Updated January 1, 2014
- What is MinnesotaCare?
- Who can get MinnesotaCare?
- How does MinnesotaCare work?
- How do I apply for MinnesotaCare?
- Is it easy to apply for MinnesotaCare through MnSure?
- Do I have to supply proof of my income and other information with the application?
- Can I apply for MinnesotaCare with a paper application?
- How can I get help in applying for MinnesotaCare?
- How soon will I be able to get on the program?
- Where is the MinnesotaCare office?
- What do I have to do to stay on the program?
- How often do I need to renew coverage for MinnesotaCare?
- Do I have to be a U.S. citizen to get MinnesotaCare?
- Does if matter how long I have lived in Minnesota?
- What is the affordability standard and how does it apply to insurance coverage offered through my employer?
- Why do I have to file my taxes to be eligible for MinnesotaCare? 120
- How does being an American Indian affect my eligibility for MinnesotaCare?
- What is a premium?
- Will MinnesotaCare pay medical bills for services before I got on MinnesotaCare?
- How much are the MinnesotaCare monthly premium payments?
- How do I pay my premiums?
- What will happen if I do not pay my premium?
- Does MinnesotaCare look at assets in considering my eligibility?
- What is a co-payment (co-pay)?
- Are there co-payments (co-pays)?
- What services are covered by MinnesotaCare?
- Does everyone in my family have to sign up for MinnesotaCare?
- Do I have to enroll in MinnesotaCare if I qualify?
MinnesotaCare is a health insurance program for Minnesotans with lower incomes who cannot get affordable insurance through their employer and do not qualify for Medical Assistance. It is administered by the Minnesota Department of Human Services.
MinnesotaCare is not a free program. People who get MinnesotaCare pay a premium each month. The amount you pay depends on the number of people in your family, the number of people who are getting health insurance and your income. The eligibility requirements for MinnesotaCare have changed with the implementation of the Affordable Care Act.
Under the new eligibility rules, MinnesotaCare is for adults (parents and adults without children) between the ages of 19 and 64. Immigrant children who have not lived in the country for five years or more and are therefore not eligible for Medical Assistance may also be eligible for MinnesotaCare. Other requirements to qualify for MinnesotaCare include:
- You must live in Minnesota.
- You must have a Social Security Number or acceptable immigration document numbers.
- You must plan to file your income taxes for the year in which you are eligible and if married you must file jointly.
- You have to have household income between 138% and 200% of the Federal Poverty Guidelines (for adults) or between 0 and 200% of the Federal Poverty Guidelines for immigrants (income is calculated using Modified Adjusted Gross Income or MAGI). To see the income amounts, see the Federal Poverty Guidelines chart.
- You cannot have access to other insurance coverage that meets the minimal essential coverage standards. Medical Assistance, Medicare, most employer-sponsored insurance, and Tri-Care count as minimal essential coverage and having access to these programs would make you ineligible for MinnesotaCare.
Once you have been approved for MinnesotaCare, you have to pick a managed care health plan (like Medica, BlueCross/BlueShield or HealthPartners). The availability of health plans varies based on the county in which you live. You will receive information about your health plan options and the providers that are available within those options. Once you select a health plan, you will get one card that says “Minnesota’s Health Care Programs” and another card from your health plan. You need to bring both cards when you go to the doctor, pharmacy or get any health service. You also have to pay your first month premium before you can get medical services. Your health insurance (coverage) will start the first day of the month after you pay your first premium.
You apply for MinnesotaCare through MnSure, the new online marketplace for buying health insurance in Minnesota. MnSure includes the application to apply for financial assistance to help pay for health insurance. Financial assistance programs include Medical Assistance, MinnesotaCare and the Advanced Premium Tax Credits. Once you complete the application for financial assistance by answering all questions and submitting the application for review, you will receive an immediate determination of your eligibility for one of the three programs. If you are eligible for MinnesotaCare, you can enroll, pay your premium and renew your coverage as necessary using MnSure. You can use MnSure at anytime during the year in order to apply for the MinnesotaCare program.
There have been some problems reported with using MnSure. However, technological improvements are being made to the site on an ongoing basis, which is helping with the user-friendliness and accuracy of the site. Here are some tips you can follow to help make the process easier.
It has been reported that some browsers work better with MnSure than others. Recommended browsers include Firefox 17-22 and 24, Google Chrome 30, Internet Explorer (IE) 9, and Safari 6.0.5 (for Apple computers).
When you come onto the MnSure site, you must first create an account if you want to apply for MinnesotaCare, Medical Assistance or the Advanced Premium Tax Credits. Setting up the account takes about 20 minutes. It is recommended that you avoid using abbreviations when filling in your personal information (for example, for your address use Avenue or Street instead of Ave or St).
