1. What is MinnesotaCare? MinnesotaCare is a health insurance program Minnesotans with lower incomes who cannot get affordable insurance through their job or somewhere else. It is not a free program. People who get MinnesotaCare pay a reduced-cost premium eery month. The amount you pay depends on the number of people in your family, the number of people who are getting health insurance (coverage), and your income. Effective July 1, 2012, the Healthy
Minnesota Contribution Program was implemented as part of the MinnesotaCare
Program.The Healthy Minnesota
Contribution Program is for some adults who do not have children in their
households.Instead of paying
premiums, the Healthy Minnesota Contribution Program provides enrollees a
monthly defined contribution amount to purchase health insurance in the private
market.All other MinnesotaCare
eligibility rules apply to the Healthy Minnesota Contribution Program.
2. Who can get MinnesotaCare? Children, families, pregnant women, and adults without children can all
get MinnesotaCare. You have to live in Minnesota and have a Social
Security Number. You also have to have income and assets below the
limits. You cannot get MinnesotaCare if you have had health insurance
during the last four months unless the insurance was Medical
Assistance. (After four months without insurance, then you could get
MinnesotaCare). You cannot get MinnesotaCare if your job offers
insurance and your employer pays 50% or more of the premium (amount due
every month). But some children can get MinnesotaCare even if
they have had insurance in the past 4 months or if their parent’s
employer offers insurance. Also, if your employer pays 50% or more of
your premium, but not 50% or more of the premium for your spouse or
children, then they can get MinnesotaCare, but you cannot.
Healthy Minnesota Contribution Program
Adults without children in their households who have incomes between 200 and 250% of the federal poverty line ($1,862 - $2,328 per month for a single adult or $2,522 - $3,153 for a married couple) will be determined eligible for the Healthy Minnesota Contribution Program. This includes single adult households as well as married couples. If you fall into this category, you must also meet all the MinnesotaCare eligibility rules including citizenship and residency requirements, the asset limits, other insurance rules and the four-month waiting rule.
3. How does MinnesotaCare work? Once you have been accepted for MinnesotaCare, you have to pick a
managed care health plan (like Medica, BlueCross/BlueShield or
HealthPartners). 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 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.
Healthy Minnesota Contribution Program
If you are an adult without children who is found eligible for the Healthy Minnesota Contribution Program you will need to purchase an insurance plan through the private insurance market. To assist you with purchasing a plan, the Department of Human Services, upon your approval for the program, will refer you to professional broker associations. These associations have formed the Agent Coalition to provide Healthy Minnesota Contribution Program enrollees with a resource for finding a professional insurance agent to assist you in finding private health insurance. With the help of the agent, you will need to choose, apply for and be approved for private insurance within four months of being approved for the Healthy Minnesota Contribution Program. Whatever private insurance company you choose will require you to apply and go through an underwriting process. This can take 30 to 60 days. After choosing a plan, your approved monthly defined contribution amount will be paid by the Department of Human Services directly to the insurance company from which you purchase your insurance plan. You are required to pay any additional amount of the health insurance premium that is more than your approved monthly defined contribution. If the premium payment is less than the monthly defined contribution amount, you are not entitled to the remaining monthly contribution amount.
If you are turned down for coverage through the private market for a pre-existing condition or other health concern, you may use your monthly defined contribution amount to purchase coverage through the Minnesota Comprehensive Health Association (MCHA). Enrollees who must purchase coverage through MCHA will receive a 20% increase in their monthly defined contribution amount to apply towards MCHA premiums, which are higher than premiums in the private market. For additional information on MCHA, click here.
4. How do I get an application for MinnesotaCare? The application is called the Minnesota Health Care Programs
Application. You can get one at your county human services office. You
can also get one mailed to your home if you call 1-800-657-3672 or
651-297-3862 (in the Twin Cities). (TTY service: 1-800-627-3529 or
711). You can also get an application on this website by clicking here. Or you can apply online using ApplyMN.
Healthy Minnesota Contribution Program
If you are an adult without children in your household who may be eligible for the Healthy Minnesota Contribution program, you must apply for MinnesotaCare using the Minnesota Health Care Programs Application described above. If you are found eligible for the Healthy Minnesota Contribution Program, you will also need to apply and be approved for insurance through the private market by going through an underwriting process. This can take up to 30 to 60 days. You will have up to four months after your approval for the Healthy Minnesota Contribution Program to get health insurance through the private insurance market or through MCHA (see question 3). If you do not complete your shopping within this period, you will be required to reapply.
