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Effective: March 1, 2009 |
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08.20.05ar2 - Processing MinnesotaCare Renewals (Archive) |
Archived: July 1, 2009 |
There are some similarities between processing renewals for MCRE and processing them for MA/GAMC. This section provides information on processing a MCRE renewal.
MCRE Renewal Processing Steps.
A complete renewal includes all of the following:
l A completed MHCP Renewal Form (DHS-3418). See Renewal Forms for more information on the renewal form and MinnesotaCare Renewals for information on what must be sent with it.
l A signature for everyone required to sign. See Renewal Signature for specific policy on who must sign the renewal form.
l Required verifications and any information needed to redetermine eligibility.
Accept and process faxed renewals.
Follow these steps to process a MCRE renewal:
1. Process renewals in the order they are received. Give priority to processing renewals to avoid a gap in coverage.
Note: If possible, process the renewal before MCRE billing (cutoff) to ensure continuous coverage and allow the client time to pay the new premium amount.
2. Review the renewal form.
l Review the renewal for missing data, verifications and the following:
n Address changes.
n Household member changes. See Adding a Household Member and Removing a Household Member.
n Pregnancy reported. Consider the woman to be pregnant upon reporting and request verification.
n Insurance changes. Request verification of access to ESI for each employer as required.
Note: This may include changes in eligibility for household members based on insurance already on file, or new insurance being reported.
n Assets.
n Income. Request verifications.
Note: For households previously determined to have excess income for MCRE, determine if the household continues to have excess income. If the household continues to have excess income, see Excess Income – MCRE for more details on how to process eligibility.
n Changes in parental status and medical support. Follow required steps.
n Required signatures.
l Contact the enrollee to obtain any missing information or verifications.
l The household has until the redetermination date to provide the necessary information to ensure continuous coverage for renewals pending additional information.
3. Enter the date the renewal was received on MMIS as soon as it is received and reviewed.
Note: Once the renewal received date is entered into MMIS it sets a new redetermination date. Be sure to process the renewal to completion (do not leave it incomplete). The system cannot automatically close a case that has had the redetermination date updated.
4. Redetermine MCRE eligibility.
l If the household has completed the renewal and sent in all required information and verifications timely and:
n The household is eligible, approve the renewal.
n The household is not eligible, close the household for the end of the month before the renewal month using the appropriate closing code.
m If the worker does not have time to process the renewal, contact MMIS User Services to extend the renewal for an additional month at the old premium rate. The household may be reinstated.
m If the renewal is being processed at the county determine eligibility for MA/GAMC.
l If information and verifications are incomplete, close the household with an incomplete code (C48).
l MMIS will automatically generate a closing notice if the renewal has not been processed (approved or closed) by the MCRE billing (cutoff) prior to the renewal month.
Renewals are late if they are received after the redetermination date. Depending on when the renewals are received at the agency, process late renewals as follows:
l Renewal is received in the renewal month: consider it a new application.
Example:
The Hogans’ renewal month is August. The renewal is sent to them 45 days before the redetermination date (May). The renewal must be received by July 31 for continued eligibility in August. The Hogans do not return the renewal form until August 15.
Action:
Process the renewal as a new application. The application date is August 15. The first month the Hogans can possibly receive MCRE coverage is September, if the renewal is complete and the premium is paid. They will not have coverage for August.
Reminder: The Hogans may request retroactive MA for August if they have medical expenses for that month.
l Renewal is received after the renewal month, but within 11 months of termination: consider it a new application and update the information on the renewal form with the client. Do not require a new application.
n See Application Not Required and Updating an Application for more information.
l Renewal is received more than 11 months since termination: a new application may be needed. See Application Required.