Out-of-State Services (Archive)

Minnesota Health Care Programs will pay out-of-state medical providers for medical services provided to Minnesota Health Care Program (MHCP) enrollees only in certain circumstances. Out-of-state health care information for providers is in the MHCP Provider Manual.

Temporary Absence

Enrollees who are temporarily absent from the state may receive health care services when they are out of the state if:

l  the services are due to a medical emergency, or

l  the services are needed and their health would be endangered if they returned to Minnesota to receive services.

Instruct managed care enrollees who report temporary absences to contact their managed care organization (MCO) An organization certified by the Minnesota Department of Health which agrees to provide all defined health care benefits to individuals in return for a capitated payment. MCOs are also referred to as "health plans." for information on receiving out-of-state services. The MCO may require prior authorization for non-emergency services and may have special provisions for payment of emergency services. Additional information is in the Prepaid MHCP Manual.

Minnesota's Responsibility

Some enrollees remain Minnesota's responsibility while living in another state. This includes:

l  Non-IV-E foster children placed in other states under the Interstate Compact. For more information on the Interstate Compact, see the DHS Web site.

l  State adoption assistance children who move to a state that does not exercise the federal option to accept responsibility for state adoption assistance children from other states.

l  Residents of North Dakota nursing homes covered under the Interstate Agreement The agreement between Minnesota and North Dakota to help resolve residence disputes that addresses state financial responsibility for MA eligibility for long-term care..

l  Other enrollees placed in another state by agents of the state of Minnesota.

See State and County Residence for further information.

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