2004 Minnesota Statutes

     256L.04 Eligible persons. 

    Subdivision 1.    Families with children.  (a) Families 
 with children with family income equal to or less than 275 
 percent of the federal poverty guidelines for the applicable 
 family size shall be eligible for MinnesotaCare according to 
 this section.  All other provisions of sections 256L.01 to 
 256L.18, including the insurance-related barriers to enrollment 
 under section 256L.07, shall apply unless otherwise specified. 

    (b) Parents who enroll in the MinnesotaCare program must 
 also enroll their children, if the children are eligible.  
 Children may be enrolled separately without enrollment by 
 parents.  However, if one parent in the household enrolls, both 
 parents must enroll, unless other insurance is available.  If 
 one child from a family is enrolled, all children must be 
 enrolled, unless other insurance is available.  If one spouse in 
 a household enrolls, the other spouse in the household must also 
 enroll, unless other insurance is available.  Families cannot 
 choose to enroll only certain uninsured members.  

    (c) Beginning October 1, 2003, the dependent sibling 
 definition no longer applies to the MinnesotaCare program.  
 These persons are no longer counted in the parental household 
 and may apply as a separate household. 

    (d) Beginning July 1, 2003, or upon federal approval, 
 whichever is later, parents are not eligible for MinnesotaCare 
 if their gross income exceeds $50,000. 

    Subd. 2.    Cooperation in establishing third-party 
 liability, paternity, and other medical support.  (a) To be 
 eligible for MinnesotaCare, individuals and families must 
 cooperate with the state agency to identify potentially liable 
 third-party payers and assist the state in obtaining third-party 
 payments.  "Cooperation" includes, but is not limited to, 
 identifying any third party who may be liable for care and 
 services provided under MinnesotaCare to the enrollee, providing 
 relevant information to assist the state in pursuing a 
 potentially liable third party, and completing forms necessary 
 to recover third-party payments. 

    (b) A parent, guardian, relative caretaker, or child 
 enrolled in the MinnesotaCare program must cooperate with the 
 Department of Human Services and the local agency in 
 establishing the paternity of an enrolled child and in obtaining 
 medical care support and payments for the child and any other 
 person for whom the person can legally assign rights, in 
 accordance with applicable laws and rules governing the medical 
 assistance program.  A child shall not be ineligible for or 
 disenrolled from the MinnesotaCare program solely because the 
 child's parent, relative caretaker, or guardian fails to 
 cooperate in establishing paternity or obtaining medical support.

    Subd. 3. Repealed, 1998 c 407 art 5 s 48 

    Subd. 4. Repealed, 1998 c 407 art 5 s 48 

    Subd. 5. Repealed, 1998 c 407 art 5 s 48 

    Subd. 6. Repealed, 1998 c 407 art 5 s 48 

    Subd. 7.    Single adults and households with no children. 
  The definition of eligible persons includes all individuals 
 and households with no children who have gross family incomes 
 that are equal to or less than 175 percent of the federal 
 poverty guidelines. 

    Subd. 7a.    Ineligibility.  Applicants whose income is 
 greater than the limits established under this section may not 
 enroll in the MinnesotaCare program. 

    Subd. 8.    Applicants potentially eligible for medical 
 assistance.  (a) Individuals who receive supplemental security 
 income or retirement, survivors, or disability benefits due to a 
 disability, or other disability-based pension, who qualify under 
 subdivision 7, but who are potentially eligible for medical 
 assistance without a spenddown shall be allowed to enroll in 
 MinnesotaCare for a period of 60 days, so long as the applicant 
 meets all other conditions of eligibility.  The commissioner 
 shall identify and refer the applications of such individuals to 
 their county social service agency.  The county and the 
 commissioner shall cooperate to ensure that the individuals 
 obtain medical assistance coverage for any months for which they 
 are eligible. 

    (b) The enrollee must cooperate with the county social 
 service agency in determining medical assistance eligibility 
 within the 60-day enrollment period.  Enrollees who do not 
 cooperate with medical assistance within the 60-day enrollment 
 period shall be disenrolled from the plan within one calendar 
 month.  Persons disenrolled for nonapplication for medical 
 assistance may not reenroll until they have obtained a medical 
 assistance eligibility determination.  Persons disenrolled for 
 noncooperation with medical assistance may not reenroll until 
 they have cooperated with the county agency and have obtained a 
 medical assistance eligibility determination. 

    (c) Beginning January 1, 2000, counties that choose to 
 become MinnesotaCare enrollment sites shall consider 
 MinnesotaCare applications to also be applications for medical 
 assistance.  Applicants who are potentially eligible for medical 
 assistance, except for those described in paragraph (a), may 
 choose to enroll in either MinnesotaCare or medical assistance. 

    (d) The commissioner shall redetermine provider payments 
 made under MinnesotaCare to the appropriate medical assistance 
 payments for those enrollees who subsequently become eligible 
 for medical assistance. 

    Subd. 9.    General assistance medical care.  A person 
 cannot have coverage under both MinnesotaCare and general 
 assistance medical care in the same month.  Eligibility for 
 MinnesotaCare cannot be replaced by eligibility for general 
 assistance medical care, and eligibility for general assistance 
 medical care cannot be replaced by eligibility for MinnesotaCare.

    Subd. 10.    Citizenship requirements.  Eligibility for 
 MinnesotaCare is limited to citizens of the United States, 
 qualified noncitizens, and other persons residing lawfully in 
 the United States as described in section 256B.06, subdivision 
 4, paragraphs (a) to (e) and (j).  Undocumented noncitizens and 
 nonimmigrants are ineligible for MinnesotaCare.  For purposes of 
 this subdivision, a nonimmigrant is an individual in one or more 
 of the classes listed in United States Code, title 8, section 
 1101(a)(15), and an undocumented noncitizen is an individual who 
 resides in the United States without the approval or 
 acquiescence of the Immigration and Naturalization Service. 

    Subd. 10a.    Sponsor's income and resources deemed 
 available; documentation.  When determining eligibility for 
 any federal or state benefits under sections 256L.01 to 256L.18, 
 the income and resources of all noncitizens whose sponsor signed 
 an affidavit of support as defined under United States Code, 
 title 8, section 1183a, shall be deemed to include their 
 sponsors' income and resources as defined in the Personal 
 Responsibility and Work Opportunity Reconciliation Act of 1996, 
 title IV, Public Law 104-193, sections 421 and 422, and 
 subsequently set out in federal rules.  To be eligible for the 
 program, noncitizens must provide documentation of their 
 immigration status.  

    Subd. 11.    MinnesotaCare outreach.  (a) The 
 commissioner shall award grants to public or private 
 organizations to provide information on the importance of 
 maintaining insurance coverage and on how to obtain coverage 
 through the MinnesotaCare program in areas of the state with 
 high uninsured populations.  

    (b) In awarding the grants, the commissioner shall consider 
 the following: 

    (1) geographic areas and populations with high uninsured 
 rates; 

    (2) the ability to raise matching funds; and 

    (3) the ability to contact or serve eligible populations. 

    The commissioner shall monitor the grants and may terminate 
 a grant if the outreach effort does not increase enrollment in 
 medical assistance, general assistance medical care, or the 
 MinnesotaCare program. 

    Subd. 12.    Persons in detention.  Beginning January 1, 
 1999, an applicant residing in a correctional or detention 
 facility is not eligible for MinnesotaCare.  An enrollee 
 residing in a correctional or detention facility is not eligible 
 at renewal of eligibility under section 256L.05, subdivision 3b. 

    Subd. 13.    Families with relative caretakers, foster 
 parents, or legal guardians.  Beginning January 1, 1999, in 
 families that include a relative caretaker as defined in the 
 medical assistance program, foster parent, or legal guardian, 
 the relative caretaker, foster parent, or legal guardian may 
 apply as a family or may apply separately for the children.  If 
 the caretaker applies separately for the children, only the 
 children's income is counted and the provisions of subdivision 
 1, paragraph (b), do not apply.  If the relative caretaker, 
 foster parent, or legal guardian applies with the children, 
 their income is included in the gross family income for 
 determining eligibility and premium amount. 

    HIST: 1986 c 444; 1992 c 549 art 4 s 5,19; 1993 c 247 art 4 s 
 5; 1993 c 345 art 9 s 4-6; 1994 c 625 art 8 s 52-55,72; art 13 s 
 2; 1995 c 234 art 6 s 6-9; 1997 c 85 art 3 s 9; 1997 c 203 art 
 12 s 1; 1997 c 225 art 1 s 4-8; 1998 c 407 art 5 s 17-25; 1999 c 
 245 art 4 s 91-94; 1Sp2003 c 14 art 12 s 73,74