Notification sent to the client at least ten calendar days before the effective date of an agency action. Most adverse actions, such as denial, reduction, or termination of health care benefits, require ten-day notice.
Provisions of the Social Security Act which allow certain employed people who would otherwise be ineligible to retain SSI status. The Social Security Administration certifies people for 1619(a) and 1619(b) eligibility. People with 1619(a) or 1619(b) status retain their MA eligibility under the SSI-related category if they received MA the month before certification for 1619(a) or 1619(b).
A provision allowing continued SSI and MA eligibility for people who would otherwise lose SSI because of a demonstrated ability to work.
A provision allowing continued MA eligibility for people who become ineligible for SSI benefits under 1619(a) due to excess income.
One of the insurance barriers for MinnesotaCare. The 18-month rule requires that some people cannot have current coverage or access to ESI. It also restricts eligibility for some people who have had access to ESI in the past 18 months if the client stopped the insurance or if the employer chose to drop coverage.
One of the insurance barriers for MinnesotaCare. The four-month rule requires some people to have been uninsured for four months before they can enroll in MinnesotaCare.
A defined contribution plan whereby employees can elect to defer receiving a portion of their salary, which is instead contributed on their behalf, pre-tax, to the 401(k) plan. Sometimes the employer may match these contributions.
Also referred to as Tax Sheltered Annuities, 403(b) plans are tax-deferred retirement plans available to employees of educational institutions and certain nonprofit organizations.
A deferred compensation program made available to employees of state and federal governments and agencies. A 457 plan is similar to a 401(k) plan. Distributions start at retirement age, but participants can also take distributions if they change jobs or in certain emergencies. Participants can choose to take distributions as a lump sum, annual installments or as an annuity.
The period of coverage that begins the last day of the pregnancy and ends the last day of the month in which a 60-day period, beginning on the last day of the pregnancy, ends.
Obsolete term for non-custodial parent. A parent who does not have physical custody of a child.
Alternative Care. A state-funded program, administered by county social services agencies, which provides home and community-based services for clients age 65 or older in an effort to keep the client in the community and avoid a nursing facility placement.
Transportation and services needed to help clients obtain medically necessary health care. These services may be provided by a health plan, a county agency or MinnesotaCare Operations.
The first phase of a deferred annuity during which the contract accumulates funds from the payments made into the annuity and accrues interest and earnings on investments.
A legal Declaration of Parentage (DOP) or Recognition of Parentage (ROP) signed by both the mother and father of a child born to a woman who was not married to the child's father when the child was conceived nor when the child was born, declaring that they are the biological parents of the child. The DOP is valid only if it was executed before August 1, 1995. For documents executed on or after August 1, 1995, only the ROP is valid.
Income a client concretely receives.
An annuity is actuarially sound if the cash value as of the date of annuitization is expected to pay out in full within the expected lifetime of the person requesting MA payment of LTC services or his or her spouse.
Obsolete.
Receipt of the fair market value, or other compensation equal to the fair market value, in exchange for the transfer or sale of real or personal property.
A notice sent no later than the date of action.
Determination of the identity of a child's father by a court.
An adoption assistance grant provided to adoptive parents. It is funded either federally through Title IV-E of the Social Security Act or by the State under Minnesota Statutes, section 259.67.
Annuity-Funded Burial. An annuity contract with an irrevocable designation of the cash surrender value (CSV) to a funeral provider as the primary beneficiary. The value of the contract is to be paid to a funeral provider in exchange for agreed-upon goods and services.
Aid to Families with Dependent Children. The program formerly authorized under Title IV-A of the Social Security Act to provide financial assistance and social services to needy families with dependent children. AFDC was replaced by the Temporary Assistance to Needy Families (TANF) block grant in 1996. Minnesota's TANF program is the Minnesota Family Investment Program (MFIP).
A method of recovering MA payments from the assets/estate of a deceased person when a probate has not been commenced.
Age 65 or older. Used interchangeably with elderly.
See County of Financial Responsibility.
The property located on agricultural land that meets the definition of \"home\" and includes the dwelling, the garage, if any, and one acre of land immediately surrounding the dwelling.
A contiguous acreage, of 10 acres or more, used during the preceding year for agricultural purposes, or a contiguous acreage, of less than 10 acres, which is exclusively and intensively used for raising or cultivating agricultural products.
Examples of agricultural products include but are not limited to livestock, dairy animals and products, poultry animals and products, fur-bearing animals, horticultural and nursery stock, fruits, vegetables, forage, grains, bees, and apiary products.
Use of property for the production of products or services offered for sale by the owner.
Agricultural services include, but are not limited to: 1) Commercial boarding of horses if the boarding is done in conjunction with raising or cultivating agricultural products. 2) Fish bred for sale and consumption if the fish breeding occurs on land zoned for agricultural use. 3) Property which is owned and operated by nonprofit organizations used for equestrian activities, excluding racing. 4) Game birds and waterfowl bred and raised for use on a shooting preserve. 5) Insects primarily bred to be used as food for animals. 6) Trees, grown for sale as a crop, and not sold for timber, lumber, wood or wood products. 7) Maple syrup taken from trees grown by a person licensed by the Minnesota Department of Agriculture as a food processor. 8) Enrollment in the Reinvest in Minnesota program or the federal Conservation Reserve Program. 9) Leasing all or a portion of the property to another person for agricultural purposes.
The program formerly authorized under Title IV-A of the Social Security Act to provide financial assistance and social services to needy families with dependent children. AFDC was replaced by the Temporary Assistance to Needy Families (TANF) block grant in 1996. Minnesota's TANF program is the Minnesota Family Investment Program (MFIP).
Obsolete term for spousal maintenance. An allowance for support that a court orders a person to pay to his or her current or former spouse.
A deduction from the income of a long-term care facility resident or a person receiving Elderly Waiver services for the maintenance needs of certain relatives.
A state-funded program, administered by county social services agencies, which provides home and community-based services for clients age 65 or older in an effort to keep the client in the community and avoid a nursing facility placement.
A person who is a member of a federally recognized Indian tribe, considered by the Secretary of the Interior to be an Indian for any purpose, or is determined to be an Indian under regulations promulgated by the U.S. Secretary of Health and Human Services.
A deduction for costs of starting a business that is deducted from the business income over a period of time.
The person(s) upon whose life expectancy annuity payments are based. Multiple annuitants in an annuity contract are commonly referred to as joint annuitants or co-annuitants. Not all annuity payments are based upon a person’s life expectancy. See “term certain annuity.” Annuitant sometimes refers to a person who receives periodic payments from an annuity.
The point in time when an annuity's settlement option is chosen.
The second phase of a deferred annuity during which the owner chooses a periodic payment option, also called a “settlement option.” At the time the payment option is chosen, the owner chooses the amount of each payment, how often the payments are to be made, and the length of time over which the payments are to be made. Selecting the settlement option is referred to as “annuitization” or “annuitizing the annuity” (also called the “Payout Phase”).
A purchased contract in which one party (annuity issuer) agrees to pay the purchaser, or the person(s) the purchaser designates (the payee or payees), a return on money deposited with the annuity issuer (either in the form of a single lump sum or several payments deposited over several months or years) according to the terms of the annuity contract.
A person or entity (an insurance company) that manages an annuity. The annuity issuer accepts funds from the owner(s) during the accumulation phase and issues payments after the funds have been annuitized. Banks and financial planners often sell annuity arrangements; however, insurance companies issue annuity-based financial arrangements.
Person(s) who may exercise rights provided in the annuity contract. For example, the owner(s) names the payee(s) who can be an owner or other parties, chooses the settlement option, and names the beneficiaries.
An annuity contract with an irrevocable designation of the cash surrender value (CSV) to a funeral provider as the primary beneficiary. The value of the contract is to be paid to a funeral provider in exchange for agreed-upon goods and services.
Income the client can reasonably expect to receive in the future.
A client's or authorized representative's request to the State of Minnesota appeals section for review of the state or a county agency’s action or inaction or for review of a managed care health plan's medical service or payment issues. Also known as a Fair Hearing.
A person who has submitted a request for coverage for whom no decision has been made regarding eligibility.
Any of several forms prescribed by the commissioner of DHS which people must complete to apply for health care coverage.
A person chosen by the applicant to assist with the application process. The application assistor performs activities such as helping complete forms and obtain verification, but cannot sign the application unless designated as the authorized representative. Require a signed release form (DHS-3549) to release information to the application assistor.
A secure, web-based application used to apply for Minnesota Health Care Programs (MHCP) including payment of long-term care services, cash assistance, Supplemental Nutrition Assistance Program (SNAP), Child Care Assistance Program (CCAP) and emergency help.
Payments of child support which were due for a prior period.
A change from one type of asset to another.
The amount of net countable assets a client may own or have available to them and remain eligible for a health care program.
Real and personal property owned wholly or in part by the client.
To transfer legal claim, such as assignment of benefits available through other health coverage or medical support.
A Minnesota Health Care Program household member whose health care expenses are used to meet another household member's medical spenddown.
A person authorized to act on a client's behalf for any of the Minnesota Health Care Programs (MHCP). An authorized representative may be designated by the client and may exercise all the rights and responsibilities of a client.
A basis of eligibility for a child who receives automatic MA or MCRE eligibility through the month of his or her first birthday. The child's mother must have been enrolled in a Minnesota Health Care Program during the month of birth and the child must continue to live in Minnesota.
Client's ability to gain access to income or to use, sell, or liquidate assets.
A lump-sum payment scheduled at the end of a series of smaller periodic payments that is selected as part of a payment agreement.
MA coverage for services not related to skilled nursing facility care, nursing facility care in an inpatient medical hospital or intermediate care facility (ICF, ICF/DD), or services covered by home and community-based waiver programs.
An identifying characteristic of a category of people specified as potentially eligible for Medical Assistance (MA). People without one of the specified characteristics are ineligible for MA but may be eligible for MinnesotaCare.
A noncitizen who is the spouse or child of a U.S. citizen or Lawful Permanent Resident (LPR) and who has been battered or subject to extreme cruelty in the U.S. by a family member residing in the same household.
A public or private nonprofit crisis shelter, housing network or other shelter facility providing services to battered women and their children.
Beneficiary Earnings and Exchange Record. A monthly IEVS tape exchange between the Social Security Administration and DHS reporting wages, self-employment, and federal pension earnings from federal tax returns. The original source is the Internal Revenue Service.
A prescription drug coverage plan that has been designated by Medicare to meet certain coverage requirements and which has a monthly premium that is fully subsidized by Extra Help.
The person named to receive benefits or payments (for example, social security payments or payments from a life insurance policy or trust). For annuities, a beneficiary is the individual, trust, or entity named by the annuity owner to receive death benefits from an annuity.
A monthly IEVS tape exchange between the Social Security Administration and DHS. The report provides information on RSDI and Medicare.
A monthly IEVS tape exchange between the Social Security Administration and DHS reporting wages, self-employment, and federal pension earnings from federal tax returns. The original source is the Internal Revenue Service.
A section of DHS which pursues collection of third party payments and determines if health insurance is cost-effective.
Burial Fund Exclusion. Allows clients to set aside, or designate, up to $1500 in assets to cover certain burial expenses. Assets designated toward the BFE are not counted in the client's net asset total.
Brain Injury. An MA waiver program for people diagnosed with a brain injury.
A basis of eligibility for a person without vision, or who meets specific limited-vision conditions.
Beneficiary Data Exchange. A monthly IEVS tape exchange between the Social Security Administration and DHS. The report provides information on RSDI and Medicare.
A facility that serves as an alternative to institutionalization and provides a program of on-site care or supervision to persons who cannot live independently because of age or physical, mental or emotional disability.
An MA waiver program for people diagnosed with a brain injury.
A gap of one calendar month or more in receiving MA payment of LTC services because the individual either: 1. Became ineligible for MA payment of LTC services; or 2. Stopped residing in a LTC facility or receiving services through a home and community-based waiver program.
Benefit Recovery Section. A section of DHS which pursues collection of third party payments and determines if health insurance is cost-effective.
Burial Space. Any repository for the remains of the deceased such as cemetery plots, urns, niches, crypts, and caskets.
Burial Space Items. Items which add to or improve burial spaces such as markers, engraving, vaults, opening and closing of the grave, and one time charges for preservation/care of the space (perpetual care).
See Certification Period.
An arrangement in which funds are deposited with a funeral director to be used for funeral expenses. The agreement may cover funeral and professional services, burial space items, or both. The money is usually held in trust by a bank or other financial institution unless the agreement is funded by an insurance policy or annuity. Burial agreements may be revocable or irrevocable.
The Burial Fund Exclusion (BFE) allows clients to set aside, or designate, up to $1500 in assets to cover certain burial expenses. Assets designated toward the BFE are not counted in the client's net asset total.
Funds paid or designated in advance for funeral expenses, including but not limited to burial agreements. Burial funds provide for preparation of the body, cremation, or burial services.
These are services which are pre-paid in a burial agreement.
Any repository for the remains of the deceased such as cemetery plots, urns, niches, crypts, and caskets.
Items which add to or improve burial spaces such as markers, engraving, vaults, opening and closing of the grave, and one-time charges for preservation/care of the space (perpetual care).
