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210-RICR-40-05-3 TITLE 210 - EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES CHAPTER 40 - MEDICAID INTEGRATED HEALTH CARE COVERAGE SUBCHAPTER 05 – COMMUNITY MEDICAID Part 3 – Retroactive Coverage 3.1 Scope and Purpose

Medicaid coverage may start retroactively for up to three (3) months prior to the month of application for IHCC groups, unless explicitly excluded. To qualify, a person must have met the criteria for Medicaid eligibility during the retroactive period. Coverage generally stops at the end of the month in which a person no longer meets the requirements for eligibility. The provisions in this section do not apply to the MAGI-eligible individuals and families in the Medicaid Affordable Care Coverage (MACC) groups identified in the Medicaid Code of Administrative Rules, Affordable Care Coverage Groups, except when a person who is ineligible for coverage in one of these groups applies for MN IHCC in accordance with the provisions in Part 2 of this Subchapter. 3.2 General Provisions A. Medicaid beneficiaries in the IHCC groups may request retroactive eligibility for up to three months prior to the month of application. 1. Eligibility criteria – To obtain retroactive coverage, applicants must meet all eligibility criteria related to the applicable IHCC group during the retroactive period. Retroactive coverage is also available to IV-E and non IV-E foster children and adoption subsidy family-related coverage groups. a. The applicant must meet Medicaid eligibility requirements for each month in which an unpaid medical bill was incurred. Thus, retroactive eligibility may be determined for one, two, or three months of the retroactive period. b. Only the income and resources available to the applicant in the retroactive period are used to determine eligibility. No deeming is required. c. The following chart details beneficiaries’ eligible retroactive benefits: