Minnesota Administrative Rules

9506.0030 APPLICATION; ENROLLMENT; COVERAGE.

Subpart 1.

Application sources.

Applicants may apply directly to the commissioner or through appropriate referral sources.

A.

Appropriate referral sources include but are not limited to: eligible provider offices; local social service agencies; school district offices; public and private elementary schools in which 25 percent or more of the students receive free or reduced price lunches; community health offices defined in Minnesota Statutes, section 145A.02; WIC program sites under United States Code, title 42, section 1786.

B.

Referral sources that accept applications from applicants must send applications to the department within five working days after receipt.

Subp. 2.

Necessary information for eligibility determination.

A.

Applicants must provide all information necessary to determine eligibility for MinnesotaCare and potential eligibility for medical assistance, including:

(1)

Social Security number;

(2)

proof of permanent residency; the signature of an applicant on the application attesting to permanent residency meets the affidavit requirement under Minnesota Statutes, section 256L.09, subdivision 4, paragraph (b), clause (3);

(3)

household composition;

(4)

availability of other health coverage, including access to employer-subsidized health coverage;

(5)

gross annual family income; and

(6)

any additional information needed by the commissioner to determine or verify eligibility.

B.

If the commissioner determines an applicant may be ineligible for MinnesotaCare because employer-subsidized coverage was lost for reasons that would disqualify the applicant from receiving reemployment benefits under Minnesota Statutes, section 268.095, the commissioner shall refer the applicant to the Department of Employment and Economic Development for a determination whether the applicant would have been disqualified.

Subp. 3.

Eligibility determination deadline.

Except during the four months after the dates on which adult individuals and families without children become eligible for MinnesotaCare, the commissioner shall determine an applicant's eligibility within 30 days after a complete application is received by the department.

Subp. 4.

Enrollment and beginning of coverage.

The date of enrollment and the date coverage begins are determined as follows:

A.

An applicant is enrolled in MinnesotaCare on the date the following are completed:

(1)

a complete application is received by the department and the applicant is determined eligible under part 9506.0020; and

(2)

the initial premium payment under part 9506.0040 is received by the department.

B.

Coverage begins the first day of the calendar month following the date of enrollment, except:

(1)

if the initial premium payment is received after noon of the last business day of the month of enrollment, coverage begins the first day of the second following calendar month;

(2)

coverage for eligible newborns in an enrolled family begins immediately from the moment of birth;

(3)

coverage for eligible adoptive children of a family enrolled in MinnesotaCare begins on the date of placement for the purpose of adoption;

(4)

coverage for other new members of an enrolled family begins the first day of the month following the month in which the new member's eligibility is determined and the first premium payment is received; and

(5)

coverage of enrollees who are hospitalized on the first day of the month following enrollment begins the day following the date of discharge from the hospital.

Statutory Authority:

MS s 256.9352; 256L.02

History:

19 SR 1286; L 1998 c 265 s 45; L 2005 c 112 art 2 s 41

Published Electronically:

October 16, 2013