Any weekday (Monday through Friday) that does not fall on a state holiday.
The process of having some or all of the client’s Medicare costs paid through MA.
A corporation in which shareholders receive profits in the form of dividends. Shareholders who perform work for the corporation also receive wages. The corporation must file a corporate tax return.
Child and Teen Checkups. A component of MA and MinnesotaCare that promotes preventive health care for children from birth to age 21. This program is federally known as the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Program.
Community Alternative Care. A federally approved home and community-based services waiver program for chronically ill people under age 65.
Community Alternatives for Disabled Individuals. A federally approved home and community-based waiver program for people under age 65 who would otherwise require the level of care provided in a nursing facility.
Combined Application Form. A form on which people can apply for multiple programs administered by DHS, including but not limited to General Assistance (GA), Supplemental Nutrition Assistance Program (SNAP), Minnesota Family Investment Program (MFIP), Medical Assistance (MA), Minnesota Supplemental Aid (MSA), and Emergency Medical Assistance (EMA).
Cash Advance Items. Items pre-paid in a burial agreement for items above and beyond basic burial services such as flowers, music, obituary notices and motor escort.
Real or personal property used in a trade or business with a useful life of one year or more.
Payment made to purchase or improve property with a useful life of more than one year.
Profit from the sale or exchange of business or personal assets. An asset owned and sold within a year is a short-term capital gain. An asset owned for more than one year is a long-term capital gain.
Loss from the sale or exchange of business or personal assets. An asset owned and sold within a year is a short-term capital loss. An asset owned for more than one year and sold is a long-term capital loss.
A method of payment for health services that involves a monthly per person rate paid on a prospective basis to a managed care organization. Capitation occurs six business days before the end of the month.
The monthly date on which DHS sends capitation payments to health plans.
Obsolete term for caretaker.
A person who provides care and support to a minor child. The person may or may not be covered and may or may not be considered part of the child's household.
A federal tax deduction used when allowable business deductions exceed gross receipts for the tax year. The business loss may be carried over into future years.
1. A method of providing health care in which the managed health care organization (MCO) coordinates the provision of health services to a managed care enrollee. 2. Services not normally covered by MA that may be covered under a waiver for people with severe and persistent mental illness.
Cash includes currency, checks, liquid assets, and money orders.
Items pre-paid in a burial agreement for items above and beyond basic burial services such as flowers, music, obituary notices and motor escort.
General Assistance (GA), Group Residential Housing (GRH), Minnesota Family Investment Program (MFIP), Minnesota Supplemental Aid (MSA), Refugee Cash Assistance (RCA) and emergency cash programs.
The amount the life insurance policy owner, including an annuity owner, would receive if the policy were cashed in.
A lawsuit.
Continuing Care Retirement Community. An organization that enters into a written contract with a client to offer a range of continuing care services while providing flexible accommodations, which may change with the client's needs. A CCRC may also be referred to as a life care community.
Certificate of Deposit. A promissory note issued by a bank entitling the bearer to receive interest. A CD is a time deposit that restricts holders from withdrawing funds on demand. Although it is still possible to withdraw money, this action will often incur a penalty.
A Minnesota-based private, nonprofit, nonpartisan organization founded in 1985. CVT exists to heal the wounds of government-sponsored torture on individuals, their families, and communities and to stop its practice.
Administers the Medicare program and works in partnership with the States to administer Medicaid and other programs. Formerly known as HCFA.
A summary of a health insurance plan's covered services, grievance and appeal processes for the policyholder. Also referred to as member contract or evidence of coverage, provided by the managed care organization.
Documentation of a person's creditable coverage. People can present certificates of creditable coverage to their new health plans to prove that they had previous coverage.
A promissory note issued by a bank entitling the bearer to receive interest. A CD is a time deposit that restricts holders from withdrawing funds on demand. Although it is still possible to withdraw money, this action will often incur a penalty.
The period of time (up to 12 months) for which eligibility is determined. The certification period may include any retroactive months of eligibility. It is also the period of time for which income is calculated to determine income eligibility and premium or spenddown amounts.
A family planning services provider who is approved by DHS to make presumptive eligibility determinations for the Minnesota Family Planning Program.
Former name of TRICARE. A Department of Defense health insurance program providing coverage to active-duty and non-active duty members of the armed forces and their dependents, and certain civilian employees. This program was formerly known as CHAMPUS.
A Department of Veterans' Affairs program that provides health care coverage for the spouse and children of certain disabled or deceased veterans. This coverage is provided for these family members if they are not eligible for TRICARE benefits.
A person under age 21.
A component of MA and MinnesotaCare that promotes preventive health care for children from birth to age 21. This program is federally known as the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Program.
Program available to help low- and moderate-income families pursue employment or education leading to economic self-sufficiency by subsidizing their child care.
A voluntary or court-ordered payment by non-custodial parents for the support of their children.
The Centers for Medicare and Medicaid Services (CMS) administers the Children's Health Insurance Program (CHIP). This program provides federal matching funds to help states expand health care coverage for the nation's uninsured children.
The forerunner of the MinnesotaCare program. CHP began in 1988 and provided comprehensive outpatient health care coverage for children ages 1-17. It was discontinued in 1993, and all children covered at that time were converted to MinnesotaCare.
Children's Health Insurance Program. The Centers for Medicare and Medicaid Services (CMS) administers the Children's Health Insurance Program (CHIP). This program provides federal matching funds to help states expand health care coverage for the nation's uninsured children.
Children's Health Plan. The forerunner of the MinnesotaCare program. CHP began in 1988 and provided comprehensive outpatient health care coverage for children ages 1-17. It was discontinued in 1993, and all children covered at that time were converted to MinnesotaCare.
Recovery of an overpayment through the civil judicial process rather than the criminal process.
A list of amounts the State of Minnesota has paid for medical services, whether it be the capitation amount or the actual cost of fee-for-service expenses.
A person who is an applicant or enrollee.
A method for clients to pre-pay a medical spenddown to DHS. Is only available to clients with an automated monthly spenddown.
The amount of monthly income institutionalized clients may keep or receive for their day-to-day expenses.
Centers for Medicare and Medicaid Services. Administers the Medicare program and works in partnership with the States to administer Medicaid and other programs. Formerly known as HCFA.
A fixed amount a person is required to pay for each episode of a particular treatment, medical supply, or equipment. For example, a policy might require a $5 co-payment for each prescription while the insurance pays the remainder.
A provision of the Consolidated Omnibus Budget Reconciliation Act (COBRA) which requires employers to allow former employees to continue coverage through the employer's group plan for 18 months after the employment has ended (29 months if the employee is disabled). In most cases, the former employee must pay the full cost of COBRA coverage.
Certificate of Coverage. A summary of a health insurance plan's covered services, grievance and appeal processes for the policyholder. Also referred to as member contract or evidence of coverage, provided by the managed care organization.
Certificate of Creditable Coverage. Documentation of a person's creditable coverage. People can present certificates of creditable coverage to their new health plans to prove that they had previous coverage.
An insured person's share of the cost of treatment. For example, if an insurance policy covers 80% of the cost, the co-insurance amount is 20%.
Cost-of-Living Adjustment. An increase in income to compensate for inflation.
The difference between a client’s long-term care (LTC) spenddown and the cost of the client’s LTC or Elderly Waiver (EW) services. A client must have incurred medical expenses, in addition to the cost of LTC or EW services, in an amount equal to or greater than the combination LTC/medical spenddown to become eligible for MA.
A form on which people can apply for multiple programs administered by DHS, including but not limited to General Assistance (GA), Supplemental Nutrition Assistance Program (SNAP), Minnesota Family Investment Program (MFIP), Medical Assistance (MA), Minnesota Supplemental Aid (MSA), and Emergency Medical Assistance (EMA).
An annuity that is purchased and set up via an insurance company or financial institution licensed or regulated by the Minnesota Department of Commerce or a similar agency of another state.
A federally approved home and community-based services waiver program for chronically ill people under age 65.
A federally approved home and community-based waiver program for people under age 65 who would otherwise require the level of care provided in a nursing facility.
A person who does not reside in a long-term care facility (LTCF) or receive services through a waiver program (EW, CAC, CADI, DD or BI) who is married to a long-term care (LTC) spouse. A community spouse may receive Medical Assistance (MA) or services through the Alternative Care (AC) program.
The calculated amount of income needed by the community spouse. It is an amount up to the maximum monthly income allowance, or the minimum monthly income allowance plus any excess shelter expenses.
A term used by insurance companies to describe a broad range of covered services including the diagnosis and treatment of most illnesses and injuries. Coverage may vary under individual policies.
Data about individuals that even the individuals themselves cannot access, such as information from an investigation about welfare fraud or adoption records.
A person, official, or institution appointed by the court to perform financial functions such as contracting, paying bills and investing assets for a minor or incapacitated person, known as the conservatee or protected person.
An organization that enters into a written contract with a client to offer a range of continuing care services while providing flexible accommodations, which may change with the client's needs. A CCRC may also be referred to as a life care community.
Enrollment in MinnesotaCare or Medical Assistance (MA) without a break in coverage of one month or more.
At least 30 consecutive days of either institutional care in a long-term care facility (LTCF) or receipt of services, based on a documented need, of nursing facility level of care that would qualify for payment by the Elderly Waiver (EW) or Alternative Care (AC) programs; or a combination of both a stay in an LTCF and receipt of services that would qualify for payment by the EW or AC programs that is at least 30 consecutive days.
A written obligation by a seller to deliver the deed to the property when certain conditions have been met, such as completion of payments by the purchaser. A contract for deed is a type of mortgage in that it places an encumbrance on the land.
These plans include a network of providers that contract with a Medicare Advantage organization to deliver a federally-approved benefit package.
Children's Health Insurance Program. The Centers for Medicare and Medicaid Services (CMS) administers the Children's Health Insurance Program (CHIP). This program provides federal matching funds to help states expand health care coverage for the nation's uninsured children.
Employer-Subsidized Insurance. Insurance coverage offered to employees or dependents for whom the employer or union pays at least 50% of the cost of coverage.
Income and/or assets that form the main body of a trust. Assets or income in the trust corpus may be available to a person but the person no longer owns them. Also known as the trust principal.
Other health care coverage for which the amount paid for premiums, coinsurance, deductibles, and other costs is likely to be less than the amount paid by MA for equivalent services.
An increase in income to compensate for inflation.
An enrollee's financial responsibility for health care program coverage, such as a co-payment, coinsurance, or premium.
The local human services office responsible for determining eligibility for Minnesota Health Care Programs.
The county responsible for the county costs of an enrollee’s MA.
The county responsible for servicing the Medical Assistance (MA) case.
An option that allows counties to choose to assume the responsibility for purchasing health services for enrollees who are eligible for PMAP.
Creditable coverage gives people credit for previous health insurance coverage when they move to new health plans to reduce the exclusion period that may be imposed due to pre-existing conditions. A person with creditable coverage must be allowed special enrollment in a health plan at a time other than the employer's open enrollment period.
This type of burial agreement is an agreement in which funds are pre-paid for burial through a cremation society.
Cash Surrender Value. The amount the life insurance policy owner, including an annuity owner, would receive if the policy were cashed in.
The household of a MinnesotaCare applicant in which at least one other household member is eligible for MHCP, SNAP, or a cash assistance program; is being terminated from MHCP or MFIP; or is being denied MHCP coverage.
A parent who has physical custody of his or her minor child.
The date by which information must be entered in the health care eligibility system to effect a change for the following month.
Center for Victims of Torture. A Minnesota-based private, nonprofit, nonpartisan organization founded in 1985. CVT exists to heal the wounds of government-sponsored torture on individuals, their families, and communities and to stop its practice.
Services for adults with developmental disabilities that: 1) include supervision, training, assistance, and supported employment, work-related activities, or other community-integrated activities designed and implemented in accordance with the individual service and individual habilitation plans required under Minnesota Rules, parts 9525.0015 to 9525.0165, to help an adult reach and maintain the highest possible level of independence, productivity, and integration into the community; and 2) are provided under contract with the county where the services are delivered by a vendor licensed under sections 245A.01 to 245A.16 and 252.28, subdivision 2, to provide day training and habilitation services.
Developmental Disabilities Waiver. A federally approved home and community-based services program for children and adults with mental retardation or a related condition who need the level of care provided in an Intermediate Care Facility for Persons with Mental Retardation or Related Conditions (ICF/MR).
A form that serves as an acknowledgement of paternity. This form may be signed before or after the child's birth. To be valid it must have been executed before August 1, 1995. Notarized signatures of both parents must be on the form.
The amount of health care expenses an insured person is required to incur before benefits are payable under a health insurance policy. For example, if an insured person has a $1000 deductible, he or she must incur $1000 in medical costs before the policy begins paying benefits.
An amount allowed to reduce a person's total net income because its use or intended use is for certain specific expenses.
Legal document which conveys ownership of property between parties.
To count the income or assets of one person when determining the eligibility of another.
A qualified employer plan that maintains a separate account or annuity to receive voluntary employee contributions to facilitate employee retirement savings.
