Ryan White HIV/AIDS Treatment Extension Act of 2009

The Ryan White HIV/AIDS Treatment Extension Act of 2009 codifies a variety of core medical and support services provided to eligible people with HIV. The Minnesota Department of Human Services (DHS) directly administers Ryan White program services for eligible people with HIV under Program HH.

Program HH provides access to crucial medications and care services for people with HIV in Minnesota. It includes:

IPA is designed to maintain the health and independence of people in Minnesota with HIV who have low income. It covers the cost of their monthly health insurance premiums.

This page provides information for people who are applying for or currently enrolled in IPA. This information is also important for professionals helping people apply for IPA (e.g., HIV medical case managers, Ryan White benefits counselors).

For information about the initial application process for people new to the program, refer to Program HH Policy Manual – Application process.

IPA uses Ryan White and Minnesota state funds to cover the cost of premiums for insurance plans that:

Program HH will choose insurance plans to cover annually before open enrollment. The approved insurance plans include qualified health plans and Medicare Advantage Plans, as well as off-market individual plans that offer statewide insurance. The person must enroll into one of the approved plans if they would like to receive help paying insurance premiums from Program HH.

In addition, Program HH pays premiums for people who are enrolled in MinnesotaCare and Medical Assistance for Employed Persons with Disabilities (MA-EPD). If a person on MinnesotaCare or MA-EPD receives a notice of premium due, they should call Program HH Customer Care at 651-431-2398, or they should send the notice they received to Program HH via email to dhs.programhh@state.mn.us, fax to 651-431-7414 or mail to:

Minnesota Department of Human Services
ATTN: Program HH Staff
P.O. Box 64972
St. Paul, MN 55164-0972

Program HH is the payer of last resort. It will not cover costs the person’s health insurance would normally cover. Program HH will pay the cost of deductibles, copayments and coinsurance for outpatient medications included in the Program HH medication formulary after any primary insurance has paid the portion it covers.

For more information, refer to Program HH Policy Manual – Payer of last resort.

The person must provide Program HH with information about the initial premium and any premium cost changes by submitting the following:

The person must submit this information electronically or via email to dhs.programhh@state.mn.us, fax to 651-431-7414 or mail to:

Minnesota Department of Human Services
ATTN: Program HH Staff
P.O. Box 64972
St. Paul, MN 55164-0972

If the person does not provide Program HH with complete and accurate information, there may be delays in premium payment that could result in a gap in coverage or termination of coverage.

Program HH must assess the person’s eligibility for Program HH and approve them before they can enroll in an insurance plan, as described on Program HH Policy Manual – Application process. Program HH cannot pay premiums for people who have not had this assessment or were not approved for the program.

Program HH must assess which insurance product is appropriate for the person and provide the person with written approval. If the person is eligible, Program HH will send a letter to let them know. Premium payments are not automatic. The approval letter from Program HH will include details about the first month of payment. Until then, the person is responsible to make payments. For information about appeals, refer to Program HH Policy Manual – Rights and responsibilities.

To be eligible for IPA, the person must:

If the person incurs a tax liability due to the APTC, Program HH may pay the person’s APTC tax responsibility. This payment must be coordinated with Program HH staff and cannot be reimbursed directly to the person.

If the person receives a tax credit due to the APTC, the person must refund this amount back to Program HH by sending the check they receive from the IRS. If the person has already cashed the check from the IRS or received the refund via direct deposit, they should send to Program HH a personal check, cashier’s check or money order in the amount of the refund received from the IRS that is attributable to the APTC.

The person should send refund checks, tax liability invoices from the IRS or copies of tax return indicating tax liability related to APTC to:

Minnesota Department of Human Services
ATTN: Accounting Officer
P.O. Box 64972
St. Paul, MN 55164-0972

The person must report changes to income, household size, address and insurance status within 10 days to Program HH by contacting a Program HH insurance specialist or by calling the customer care line at 651-431-2398. Program HH staff can assist the person with referrals to MNsure to report changes and adjust the APTC.

The person also must inform Program HH of the new premium amounts and any changes in the APTC that impacts the premium amount.

If the person does not repay the APTC tax credit or does not accurately report their income, they may lose their IPA coverage.

IPA makes regular payments for health insurance for eligible people with eligible insurance policies on or before the due date for coverage with checks issued by the state of Minnesota. Each check includes a remittance advice (RA) sheet that identifies the:

Note: For MinnesotaCare and MA-EPD premiums, Program HH created an internal process to make payments to other areas of DHS for premiums owed for people on Program HH. For more information, refer to the covered premiums section.

Refunds

Refunds for overpayment or when coverage ends should be made payable to the state of Minnesota and mailed to:

Minnesota Department of Human Services
ATTN: Accounting Officer
P.O. Box 64972
St. Paul, MN 55164-0972

With the refund, the submitter must include an RA that identifies the person receiving services and the reason for the refund.

If the person receives a refund check issued by an insurance company (or by the state of Minnesota for people enrolled in MinnesotaCare and MA-EPD), they should send it to Program HH using the address above. If the person has already cashed the refund check issued by the insurance company or the state of Minnesota, the person should send a personal check, cashier’s check or money order in the amount of the refund instead.

The person is responsible to provide Program HH with invoices from the insurance company to ensure the correct amount is paid each month.

To have monthly premium notices sent directly to Program HH, the person should contact the insurance company and request that the notices be sent to:

Minnesota Department of Human Services
P.O. Box 64972
St Paul MN 55164-0972

The person must inform a Program HH insurance specialist or call the customer care line at 651-431-2398 before making any changes to their insurance policy.

The person is responsible to notify Program HH of any late or termination notices from the insurance company by calling the customer care line at 651-431-2398. Failing to do so may result in termination of coverage.

If an eligible person lost insurance coverage due to failure to reapply, Program HH will attempt to reinstate the person’s coverage.

Program HH will pay the premiums associated with reinstating insurance coverage for a eligible person within the following grace periods:

For information about the recertification process, refer to Program HH Policy Manual – Application process.