Updated January 1, 2014.
- What is Medical Assistance?
- Who can get Medical Assistance?
- How does Medical Assistance work?
- How do I get an application for Medical Assistance?
- How does MA look at household size?
- How soon will I be able to get on the program?
- Do I have to file my taxes to receive MA?
- How is my income counted?
- Do I have to be a U.S. citizen to get Medical Assistance?
- I am an Immigrant. Do I become a public charge if I get Medical Assistance?
- Does it matter how long I have lived in Minnesota?
- Are there any asset limits for Medical Assistance?
- How is Medical Assistance different for pregnant women?
- How are adults without children living in their household elgible for Medical Assistance?
- How do I apply for MA?
- Is it easy to apply for MA through MnSure?
- Can I get help applying for MA?
- Do I have to supply proof of my income and other information when I apply?
- How soon will I be able to get on the program?
- What services are covered on Medical Assistance?
- What is a premium?
- Are there premiums?
- Will Medical Assistance pay for medical bills for services I got before I got on Medical Assistance?
- What is a co-pay?
- Are there co-payments (co-pays)?
- What do I have to do to stay on the program?
- How often do I need to renew coverage for Medical Assistance?
- Do I have to enroll in MA if I qualify?
It is a health insurance program for some Minnesotans with lower incomes. It is Minnesota’s name for Medicaid. It is usually a free program, although there are some small costs (co-pays) for parents and adults without children.
Medical Assistance is administered by the Minnesota Department of Human Services but eligibility and case management are done by county human services departments.
Children (under 18), adults aged 19 to 65 (both parents and those without children in their households), pregnant women, and people who are elderly, blind or disabled can all get Medical Assistance. To get MA you must also live in Minnesota and be a U.S. citizen or a legal immigrant (with an acceptable immigration status). The immigration status of pregnant women, however, does not matter. Most people also have to have income below certain limits to get MA. If you are getting help from the Center for Victims of Torture, you can receive MA regardless of your income and immigration status. The income standards for MA differ for each household member based on age. Children age 18 and under and pregnant women are eligible for MA up to 275% of the Federal Poverty Guidelines; older children aged 19 and 20 and adults up to age 65 are eligible up to 138% of the Federal Poverty Guidelines. Seniors and those who are blind and disabled have different income eligibility guidelines that are not screened for on the Bridge to Benefits site. To see a chart with the income limits for Federal Poverty Guidelines, click here.
NOTE: The rest of this document is written for able-bodied adults and children who are MA eligible under the age of 65. It does not talk about how MA works for other people, such as those who are elderly, blind or disabled, disabled children (TEFRA), or those who can get MA during the year after leaving MFIP. If you fall into one of these categories and want to know more about how MA works for you, click here for the Department of Human Services website.
Medical Assistance looks at every family member individually to see who can get help. Some people in your family may be able to get MA, but others may not. It is easier for young children and pregnant women to get MA than older children or adults. Once you have been accepted for Medical Assistance, you have to pick a managed care health plan (like Medica, BlueCross/BlueShield or HealthPartners). If you do not pick a plan, one will be selected for you. 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.
The application is called the Minnesota Health Care Programs Application. You can get one at your county human services office. You can also call 1-800-657-3672 and get an application mailed to your home (TTY service: 1-800-627-3529). You can also get applications on this website by clicking here.
Under the requirements of the Affordable Care Act, MA looks first at whether or not you file your taxes. If you file your taxes, your household members will be those people (spouse, children and others) that you claim as dependents. Your dependents can be anyone you claim as allowed under IRS tax code (they don’t necessarily have to be related to you or live with you). If you do not file your taxes, MA will count your household size as they did in the past and look at who is related to you and who lives with you half of the year or more.
No, you do not have to file your taxes to apply for MA. If you do NOT qualify for MA, however, you will have to file your taxes to be eligible for other types of financial assistance for help paying your health insurance such as MinnesotaCare and Advanced Premium Tax Credits.
All health care programs, including MA, now ask you to estimate your income based on what you expect to earn or receive in the upcoming year. Your income will be calculated using your Modified Adjusted Gross Income (MAGI). This aligns with how you report your income when you file your taxes. Your adjusted gross income allows you to deduct expenses from your gross income such as contributions to a health savings account and/or retirement account, student loan interest, education related tuition and fees, job-related moving expenses and/or alimony. Under the Affordable Care Act, all health care programs now use MAGI as the income standard. MA looks at both your expected income and your expected household size in determining if you qualify.