An individual who for MA purposes is considered to be receiving SSI. This includes people eligible under 1619(a) and (b); children eligible under the TEFRA waiver; people eligible for the Pickle disregard; Disabled Adult Children; Disabled Widows and Widowers; and people not receiving SSI payment because of recoupment or one-month suspension due to excess income.
An annuity contract under which periodic payments will begin sometime in the future. A deferred annuity contract provides the purchaser with the opportunity to accumulate savings over an extended period before the contract enters its payout phase. A deferred annuity has two phases: 1) the accumulation phase; and 2) the annuitization phase (also called the payout phase).
The act of disapproving an application, a request to add a person to coverage, or a request for specific medical services.
An income deduction based on the cost of caring for a child or adult.
A child who lives with a parent, legal guardian, relative caretaker or foster parent and is under age 18 or 18 years old, a full-time student, expected to graduate by age 19.
Health insurance coverage offered or provided to the insured's specified dependents.
A federal income tax deduction for the cost of a business asset that gradually loses value through the wear and tear of use.
A method for clients to pay their waiver obligation or medical spenddown to a chosen provider. Clients who receive certain types of services may choose the designated provider option. Clients with long-term care spenddowns must use this option.
A federally approved home and community-based services program for children and adults with mental retardation or a related condition who need the level of care provided in an Intermediate Care Facility for Persons with Mental Retardation or Related Conditions (ICF/MR).
People diagnosed with mental retardation or a related condition who have substantial functional limitations or deficits in adaptive behavior and who manifest these conditions before their 21st birthday.
The Minnesota Department of Human Services.
The DHS Systems Information Resource (SIR) provides system availability information, announcements, and targeted links and content. A login ID and password are required for access.
A basis of eligibility based on the Social Security Administration (SSA) disability standards. Disability may be determined by the SSA or the State Medical Review Team (SMRT).
A policy which pays a fixed amount of income to a person who becomes disabled under the terms of the policy. Disability insurance is intended as an income replacement and is not health insurance.
Any payment from a trust, including, but not limited to, cash and other liquid items, personal property, real property or the right to use and occupy real property.
A trust authorizing the trustee to use full discretion to determine how much is paid out from the trust.
An amount not counted when determining a person's total net income.
The amount of the profit distribution a shareholder receives or the amount of the surplus distribution a policyholder of a participating insurance policy receives.
Dividends that the policy holder has left in the custody of the insurer to accumulate interest.
Amounts of additional life insurance purchased with dividends.
Declaration of Parentage. A form that serves as an acknowledgement of paternity. This form may be signed before or after the child's birth. To be valid it must have been executed before August 1, 1995. Notarized signatures of both parents must be on the form.
Day Training and Habilitation. Services for adults with developmental disabilities that: 1) include supervision, training, assistance, and supported employment, work-related activities, or other community-integrated activities designed and implemented in accordance with the individual service and individual habilitation plans required under Minnesota Rules, parts 9525.0015 to 9525.0165, to help an adult reach and maintain the highest possible level of independence, productivity, and integration into the community; and 2) are provided under contract with the county where the services are delivered by a vendor licensed under sections 245A.01 to 245A.16 and 252.28, subdivision 2, to provide day training and habilitation services.
People enrolled in Medicare Part A or B simultaneously with MA or any of the Medicare savings programs.
Money received from employment or self-employment. This includes but is not limited to salaries, wages, tips, commissions, vacation, and sick pay.
A federal tax credit given to low income people. Household members may receive an EIC once a year as a refund or as an advance payment or tax reduction with each paycheck.
An amount deducted from earned income, as an employment incentive, when determining a client's total net income.
The time period during which the earned income disregard is applied.
The begin date of a specific action such as an approval, denial, closure or other change in eligibility or coverage.
One of the insurance barriers for MinnesotaCare. The 18-month rule requires that some people cannot have current coverage or access to ESI. It also restricts eligibility for some people who have had access to ESI in the past 18 months if the client stopped the insurance or if the employer chose to drop coverage.
Age 65 or older. Used interchangeably with aged.
An MA waiver program providing home and community-based services for clients age 65 or older who need a nursing home level of care to enable them to stay in the community.
The date a client is eligible for coverage under the Minnesota Health Care Programs.
One of four groups assigned to a MinnesotaCare enrollee based on certain factors. The eligibility group determines the eligibility requirements that apply to MinnesotaCare applicants and enrollees.
DHS's system to verify an enrollee's coverage and eligibility dates under the Minnesota Health Care Programs. Providers contact EVS by phone or online to confirm eligibility.
A person under the age of 18 who is or was married, is on active duty in the uniformed services, or has been declared emancipated by a court. In Minnesota, a person is an adult at age 18 and adults are considered \"emancipated\" from their parents.
A person has been admitted or held for emergency care and treatment due to mental illness, developmental disability or chemical dependency and is in danger of causing injury to self or others.
A facility that provides shelter when an individual or family loses their housing due to an emergency, such as a fire, flood or condemnation.
A form of defined contribution plan in which the investments are primarily in employer stock.
Insurance coverage offered to employees or dependents for whom the employer or union pays at least 50% of the cost of coverage.
Estimated Market Value. The value assigned to real estate by the county assessor for the purpose of levying property taxes. EMV is found on the annual property tax assessment statement.
A legal claim against real or personal property payable when the property is sold.
A person receiving coverage through a Minnesota Health Care Program or a managed care organization (MCO).
The total amount of payments, and/or the value of property, made or promised as full or partial consideration for acceptance into or maintaining residence in a continuing care retirement community (CCRC).
Explanation of Medical Benefits. A statement from DHS, an insurance company, or a health plan reporting amounts paid, reduced, or denied for the client's health care expenses.
The fair market value of real or personal property minus any encumbrances.
A deed, bond, money, or piece of property held in trust by a third party to be turned over to the grantee only on fulfillment of a condition.
Employer-Subsidized Insurance. Insurance coverage offered to employees or dependents for whom the employer or union pays at least 50% of the cost of coverage.
Employee Stock Ownership Plan. A form of defined contribution plan in which the investments are primarily in employer stock.
On or after August 1, 2003: Estate is defined as the probate estate under Minnesota Statutes, Chapter 524, along with all of the person's interest established on or after August 1, 2003; or proceeds from those interests in real property owned by the person as a life tenant or joint tenant with the right of survivorship at the time of death, and to the extent the following interests become part of the probate estate, all interests or proceeds of those interests in securities owned by the person in beneficiary form and all interests in joint accounts, multiple party accounts, and pay on death accounts or proceeds of those accounts are subject to estate recovery. Prior to August 1, 2003: Estate is defined as described and used in Minnesota Statutes Chapter 524, Uniform Probate Code.
A method of recovering MA from the estate of a deceased person.
The value assigned to real estate by the county assessor for the purpose of levying property taxes. EMV is found on the annual property tax assessment statement.
Eligibility Verification System. DHS's system to verify an enrollee's coverage and eligibility dates under the Minnesota Health Care Programs. Providers contact EVS by phone or online to confirm eligibility.
Elderly Waiver. An MA waiver program providing home and community-based services for clients age 65 or older who need a nursing home level of care to enable them to stay in the community.
The amount of total countable assets which exceed the client's asset limit.
Income not counted in determining a client's total net income.
A service or living arrangement which is a factor in determining a client's county of financial responsibility.
A provision in a trust that provides for the suspension, termination, limitation or diversion of the principal, income or beneficial interest of a beneficiary if the beneficiary applies for, and is determined eligible for or receives public assistance.
A statement from DHS, an insurance company, or a health plan reporting amounts paid, reduced, or denied for the client's health care expenses.
A Medicare Part D cost-sharing subsidy program. Full-benefit, dual eligible enrollees are automatically eligible for the full Extra Help subsidy. Others may apply to the Social Security Administration for full or partial Extra Help subsidies.
The policy’s death benefit (the amount paid out at the death of the insured) at the time a life insurance policy is purchased.
The price an item would sell for on the open market in a local geographic area.
A state-funded program that provides funds to help families provide home care for dependents with mental retardation or related conditions.
Federal Benefit Rate. The maximum federal benefit rate for the Supplemental Security Income (SSI) program. This amount is updated each January and is used to determine the Pickle Disregard and the Special Income Standard (SIS) for the Elderly Waiver (EW) program.
The maximum federal benefit rate for the Supplemental Security Income (SSI) program. This amount is updated each January and is used to determine the Pickle Disregard and the Special Income Standard (SIS) for the Elderly Waiver (EW) program.
Federal reimbursement to DHS for some of the cost of a client's health care services. People must meet certain criteria to be eligible for health care programs with FFP.
The Internal Revenue Service (IRS) forms that people who are not exempt must file annually to establish their federal income tax liability. Federal tax forms usually consist of Form 1040 and various supplemental schedules depending on the taxpayer's circumstances.
The amount of income below which a household of a given size is considered impoverished. The federal government updates the FPG annually. All Minnesota Health Care Programs income standards are based on the FPG.
A method of payment for health services. The medical provider bills the insurer and is paid for specific individual services.
Federal Financial Participation. Federal reimbursement to DHS for some of the cost of a client's health care services. People must meet certain criteria to be eligible for health care programs with FFP.
Social Security payroll taxes that are collected under the authority of the Federal Insurance Contributions Act (FICA).
A managed care enrollee's opportunity to change health plans once during the first year of enrollment in a health plan.
A 12-month accounting period. The DHS fiscal year begins July 1 and ends June 30. The fiscal year is designated by the calendar year in which it ends. For example, fiscal year 2009 is the year that begins July 1, 2008, and ends June 30, 2009.
A type of annuity in which benefits have guaranteed or fixed dollar amounts.
Employer-established benefit plan that allows employees to be reimbursed for medical expenses. These may be offered in conjunction with other employer-provided benefits. FSAs are usually funded through voluntary salary reduction agreements with an employer. Both employees and employers may make contributions to the FSA. See IRS Publication 969 for more information.
Fair Market Value. The price an item would sell for on the open market in a local geographic area.
Former name of the Federal term for the Federal Supplemental Nutrition Program (SNAP), a U.S. Department of Agriculture programs that issues benefits in the form of electronic benefits to increase food purchasing power.
Former name of the Supplemental Nutrition Assistance Program, a U.S. Department of Agriculture programs that issues benefits in the form of electronic benefits to increase food purchasing power.
Care given to a child or adult including emergency, interim, or permanent care that cannot be furnished by a parent or legal guardian in the home.
A child under age 21 whose placement, care, and supervision are the responsibility of a social services agency.
A home licensed to provide care to dependent children and/or adults.
A person giving care to a child in foster care.
One of the insurance barriers for MinnesotaCare. The four-month rule requires some people to have been uninsured for four months before they can enroll in MinnesotaCare.
Federal Poverty Guidelines. The amount of income below which a household of a given size is considered impoverished. The federal government updates the FPG annually. All Minnesota Health Care Programs income standards are based on the FPG.
A transfer with an uncompensated amount less than the SAPSNF.
Flexible Spending Arrangement. Employer-established benefit plan that allows employees to be reimbursed for medical expenses. These may be offered in conjunction with other employer-provided benefits. FSAs are usually funded through voluntary salary reduction agreements with an employer. Both employees and employers may make contributions to the FSA. See IRS Publication 969 for more information.
Evaluation of the level of care needed by a person who is assessed as being at risk of placement in an intermediate care facility for the developmentally disabled (ICF/MR), nursing facility, or is requesting residential, training and habilitation, or family support services.
People who are enrolled in both federally funded MA and Medicare. People gain full-benefit dual eligible status in the first month they are enrolled in both Medicare and federally funded MA. People enrolled in Medicare and MA with a spenddown gain full-benefit dual eligible status in the first month they meet the MA spenddown. Full benefit dual eligibles automatically qualify for Extra Help through the rest of the calendar year.
A person who is enrolled in a graded or ungraded primary, intermediate, secondary, GED preparatory, trade, technical, vocational, or post-secondary school and who meets the school's standard for full-time attendance. Summer vacations and school holidays do not affect the student's full-time status. Consider people who are enrolled and attending but do not meet the school's standard for full-time attendance to be part-time students.
Face Value. The policy’s death benefit (the amount paid out at the death of the insured) at the time a life insurance policy is purchased.
General Assistance. A program authorized under Minnesota Statutes 256D to provide cash assistance to needy individuals and couples without children.
A program authorized under Minnesota Statutes 256D to provide cash assistance to needy individuals and couples without children.
Also known as Open Enrollment. A term used by the insurance industry, as well as by DHS, for a time period during which a person can change coverage or enroll in a health plan.
The circumstances beyond a person's control which keep the person from following program requirements or specific eligibility conditions, such as premium payment or cooperation with medical support.
Group of people who evaluate, approve or deny good cause claims for medical and child support referrals.
A document which lists the merchandise and services the owner of a burial agreement has agreed to purchase from a funeral provider. A goods and services statement must accompany all burial agreements regardless of the funding source.
The individual who provides the trust corpus, also called a settler or trustor. The individual funding the trust is the grantor even if an agent (such as, power of attorney or conservator) establishes the trust with funds or property that belong to the individual and even in situations where the trust agreement shows a person legally empowered to act on the individual’s behalf as the grantor.
Group Residential Housing. A group living situation which has a fixed rate contract with a county to provide room and board for MSA or GA clients. This includes foster care settings. It does not include battered women's shelters or medical care (Title XIX) facilities.