5. What is the application like? The application is 8 pages long, plus instructions. It is available
in English, Spanish, Hmong, Somali, Khmer (Cambodian), Lao, Vietnamese,
Arabic, Oromo, Serbo-Croatian (Bosnian) and Russian. The application
will ask you about everyone who lives with you, how much money they
make and what they own (assets). You will also have to provide
copies of “documents of proof” that show your income (such as pay stubs
or tax returns) and assets. You can complete the application yourself or you
can get help filling it out from a county worker or other organizations. You
can use the Program Directory on this website to find places that
help in your county.
Healthy Minnesota Contribution Program
The same application is completed for the Healthy Minnesota Contribution Program.
6. Do I have to go in person to apply? No. You can apply for MinnesotaCare by sending your application and
copies of your documents of proof in the mail. (Do not send the
original documents, because they could get lost.) You can mail or bring
them to the MinnesotaCare office in St. Paul. Some county human service
offices will take MinnesotaCare applications, but not all of them. It
is best to send or bring your application to the St. Paul office so you
can find out as soon as possible if you can get MinnesotaCare.
7. Where is the MinnesotaCare office? 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: MinnesotaCare P. O. Box 64838 St. Paul, MN 55164-0838
8. How soon will I be able to get on the program? After you send in your application and copies of your documents of
proof, it usually takes about 1-2 months before you can get on the
program. You will get a letter in the mail telling you if you are
enrolled in MinnesotaCare (you have been accepted). After you have paid
your first premium, your coverage (insurance) will start the first day
of the next month.
Healthy Minnesota Contribution Program
As the Healthy Minnesota Contribution Program is a part of the MinnesotaCare program, eligibility for traditional MinnesotaCare will be determined first. If you are found eligible for the Healthy Minnesota Contribution Program, you will be notified within the 1 to 2 month timeframe described above and be referred to a professional broker association. A broker will help you evaluate your private insurance options, select and apply for a plan. Private insurance companies will require you to apply and go through an underwriting process. This can take an additional 30 to 60 days. Enrollees are encouraged to begin shopping for private health insurance as soon as they receive their Healthy Minnesota Contribution Program approval notice. The effective date of Healthy Minnesota Contribution eligibility is the first day of the month following the month eligibility is determined. The effective date of the start of insurance coverage is determined by the health insurance plan purchased by the enrollee.
9. What do I have to do to stay on the program? You have to pay your premium every month. You also must tell a MinnesotaCare worker about any changes in your household within 10 days of
them happening. Things you must report include births, deaths, moving,
income or job changes, and people moving in or out of your household.
You also have to always renew your coverage (tell them some information
about you to make sure that you can still get MinnesotaCare) when they
send you a letter in the mail.
Healthy Minnesota Contribution Program
For those enrolled in the Healthy Minnesota Contribution Program, you must pay any premium amount in excess of your monthly contribution amount and adhere to MinnesotaCare rules above.
If you fail to pay your portion of the health insurance premium or elect to voluntarily terminate your coverage, you cannot reenroll in the Healthy Minnesota Contribution Program for four (4) calendar months.
10. How often do I need to renew coverage for MinnesotaCare? Every 12 months. You will get a “Renewal Form” in the mail that asks
you questions. Fill it out, sign your name, and mail it back right away
so that you can keep getting your health insurance. If you move, be
sure to let your MinnesotaCare worker know your new address so that you
will get this letter.
Healthy Minnesota Contribution Program
Healthy Minnesota Contribution Program enrollees must renew their eligibility every 12 months, same as traditional MinnesotaCare.
11. Do I have to be a U.S. citizen to get MinnesotaCare? No, but you need a Social Security Number to get MinnesotaCare (and Healthy Minnesota Contribution Program). You do not have to show proof if you are an adult without children and are applying for or enrolled in MinnesotaCare or the Healthy Minnesota Contribution Program, getting Medicare benefits or getting or previously received Supplemental Security Income (SSI).
You do not need to provide copies of Social Security cards. Parents without acceptable immigration status can apply for their children as long as the children are U.S. citizens or have acceptable immigration status. Also, if only some people in your household have a Social Security Number,
you can apply just for them. You may be asked to provide copies of your immigration documents if you are not a U.S. citizen.
