Rights and Responsibilities - Medical Assistance and MinnesotaCare
This page is about rights and responsibilities. Please also see the Notice of Privacy Practices.
Making a MinnesotaCare Payment
If you have MinnesotaCare, you must pay your monthly premium on time to keep your coverage active. (Medical Assistance does not have premiums.)
If you have Medical Assistance (MA), you must report a change within 10 days of the change happening. Call your county agency to report the change.
If you have MinnesotaCare, you must report a change within 30 days of the change happening. If everyone in your household receives MinnesotaCare, call MinnesotaCare Operations at 800-657-3672 or 651-297-3862 to report the change. If anyone in your household has MA, call your county agency to report the change.
If you do not report changes, you may have to pay money back to the state or federal government for benefits that you received but were not eligible for. If you are not sure whether to report a change, call and explain what is happening. Examples of changes you need to report include the following:
Income changes when you
- Start a new job, change jobs, stop a job or have an increase or decrease in your current job's income
- Start to get, or receive changes in the amount of, other income like Social Security, other retirement income or unemployment
Residence changes when you
Life changes in your household when someone
- Starts or stops other health insurance or Medicare
- Becomes pregnant or has a baby
- Moves in or out of your home
- Changes tax filing status
- Loses Minnesota residency
- Changes lawful presence status or becomes a citizen
- Changes incarceration status
- Dies, gets married or gets a divorce
- Becomes disabled
You Have the Right to Ask for a Hearing
If you feel your health care eligibility or benefits are wrong or your application was not processed correctly, you may ask for an appeal hearing. By requesting an appeal hearing, you are requesting a fair review of your case. You can represent yourself or use an attorney, advocate, authorized representative, relative, friend or other person. Find specific appeal instructions on all eligibility notices that you receive. Learn more about the appeals process and how to ask for a hearing on the MNsure website or the Minnesota Department of Human Services website.
The state or federal agency's health care program auditors may look at your case. They will review the information you gave us and check to make sure we processed your case correctly. They will let you know if they need to ask you questions.
Other Health Care
You and your household members enrolled in MA must tell us about any other health insurance that you have or that is available to you, including employer-sponsored coverage, private health insurance, long-term-care insurance, and any limited health coverage, such as dental or accident coverage. You must tell us whether your employer offers insurance and whether you accepted it.
You and your household members enrolled in MA may need to accept and keep a health insurance policy when the policy is found to be cost effective. If you have a good reason for not doing that, you may ask the state to approve the reason. If you do not give us information about your health insurance policy, you may not get coverage.
You must also tell us when you have become eligible for Medicare. MA pays for the Medicare premiums of some low-income people.
Consent for Sharing of Medical Information
By accepting or receiving MA or MinnesotaCare, I give my consent to the following agencies and people to share between them medical information about me only for the limited purposes indicated:
- Health providers, including health plans, insurance agencies, MA or MinnesotaCare, county advocates, school districts, my county or state case workers, and their contractors and subcontractors, for these purposes:
- To determine who should pay for my health care
- To provide, manage and coordinate health care services
- All other agencies or people listed in this notice of rights and responsibilities and in the Notice of Privacy Practices, for this purpose:
- To administer Minnesota Health Care Programs, pay for services, and conduct research and investigations
This consent applies to medical information about my minor children I applied for on the application.
I can stop this consent at any time by asking in writing for it to end. The written notice to stop this consent will not affect information the agency has already given to others. This consent is good while I am enrolled in MA or MinnesotaCare, up to one year or longer if the law permits.
However, it does not end after one year for records given to consulting providers or for payment of my bills, fraud investigations or quality-of-care review and studies.
An agency or person who gets my information through this consent could give the information to others.
MA Medical Support
If you are applying for yourself and your children and you do not live with the other parent, the law says you may have to give information to child support staff if both you and your child are eligible for MA. This includes helping the state prove who the father of your children is and helping the state to get the other parent to help pay the children's medical expenses. If you do not help child support staff, your children will still get coverage, but your coverage will end unless you are pregnant.
If you are afraid the other parent may cause harm to you or your child, you can give your county or tribal agency proof that supports your fears. The agency will review your proof and tell you whether you still must give information to child support staff.
MA Estate Claims and Liens
In certain circumstances, federal and state law require the Minnesota Department of Human Services and local agencies to recover costs that the MA program paid for its members. This recovery process is done through Minnesota's MA estate recovery and lien program.
If you are enrolled in MA when you are 55 years old or older, then, after you die, Minnesota must try to recover the total cost of all MA services that MA paid for your health care between your 55th birthday and December 31, 2013. For the period from January 1, 2014, to the day your coverage ends, Minnesota must recover only the costs of long-term services and supports (LTSS). LTSS include:
- Nursing home services
- Home and community-based services
- Related hospital and prescription drug costs
If you turned 55 years old on or after January 1, 2014, Minnesota must recover only the costs of LTSS you received.
Even after you die, Minnesota cannot start recovery of these costs if your spouse survives you, you have a child under 21 years old, or you have a child who is permanently disabled. Once your spouse dies, Minnesota must try to recover your MA costs from your spouse's estate. However, recovery is further delayed if you still have a child who is under 21 or permanently disabled. Your children do not have to use their assets to reimburse the state for any MA services you received.
Also, Minnesota must try to recover the costs of all MA services an MA member received at any age while permanently living in a medical institution. However, MA members who qualify for services under modified adjusted gross income (MAGI) eligibility criteria are not subject to recovery for services received before the age of 55.
The state may file an MA lien against your real property to recover MA costs before your death, but only if you are permanently living in a medical institution. The state also may file a notice of potential claim, which is a form of lien, against real property to recover MA costs after death. Liens to recover MA costs may be filed against the following:
- Your life estate or joint tenancy interest in real property
- Your real property that you own solely
- Your real property that you own with someone else
You have the right to speak with a legal-aid group or a private attorney if you have specific questions about how MA estate recovery and liens may affect your circumstance and estate planning. The Minnesota Department of Human Services cannot provide you with legal advice. For more information, go to http://mn.gov/dhs/ma-estate-recovery/.
Assignment of Medical Payments
By accepting MA, you give your rights to all medical payments for yourself and anyone else you apply for to the state of Minnesota. These include medical payments from all other people or companies, including medical support payments from an absent parent. This assignment of medical payments begins as soon as health care coverage starts.
You also agree to help the state get paid back for medical expenses that should have been paid by others. You may not have to help the state if you have a good reason for not helping and the state approves the reason.
Discrimination is against the law. See MNsure and the Minnesota Department of Human Services (DHS) nondiscrimination notice.