Total earned and unearned income that is available before any deductions or disregards are applied.
The RSDI benefit amount before deducting the Medicare premium and other withholdings.
Other health care coverage that is available to individuals who are members of a defined group, such as eligible employees and former employees of a particular employer or members of a union and their eligible dependents. Group health care coverage also includes COBRA coverage.
A specialized facility providing 24-hour care for no more than 10 children, including the group home parents' own children under age 21.
A public or private non-profit facility certified under Section 1616(e) of the Social Security Act or a comparable state law or rule which serves no more than 16 people. This may include ICF/MRs.
A group living situation which has a fixed rate contract with a county to provide room and board for MSA or GA clients. This includes foster care settings. It does not include battered women's shelters or medical care (Title XIX) facilities.
A person appointed by the court to provide for the care, comfort and maintenance needs of a minor or incapacitated person who is known as the ward.
An account established at a financial institution in the name of a guardian who acts on behalf of and administers the funds for the benefit of a minor under age 18 or a person who is incapacitated or otherwise unable to handle financial transactions.
A place that provides a temporary residence for people waiting for an institutional placement or for people who have left an institution and are preparing to re-enter the community.
Health Care Application. A form which people can use to apply for Minnesota Health Care Programs.
High Deductible Health Plan. Sometimes referred to as a “catastrophic” health insurance plan, an HDHP is an inexpensive health insurance plan that generally does not pay for the first several thousand dollars of health care expenses. It has a higher annual deductible than typical health plans and a maximum limit on the sum of the annual deductible and out-of-pocket medical expenses that an individual must pay for covered expenses. In 2010, the HDHP minimum annual deductible is $1,200 for individual coverage and $2,400 for family coverage. In 2010, the HDHP maximum annual deductible and other out-of-pocket expenses is $5,950 for individual coverage and is $11,900 for family coverage. A HDHP is required to have a Health Savings Account. See IRS Publication 969 for more information.
A form which people can use to apply for Minnesota Health Care Programs.
A group of health coverage programs available through the State of Minnesota to people who qualify including: MinnesotaCare, Medical Assistance (MA) which includes QMB, QWD, SLMB, QI, MA-EPD, and federally funded waiver programs.
A DHS form (DHS-1922 or -1922B) used to gather other health care coverage information.
A federal law passed in 1996 that protects health insurance coverage for workers and their families when they change or lose their jobs. Title II Administration Simplification provides national uniformity of transaction coding and national identifiers for providers. Data privacy is included in Title II.
An organization licensed by the Department of Health to provide all defined health care benefits to people in return for a capitated payment.
An organization contracting with the State to provide health services to enrollees covered by a Minnesota Health Care Program in exchange for a monthly capitation payment. A health plan may be a HMO or other defined group of medical providers. Also referred to as a managed care organization (MCO).
An employer-established benefit plan where employees are reimbursed tax free for qualified medical expenses. These may be offered in conjunction with other employer-provided health benefits. Employees may not make contributions and the contribution cannot be paid through a voluntary salary reduction agreement. Only employers may make contributions to the HRA. See IRS Publication 969 for more information.
A tax-exempt trust or custodial account (an account managed for eligible employees by a custodian) that an individual sets up with a qualified HSA trustee to pay or reimburse certain medical expenses. To qualify for an HSA an individual must have a high deductible health plan. See IRS Publication 969 for more information.
The automated system for submitting health care program policy and procedural questions to DHS.
Sometimes referred to as a “catastrophic” health insurance plan, an HDHP is an inexpensive health insurance plan that generally does not pay for the first several thousand dollars of health care expenses. It has a higher annual deductible than typical health plans and a maximum limit on the sum of the annual deductible and out-of-pocket medical expenses that an individual must pay for covered expenses. In 2012, the HDHP minimum annual deductible is $1,200 for individual coverage and $2,400 for family coverage. In 2012, the HDHP maximum annual deductible and other out-of-pocket expenses is $6,050 for individual coverage and is $12,100 for family coverage. A HDHP is required to have a Health Savings Account. See IRS Publication 969 for more information.
Health Insurance Information Form. A DHS form (DHS-1922 or -1922B) used to gather other health care coverage information.
A federal act that gives hospitals and other health facilities money to build and remodel in return for providing a limited volume of services to people living in their area who cannot pay for health care.
Health Insurance Portability and Accountability Act. A federal law passed in 1996 that protects health insurance coverage for workers and their families when they change or lose their jobs. Title II Administration Simplification provides national uniformity of transaction coding and national identifiers for providers. Data privacy is included in Title II.
Property an applicant or enrollee owns in whole or in part or has an ownership interest in, and in which he or she occupies, or occupied immediately prior to receiving LTC services, as the primary dwelling. A home includes the primary dwelling, all surrounding land and any building on that land, provided the land is not separated from the dwelling by property owned by another person. Land separated from the dwelling by a public right-of-way is included in the definition of the home.
Services not normally covered by MA which are covered under a waiver program, including case management, homemaker services, home health aide, personal care, adult day health treatment, habilitation, respite care, and day treatment for individuals with chronic mental illness. Also known as waivered services.
The home which is owned by and is the usual residence of the client.
A benefit that offers comfort, care, and support to clients who are terminally ill with a life expectancy of less than six months. It also provides support to the client's family.
Each day an LTCF is eligible for MA payment even though the client has transferred to an inpatient hospital for medically necessary health care.
Items of personal property found in or near a home that are used on a regular basis; items needed by the household for maintenance, use and occupancy of the premises as a home.
A form (DHS-2120) used by enrollees to report changes in income, assets and circumstances.
The number of people included in a health care household. This number is used to determine income and asset eligibility and premium amount, if applicable.
A community living arrangement commonly referred to as assisted living, that provides supportive services.
Health Reimbursement Arrangement. An employer-established benefit plan where employees are reimbursed tax free for qualified medical expenses. These may be offered in conjunction with other employer-provided health benefits. Employees may not make contributions and the contribution cannot be paid through a voluntary salary reduction agreement. Only employers may make contributions to the HRA. See IRS Publication 969 for more information.
Household Report Form. A form (DHS-2120) used by enrollees to report changes in income, assets and circumstances.
Health Savings Account. A tax-exempt trust or custodial account (an account managed for eligible employees by a custodian) that an individual sets up with a qualified HSA trustee to pay or reimburse certain medical expenses. To qualify for an HSA an individual must have a high deductible health plan. See IRS Publication 969 for more information.
A person who presides over an appeal hearing and issues a recommendation on the appealed matter to the Commissioner of DHS. Also known as a Referee. An appeal is also known as a fair hearing.
Irrevocable Burial Agreement. A burial agreement with an unalterable assignment to any funeral home. The irrevocable portion of this type of agreement cannot be withdrawn before the depositor’s death.
Interstate Compact on Adoption and Medical Assistance. The Interstate Compact on Adoption and Medical Assistance (ICAMA) is a federal contract between Minnesota and other states designed to prevent and overcome barriers to interstate adoptions and to coordinate services to adopted children with special needs.
Intermediate Care Facility for the Developmentally Disabled. A residential facility licensed as a health care institution and certified by the Minnesota Department of Health to provide health or rehabilitative services for persons with developmental disabilities who require active treatment.
Individual Development Account. A special bank account established under the Family Assets for Independence in Minnesota (FAIM) program that helps a person save for education, purchase of a first home, or to start a business. Eligible people must have earned income and have low income and assets.
Income and Eligibility Verification System. A set of data exchanges with other state and federal sources used to verify income and assets of MA applicants and enrollees.
Insurance-Funded Burial. A life insurance policy with an irrevocable designation of the cash surrender value (CSV) to a funeral provider as the primary beneficiary. The value of the policy is to be paid to a funeral provider in exchange for agreed-upon goods and services.
Institution for Mental Diseases. A facility for the treatment of mental diseases.
An annuity contract under which the periodic payments will begin within one payment interval following the payment of the annuity premium. A payment interval is the period that will elapse between payments (a month, a calendar quarter, a year).
A person who leaves another country to settle permanently in the U.S.
Any person, or public or private agency or organization, who signed an affidavit agreeing to support an immigrant (who is not the dependent child or the spouse of the sponsor) as a condition of the immigrant's entry into the U.S. Also referred to as Sponsor.
The Act (INA) which, along with other immigration laws, treaties, and conventions of the United States, relates to the immigration, temporary admission, naturalization, and removal of aliens.
The former name of U.S. Citizenship and Immigration Services (USCIS). The federal agency responsible for immigration and citizenship.
The legal status granted to a noncitizen by immigration law.
See Uncompensated Transfer.
Payment for a service in a form other than money, or receipt of non-cash gifts or non-cash contributions such as food or clothing.
Immigration and Nationality Act. The Act (INA) which, along with other immigration laws, treaties, and conventions of the United States, relates to the immigration, temporary admission, naturalization, and removal of aliens.
A set of data exchanges with other state and federal sources used to verify income and assets of MA applicants and enrollees.
Also known as Certification Period. The period of time a client can be active before the next renewal is processed. It is also the period of time for which income is calculated to determine income eligibility as well as premium or spenddown amounts.
Also known as Six-Month Renewal. A review of income and/or assets to redetermine program eligibility for the next six-month period.
The method through which child support payments are made for most employed non-custodial parents. The non-custodial parent's employer must withhold the child support amount from the non-custodial parent's paycheck. The employer can either mail that amount to the Child Support Payment Center in St. Paul or electronically transfer the funds to the state.
Data or other information received from the client that does not match the information provided by the client or other information on file.
An insurance policy that pays benefits directly to people for each day of hospitalization or for a specified injury. Indemnity payments may cover costs not covered by other insurance but do not always limit benefits to paying for medical expenses. Consider indemnity payments as third party liability unless the insurance company designates them as income replacement.
A special bank account established under the Family Assets for Independence in Minnesota (FAIM) program that helps a person save for education, purchase of a first home, or to start a business. Eligible people must have earned income and have low income and assets.
Other health care coverage that individuals can purchase for themselves and their dependents without having to be part of a defined group.
An Individual Retirement Arrangement (IRA) held in the form of a trust or account is commonly referred to as a Traditional IRA.
An Individual Retirement Arrangement (IRA) held in the form of an annuity.
An umbrella term used to describe a personal savings plan that provides the owner tax advantages for setting aside money for retirement. IRAs can be in the form of a trust, an account, or an annuity.
For MinnesotaCare, the first month in which an individual or household has MinnesotaCare coverage. The initial enrollment month does not change unless there is a break in coverage of more than one full calendar month. For managed care, this term refers to the first time an individual is enrolled in a managed care organization (MCO).
The first monthly premium payment which an applicant must make before coverage begins.
A person admitted to a hospital. Inpatient applies to a person temporarily absent from the hospital with the approval of a physician. Inpatient does not apply to a person absent from the hospital against medical advice.
Immigration and Naturalization Service. The former name of U.S. Citizenship and Immigration Services (USCIS). The federal agency responsible for immigration and citizenship.
A program or facility providing food, shelter and some care to four or more people. An institution may include medical facilities, residential treatment programs and group homes. It also includes foster care homes, with the exception for children receiving IV-E foster care and adoption assistance.
A facility for the treatment of mental diseases.
A level of care that is equivalent of what would be received in a nursing facility, a hospital, or an intermediate care facility for the developmentally disabled (known as an ICF/MR).
Eligibility criteria which govern when an applicant or enrollee may have other health coverage or access to other health coverage currently or during a specified period.
A life insurance policy with an irrevocable designation of the cash surrender value (CSV) to a funeral provider as the primary beneficiary. The value of the policy is to be paid to a funeral provider in exchange for agreed-upon goods and services.
Latin for “between the living.” An inter vivos transfer, for example, is a transfer made during one’s lifetime as opposed to a testamentary transfer, which takes effect at the grantor’s death.
Money charged as a borrower's fee on a loan or money earned and paid to the holder of a bank account, loan, or other investment. Earned interest may be credited to the account or paid directly to the owner.
A residential facility licensed as a health care institution and certified by the Minnesota Department of Health to provide health or rehabilitative services for persons with developmental disabilities who require active treatment.
The agreement between Minnesota and North Dakota to help resolve residence disputes that addresses state financial responsibility for MA eligibility for long-term care.
The Interstate Compact on Adoption and Medical Assistance (ICAMA) is a federal contract between Minnesota and other states designed to prevent and overcome barriers to interstate adoptions and to coordinate services to adopted children with special needs.
An agreement among all 50 states that coordinates the movement of children across state lines for the purpose of placement in foster care, adoptive homes, group homes, residential treatment centers, or on a trial basis with a parent. See DHS web site for more information.
Income Review. Also known as Six-Month Renewal. A review of income and/or assets to redetermine program eligibility for the next six-month period.
Individual Retirement Arrangement. An umbrella term used to describe a personal savings plan that provides the owner tax advantages for setting aside money for retirement. IRAs can be in the form of a trust, an account, or an annuity.
A burial agreement with an unalterable assignment to any funeral home. The irrevocable portion of this type of agreement cannot be withdrawn before the depositor’s death.
A trust that may not be revoked after its creation by the grantor or the grantor’s representative.
