Your Rights and Responsibilities

Summary of rights and responsibilities

Your rights and responsibilities	Health plans sold through MNsure	Medical Assistance (MA)	MinnesotaCare
You must pay your monthly premium to stay covered	Yes	No premium	Yes, if you have a monthly premium
You must report household changes	Within 30 days	Within 10 days – if anyone has MA	Within 30 days – if everyone has MinnesotaCare
You must file a federal income tax return	Yes, if you get tax credits to lower your costs.	No	No
You have the right to ask for a hearing	Yes	Yes	Yes

Report Changes

What you need to do: Report all changes in your household.

Why it matters

• You could miss out on financial help (and pay higher costs!).
• You could miss a special enrollment period that would let you change plans.
• You could have to pay money back to the government. You may have to repay benefits that you received but were not eligible for.
• You could lose access to your current plan.

File Taxes

What you need to do: File a federal income tax return, if you get advanced premium tax credits or want to claim the premium tax credit when you file.

Why it matters

• You could owe less at tax time (or get a larger refund).
• You could have to pay money back to the government. You may have to repay benefits that you received but were not eligible for.
• You could lose access to tax credits.

Get ready to file: Tax time information.

Ask for a Hearing

If you disagree with a decision you get from MNsure, you can ask for a review of your case. There is no cost. This is usually the fastest way to resolve an issue—without filing an appeal.

Learn more about your options for decision review.

Nondiscrimination Notice

Discrimination is against the law. See MNsure and the Minnesota Department of Human Services nondiscrimination notice.

Additional Rules for Medical Assistance and MinnesotaCare Only

Immigration

Immigration information you give to us is private. We use it to see whether you can get coverage. We share it only when the law allows it or requires it, such as to verify identity. In most cases, applying will not affect your immigration status unless you are applying for payment of long-term-care services. You do not have to give us your immigration information if you are a pregnant woman living in the United States without the knowledge or approval of the United States Citizenship and Immigration Services (USCIS). You also do not have to give us your immigration information if you are:

• Applying for emergency medical care only
• Helping someone else apply
• Not applying for yourself

Genetic Information

MNsure does not collect, maintain or use genetic information.

Record Retention

Information provided in an application for coverage through MNsure is subject to the False Claims Act and may be kept for up to 10 years. MNsure follows the general records retention schedules for state agencies and for the Department of Human Services and maintains data according to state and federal law. After the appropriate time period, MNsure destroys the data in a way that prevents their contents from being determined, including by shredding paper files and permanently removing electronic data so as to prevent recovery.

Reviews

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.

Consent for Sharing of Medical Information

In your application for Minnesota Health Care Program coverage, you have given your written and signed consent to the following agencies and people to share between them medical information about you only for the limited purposes indicated:

• Health providers, including health plans, insurance agencies, MA or MinnesotaCare, county advocates, school districts, your county or state case workers, and their contractors and subcontractors, for these purposes:
  • To determine who should pay for your 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 your minor children you applied for on the application.

You 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 you are 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 your bills, fraud investigations or quality-of-care review and studies.

An agency or person who gets your information through this consent could give the information to others.

If you end this consent, you cannot enroll or stay enrolled in Minnesota Health Care Programs.

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.

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.

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.

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’ health care services. This recovery process is done through Minnesota’s MA estate recovery and lien program.

Learn more: MA Estate Recovery and Liens

If you are enrolled in MA when you are 55 years old or older, after you die, Minnesota must try to recover certain payments the MA program made for your health care, including:

• Nursing home services
• Home and community-based services
• Related hospital and prescription drug costs

Home and community-based services include home health and skilled nursing services, personal care attendant costs, and medical supplies and equipment. They also include physical therapy, occupational therapy and speech therapy, when the therapy is provided by a home health or home rehabilitation agency.

If you permanently live in a medical institution, Minnesota must also try to recover the costs of all MA services you received while living in a medical institution. If you are permanently living in a medical institution and you do not have a spouse or disabled child living on your homesteaded real property, the state may file an MA lien against your real property to recover MA costs before your death.

After you die, the state also may file a notice of potential claim, which is a form of lien, against real property to recover MA costs. 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

Minnesota cannot start recovery of these costs while your spouse is still living or if you have a child under 21 years old or 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.

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.