No. Immigrants with an acceptable immigration status can also get MA. But undocumented immigrants cannot get MA unless they are pregnant. 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 are U.S. citizens or have acceptable immigration status, you can apply just for them. In a medical emergency, some undocumented immigrants can get help from Emergency MA. You will not have to supply immigration information for family members who are not applying for the program.
- If you are receiving care or services from the Center for Victims of Torture, you are eligible for MA regardless of your immigration status, assets or income.
- If you are a sponsored immigrant, your sponsor's income will be considered for MA unless you are applying for a pregnant woman or a child(ren) under age 21.
- A new federal law requires some MA applicants and enrollees to prove that they are U.S. citizens and give proof of their identity when they apply for or renew their coverage. This includes U.S. nationals from American Samoa and Swains Island. You do not have to show proof if you are getting Medicare benefits or getting or previously received Supplemental Security Income (SSI).
NO. As of March 9th 2021, the Trump administration public charge regulations are no longer in effect. DHS and USCIS will now follow the policy in the 1999 Interim Field Guidance which allows immigrant families to safely access health, nutrition, and housing programs WITHOUT being at risk of negative public charge consequences.
If you are an immigrant, you should apply for any of the programs on the Bridge to Benefits site for which you appear eligible.
No. But you must plan to stay in Minnesota to get MA.
Under the Affordable Care Act, MA no longer looks at your assets or the things you own like savings/checking accounts, houses, cars, retirement accounts and so on. Only earned and unearned income is looked at to determine financial need.
Pregnant women have different rules that make it easier for them to get MA. Pregnant women do not have to provide their immigration status. Because of this, some undocumented immigrants can get MA if they are pregnant, and their income is below the limit. If this applies to you, please note that you will be asked about your immigration status on the application but if you do not have immigration information, you will not be denied coverage.
Effective March 1, 2011, adults without children living in their households can receive MA if they meet eligibility requirements. Adults without children living in their household are eligible if they earn less than $1,321 per month for single adults and $1,783 dollars per month for a married couple. There is no asset limit for adults without children applying for MA. Applicants must also meet the citizenship and residency requirements for MA. There is no premium payment for adults without children receiving MA, but there may be some co-payments. Click here for more information on Medical Assistance for Adults Without Children.
You apply for MA through MnSure, the new online marketplace for buying health insurance in Minnesota. MnSure includes the application 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 MA, you will receive an enrollment notification from your county human services agency and information for selecting a health plan.
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. Using a paper application, however, will make the application process longer. You can find that application here.
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). 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.
In most cases, if you are applying online through MnSure, you will not have to provide proof of the information you enter 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.
If you elect to apply for MA 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 qualify, you should also get a letter in the mail from your county human services agency telling you that you have been enrolled in Medical Assistance along with information on your health plan choices. You will need to select a health plan before you begin using your MA health insurance.
MA pays for most health care services, but not everything. Services that are covered include: doctor and clinic visits, family planning, immunizations, prenatal care and delivery, inpatient (hospital) and outpatient surgery, prescription drugs, eye exams and eyeglasses, dental work and exams, child and teen check-ups, podiatry (foot) services, chiropractic care, medical equipment and supplies, rehabilitative therapies (PT, OT and speech), lab and x-ray services, alcohol and drug treatment (residential and outpatient), and mental health services.
It is the amount of money you must pay every month to get some health insurance programs.
Yes. If you get accepted for MA, it will pay medical bills for health services that you got during the three months before you applied for MA (the day the county gets your application) providing that you can prove you met eligibility requirements during those three months.
It is a small amount of the total bill that you have to pay when you get some services (get a prescription, get eyeglasses, etc.).
Children and pregnant women do not have any co-pays. Parents and adults without children living in their household have small co-pays for some services. Click here for a list of covered services and co-pays.
Once you qualify for MA, you are approved for the program for one year. The one-year approval period is an extension as required under the Affordable Care Act. During the year, you have to tell your county human services agency 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. If you move, be sure to contact your worker to inform them of your new address. If you want, you can report these changes on the MnSure site.
Every year, you will have to renew your MA coverage. Near the end of each year, you will receive a renewal notice by e-mail or by regular mail (when you apply, you will have the opportunity to elect how you prefer to receive notices). The preferred method for renewing will be through MnSure, but paper renewal forms will be available. The renewal form will have your current information filled in and you will only need to update the information that has changed or that you expect to change in the upcoming year.
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. You can always elect to purchase private insurance through MnSure without financial assistance.