A state, county, or private agency that is responsible for establishing paternity and collecting child support and medical support according to Title IV-D of the Social Security Act. In Minnesota, the IV-D agency is a unit within a county agency.
Adoption assistance placements funded under Title IV-E of the Social Security Act.
Foster care placements funded under Title IV-E of the Social Security Act.
An ownership agreement in which two or more people own the same piece of property. Different types of joint ownership include but are not limited to joint tenancy and tenants-in-common.
Each owner has one and the same interest and must obtain the permission of the other joint owners in order to sell their share.
A tax deferred pension plan available to self-employed individuals or unincorporated businesses for retirement purposes. A Keogh plan can be set up as either a defined-benefit or defined-contribution plan, although most plans are defined-contribution plans.
An immigrant legally admitted to the U.S. on a permanent basis under the U.S. Immigration and Nationality Act.
A non-immigrant legally admitted to the U.S. on a temporary basis under the U.S. Immigration and Nationality Act.
A noncitizen who is present in the United States in accordance with immigration laws, who has not violated the terms of his or her status. Lawfully present noncitizens include, but are not limited to Refugees, Asylees, victims of Trafficking, Lawful Permanent Residents (LPRs), battered noncitizens, Lawful Temporary Residents, Parolees, people with a pending immigration status, and Temporary Protected Status.
Life Care Community. An organization that contractually offers a range of continuing care services while providing flexible accommodations, which may change with the client's needs. An LCC may also be referred to as a continuing care retirement community (CCRC).
The health plan, county or tribal agency staff person who provides case coordination or case management services.
A person who is granted legal custody of a minor child by the court but who does not have legal guardianship.
Any instrument that exhibits the general characteristics of a trust, but is not called a trust, is treated in the same way for MA purposes as a trust. This can include, but is not limited to, escrow accounts, investment accounts, pension funds and other similar devices managed by an individual or entity with fiduciary obligations.
Limited English Proficiency. People with limited English proficiency, or “LEP,” are not able to speak, read, write, or understand the English language well enough to allow them to interact effectively with health and social services agencies and other providers.
Life Insurance. A type of policy which pays a beneficiary a designated sum upon the death of the insured person. There are two basic forms of life insurance policies: term and non-term.
A legal claim against property for the satisfaction of a debt. The lien is paid off at the time the property is sold.
An annuity under which the payments continue for the life of the annuitant.
An organization that contractually offers a range of continuing care services while providing flexible accommodations, which may change with the client's needs. An LCC may also be referred to as a continuing care retirement community (CCRC).
An interest in real property held only for the duration of a specified person’s life (usually for the life of the person or people who have the life estate interest). A life estate is a form of legal ownership that is usually created through a deed, will, or by operation of law.
An interest in real property that is limited to the duration of the lifetime of a specified person or people.
A table used to compute the value of a life estate based on a person's age. It is issued by the Social Security Administration.
The person with an interest in real property subject to the duration of a specified person's life. Unless the instrument establishing the life estate places restrictions on the rights of the life estate owner(s), the life estate owner has the right to possess, use and obtain profits from the property and to sell the life estate interest. The life estate owner cannot take any action concerning the interest of the remainderman. A life estate owner is also referred to as \"life tenant\" or \"tenant for life.\"
A chart used to determine whether annuitizing an annuity is a transfer for less than fair market value. It is issued by the Social Security Administration.
A type of policy which pays a beneficiary a designated sum upon the death of the insured person. There are two basic forms of life insurance policies: term and non-term.
People with limited English proficiency, or “LEP,” are not able to speak, read, write, or understand the English language well enough to allow them to interact effectively with health and social services agencies and other providers.
Cash or other types of assets that can be easily converted to cash, such as bank accounts, stocks, bonds, certificates of deposit, some retirement accounts and money market accounts.
LTC services include skilled nursing facility (SNF) care, nursing facility care in an inpatient medical hospital or intermediate care facility (ICF, ICF/DD), or services covered by home and community-based waiver programs (CAC, CADI, DD, EW, and TBI).
Amount of income an enrollee is responsible for paying toward the cost of LTC services as determined by a LTC income calculation.
A program to help people make decisions about long-term care and prevent inappropriate nursing home or boarding care placement.
A place such as a skilled nursing facility, Intermediate Care Facility for the Developmentally Disabled (ICF/DD) or medical hospital in which the individual receives skilled nursing services. Group Residential Housing (GRH) and Housing with Services Establishments are not long-term care facilities.
A person married to a community spouse who either: resides in a long-term care facility (LTCF) and has resided, or is anticipated to reside, in an LTCF for at least 30 consecutive days, or requests services through the Elderly Waiver (EW) or Alternative Care (AC) programs and has received a long-term care consultation (LTCC) that demonstrates the individual requires an institutional level of care and the individual has received, or is anticipated to receive, EW or AC services for at least 30 consecutive days.
A specific period for evaluating transfers prior to the date a person requests MA payment of LTC services.
Lawful Permanent Resident. An immigrant legally admitted to the U.S. on a permanent basis under the U.S. Immigration and Nationality Act.
Long-Term Care Consultation. A program to help people make decisions about long-term care and prevent inappropriate nursing home or boarding care placement.
Long-Term Care Facility. A place such as a skilled nursing facility, Intermediate Care Facility for the Developmentally Disabled (ICF/DD) or medical hospital in which the individual receives skilled nursing services. Group Residential Housing (GRH) and Housing with Services Establishments are not long-term care facilities.
Lawful Temporary Resident. A non-immigrant legally admitted to the U.S. on a temporary basis under the U.S. Immigration and Nationality Act.
Cash received on a non-recurring or irregular basis that cannot be reasonably anticipated. Examples of lump sums include winnings, insurance settlements, inheritances, and retroactive payments of RSDI.
Medical Assistance. A Minnesota Health Care Program administered by county agencies that provides health care for needy people. People may receive MA as a separate program or in conjunction with an MSA grant. Known federally as Medicaid.
Medical Assistance for Breast and Cervical Cancer. An MA basis of eligibility for women who have been screened through the Sage Screening Program and found to need treatment for breast or cervical cancer.
Medical Assistance for Employed Persons with Disabilities. Program which provides MA coverage to certain employed disabled people who would not otherwise be eligible.
The amount of monthly income protected for people eligible under the SIS-EW program. It is determined by adding the MSA equivalent rate and the clothing and personal needs allowance and changes annually.
The MPET is the combination of the major program and the eligibility type. MMIS uses the MPET to assign the correct benefit set and Federal Financial Participation (FFP) amount to each enrollee.
A health care delivery system under which enrollees receive most medical services through a health plan or network of providers which coordinates the services provided. DHS pays a fixed rate in advance for each enrollee.
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 health care program eligibility, marriage must be a union that is legally recognized in Minnesota (as defined in MN State Statute 517.01). See Chapter 17 of this manual (Household Composition) for further information.
A change brought about by a shift in federal or state policy which affects many or all clients.
A program offered by some Voluntary Resettlement Agencies (VOLAGs). The program's goal is to help some refugees attain self-sufficiency without access to public cash assistance.
A maternity home is a residential program for pregnant women that provides comprehensive services including health and wellness, safety, parenting and independent life skills.
Minnesota's statewide automated eligibility system for county-administered programs, including Food Support (FS), General Assistance (GA), Medical Assistance (MA), Minnesota Family Investment Program (MFIP), and Minnesota Supplemental Aid (MSA).
Minnesota Comprehensive Health Association. A plan that provides health insurance to people who are otherwise uninsurable due to health conditions or other circumstances specified in statute.
Managed Care Organization. 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.\"
The federal program known in Minnesota as Medical Assistance (MA) which provides health care to needy people.
A state effort, in compliance with federal law, to conduct reviews of Medicaid cases in order to improve service to recipients and access to eligibility for publicly funded health care programs, and to assure the integrity of the programs.
Minnesota's statewide automated system for MinnesotaCare, and payment of medical claims and capitation payments for all Minnesota Health Care Programs.
A Minnesota Health Care Program administered by county agencies that provides health care for needy people. People may receive MA as a separate program or in conjunction with an MSA grant. Known federally as Medicaid.
An MA basis of eligibility for women who have been screened through the Sage Screening Program and found to need treatment for breast or cervical cancer.
Program which provides MA coverage to certain employed disabled people who would not otherwise be eligible.
A listing of a client's medical expenses paid by the Minnesota Health Care Programs.
An account that allows a person to set aside pre-tax dollars to be used for reimbursement of qualified medical expenses not covered by health insurance. Medical expense accounts are often set up by employers and include Medical Savings Accounts, Flexible Spending Arrangements, Health Reimbursement Arrangements and Health Savings Accounts.
A nursing facility, intermediate care facility for persons with mental retardation, or an inpatient hospital stay of 30 days or more.
A tax-deferred savings account that can be offered by employers as part of a benefits package. Medical savings accounts are designed to help participants pay for medical and healthcare expenses by allowing them to save for those expenses in a tax-sheltered environment. See IRS Publication 969 for more information.
The difference between a client’s net countable income and the appropriate FPG standard as calculated in a community income calculation. A client must have incurred medical expenses in an amount equal to or greater than the medical spenddown to become eligible for MA Medical expenses include reasonable and necessary medical expenses, services provided through a home and community-based waiver program, LTCF costs, and Medicare and other health insurance premiums.
Health insurance coverage or cash payments that a parent provides or is court-ordered to provide to meet the medical needs of the parent's child. Court orders generally require medical support payments until the child is 18 but may require payments beyond age 18 in some cases.
A health service rendered in response to a life-threatening condition or pain; to treat an injury, illness, or infection; to achieve a level of physical or mental function consistent with prevailing community standards for the diagnosis or condition; to care for a mother and child through the maternity period; is a preventative health service; or to treat a condition that could result in physical or mental disability. The provider's professional peer group must recognize the service as the prevailing standard or current practice and as consistent with the client's diagnosis or condition.
A federal health insurance program for people who are age 65 or older, disabled, blind, or have permanent kidney failure.
A period of extended Medicare eligibility for some disabled people who lost their RSDI benefit because they earn more than the Substantial Gainful Activity (SGA) level.
A two-part plan that includes a high-deductible health plan and a bank account. Medicare pays the plan to provide Medicare coverage. The plan deposits a portion of the money into a beneficiary's account, to be used to pay for Medicare-covered Part A and B services. The beneficiary is responsible for services provided in excess of account funds, up to the health plan deductible. Money left in the account rolls over to be used in subsequent years.
A prescription drug coverage plan that has been designated by Medicare to meet certain coverage requirements and which has a monthly premium that is fully subsidized by Extra Help.
A collective term for the following MA programs: QMB, SLMB, QI and QWD. The MSPs provide payment for some Medicare premiums and other costs. Formerly known as the Medicare Supplement Programs.
The former name of the Developmental Disabilities (DD) waiver program.
Medicaid Eligibility Quality Control. A state effort, in compliance with federal law, to conduct reviews of Medicaid cases in order to improve service to recipients and access to eligibility for publicly funded health care programs, and to assure the integrity of the programs.
Minnesota Extended Treatment Option. A specialized short-term service designed to meet the needs of individuals with mental retardation or a related condition whose behavior or actions present a risk to public safety.
Minnesota Family Investment Program. A program authorized under the federal Temporary Assistance to Needy Families (TANF) block grant and Minnesota Statutes 256J to provide cash assistance and employment support to needy families. MFIP replaced the Aid to Families with Dependent Children (AFDC) program.
Minnesota Family Planning Program. A DHS-administered health care program that covers family planning services and related supplies for people who are not enrolled in Minnesota Health Care Programs.
Minnesota Health Care Programs. A group of health coverage programs available through the State of Minnesota to people who qualify including: MinnesotaCare, Medical Assistance (MA) which includes QMB, QWD, SLMB, QI, MA-EPD, and federally funded waiver programs.
The Minnesota COBRA Premium Subsidy provided partial payment of COBRA insurance premiums to workers who became unemployed between September 2008 and May 2010. The Minnesota COBRA Premium Subsidy expired August 31, 2011.
A DHS program that helps people enroll in Minnesota Health Care Programs (MHCP) by providing outreach and application assistance via participating community organizations.
A plan that provides health insurance to people who are otherwise uninsurable due to health conditions or other circumstances specified in statute.
A specialized short-term service designed to meet the needs of individuals with mental retardation or a related condition whose behavior or actions present a risk to public safety.
A program authorized under the federal Temporary Assistance to Needy Families (TANF) block grant and Minnesota Statutes 256J to provide cash assistance and employment support to needy families. MFIP replaced the Aid to Families with Dependent Children (AFDC) program.
A DHS-administered health care program that covers family planning services and related supplies for people who are not enrolled in Minnesota Health Care Programs.
A group of health coverage programs available through the State of Minnesota to people who qualify including: MinnesotaCare, Medical Assistance (MA) which includes QMB, QWD, SLMB, QI, MA-EPD, and federally funded waiver programs.
A state-funded program that provides cash assistance to SSI recipients, blind people, people age 65 or older, and disabled people who are age 18 and older.
