HIV/AIDS Division Program HH Policy Manual

Please note our program policies are currently under review to update them in accordance with Affordable Care Act implementation. Until the revision is complete, if you have questions regarding Program HH Policy please contact Program HH Policy Coordinator Andy Ansell at 651.431.2397. New policy changes that will go into effect on January 1, 2014 are:

• Elimination of asset limitations

• COBRA will no longer be purchased after January 1.  Instead clients will be directed to sign up for insurance through MNSure.  (anyone with COBRA prior to January 1 can keep it until it’s exhausted but can transition sooner if they choose)

• Same sex marriages will be recognized and anyone in a legal same sex marriage will have to apply under the same criteria as heterosexual married couples

• We will no longer be asking for out of pocket medical expenses with the application.  If an ES determines a client is over income, the client will be asked to submit out of pocket medical expenses at that time

• Bank statements will no longer be requested as a required proof

I. PROGRAM OVERVIEW
II. PROGRAM HH APPLICATIONS
III. ELIGIBILITY AND ENROLLMENT
IV. INSURANCE

Table of Contents

I. Programs

1. Drug Assistance---------------------------------------------
1.1 AIDS Drug Assistance Program (ADAP)

2. Medical Coverage--------------------------------------------
2.1 I
nsurance Continuation Program

3. Basic Nutritional Supplement----------------------------
3.1 Nutrition Program

4. Basic Oral Care------------------------------------------------
4.1 Dental Program

5. Basic Mental Health-------------------------------------------
5.1 Mental Health Program

6. General Program Guidelines-------------------------------
6.1 Consumer Complaints

6.2 Consumer Appeal

6.3
Fraud Investigations

6.4
Communication with Vendors on behalf of clients

II. Program HH Applications

1. Requirements-----------------------------------------------------
1.1
Processing New Program HH Application

1.2
Complete Program HH application policy

1.3
Application Faxing Requirements

2. Intake-----------------------------------------------------------------
2.1 Application Receip
t Policy

2.2 Application Retention Policy

3. Timelines------------------------------------------------------------
3.1 Appli
cation Timeline Policy

3.2 Retroactive Coverage

4. Categories-----------------------------------------------------------
4.1
Annual Reapplications

4.2 Re-opening Closed Applications

4.3 Emergency Application for Drug Coverage

III. Eligibility and Enrollment

1. Guidelines------------------------------------------------------------
1.1
Eligibility Requirements

1.2
Income Verification

1.3
Release of Information

1.4
Minnesota Residency Verification

1.5
Household Size Determination

1.6
Medical Mailing Address

1.7
Eligibility and Insurance Specialist Enrollment Duties

1.8 Appeals Procedure for Denied HH Benefits

1.9
Eligibility Specialist Position Description (PD)

1.10
Referring client/applicant to other Minnesota Healthcare Programs

2. Case Notes-----------------------------------------------------------
2.1 Case Notes Policy

3. Exclusions------------------------------------------------------------
3.1 Incomplete Application

3.2 Closure for Failure to reapply to Program HH

3.3 Closing of deceased client

4. Prior Authorizations-----------------------------------------------
4.1 Prior Authorization Policy

5. MA-EPD--------------------------------------------------------------------
5.1 Program HH MA-EPD Policy

6. Supplemental Programs----------------------------------------------
6.1 Program Benefits for Veterans

6.2 State Medical Review Team (SMRT
) for Program HH

IV. Insurance

1. Applications and Guidelines-----------------------------------------
1.1
Complete Insurance Applications

1.2
Processing New Insurance Application for Program HH

1.3
Insurance Application Timeline

1.4
Insurance Enrollment and Status Notification Policy

1.5
Program HH Insurance Specialist Position Description (PD)

2. Minnesota Comprehensive Health Association (MCHA)----
2.1
Opening an MCHA Case

3. Cobra and other Insurance--------------------------------------------
3.1
Opening a COBRA, ESI or Private Insurance Case

4. Third Party Liability (TPL)----------------------------------------------
4.1
Third Party Insurance Plan Maintenance and Consumer Responsibility

4.2
Verifying TPL Information

4.3
Insurance Closure

4.4
Insurance Reinstatement

5. Medicare Part D---------------------------------------------- ----------
5.1 Co-payment and Premium Assistance

Contact us with questions or feedback:

HIV/AIDS Programs
Department of Human Services
PO Box 64972
St. Paul, MN 55164-0972

Twin Cities Metro area: (651) 431-2414 (voice) or (651) 431-7414 (fax)
Statewide: 1 (800) 657-3761 (voice) or 1 (800) 627-3529 (TTY)

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