After creating your account, you will need to indicate if you are applying for “financial assistance with your health insurance.” This is the option to select if you want to see if you are eligible for MinnesotaCare, Medical Assistance or the Advanced Premium Tax Credits. The application process can take up to an hour. Keep in mind that you must answer each question as it is asked. You can’t skip ahead and come back to a question later. If you don’t know the answer to a question, you will need to save your application and come back to it (by logging in with your password) with the proper information. So, having the following information at hand may help:
- Names, birth dates and social security numbers (or document numbers for immigrants) for everyone in the household
- Accurate income information for all household members (you may want pay stubs and a copy of your previous year’s tax return available)
- Information on any sources of unearned income (alimony received, child support, unemployment income, retirement benefits, etc)
- Information on employer-sponsored insurance available to the family even if the family is not currently enrolled in that coverage (a form called Employer Coverage Tool is available that employers can complete with the requested information).
If you prefer or do not have access to a computer, you can elect to use a paper application to apply for health coverage with financial assistance. You can find that application here.
In most cases, if you are applying online through MnSure, you will not have to provide proof of the information you supply on your application. One of the advantages of using MnSure is its ability to electronically verify income, citizenship or immigration status and identity through a federal data hub. If for some reason your information cannot be electronically verified or if the information you supply is significantly different than the data hub, you may be asked to supply documents of proof.
Yes, you can apply for MinnesotaCare by mailing your paper application to MnSure or the MinnesotaCare Office. However, it will take longer to find out if you are eligible and you may be asked to supply documentation. The health care application for financial assistance can be downloaded here. However, MnSure is the recommended method for applying for MinnesotaCare.
The Affordable Care Act requires states to provide help to individuals who are trying to determine their health insurance options. Assistance is available through navigators, in-person assisters and brokers. Navigators and in-person assisters can answer questions about any of the financial assistance programs (Medical Assistance, MinnesotaCare and Advanced Premium Tax Credits) and assist anyone who needs help with getting through the application process (MnSure or the paper application). Brokers can also assist and they can help you compare the health plan options that are available on MnSure. A statewide directory of navigators, in-person assisters and brokers can be found on the MnSure site under the Assisters tab. There is no charge to use a navigator, in-person assister or broker. If you use the Bridge to Benefits screening tool, the name and contact information for a navigator/in-person assister in your county will be provided if you select “One-on-one Assistance” as your “How to Apply” option.
If you elect to apply for MinnesotaCare online through MnSure, you should receive an immediate determination of your eligibility once you submit your application. You will need to fully complete the application in order to submit it. You cannot submit an incomplete application. If you are found eligible, you should also get a letter in the mail telling you that you have been enrolled in MinnesotaCare along with information on your health plan choices. After you have paid your first month premium, your coverage (insurance) will start the first day of the following month. For example, if you pay your premium before December 15, your coverage will be effective on January 1.
It is located in the Elmer L. Andersen Building in downtown St. Paul at 540 Cedar Street - 1st floor - St. Paul, MN. This is at the intersection of Cedar Street and 10th Street East. This office is open Monday through Friday, from 8:30 a.m. to 4:30 p.m. Click here for a map and directions.
If you are mailing your completed MinnesotaCare application, send it to:
P. O. Box 64838
St. Paul, MN 55164-0838
You have to pay your premium by the 15th of every month. You also must notify MnSure or the MinnesotaCare office about any changes in your household within 10 days of them happening. Things you must report include births, deaths, moving, income or job or tax status changes, and people moving in or out of your household.
Every 12 months. You will get notification of your renewal in the mail or by e-mail (you will be asked on the application to indicate how you would like to be notified). You will be able to renew your coverage on the MnSure site. The renewal form will have your current information filled in and you will only need to update that information if something has changed or if you expect it to change within the upcoming year.
No, but you will need to provide a Social Security Number or the numbers from your acceptable immigration documents to get MinnesotaCare. You do not need to provide copies of Social Security cards. Your information will be electronically verified when you apply. If only some people in your household have a Social Security Number or acceptable immigration status, you can apply just for those household members.
MinnesotaCare has always had rules about insurance that is offered through your employer. Under the Affordable Care Act (ACA), the rules about employer-sponsored insurance have changed but you still may be barred from participating in MinnesotaCare if you have the offer of affordable insurance coverage (as defined by the ACA) through your employer even if you are not enrolled in that coverage.
The new affordability standard for employer-sponsored insurance says that insurance is affordable if the premium for employee-only coverage is less than 9.5% of the employee’s W-2 reported income. The standard is not based on household income, just the employee’s income, and the 9.5% affordability standard is based on employee-only coverage not dependent coverage. This means that if your employer offers coverage for you and your dependents and it meets the affordability standard for employee-only coverage, you and your dependents will NOT be eligible for MinnesotaCare even if dependent coverage is higher than 9.5% of your household income.
