Program for People Living in Institutions for Mental Diseases

Minnesota provides health care for people who meet Medical Assistance (MA) eligibility criteria while living in an Institution for Mental Diseases (IMD). This health care may be federally or state-funded. State-funded MA for people living in an IMD is also known as Program IM.

An IMD is a hospital, nursing facility, or other institution of 17 beds or more that primarily provides diagnosis and treatment for people with mental illness or chemical dependency. See Appendix E Institutions for Mental Diseases for more information.

People must have an MA basis of eligibility and meet all of the MA eligibility requirements associated with their basis. People are in one of the following eligibility groups:

• MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD)
• MA for Employed Persons with Disabilities (MA-EPD)
• MA for Families With Children and Adults (MA-FCA)

When an MA enrollee moves into an IMD, they do not need to file a new application for health care.

The following people continue to be eligible for federally funded MA while living in an IMD:

• People age 65 or older
• Children younger than age 21 in an accredited, licensed inpatient psychiatric hospital
• People residing in an IMD that is an accredited, licensed inpatient psychiatric hospital who received MA covered services prior to their 21st birthday. Enrollees who continue to receive these services in the same facility after age 21 are covered by MA until they turn age 22.
• People residing in an IMD facility approved to participate in the 1115 Substance Use Disorder (SUD) System Reform Demonstration
• People enrolled in Refugee Medical Assistance (RMA)
• People ages 21 up to 65 enrolled in a managed care plan with a length of stay of no more than 15 days during the calendar month

This subchapter includes policies that apply to Program IM and links to policies that apply to all MA and all Minnesota Health Care Programs (MHCP) programs.

1. IMD General Requirements
2. MA-ABD General Requirements
3. MA-EPD General Requirements
4. MA-FCA General Requirements
5. Program IM Non-Financial Eligibility
6. MA-ABD Bases of Eligibility
7. MA-ABD Certification of Disability
8. MA-FCA Bases of Eligibility
9. MA Citizenship and Immigration Status
10. MA County Residency
11. MA Social Security Number
12. MHCP State Residency
13. Program IM Financial Eligibility
14. MA-ABD Financial Eligibility
15. MA-EPD Financial Eligibility
16. MA-FCA Financial Eligibility
17. Program IM Post-Eligibility
18. MA Begin and End Dates
19. MA Benefit Recovery
20. MHCP Change in Circumstances
21. MA Cooperation
22. Program IM Medicare
23. MA Cost Sharing
24. MHCP Fraud
25. Program IM Health Care Delivery
26. MHCP Inconsistent Information
27. Program IM Leave Days
28. MA-EPD Premiums and Cost Sharing
29. MA Qualifying Health Coverage
30. MA Referral for Other Benefits
31. MA-ABD Renewals
32. MA-FCA Renewals