Health Care Renewal Notice Page 25
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46Nov 24, 2014 7:35 PM
Reference Number : 10166532
8 -of- 9
Your benefits will automatically continue at the rate of prior coverage. But if you lose your appeal, you will have to pay
back the benefits that you were not eligible to receive. You may want to ask to have your benefits reduced during your
appeal so you do not have to pay them back if you lose. Check “I want to reduce or stop my benefits...” on the appeal
request form, or call the MNsure Contact Center at 1-855-366-7873.
For Medical Assistance or MinnesotaCare, your benefits continue only if you follow these time frames. You must appeal:
•
Within 10 days of the date on the Health Care Notice or
•
Before the date when the action takes place.
Important: If you do not appeal within 10 days of the date on the Health Care Notice, you can still appeal within 30 days.
Your benefits will only go back to your prior coverage if you win the appeal.
What if I lose my appeal?
If you lose your appeal, you will have to pay back the benefits you got while your appeal was pending.
Important: You have the right to apply for Medical Assistance or MinnesotaCare again if your benefits stop.
Can I get help with my appeal?
You may represent yourself at the hearing. You may also have someone else speak for you. You must let us know in
writing who the person is that you want to speak for you. You can do that on the appeal request form. If your income is
below a certain limit, you may be able to get legal advice or help with an appeal from your local legal aid office.
Discrimination is against the law
The U.S. Department of Health and Human Services’ Office for Civil Rights prohibits discrimination in its programs
because of race, color, national origin, age, disability and sex, including sex stereotypes and gender identity. If you
believe you have been discriminated against, you have the right to file a complaint directly with the federal agency. Write
to the U.S. Department of Health and Human Services Office for Civil Rights Region V at 233 North Michigan Avenue,
Suite 240, Chicago, IL 60601 or call at (312) 886-2359 (Voice) and (800) 368-1019 (Toll-Free) (800) 537-7697 (TTY).
In Minnesota, if you believe you have been discriminated against because of race, color, national origin, religion, creed,
sex, sexual orientation, public assistance status, age, or disability, you have the right to file a complaint with:
•
Minnesota Department of Human Services, Equal Opportunity and Access Division, P.O. Box 64997, St. Paul,
MN 55164-0997. Telephone (651) 431-3040. Minnesota Relay 711 or (800) 627-3529.
•
Minnesota Department of Human Rights, Freeman Building, 625 Robert Street North, St. Paul, MN 55155.
Telephone (651) 539-1100 and Toll-Free (800) 657-3704. TTY (651) 296-1283.
•
MNsure Accessibility and Equal Opportunity Office, 81 7th Street East, Suite 300, St. Paul, MN 55101-2211,
, Telephone (612) 279-8955.
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