Medical Assistance, however, does not look at the availability of employer-sponsored insurance. If you are income eligible for Medical Assistance, you can enroll even if you have access to employer-sponsored insurance. This means that most dependent children of families that are income eligible for MinnesotaCare will be income eligible for Medical Assistance so the children will not be affected by the employer sponsored insurance rules.
Under the Affordable Care Act, the MinnesotaCare program must abide by the same rules for determining income and household size that other federally funded health care assistance programs do -- like Medicaid (Medical Assistance in Minnesota) and the Advanced Premium Tax Credits. All these programs now look at tax households (who you claim as dependents) and your Modified Adjusted Gross Income (which is line 37 on a standard 1040 IRS form). The federal government reimburses states for individuals based on their MAGI/household size. So to be eligible for MinnesotaCare, you must file your taxes and your household will no longer be determined by who lives with you but by whom you claim as dependents. If you are a married couple, you must file jointly. Keep in mind, too, that income is now determined by what you expect to earn in the year you seek coverage. It is not based on what you earned in the previous year. So, for example, even if you didn’t file taxes in 2013, you are eligible for MinnesotaCare in 2014 as long as you intend to file taxes at the end of 2014.
Being an American Indian does not affect your eligibility for MinnesotaCare. However, American Indians enrolled in MinnesotaCare and all their MinnesotaCare household members are exempt from paying premium payments. To be eligible for premium exemption as an American Indian you must provide verification of American Indian status from a tribe, Indian Health Services (IHS), or the Bureau of Indian Affairs (BIA) including:
- Document issued by a federally recognized American Indian/Alaska Native tribe,
- Document issued by the IHS indicating that the person is eligible for IHS services as an American Indian, or
- Document obtained from the BIA recognizing the person as an American Indian.
If you are an American Indian or have an American Indian in your MinnesotaCare household and you are currently paying MinnesotaCare premiums, you should contact your worker and submit any of the proofs mentioned above to receive the premium exemption, and you could receive a refund for premiums paid since July 2009.
For more information about how American Indians are eligible for health care programs under the Affordable Care Act, click here.
It is the amount of money you must pay every month to start and to keep your health insurance coverage.
No. It will not pay for any past medical bills.
It depends on your household size and income. The higher your income, the higher your premium amount will be. You will not know the exact amount of your premium until you submit your application and are determined eligible. You can receive an estimated MinnesotaCare premium amount by completing the Bridge to Benefits screening tool on this site. The maximum premium per person is $50.
When you apply for MinnesotaCare on MnSure, you will be asked to indicate how you would like to pay your premiums. You can elect to pay online through MnSure or you can request that MnSure bill you. Whichever option you choose, you must make certain your premium payment is received by the 15th of each month to ensure coverage is in effect for the following month.
If you elect to receive a bill each month, you can return payment by check, money order or credit card. You will be instructed on the bill on where to mail your payment. You cannot pay your premium at your county human services office.
If you do not pay your premium, your MinnesotaCare will be cancelled and you will need to reapply to get on the program again. Keep in mind that you may be subject to a tax penalty if you go without health insurance for more than three months each year. Read more about the penalty that was enacted as part of the Affordable Care Act.
In keeping with the guidelines of the Affordable Care Act, MinnesotaCare no longer looks at a person’s assets. Assets refer to the things a person owns like savings accounts, retirement accounts, vehicles, houses, and so on. There is no limit on assets. However, the interest you earn on your assets is now counted as part of your income.
Yes, for some services. Children under age 21 and pregnant women do not have co-pays. Click here for a basic list of covered services and co-pays for all MinnesotaCare enrollees.
MinnesotaCare provides a very comprehensive set of benefits and covers a wide range of preventive, inpatient and outpatient health care services. Some very small co-pays may be required. Click here for a basic list of covered services and co-pays for all MinnesotaCare enrollees.
No, you can sign up just some people in your family, but under the Affordable Care Act there will be a tax penalty for people who are uninsured for more than three months in a calendar year. Read more about the penalty that was enacted as part of the Affordable Care Act.
No, however, if you want financial assistance for help with paying for health insurance, you must enroll in the financial assistance program for which you qualify. For example, if you are eligible for Medical Assistance, you cannot ask to enroll in MinnesotaCare or the Advanced Premium Tax Credits and if you are found eligible for MinnesotaCare you will be barred from claiming the Advanced Premium Tax Credits. You can always elect to purchase private insurance through MnSure without financial assistance.