This article is a section taken from MinnesotaCare Post-Eligibility, a part of the revisions and additions to the Minnesota Health Care Program Eligibility Policy Manual.
MinnesotaCare Begin and End Dates
Eligibility and coverage are separate concepts for MinnesotaCare:
- Eligibility refers to when a person meets the MinnesotaCare eligibility rules.
- Coverage refers to when a person can receive MinnesotaCare benefits.
MinnesotaCare eligibility and coverage begin dates can be different dates. When a person is determined eligible for MinnesotaCare, coverage can begin no earlier than the first of the month following the determination. Once a person has been determined eligible for MinnesotaCare, that person remains eligible for MinnesotaCare for the rest of the certification period, unless a change in circumstances makes the person ineligible during the certification period. A person may still be eligible for MinnesotaCare even if they fail to pay a premium. A person required to pay a premium has coverage for only those months for which a premium is paid, subject to the grace month policy.
See MinnesotaCare Premiums and Cost Sharing for more information.
MinnesotaCare eligibility and coverage end dates can be different dates as well. For example, a person can remain eligible for MinnesotaCare but have coverage end due to nonpayment of their premium.
When a MinnesotaCare enrollee received coverage for a month they were not eligible for MinnesotaCare, an overpayment may exist. See the MHCP Overpayment policy for more information.
Eligibility Begin Date
MinnesotaCare eligibility begins the first day of the month that a person meets the eligibility requirements. Eligibility can begin no earlier than the first day of the month of application. If a request for an eligibility determination does not require a new application, the eligibility begin date can begin no earlier than the first day of the month the request for coverage is received.
Generally, people who meet all eligibility requirements at any time during a month are eligible for the entire month. The eligibility begin date exceptions are:
- When a person is born, eligibility can begin no earlier than the date the person was born.
- When a person moves to Minnesota, eligibility can begin no earlier than the date the person became a Minnesota resident.
Coverage Begin Date
When a MinnesotaCare enrollee no longer meets the MinnesotaCare eligibility requirements, eligibility generally ends on the last day of the month in which the change occurred. The exceptions are:
- When a MinnesotaCare enrollee dies, eligibility ends the date the person died.
- When the change occurred too late in the month to send a 10-day advance notice, MinnesotaCare eligibility ends the last day of the month following the month in which the change occurred.
- When a MinnesotaCare enrollee becomes newly eligible for MA, MinnesotaCare eligibility ends the day before MA eligibility begins.
Coverage End Date
MinnesotaCare coverage ends if a MinnesotaCare enrollee no longer meets the eligibility requirements or fails to pay the MinnesotaCare premium.
Coverage End Date due to Ineligibility
When a MinnesotaCare enrollee no longer meets the MinnesotaCare eligibility requirements, MinnesotaCare coverage ends the last day of the month for which 10-day advance notice can be given.
Generally, 10-day advance notice is needed to end MinnesotaCare coverage. See the MHCP Notices policy for specific situations that require less than 10-day advance notice.
Coverage End Date due to Non-Payment of Premium
The monthly household premium must be paid to maintain coverage for a MinnesotaCare enrollee. See the MinnesotaCare Cost Sharing and Premiums policy for more information about the coverage end date due to nonpayment of premiums.
Households that are exempt from premiums and household members who are not required to pay premiums remain covered regardless of whether premiums are paid.
Legal Citations
Minnesota Statutes, section 256L.05
Minnesota Statutes, section 256L.15
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.