A subsidized premium-based Minnesota Health Care Program for some families with children and some adults without children. It is administered by DHS and county agencies that elect to be MinnesotaCare enrollment sites. However, all county agencies, even non-enrollment sites, must administer the program for Transitional MinnesotaCare enrollees who transition to MinnesotaCare.
The organizational unit at DHS responsible for determining MinnesotaCare eligibility and providing case maintenance to clients.
A performance evaluation system established by the Minnesota Legislature to review the accuracy of MinnesotaCare determinations.
A non-emancipated child who is the parent of a child living in his/her household. For MHCP purposes a minor caretaker is under age 21. For medical support and social services referrals a minor caretaker is under age 18.
A child under age 18.
Medicaid Management Information System. Minnesota's statewide automated system for MinnesotaCare, and payment of medical claims and capitation payments for all Minnesota Health Care Programs.
Minnesota Community Application Agent Program. A DHS program that helps people enroll in Minnesota Health Care Programs (MHCP) by providing outreach and application assistance via participating community organizations.
The month in which a client's application for coverage under the Minnesota Health Care Programs is received by MinnesotaCare or a county agency.
The requirement to complete a Household Report Form (HRF) every month.
See Life Estate Mortality Table and/or Life Expectancy Table.
Major Program Eligibility Type. The MPET is the combination of the major program and the eligibility type. MMIS uses the MPET to assign the correct benefit set and Federal Financial Participation (FFP) amount to each enrollee.
Minnesota Supplemental Aid. A state-funded program that provides cash assistance to SSI recipients, blind people, people age 65 or older, and disabled people who are age 18 and older.
Medicare Savings Programs. A collective term for the following MA programs: QMB, SLMB, QI and QWD. The MSPs provide payment for some Medicare premiums and other costs. Formerly known as the Medicare Supplement Programs.
A person who was not born in the United States, but who became a citizen by meeting legal requirements for citizenship and taking an oath of allegiance to the United States.
Income remaining after subtracting each program's deductions and disregards from gross income.
For initial managed care enrollment, the next available month is defined as the current month plus one if prior to managed care enrollment cut-off or the current month plus two if after managed care enrollment cut-off.
Noncitizens Medical Assistance. A state-funded program that provides MA coverage for some noncitizens who do not meet immigration status requirements for federally funded MA. NMED was enacted by the legislature in 1997 in response to the federal Personal Responsibility and Work Opportunity Act (PRWORA) of 1996. PRWORA brought about the end of federally funded MA for noncitizens with certain immigration statuses.
A parent who does not have physical custody of a child.
Property that is not in the form of cash and cannot be easily or quickly converted to cash such as a home, a vehicle or a piece of property.
An expense that is not eligible for payment under Minnesota Health Care Programs but that is prescribed or recommended in writing by the enrollee’s physician or dentist and of direct benefit to the enrollee and available but not necessarily obtained through a licensed medical provider. These expenses, which are medically necessary, may be used to meet a spenddown.
A person present in the United States who has not attained U.S. citizenship by birth or naturalization.
A state-funded program that provides MA coverage for some noncitizens who do not meet immigration status requirements for federally funded MA. NMED was enacted by the legislature in 1997 in response to the federal Personal Responsibility and Work Opportunity Act (PRWORA) of 1996. PRWORA brought about the end of federally funded MA for noncitizens with certain immigration statuses.
A noncitizen who seeks temporary entry to the United States for a specific purpose. The person must have a permanent residence abroad (for most classes of admission) and qualify for the non-immigrant classification sought. The non-immigrant classifications include foreign government officials, visitors for business and for pleasure, noncitizens in transit through the United States, treaty traders and investors, students, international representatives, temporary workers and trainees, representatives of foreign information media, exchange visitors, fiancé(e)s of U.S. citizens, intracompany transferees, NATO officials, religious workers, and some others.
A statement of rights given to people who are asked to provide private or confidential data about themselves. The Notice of Privacy Practices was formerly referred to as “Tennessen Notice,” “Practices Rights Statement,” or “Privacy Act Notice.”
The person obligated to pay support.
A term used by managed care organizations, DHS, and other entities to designate a period during which a person may make a change in coverage or health plan enrollment.
Assets used in a trade or business such as bank accounts, stocks, bonds, mutual funds, certificates of deposit, trusts or property agreements.
An arrangement purchased through a Health Maintenance Organization (HMO), an insurance company or provided through a self-insured plan to pay for a person’s health care costs. Other Health Care Coverage includes group and individual health care coverage, but does not include Minnesota Health Care Programs (MHCP) coverage.
A person is otherwise eligible in a month where he or she meets all of the eligibility criteria for Medical Assistance (MA) payment of long-term care (LTC) services, except is ineligible because of having an uncompensated transfer penalty.
Benefits clients receive that exceed the amount for which they are eligible.
A child's legal biological or adoptive mother or father whose parental rights have not been terminated. MinnesotaCare also includes a stepparent as a parent.
An amount assessed to the parents of a minor child as reimbursement for the cost of care of a child under 18 receiving MA without consideration of parental income.
A self-employment enterprise in which two or more people share in the profits and losses of the business according to their individual shares of ownership.
Long-Term Care insurance that qualifies for asset protection under the Long-Term Care Partnership.
Plan to Achieve Self Support. A plan approved by the county agency for MA or MSA recipients or approved by the Social Security Administration for SSI recipients which allows certain assets or income of the client to be excluded in determining benefits for some assistance programs.
Legal fatherhood, either adjudicated or acknowledged by the father.
Someone to whom a benefit is paid. Some benefits, such as an annuity contract, may provide for two or more payees. An annuity payee is sometimes called the annuitant; however, a payee may not also be an annuitant.
The party responsible for payment of medical claims only after all other parties have paid the portion for which they are liable. Clients with Third Party Liability (TPL) must have medical costs paid by the third party before Minnesota Health Care Programs (MHCP) pays claims.
A comprehensive, ongoing audit implemented by the Centers for Medicare and Medicaid Services (CMS) to measure improper payments in the Medicaid program and the State Children's Health Insurance Program (SCHIP). In Minnesota, the DHS Office of Compliance - Internal Audits Office Division conducts MinnesotaCare and Medicaid Eligibility Quality Control (MEQC) eligibility audits and PERM activities.
See Annuitization Phase.
A retirement savings plan in which an employer sets up a payroll deduction to fund an individual retirement account program with a financial institution, such as a bank, mutual fund or insurance company. The employer establishes either a traditional or Roth IRA (based on the employee’s eligibility and personal choice) with the financial institution. The employer withholds the payroll deduction amounts that the employee has authorized and transmits the funds to the financial institution. The employee and the financial institution are responsible for the amounts contributed.
The status of an applicant whose eligibility has not yet been approved or denied.
To approve an application conditioned on the receipt of the initial premium payment. For MinnesotaCare, if an application is pending awaiting payment, then the household has been found eligible for MinnesotaCare but will not have coverage until the month after DHS receives the initial payment.
A fixed sum paid regularly to retired people or their dependents.
Payments received at a regular interval, such as monthly, to which the client is entitled under an agreement through a retirement fund, annuity, etc. For annuities, a periodic payment is an annuity payment disbursed to the payee(s) based on a payment interval (i.e., a month, calendar quarter or year) chosen by the annuity owner(s).
Payment Error Rate Measurement. A comprehensive, ongoing audit implemented by the Centers for Medicare and Medicaid Services (CMS) to measure improper payments in the Medicaid program and the State Children's Health Insurance Program (SCHIP). In Minnesota, the DHS Office of Compliance - Internal Audits Office Division conducts MinnesotaCare and Medicaid Eligibility Quality Control (MEQC) eligibility audits and PERM activities.
A unique identification number that MAXIS assigns to each person. The PMI number is used to verify a person's eligibility under the Minnesota Health Care Programs.
Items of personal property ordinarily worn or carried by the individual, and articles otherwise having an intimate relation to the individual. These include items of cultural or religious significance and items required because of a person’s physical or mental disability. Items that are acquired or held because of their value or as an investment are not considered personal effects.
See Clothing and Personal Needs Allowance.
Property that is not considered real property.
Federal law signed on August 22, 1996 which eliminated the federal entitlement program AFDC and created a new program called Temporary Assistance for Needy Families (TANF). PRWORA provides block grants to states to offer time-limited cash assistance. It also made major changes in the Food Support Program and delinked eligibility for Medicaid from receipt of cash assistance.
Private Fee-For-Service Plan. A Medicare Advantage Plan offered by a private insurance company. The plan decides how much it will pay providers and how much enrollees will pay in premiums, deductibles, and other cost sharing. Providers are not required to furnish services to people in PFFS plans. Members must find providers who are willing to accept the plan’s terms of payment. Some PFFS plans include extra benefits at an additional cost to the beneficiary.
An unearned income disregard for some MA clients who lost eligibility for 1619(a), 1619(b), SSI or MSA and would remain eligible if RSDI cost-of-living increases are not counted in the client's net income total.
A plan approved by the county agency for MA or MSA recipients or approved by the Social Security Administration for SSI recipients which allows certain assets or income of the client to be excluded in determining benefits for some assistance programs.
Prepaid Medical Assistance Program. The program through which MA managed care enrollees receive medical services.
Person Master Index Number. A unique identification number that MAXIS assigns to each person. The PMI number is used to verify a person's eligibility under the Minnesota Health Care Programs.
A school serving students beyond the 12th grade, such as a community college, university, or technical college.
The period of coverage that begins the last day of the pregnancy and ends the last day of the month in which a 60-day period, beginning on the last day of the pregnancy, ends.
The process of applying health care claims to the recipient amount as DHS receives them. DHS does not pay health care claims for any amount equal to or less than the recipient amount shown in MMIS. MMIS issues a monthly Explanation of Medical Benefits (EOMB) that lists the client’s incurred health care expenses for the month. The client uses the EOMB to determine which bills DHS paid and which bills the client is responsible to pay.
A legally binding document that authorizes a person or corporation to act on another person’s behalf in financial matters.
A screening to assess a person’s need for a nursing facility level of care required for all people entering a certified nursing facility, hospital \"swing\" bed, or a certified boarding care facility.
A medical condition existing before an insurance policy took effect. Some health insurance policies limit or exclude coverage for pre-existing conditions.
The person or entity required to be named as a beneficiary of a death benefit under an annuity. A preferred remainder beneficiary has preferential rights to the death benefit.
An amount paid, usually monthly, for a contract of insurance.
The program through which MA managed care enrollees receive medical services.
A temporary period of eligibility that is determined at the point of service by certain health care providers using preliminary information. Presumptive eligibility is used in the Minnesota Family Planning Program (MFPP), and MA for Breast and Cervical Cancer (MA-BC).
A term used by insurance companies to describe services provided to keep enrollees healthy and promote continuous health care. Preventive care includes services such as routine physical exams, immunizations, and prenatal care.
The living structure in which an applicant or enrollee, requesting MA payment of LTC services, currently lives in or lived in immediately prior to receiving LTC services. A primary dwelling can be real or personal property, fixed or mobile and can be located on land or water.
Minnesota's automated system for the establishment and enforcement of child and medical support.
An annuity that is purchased and set up by a private individual that is not part of selling the annuity as an employee of an insurance company or financial institution, licensed or regulated by the Minnesota Department of Commerce or a similar agency of another state.
Data about individuals which can be disclosed only to the subject of the data or to government entities, employees, and contractors whose work assignments reasonably require access to the data.
A Medicare Advantage Plan offered by a private insurance company. The plan decides how much it will pay providers and how much enrollees will pay in premiums, deductibles, and other cost sharing. Providers are not required to furnish services to people in PFFS plans. Members must find providers who are willing to accept the plan’s terms of payment. Some PFFS plans include extra benefits at an additional cost to the beneficiary.
The legal process wherein the estate of a deceased person (decedent) is administered.
The time program rules allow for processing an application.
A plan that gives employees a share in the profits of the company. Each employee receives a percentage of those profits based on the company’s earnings. Also known as a deferred profit-sharing plan (DPSP).
A written, unconditional agreement whereby one party promises to pay a specified sum of money at a specified time (or on demand) to another party. It may be given in return of goods, money loaned, or services rendered.
A pledge or security of particular property for the payment of a debt or the performance of some other obligation within a specified period.
The total dollar amount of assets a person is allowed to protect through the Long-Term Care Partnership. This amount is equal to the dollar amount of insurance benefits that a Partnership policy has paid on behalf of that person.
See Health Insurance Portability and Accountability Act (HIPAA).
Personal Responsibility and Work Opportunity Reconciliation Act. Federal law signed on August 22, 1996 which eliminated the federal entitlement program AFDC and created a new program called Temporary Assistance for Needy Families (TANF). PRWORA provides block grants to states to offer time-limited cash assistance. It also made major changes in the Food Support Program and delinked eligibility for Medicaid from receipt of cash assistance.
Data which can be disclosed to anyone for any purpose, such as names and salaries of agency employees.
Qualified Individual. A Medicare Savings Program which pays for the Medicare Part B premium.
Qualified Medicare Beneficiary. A Medicare Savings Program which pays for some Medicare expenses including premiums, co-payments and deductibles.
A Medicare Savings Program which pays for the Medicare Part B premium.
