Extra Help application data transmitted by SSA to initiate an application for MA or MSP eligibility. See Applications for Minnesota Health Care Programs (MHCP) - SSA Data as a Request for MHCP for more information.