First MA-EPD Premium PaymentsPremium Processing: Payments
As we said earlier, workers cannot approve MA-EPD eligibility until the applicant has paid their first premium. Keep reading to learn about the payment options applicants have for both their initial premium as well as subsequent premium payments.
First MA-EPD Premium Payments
First, the worker mails the Initial Premium Notice (DHS-3547) to the applicant.
After receiving the Initial Premium Notice, the applicant may decide to pay all or only some of the retroactive months. If the applicant does not submit premiums for all of the retro months, only approve eligibility for the paid months of MA-EPD.
If any of the months included in the Initial Premium Notice includes an overdue premium month, that overdue premium must be paid before eligibility for any new coverage can be approved. Premium payments are applied in the following order:
- The oldest unpaid premium(s).
- The current month's premium.
- A credit toward future premiums.
How many days does the applicant have to pay their first premium? Click below for the answer.
If the applicant is in the county agency and wants to pay the premium right away, go ahead and collect the premium while following your agency's procedures and approve eligibility.
County agencies cannot collect premiums for subsequent months; these must be billed and collected by the SRU at DHS.
Once the payment is received at your county agency, approve eligibility in MAXIS and record in MMIS. Send the DHS Special Recovery Unit (SRU) a SIR webmail message to "DHS.MADE@state.mn.us" with a subject of "MA-EPD Premium New" to initiate billing for all of the subsequent premiums. Case note documenting the premium amount and that a request to initiate billing was send to SRU.
Note: Applicants who request retroactive coverage must pay the premium for a retroactive month before coverage can be approved for that month. The applicant can choose which months they pay for. Eligibility can only be granted for months that are paid. More information about premium payments can be found in the Health Care Programs Manual.
Ongoing MA-EPD Premium Payments
SRU mails MA-EPD premium notices on the fourth of each month.
To discontinue or report changes in MA-EPD billing for any reason, send a SIR webmail to "DHS.MADE@state.mn.us" with a subject of "MA-EPD Premium Change." Include the enrollee's name, PMI number and the effective date for the change. SRU will not discontinue or change billing unless they receive an email.
Note:The process for starting an MA-EPD case for a verified American Indian enrollee exempt from premium payments requires additional steps. Please refer HCPM 03.30.20 MA for Employed Persons With Disabilities, HCPM 03.45 Programs for Special Populations, and HCPM 25.10 MA-EPD Premiums for more information.