Medical support orders that include specific information such as a description of the type of coverage to be provided by each plan and the period to which the order applies. Employer Retirement Income Security Act (ERISA) plans are only required to offer special enrollment periods to people covered by a qualified medical support order.
A Medicare Savings Program which pays for some Medicare expenses including premiums, co-payments and deductibles.
A person who meets certain USCIS criteria has this legal status designation. Qualified noncitizens must meet all eligibility requirements. The qualified status does not give a noncitizen automatic MHCP eligibility or ensure federal funding. The person must meet one of the following: was lawfully admitted for permanent residence under the Immigration and Nationality Act (INA), or, was admitted to the U.S. as a refugee under section 207 of the INA, or, was granted asylum under section 208 of the INA, or, removal is being withheld under section 241(b)(3) of the INA (or deportation was withheld under section 243(h) as in effect prior to April 1, 1997), or, was paroled under section 212(d)(5) of the INA for a period of at least one year, or, was granted conditional entry pursuant to section 203(A)(7) of the INA as in effect prior to April 1, 1980, or, is a Cuban or Haitian entrant, or, is a battered noncitizen with an approved or pending petition for immigration status.
A person eligible for payment of the Medicare Part A premium. The person cannot receive MA or QMB benefits.
People can earn up to four work credits each year, which is equivalent to four work quarters. Also referred to as \"work credits\" by the Social Security Administration (SSA), this is a measure of wage or self-employment earnings that SSA uses to determine Social Security benefits for people who have worked and paid Social Security taxes.
A performance evaluation and reporting system established by Congress to review federal assistance programs including MA.
The person designated by the state or federal government to conduct the Quality Control or Quality Assurance review according to federal and state standards.
Qualified Working Disabled Adult. A person eligible for payment of the Medicare Part A premium. The person cannot receive MA or QMB benefits.
Revocable Burial Agreement. A burial agreement which allows the value of the agreement to be cashed in by the purchaser at any time.
Refugee Cash Assistance. A program that provides financial help to refugees ineligible for both MFIP and SSI.
Land, all buildings, structures, improvements, or other fixtures on it belonging or pertaining to the land, including mobile or manufactured homes attached to a permanent foundation on land owned by the client, all mines, minerals, fossils, and trees on or under it, and life estate and remainder interests.
Value received in exchange for transferred property which equals or exceeds the property's fair market value, less any encumbrances and sale costs.
To be generally consistent with the income reported by the client. What is reasonably compatible may vary depending on the particular circumstances. Use this standard to determine if income verification available for a MinnesotaCare eligibility determination is acceptable.
Former term for Renewal. The process to determine a household's continued eligibility for Minnesota Health Care Programs.
The amount of medical costs an enrollee must incur and be responsible to pay on the satisfaction date before MA will begin payment of other medical expenses.
A DHS form (DHS-3159) that serves as legal acknowledgment of paternity. This form can only be signed after the child's birth and both of the parents' signatures must be notarized.
A system date used to identify when a renewal must be returned and processed. It is the last day of the month before the renewal month.
A person who presides over an appeal hearing and issues a recommendation on the appealed matter to the Commissioner of DHS. Also known as a Human Services Judge. An appeal is also known as a fair hearing.
A person who is a noncitizen who has permission to enter and live in the United States because of a well-founded fear of persecution in their home country due to race, religion, membership in a particular social group or political opinion.
A program that provides financial help to refugees ineligible for both MFIP and SSI.
A federally authorized program providing MA to refugees.
A person who: is under 18 years of age (or 21, under state law on benefits to children who were in foster care at age 18), AND entered the United States unaccompanied by and not destined to (a) a parent, (b) a close non-parental adult relative who is willing and able to care for the child, or an adult with a clear and court verifiable claim to custody of the minor, AND has no parents in the United States. The U.S. Citizenship and Immigration Services (USCIS) determines Refugee Unaccompanied Minor status when a person enters the United States.
State hospital for the treatment of mental diseases. RTCs are part of State Operated Services (SOS), which is the DHS division that manages and operates all state owned and operated facilities.
To restore coverage for a previously denied or closed time period.
A MinnesotaCare term for the month following the month clients are closed for not paying their premium. Clients paying all billed payments by the due date in the reinstatement month will have coverage reinstated back to the effective date of closure.
A caretaker of a dependent child who has one of the following relationships, or is the spouse of a person with one of the following relationships even if the marriage terminated by death or divorce: biological or adoptive parent, stepparent, grandparent, great-grandparent, great-great-grandparent, sister, stepsister, brother, stepbrother, aunt, great or great-great-aunt, uncle, great or great-great-uncle, nephew, niece, first cousin, first cousin once removed.
A property right that passes to a specified person or people upon the termination of a life estate interest. Unless restricted by the instrument establishing the remainder interest, the remainderman is generally free to sell his or her interest in the physical property even before the life estate interest expires. In such cases, the market value of the remainder interest is likely to be reduced because such sale is subject to the life estate interest.
The person or people entitled to the remainder interest of an estate after the termination of a life estate.
A deduction that can be used by a person who resides in a residential living arrangement to meet a medical spenddown or as a medical expense deduction in a LTC income calculation.
The process to determine a household's continued eligibility for Minnesota Health Care Programs.
The month for which eligibility is being renewed; the first month of the new certification period.
A person or organization, selected by the Social Security Administration, who is designated to receive benefits on behalf of an RSDI or SSI recipient and is obligated to use those benefits for the RSDI or SSI recipient's personal care and well being.
Any written statement indicating that a person wants to apply for Minnesota Health Care Programs coverage that contains at least the applicant's name and address or other means of contacting the applicant.
Community living arrangements such as group residential housing (GRH), board and lodge, and corporate and foster care settings that provide supportive services.
A program operated by the Social Security Administration that provides a monthly income to retired people, survivors or dependents of insured people, and people with disabilities.
Eligibility that is requested and determined for months prior to the month of application.
A special type of home equity loan for people age 62 or older. Reverse mortgages allow owners to convert some of the equity in their home to cash. The loan does not usually have to be repaid during the homeowner’s lifetime.
A burial agreement which allows the value of the agreement to be cashed in by the purchaser at any time.
A trust in which the grantor(s) reserve the right to revoke, reclaim or take back the assets deposited in the trust. A trust that does not specifically state that it is irrevocable is considered revocable. A trust that provides that it can be modified or terminated by a court is considered to be a revocable trust because the grantor or grantor’s representative can petition the court to terminate the trust.
Refugee Medical Assistance. A federally authorized program providing MA to refugees.
Recognition of Parentage. A DHS form (DHS-3159) that serves as legal acknowledgment of paternity. This form can only be signed after the child's birth and both of the parents' signatures must be notarized.
Roth 401(k) plans began January 1, 2006, as a new retirement savings plan option for employers to offer their employees. A Roth 401(k) is a hybrid that combines features of a Roth IRA and a traditional 401(k).
An IRA designated as a Roth IRA when it is set up. Unlike a Traditional IRA, a person can make contributions to a Roth IRA after age 70½ in certain circumstances.
Retirement, Survivors, and Disability Insurance. A program operated by the Social Security Administration that provides a monthly income to retired people, survivors or dependents of insured people, and people with disabilities.
Regional Treatment Center. State hospital for the treatment of mental diseases. RTCs are part of State Operated Services (SOS), which is the DHS division that manages and operates all state owned and operated facilities.
Minnesota's Consolidated Treatment Fund.
Facility offering a rehabilitation program to five or more chemically dependent people at one time.
Facility offering residential care and program services to five or more mentally ill adults at one time.
A funding mechanism for community mental health grants. Rule 78 may fund placements in Rule 31 facilities or other living arrangements in the community.
A business corporation of 35 or fewer shareholders. Each shareholder reports his or her share of income or loss separately.
A free statewide comprehensive breast and cervical cancer screening program administered by the Minnesota Department of Health whose primary objective is to increase the proportion of low or moderate income age-appropriate women who are screened for breast and cervical cancer.
Statewide Average Payment for a Skilled Nursing Facility. The monthly SAPSNF is used to determine the period of ineligibility for long-term care services resulting from an improper transfer.
The date on which the client has incurred medical costs that meet or exceed the medical spenddown amount.
Systematic Alien Verification for Entitlement. A process which allows access to USCIS data to validate the immigration status of noncitizen applicants, or for enrollees who report a change in immigration status, for MA, RMA, and MinnesotaCare for Families with Children. Workers access the USCIS data through the Alien Status Verification System (ASVS).
An IRA-based retirement savings plan designed specifically to make it easier for small employers to establish a retirement plan for employees and self-employed people. A SIMPLE IRA is a salary-reduction plan that allows employees to divert some compensation into retirement savings. Contributions to a SIMPLE IRA are deposited into a separate IRA for each participating employee.
See Children's Health Insurance Program (CHIP).
A monthly IEVS tape exchange between the Social Security Administration and DHS. It includes information on the SSI grant and income and asset information SSA uses to compute the grant. It is the State Data Exchange Report.
Income that is regularly received for only part of the year.
A federal income tax deduction that is the maximum deduction for certain property in the year the business owner purchases the property.
Employment in which people generally work for themselves rather than an employer and are responsible for their own work schedule. Self-employed people must file specific schedules as part of their federal tax returns.
An employee health insurance plan that an employer administers itself or through an insurer, trust, or agent. Under a self-insured plan, the employer provides coverage to employees directly or indirectly rather than purchasing coverage from an insurance company. Self-insured plans are regulated under the Employer Retirement Income Security Act (ERISA) and are not subject to state insurance regulations.
A program that provides training, counseling, and supervision services for people who need less than 24-hour care.
Simplified Employee Pension (SEP) IRA. A special type of IRA that can be established by an employer or by self-employed people. Designed for small businesses, SEP IRAs have many of the characteristics of qualified pension plans, but are much simpler to set up and administer. Under a SEP IRA, each participant has his or her own Traditional IRA to which the employer contributes. The contributions are excluded from the employee’s pay and are not taxable until distributed from the plan.
A Medicare Savings Program that pays for the Medicare Part B premium.
See County of Service.
See Grantor.
Substantial Gainful Activity. A level of work activity and earnings, defined by the Social Security Administration.
A person who owns shares in a publicly held company.
A stay in a long-term care facility for less than 30 days. This includes respite care.
Brothers and sisters related through one or both parents.
Semi-Independent Living Services Program. A program that provides training, counseling, and supervision services for people who need less than 24-hour care.
Savings Incentive Match Plan for Employees IRA. An IRA-based retirement savings plan designed specifically to make it easier for small employers to establish a retirement plan for employees and self-employed people. A SIMPLE IRA is a salary-reduction plan that allows employees to divert some compensation into retirement savings. Contributions to a SIMPLE IRA are deposited into a separate IRA for each participating employee.
A special type of IRA that can be established by an employer or by self-employed people. Designed for small businesses, SEP IRAs have many of the characteristics of qualified pension plans, but are much simpler to set up and administer. Under a SEP IRA, each participant has his or her own Traditional IRA to which the employer contributes. The contributions are excluded from the employee’s pay and are not taxable until distributed from the plan.
Special Income Standard. An income standard equal to three times the Federal Benefit Rate (FBR). It is used to determine eligibility for some elderly waiver (EW) clients.
Special Income Standard Elderly Waiver. An MA program for clients who receive Elderly Waiver (EW) services and whose income is at or below the Special Income Standard (SIS).
Service Limited Medicare Beneficiary. A Medicare Savings Program that pays for the Medicare Part B premium.
State Medical Review Team. A unit at DHS that determines disability in consultation with medical professionals appointed by the commissioner.
A term used to describe payments from the Social Security Administration.
A federal law authorizing such programs as RSDI, TANF, SSI, and MA.
A federal agency which administers the SSI, RSDI and Medicare programs.
A benefit to disabled or blind individuals who have contributed to FICA. It may be discontinued if a person reaches a certain level of income. It is also referred to as Retirement, Survivors, and Disability Insurance (RSDI).
A person who is the sole owner of an unincorporated self-employment business.
An income standard equal to three times the Federal Benefit Rate (FBR). It is used to determine eligibility for some elderly waiver (EW) clients.
An income disregard for certain MA clients with mental retardation.
The unit within DHS that bills and collects MA-EPD premiums.
The amount that a person’s income exceeds the applicable MA income standard. People with an MA basis of eligibility may become eligible by incurring medical expenses equal to or greater than the amount of excess income. There are several types of spenddowns including monthly medical spenddown, six-month medical spenddown, LTC spenddown and combination LTC/medical spenddown.
Also known as Satisfaction Date. The date the client meets or exceeds his or her medical spenddown amount.
For purposes of Minnesota Health Care Program eligibility, a sponsor is a U.S. citizen or lawful permanent resident (LPR) who signs a USCIS form I-864, Affidavit of Support, on behalf of a noncitizen as a condition of the noncitizen's entry into the U.S.
An Individual Retirement Arrangement (IRA) set up by an employed spouse to make contributions for a non-working spouse or for a spouse who has little or no income.
An allowance for support that a court orders a person to pay to his or her current or former spouse. Formerly referred to as alimony.
A person who is legally married to another person; a husband or wife.
Special Recovery Unit. The unit within DHS that bills and collects MA-EPD premiums.
Social Security Administration. A federal agency which administers the SSI, RSDI and Medicare programs.