12. Does if matter how long I have lived in Minnesota? You just have to plan to stay in Minnesota to get
MinnesotaCare. It doesn’t matter how long you have lived in this state.
13. How does being an American Indian affect my eligibility for MinnesotaCare? 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.
Healthy Minnesota Contribution Program
Being an American Indian does not affect your eligibility or the program rules for the Healthy Minnesota Contribution Program. If you are an adult without children in your household and your income falls between 200 to 250% of the Federal Poverty Guidelines and you meet the other MinnesotaCare program requirements, you will be eligible for the MinnesotaCare/Healthy Minnesota Contribution Program and will receive a monthly defined contribution amount based on your age and household income to help you purchase health insurance from private insurance companies. All the program rules that are described in this section will apply to you.
14. Will MinnesotaCare pay medical bills for services before I got on MinnesotaCare? No. It will not pay for any past medical bills.
15. What is a premium? It is the amount of money you must pay every month to start and to keep your health insurance coverage.
Healthy Minnesota Contribution Program
Under the Healthy Minnesota Contribution Program, you will not pay a MinnesotaCare premium. Rather, you will receive a defined monthly contribution amount, based on your age and household income, to help you pay the monthly premium for an insurance coverage plan you purchase from a private insurance company. Your defined monthly contribution amount will be sent directly to the insurance company and you will be billed for the difference between your Healthy Minnesota Contribution Program amount and your premium payment.
16. How much are the MinnesotaCare monthly premium payments? 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 a worker looks at your application. You can receive an estimated MinnesotaCare premium amount by completing the Bridge to Benefits screening tool on this site. Effective July 2012, some children (those in households with incomes under 200% of the Federal Poverty Guidelines) are exempt from MinnesotaCare premium payments and are allowed to enroll at no charge. This rule applies to children only.
Healthy Minnesota Contribution Program
Instead of a MinnesotaCare premium payment, enrollees in the Healthy Minnesota Contribution Program receive a defined monthly contribution amount to help them purchase private insurance. The contribution amount is sent directly to the health insurance company and the enrollee is responsible for the difference between the defined contribution amount and the insurance premium for the plan they purchase. If an enrollee is unable to purchase insurance from a private insurance company because of a pre-existing condition or chronic health issue, the enrollee may purchase insurance through the Minnesota Comprehensive Health Association (MCHA). Because MCHA premiums are higher than the private market, the defined contribution amount will be increased by 20% in these cases. The defined contribution amount is calculated based on age, income and household size. However, the amounts are calculated per person. Individuals who are married will each receive a monthly defined contribution amount.
Below is a chart detailing the contribution amounts for each age group for private health insurance and MCHA:
Age
Estimated amount the program
pays for private health insurance monthly premium
Estimated amount the program
pays for MCHA premiums
21-39
$100 - $131
$120 - $158
40-49
$140 - $200
$168 - $240
50-54
$236 - $275
$284 - $330
55+
$276 - $335
$332 - $402
17. How do I pay my premiums? Each month you will receive a bill by mail. You can pay at the
MinnesotaCare office in St. Paul, by mail with a check or money order,
or you can pay online with a check or credit card. You cannot pay at your county human services office.
Bring your MinnesotaCare payment to:
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.
Mail your MinnesotaCare payments to:
Cashier, MinnesotaCare
P.O. Box 64834
Saint Paul, MN 55164-0834
Pay your premium online at the Minnesota Department of Human Services website.
Healthy Minnesota Contribution Program
The defined contribution amount you receive when enrolled in the Healthy Minnesota Contribution Program is sent directly to the health insurance company from which you purchase your health plan. You are responsible for paying the difference between the monthly premium amount for the plan you selected and the defined contribution amount. You must pay this difference directly to the health insurance company NOT MinnesotaCare.
If your premium payment is less than your monthly defined contribution amount, the difference is not available to you.
18. What will happen if I do not pay my premium? If you do not pay your premium, your MinnesotaCare will be cancelled.
Healthy Minnesota Contribution Program
If you do not pay the difference between the premium for the plan you select in the private market and your monthly defined contribution amount, you will be terminated effective the first day of the calendar month following the month for which you failed to pay your portion of the health insurance premium. If you are terminated because you did not pay your portion of the premium payment, you cannot reenoll in the Healthy Minnesota Contribution Program for four (4) calendar months. However, if your income goes below 200% of the Federal Guidelines you are allowed to enroll in traditional MinnesotaCare without regard to the four-month waiting period.
