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MNsure offers health care options for eligible consumers

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MNsure recently announced implementation procedures for consumers eligible for a Qualified Health Plan to obtain retroactive coverage, tax credits and cost sharing reductions.

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The procedures are in response to a federal government bulletin published February 27 that gives state-based marketplaces, like MNsure, flexibility in addressing consumers with “exceptional circumstances.”

These guidelines apply to people who:

● Have not been continuously enrolled in coverage since January 1, 2014.

● Enrolled in coverage outside of MNsure but eligible for tax credits and/or cost sharing reductions.

If a consumer has not been continuously enrolled in coverage since January 1, and either has record of some activity in the MNsure system or can credibly document failed attempts to enroll because of technical issues, he or she may qualify for retroactive coverage.

The consumer may be eligible to obtain retroactive coverage back to the first effective date available after a first enrollment attempt was made. The earliest is January 1. Consumers must pay premiums for all months back to the effective date of retroactive coverage.

If a consumer enrolled in a qualifying individual market plan outside of MNsure but believes he is eligible for an Advanced Premium Tax Credit, he must contact MNsure.

Consumers must have purchased a qualifying individual market plan from a health insurance company that offers products through MNsure in order to be eligible to participate.

The consumer will need to enroll through MNsure and must keep the same insurance company and policy they purchased outside of MNsure (if the same plan is offered through MNsure).

Retroactive Advanced Premium Tax Credit or cost sharing reduction will be applied by the insurance carrier. The consumer’s effective date of coverage will stay the same. The consumer will also be eligible for a Special Enrollment Period to choose a different plan going forward if needed.

Tax credits are available to consumers within defined income limits. Consumers with employer-sponsored coverage are generally not eligible for tax credits. More information about tax credit and/or cost sharing reduction eligibility is available at www.mnsure.org/individual-family/cost/.

Minnesotans who believe they fall into either of these two categories must call the MNsure Contact Center at 1-855-366-7873 by Thursday, May 15 to report their case and start the process.

MNsure’s complete policy regarding this federal bulletin can be found at www.mnsure.org/updates/retroactive-coverage.jsp.

This does not apply to those consumers determined eligible for Medical Assistance or MinnesotaCare.

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