This article is a section taken from Medical Assistance (MA), a part of the revisions and additions to the Minnesota Health Care Program Eligibility Policy Manual.
Medical Assistance (MA) Referral For Other Benefits
Medical Assistance (MA) enrollees who appear to have eligibility for other programs are required to apply for those programs to continue MA eligibility. Enrollees must apply for benefits from other programs if it could increase their income or help pay medical expenses. Enrollees must apply within 30 days of when the county, tribal or state servicing agency notifies them of their potential eligibility, unless they can show good cause for not doing so.
Social Security benefits
Enrollees, potentially eligible for the following benefits, must apply to maintain MA eligibility.
Retirement Survivors Disability Insurance
The federal Social Security Administration (SSA) administers Retirement, Survivors and Disability Insurance (RSDI) benefits. RSDI provides a monthly income based on payroll contributions made via Social Security taxes.
The following people, if qualified under a Social Security number having at least 40 work quarters, may be eligible for RSDI:
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Retired people who meet SSA age requirements
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People certified disabled by SSA
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Dependents of a wage earner who is disabled or retired
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Dependent survivors of a wage earner who has died
RSDI eligible MA enrollees at full retirement age must apply for benefits. MA enrollees who are family members of RSDI eligible people must also apply for potential benefits.
People who are eligible for RSDI may also be eligible for Supplemental Security Income (SSI) if their RSDI payment is less than the SSI income standard.
Supplemental Security Income
Supplemental Security Income (SSI) is a federal supplemental income program operated by SSA and funded by general tax revenues. It provides monthly cash payments to people aged 65 or older and people certified disabled by SSA, who have little or no income, to help them meet basic needs for food, clothing, and shelter. MA enrollees, potentially eligible for SSI, must apply for benefits.
Medicare
Enrollees who are potentially eligible for Medicare must apply to maintain MA eligibility. Enrollees who meet one of the following may qualify for Medicare:
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People age 65 or older who qualify for RSDI or Railroad Retirement Board (RRB) benefits
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Citizens and qualifying non-citizens age 65 or older who pay a Medicare Part A premium
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People certified disabled by SSA, after a 24-month waiting period. People with Amyotrophic Lateral Sclerosis (ALS) are eligible the same month they start receiving RSDI benefits.
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Widows and widowers and divorced widows and widowers with an SSA certified disability, after a two-year waiting period
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People with 1619(a) or 1619(b) status
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People with End-Stage Renal Disease (ESRD) defined as permanent kidney failure requiring dialysis or a kidney transplant
Medicare Part A
Medicare Part A is federal hospitalization insurance. People who are eligible for premium-free Medicare Part A may not refuse to apply or turn down this coverage to gain or continue MinnesotaCare or Advance Premium Tax Credit (APTC) eligibility.
Medicare Part B
Medicare Part B is medical insurance. There is a monthly premium for Part B. MA enrollees must apply and maintain Medicare Part B coverage, even if they are required to pay a premium. Medicare Savings Programs (MSP), the Medicare Buy-In and MA-EPD can help eligible clients with premiums and other costs. People have a wide variety of Medicare-approved plans from which to choose.
Medicare Part D
Medicare Part D is prescription drug coverage. Enrollment in Medicare Part D is not required as a condition of MA eligibility. However, there are specific rules established for clients eligible for Medicare Part D who fail or refuse to enroll in, or opt out of, that program. MA cannot pay prescription drug costs that would be covered by Medicare Part D for eligible Part D beneficiaries who do not enroll.
Medicare eligible MA and MSP enrollees qualify for a full Extra Help subsidy automatically and must select a Medicare Part D benchmark plan. Medicare beneficiaries of all ages can get free assistance with selecting a Part D plan by calling the Senior LinkAge Line® at (800) 333-2433.
Railroad Retirement Benefits
The federal Railroad Retirement Board (RRB) administers railroad retirement benefits and Medicare for railroad workers and their families. RRB eligible MA enrollees at full retirement age must apply for benefits. The railroad worker’s family members must also apply for potential benefits if the railroad worker is currently receiving RRB benefits or was receiving or eligible to receive benefits but is now deceased. People turning age 65 who are receiving railroad retirement benefits must apply for Medicare through the RRB.
Financial Needs
Enrollees, potentially eligible for the following benefits, must apply to maintain MA eligibility.
Minnesota Unemployment Insurance (UI) benefits provide a temporary partial wage replacement to workers who become unemployed through no fault of their own.
Workers’ Compensation provides benefits for people injured or ill from their job.
MA enrollees who are veterans or a spouse of a veteran, using the People Aged 65 or Older, Blind or Disabled basis, living in a long-term care facility, must apply for the federal Veterans’ Aid and Attendance program through the U.S. Department of Veterans Affairs (USDVA).
Exceptions
Enrollees are not required to reapply for benefits that were previously denied unless there has been a change in circumstances or eligibility requirements of the benefit program.
Legal Citations
Code of Federal Regulations, title 42, section 435.608
CREDIT: The content of this post has been copied or adopted from the Minnesota Healthcare Programs Eligibility Policy Manual, originally published by the Minnesota Department of Human Services.
This is also part of a series of posts on Minnesota Healthcare Eligibility Policies.