19. How do I find a professional health insurance agent to help me find and purchase insurance through the private market as part of the new Healthy Minnesota Contribution Program? The Department of Human Services will send you a notice informing you that you are eligible for the Healthy Minnesota Contribution Program. Included in the notice will be the amount of your monthly defined contribution that you can use to purchase insurance. The notice will also include referral information for professional broker associations. You can select an agent from one of these associations to help you find, apply for and purchase a plan from one of Minnesota’s private insurance companies. There is no cost to get help from an agent. To find an agent now, go to www.HealthyMNAgents.org.
You can also contact one of Minnesota’s health insurance companies directly. The companies listed below are participating in the Healthy Minnesota Contribution Program:
Blue Cross and Blue Shield of Minnesota
651-662-5050 or 1-800-262-0823
HealthPartners
952-883-5599 or 1-877-838-4949
Medica
1-855-844-6389
Minnesota Comprehensive Health Association (MCHA)
1-866-894-8053
20. What are assets? What are the asset limits for MinnesotaCare? Assets include money in a bank account or other things of value that
you or your family own. MinnesotaCare will count up some of your assets
to see if you are over the limit. There is no asset limit for pregnant women and children under 21. For
all others, the asset limit is $10,000 for a family of one and $20,000
for a family of two or more.
The most commonly counted assets include:
• Cash
• Savings accounts
• Checking accounts
• Certificates of deposit
• Stocks and bonds • Motor vehicles not used for employment purposes
• Recreational vehicles such as 4-wheelers, snowmobiles, boats/motors/trailers and campers • Land or houses you do not live on or in • Amount of capital and operating assets of a trade or business that exceed $200,000
Assets that are NOT counted include:
• The home you live in
• Household and personal goods such as clothing, jewelry, furniture, appliance and tools and equipment used in the home
• Motor vehicles used for employment purposes • Individually owned pension and retirement funds
• There may be other assets that your family owns that may be counted or excluded
21. What if I am self-employed? What is counted as an asset? If you are self-employed, the first $200,000 of capital and operating assets for your business are not counted.
22. What is a co-payment (co-pay)? It is a small amount you have to pay when you get a service (see a doctor, get eyeglasses, etc.).
The co-pays you are responsible for under the Healthy Minnesota Contribution Program are dictated by the terms of the health plan you purchase in the private market and will vary accordingly. You must check with your insurance agent or read your policy to learn more.
If you are determined eligible for the Healthy Minnesota Contribution Program you will receive the health care services provided by the health insurance plan you choose to purchase in the private market. There are no direct medical services provided by the Healthy Minnesota Contribution Program. However, the private health insurance plan you select to purchase with your monthly defined contribution amount must provide coverage for mental health and chemical dependency treatment services and can only provide coverage of abortion services under limited circumstances. Your professional health insurance agent will help you understand which plans meet these requirements.
25. Does everyone in my family have to sign up for MinnesotaCare? No, you can sign up just some people in your family, but there are some
rules. If you have more than one child who is uninsured and eligible
for MinnesotaCare, you have to enroll all of your eligible children in
MinnesotaCare. And if you have more than one parent in your household
who is uninsured and eligible for MinnesotaCare, you have to enroll
both parents. Also, you cannot enroll parents if you do not enroll your
eligible children. But you can enroll your children, even if you do not
enroll any parents.
Healthy Minnesota Contribution Program
This program is only for adults without children so the household size will either be one or two adults. Because private health insurance coverage is purchased individually, it does not matter if one or both adults in the household choose to enroll.
26. Do I have to cooperate with the child support office to get MinnesotaCare? For most people, yes. If you do not cooperate, you will not be able to
get MinnesotaCare. But your children can get MinnesotaCare even if you
do not cooperate with the child support office. However, if you have a
good reason for not wanting to cooperate (for example, if you fear
physical or emotional harm to you or your child), you may not have to
cooperate. If this applies to you, you have to tell your worker that
you want to claim “good cause.” You will have to fill out a form to
explain your situation.