Social Security Disability Insurance. SSDI is a benefit to disabled or blind individuals who have contributed to FICA. It may be discontinued if a person reaches a certain level of income. It is also referred to as Retirement, Survivors, and Disability Insurance (RSDI).
Supplemental Security Income. A program based on financial need operated by the Social Security Administration that provides monthly income to low income people who are age 65 or older, blind or disabled.
Social Security Number.
State-funded adoption assistance for children who do not qualify for federally funded IV-E adoption assistance.
The Centers for Medicare and Medicaid Services (CMS) administers the State Children's Health Insurance Program (SCHIP). This program provides federal matching funds to help states expand health care coverage for the nation's uninsured children.
A unit at DHS that determines disability in consultation with medical professionals appointed by the commissioner.
A person who is not a child's biological or adoptive parent but is the spouse of a child's biological or adoptive parent.
The biological or adoptive child of a child's stepparent.
A person enrolled in and attending an educational institution.
Loans, grants, scholarships, and work study funds to be used for educational and living expenses while attending school.
An adoption for which an agreement is made with the adoptive parents, guardian or conservator because of the special needs of a child who is certified eligible for adoption assistance.
A change in income from what a household reported on the previous year's tax forms.
A level of work activity and earnings, defined by the Social Security Administration.
A U.S. Department of Agriculture programs that issues benefits in the form of electronic benefits to increase food purchasing power. Formerly known as \"Food Support\" or \"Food Stamps\"
A program based on financial need operated by the Social Security Administration that provides monthly income to low income people who are age 65 or older, blind or disabled.
A process which allows access to USCIS data to validate the immigration status of noncitizen applicants, or for enrollees who report a change in immigration status, for MA, RMA, and MinnesotaCare for Families with Children. Workers access the USCIS data through the Alien Status Verification System (ASVS).
An MA option that provides eligibility to some disabled children who live with their families.
Tax Equity and Fiscal Responsibility Act. An MA option that provides eligibility to some disabled children who live with their families.
A period of time a person may be physically absent from a residence but still considered to be in the household.
Notification sent to the client at least ten calendar days before the effective date of an agency action. Most adverse actions, such as denial, reduction, or termination of health care benefits, require ten-day notice.
A form of property ownership in which each owner of real property has an undivided interest in the property and is able to sell their share of the property without obtaining the permission of the other owners.
The former name of the statement of rights given to people who are asked to provide private or confidential data about themselves. This statement is now known as the Notice of Privacy Practices.
An annuity under which payments are scheduled to continue for a specified period of time, such as for 10 years, irrespective of the annuitant's lifetime.
A discontinuation of program participation and benefits. Also known as cancellation and closure.
The obligation of a person or organization other than MA or MinnesotaCare to pay for a person's medical expenses. Examples of TPL include group or private health insurance, auto insurance, worker's compensation, and personal liability insurance.
A person or entity other than the client pays for the cost of a medical expense.
A household consisting of an adult parent, the child of the adult parent who is a minor caretaker and the minor caretaker's child.
A federal government sponsored retirement defined contribution plan for federal employees. Congress established the TSP in the Federal Employees’ Retirement System Act of 1986. The purpose of a TSP is to provide retirement income. Contributions are held in individual accounts rather than in a trust fund, and employees usually have considerable say over how their funds are invested. Most thrift plans allow participants to borrow against the balances in their accounts or to make early withdrawals in cases of financial hardship.
Another term for a savings account or certificate of deposit (CD) held in a financial institution, usually a bank.
A notice sent in advance of the proposed action as required by program rules.
The part of the Social Security Act that authorizes establishing paternity and collecting child and medical support by the IV-D unit.
Federal funding for adoption assistance for children who meet IV-E requirements.
Federal funding for foster care for children who meet IV-E requirements.
A national law that protects people from discrimination based on their race, color, or national origin for programs that receive federal financial assistance through the U.S. Department of Health and Human Services (HHS).
The section of the Social Security Act authorizing the MA Program.
Transitional Medical Assistance. Up to four months of additional medical coverage provided to some people terminated from regular MA because of increased child or spousal support.
The legal obligation of a party responsible for an accident or injury to pay for the resulting costs.
Compensation awarded because of a lawsuit filed to recover costs related to an accident or injury.
Third Party Liability. The obligation of a person or organization other than MA or MinnesotaCare to pay for a person's medical expenses. Examples of TPL include group or private health insurance, auto insurance, worker's compensation, and personal liability insurance.
To cause right, title, or interest in real or personal property to pass from one person to another.
The entity who received a transferred asset. A transferee could be a person or a group of people, a corporation, a trust or some other legal entity recognized by law as having right and duties.
The person who owned an asset at the time of the transfer. A transferor can be the individual who is subject to the transfer penalty, the individual's spouse, or both the individual and his or her spouse.
Up to 12 months of additional medical coverage provided to some people terminated from regular MA due to increased earnings, loss of earned income disregards, or a combination of increased child/spousal support and increased earnings/loss of earned income disregards.
Up to four months of additional medical coverage provided to some people terminated from regular MA because of increased child or spousal support.
A Department of Defense health insurance program providing coverage to active-duty and non-active duty members of the armed forces and their dependents, and certain civilian employees. This program was formerly known as CHAMPUS.
A Department of Defense health insurance program providing Medicare supplement entitlement for Medicare-eligible military retirees and their dependents. To receive coverage a person must be over age 65 and have Medicare Part B.
Any arrangement in which a grantor transfers money or property to a trustee with the intention that it be held, managed or administered by the trustee for the benefit of certain designated persons.
The legal documentation establishing a trust.
The assets and undisbursed income held in a trust, also referred to as the trust principal, estate or res (Latin for the subject matter of a trust or will). Assets and undisbursed income held in a trust are owned by (titled to) the trust and are not owned by the client. The trust corpus of a trust, however, may be available to the client.
The formal document that creates a trust and contains the powers of the trustees and the rights of the beneficiaries. A trust instrument can be a will or a formal declaration of a trust. Sometimes referred to as the Trust Agreement.
Also known as Trust Corpus. Income and/or assets that form the main body of a trust. Assets or income in the trust corpus may be available to a person but the person no longer owns them.
The person or entity who manages a trust corpus. When two or more trustees manage trust funds at the same time, they are referred to as co-trustees.
See Grantor.
Thrift Savings Plan. A federal government sponsored retirement defined contribution plan for federal employees. Congress established the TSP in the Federal Employees’ Retirement System Act of 1986. The purpose of a TSP is to provide retirement income. Contributions are held in individual accounts rather than in a trust fund, and employees usually have considerable say over how their funds are invested. Most thrift plans allow participants to borrow against the balances in their accounts or to make early withdrawals in cases of financial hardship.
Transitional Year Medical Assistance. Up to 12 months of additional medical coverage provided to some people terminated from regular MA due to increased earnings, loss of earned income disregards, or a combination of increased child/spousal support and increased earnings/loss of earned income disregards.
A person (other than the child of a foreign diplomat) born in one of the several States or in the District of Columbia, Puerto Rico, Guam, the U.S. Virgin Islands, or the Northern Mariana Islands who has not renounced or otherwise lost his or her citizenship; or a person born outside of the United States to at least one U.S. citizen parent (sometimes referred to as a ‘‘derivative citizen’’); or a naturalized U.S. citizen.
The federal agency responsible for immigration and citizenship. This agency was formerly known as the Bureau of Citizenship and Immigration Services (BCIS) and Immigration and Naturalization Service (INS).
A person born in American Samoa or Swains Island who does not derive U.S. citizenship from a parent or acquire it from a spouse. U.S. nationals are considered U.S. citizens for purposes of Social Security and for the citizenship documentation requirement under the federal Deficit Reduction Act (DRA) of 2005.
An IEVS tape exchange, containing Unemployment Insurance data, with the Minnesota Department of Economic Security completed monthly for enrollees and semi-monthly for applicants for federal programs.
Unemployment Insurance. A state cash payment made to some people who have lost their jobs. This program was formerly known as Reemployment Insurance in Minnesota.
Unearned Income Obligation. An amount added to premiums for MA-EPD clients who have unearned income. The UIO is .005 (one-half of one percent) of the unearned income.
Giving away, selling, conveying ownership or otherwise disposing of income or assets without receiving adequate compensation.
Health insurance that lacks coverage in two or more major areas of coverage as set by MinnesotaCare policy for children with income less than 200% FPG or children originally enrolled in the Children's Health Plan.
Income that could be paid out of a trust to the beneficiary, but remains in the trust.
Term referring to people living in the U.S. without the knowledge or approval of the U.S. Citizenship and Immigration Services (USCIS).
Income received without being required to perform any labor or service.
An amount added to premiums for MA-EPD clients who have unearned income. The UIO is .005 (one-half of one percent) of the unearned income.
A state cash payment made to some people who have lost their jobs. This program was formerly known as Reemployment Insurance in Minnesota.
Former name for the Uniform Transfer to Minors. Allows an adult to contribute to a custodial account in a minor's name without having to establish a trust or name a legal guardian. The minors can have securities bought and money invested in their names, while the custodian is responsible for managing the funds in the account. The custodian has a fiduciary duty to manage the account prudently, but once the minor reaches the age of majority, he/she has complete rights to the funds in the account. The assets are the legal property of the minor, and the parent has no legal control over the uses of the proceeds of the account. The Uniform Transfers to Minors Act supersedes The Uniform Gift to Minors Act.
An Act which allows an adult to contribute to a custodial account in a minor's name without having to establish a trust or name a legal guardian. The minors can have securities bought and money invested in their names, while the custodian is responsible for managing the funds in the account. The custodian has a fiduciary duty to manage the account prudently, but once the minor reaches the age of majority, he/she has complete rights to the funds in the account. The assets are the legal property of the minor, and the parent has no legal control over the uses of the proceeds of the account. The Uniform Transfers to Minors Act supersedes The Uniform Gift to Minors Act.
Income that can reasonably be anticipated to be the same amount every month.
An IEVS tape exchange of Unverified Unearned Income completed annually for recipients and monthly for applicants of federal programs. The source is the Internal Revenue Service (IRS). It reports information such as dividends, interest, and lottery winnings.
US Citizenship and Immigration Services. The federal agency responsible for immigration and citizenship, formerly known as the Bureau of Citizenship and Immigration Services (BCIS). This agency was formerly known as Immigration and Naturalization Service (INS).
A type of annuity in which periodic payments vary according to income generated by assets in an underlying investment portfolio. Payment amounts may fluctuate because the annuity payments vary based upon the performance of the market.
Income that cannot reasonably be anticipated to be the same amount every month.
Voluntary Employees' Beneficiary Association. A mutual association of employees providing certain specified benefits to its members or their beneficiaries. It may be funded by the employees or their employer. Funds in the possession of the VEBA are held in trust for the payment of benefits. Typical benefits are life, sick, accident, and medical benefits. See IRS Voluntary Employees’Beneficiary Association for more information.
The process and evidence used to establish accuracy or completeness of information from a client, third party, or authorized representative. Verification is also referred to as proof or documentation.
Benefits and services provided by the U.S. Veterans Administration (VA) to people who have served in the U.S. armed forces and their dependents.
A document which allows the bearer to apply for entry to the U.S. in a certain classification. It does not grant the bearer the right to enter the United States. The Department of Homeland Security (DHS), Bureau of Customs and Border Protection (BCBP) immigration inspectors determine admission into, length of stay and conditions of stay in, the U.S. at a port of entry. The information on a non-immigrant visa only relates to when an individual may apply for entry into the U.S.
A mutual association of employees providing certain specified benefits to its members or their beneficiaries. It may be funded by the employees or their employer. Funds in the possession of the VEBA are held in trust for the payment of benefits. Typical benefits are life, sick, accident, and medical benefits. See IRS Voluntary Employees’Beneficiary Association for more information.
An IEVS tape exchange with the Minnesota Department of Economic Security completed quarterly for recipients and monthly for applicants of federal programs. It provides information on wages earned in Minnesota.
A suspension or change of a federal regulation, service limitation, or eligibility requirement.
The amount of income over the maintenance needs allowance that people eligible for SIS-EW must contribute toward the monthly cost of waiver services.
Workforce Investment Act. Federal legislation passed in 1998 to consolidate, coordinate, and improve employment, training, literacy, and vocational rehabilitation programs in the United States, and for other purposes.
Women, Infants, and Children Nutrition Program. A federal program authorized by the Child Nutrition Act of 1966 to provide nutritious food and nutrition education to low-income pregnant and postpartum women and their children.
An unearned income disregard available to some MA clients who are widows or widowers with a disability.
A federal program authorized by the Child Nutrition Act of 1966 to provide nutritious food and nutrition education to low-income pregnant and postpartum women and their children.
An employee of a county agency or MinnesotaCare Operations who determines initial and continued eligibility for the Minnesota Health Care Programs.
A state program providing payments and reimbursement of medical expenses for people injured on the job.
Federal legislation passed in 1998 to consolidate, coordinate, and improve employment, training, literacy, and vocational rehabilitation programs in the United States, and for other purposes.
All or part of a health care expense that the client will no longer be responsible to pay to a provider because the provider has decided to absorb the cost of the expense.