Information subject to change.
What is MinnesotaCare?
MinnesotaCare is a reduced-cost health coverage program primarily for families who do not have access to employer-subsidized insurance (ESI) and cannot afford private insurance. The program is administered by the state through the Department of Human Services. MinnesotaCare enrollees pay a low-cost monthly premium, which is calculated based on income, family size and number of family members enrolled in the program.
Who is eligible for MinnesotaCare?
MinnesotaCare is open to all Minnesota residents who are U.S. citizens or have acceptable immigration status (a social security number is required for each person applying to the program) and who meet income and program guidelines. Families are eligible for MinnesotaCare if their income is at or below 275% of the Federal Poverty Guidelines (FPG). All members of the family (parents and children) are eligible at the same income guidelines. However, in large families with incomes over $50,000 per year, only the children in the family are eligible for coverage up to 275% of FPG. In addition to meeting income eligibility, applicants for MinnesotaCare cannot currently have or have had employer-subsidized insurance (ESI) within the past four months nor can they have had access to employer-subsidized insurance (through their current employer) within the past 18 months. ESI is defined as an insurance plan offered by an employer for which the employer pays at least 50% of the premium.
Are adults eligible for MinnesotaCare?
As stated above, parents, relative caregivers and some other adults with children in the household may be eligible for MinnesotaCare providing they meet income eligibility and other program requirements. Adults without children in the household are also eligible for MinnesotaCare but at a lower income level and with a limited benefits package. Adults without children must have an income below 175% of FPG to be eligible for MinnesotaCare. Recipients pay a low-cost monthly premium and receive coverage only for physician, drugs, outpatient and lab/diagnostic services with an annual cap of $5,000. Hospitalization (inpatient services) is covered with an annual cap of $10,000 a year. Adults without children in MinnesotaCare also are required to pay some co-payments for these services.
Are there asset limitations for MinnesotaCare?
Yes. Families with one adult in the household can only have assets totaling $10,000. Families with two adults in the household can have assets totaling $20,000. (Homes and cars used to get to and from work are exempt.)
What services does MinnesotaCare cover?
For families, MinnesotaCare pays for many, but not all, health care services. Coverage includes routine check ups, immunizations, prenatal care and delivery, hospital and doctor care, prescriptions, glasses, dental work and routine dental exams, chemical dependency treatment, mental health services and more. Some co-payments for services are required. Once accepted under MinnesotaCare, applicants enroll in one of the health plans (BlueCross BlueShield, Medica, HealthPartners, etc.) under contract to MinnesotaCare.
What if I have past medical bills?
Unlike MA, MinnesotaCare does not pay for any past medical bills. All applicants who are eligible for MinnesotaCare must enroll in a managed care health plan and pay their first month premium before they are able to receive medical services.
How often do I need to reapply for MinnesotaCare?
MinnesotaCare recipients must reapply annually (once a year) from the date of the first premium payment. If you are cancelled for nonpayment of premium, you must wait the 4-month insurance rule before re-enrolling. Changes in household income and composition need only be reported at the annual renewal period. Effective 10/1/04, MinnesotaCare enrollees will be required to renew coverage every six months.
How much are the MinnesotaCare monthly premium payments?
Only a MinnesotaCare enrollment representative can accurately calculate the MinnesotaCare premium.
To download a health care application or for more information about this program, click here.
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