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.l.
Medical Assistance (MA) Other Third Party Liability
In some situations, Medical Assistance (MA) enrollees may have access to third party liability other than health care coverage for all or part of their medical expenses related to an illness, accident or injury. The DHS Benefit Recovery Section (BRS) assists in the coordination of Third Party Liability (TPL) benefits and MA.
Examples of TPL that are not health care coverage include, but are not limited to the following:
Workers’ Compensation may be liable for the cost of medical care and subsistence related to on-the-job injuries
Auto insurance policies may cover medical costs related to auto accidents or injuries involving a motor vehicle
Homeowners or business liability policies may cover medical costs related to accidents on the home or business owner’s property
Tort claims and lawsuits may result in court-ordered awards for recovery of medical expenses caused by another party’s negligence or malpractice including but not limited to:
Funds raised by a community group or organization available to pay for medical expenses
Health Reimbursement Account (HRA) is considered a Group Health Plan (GHP) as provided for Under the Internal Revenue Code.
Actual or potential non-health care coverage TPL payments are not a barrier to MA eligibility; however, the enrollee must cooperate in providing information to determine whether those third parties are liable.
Accidents and Injuries
Enrollees must complete a Medical Service Questionnaire (MSQ) (DHS-2237A) when there is an accident or injury with possible TPL coverage. Adults who fail to cooperate with TPL requirements may have their MA coverage ended. See the MHCP Cooperation policy for more information.
Minnesota Statutes, section 256B.056
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.