Haris Ashley
Minnesota offers a range of health insurance options for its residents, including public programs such as Medical Assistance (MA) and MinnesotaCare. These programs provide coverage for those with low to no income, with MinnesotaCare offering a premium-based program for those who earn too much to qualify for MA but cannot afford private insurance. Additionally, Minnesota has an online health insurance marketplace called MNsure, where individuals and families can shop, compare, and choose from various health insurance plans. MNsure also offers subsidies to help lower-income individuals afford insurance. While health insurance is not mandatory in Minnesota, it is essential to understand the available options and choose a plan that meets one's needs and financial situation.
| Characteristics | Values |
|---|---|
| Is health insurance mandatory in Minnesota? | Yes, under the ACA, everyone not covered by an employer group plan, Medical Assistance (MA), Medicare, or other public insurance is required to purchase health insurance or pay a penalty. However, since 2019, there has been no tax penalty for individuals who don't have coverage. |
| What are the exemptions? | Members of recognized religious sects (e.g. Christian Scientist, Jehovah's Witness), American Indian tribal members, and those with financial hardship may be excused. |
| What is MNsure? | MNsure is Minnesota's health insurance marketplace, where individuals and families can shop, compare, and choose health insurance coverage that meets their needs. |
| What is MinnesotaCare? | MinnesotaCare is a premium-based public program for people who earn too much to qualify for Medical Assistance but too little to pay for private insurance. It has provided insurance to low-income Minnesota residents for decades. |
| What is the income limit for MinnesotaCare? | The income limit depends on who lives with you and who you include on your federal income tax return. There is no asset limit for MinnesotaCare. |
| Who is not eligible for MinnesotaCare? | You cannot qualify for MinnesotaCare if you have other health insurance or if you can get insurance that is considered affordable and comprehensive through a job. |
| Who is exempt from paying premiums for MinnesotaCare? | Children under the age of 21, American Indians and Alaska Natives and their households, and members of the military approved for MinnesotaCare within 24 months after completing active duty and their households. |
| What does MinnesotaCare cover? | MinnesotaCare pays for a variety of services, including doctor visits, prescriptions, and hospital stays. Coverage may differ for children, pregnant people, and other adults, and some services and prescriptions may require prior approval. |
| What is the Small Business Health Options Program (SHOP)? | SHOP is a program where businesses with fewer than 50 employees can buy coverage through MNsure. Companies with fewer than 25 employees, an average pay of less than $50,000, and that pay half the cost of insurance for their employees are eligible for a tax credit. |
| What is the employer mandate? | All employers with 50 or more employees must offer affordable insurance to their employees or pay a fine. |
| What is COBRA? | COBRA allows individuals to continue their employer-provided health coverage after leaving their job for a certain period, usually 18 or 36 months. |
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What You'll Learn
Minnesota's health insurance marketplace, MNsure
In the state of Minnesota, health insurance is mandatory for all residents. Those who are not covered by an employer group plan, Medical Assistance (MA), Medicare, Medicaid, or other public insurance are required to purchase health insurance or pay a penalty.
Minnesota's health insurance marketplace is called MNsure. It is an online marketplace for individual and small employer health insurance. MNsure helps Minnesotans find, choose, and enrol in comprehensive health coverage. It is also the only place to get financial help to lower the cost of insurance. MNsure offers a range of Qualified Health Plans (QHPs) with different levels of coverage and cost-sharing. These plans are sold in four "metal" levels: bronze, silver, gold, and platinum, with varying actuarial values.
MNsure is the only place where Minnesotans can apply for financial assistance with their health insurance premiums and out-of-pocket costs. Most residents are eligible for financial assistance, but it depends on their income and whether they have access to affordable employer-sponsored insurance. MNsure will also determine if individuals with lower incomes qualify for a subsidy to help pay for their insurance.
In addition to MNsure, Minnesota offers other health care coverage options. These include MinnesotaCare, a premium-based public program for those who earn too much to qualify for Medical Assistance but cannot afford private insurance, and Emergency Medical Assistance (EMA), which provides coverage for undocumented Minnesotans who do not have an immigration status that qualifies for Medical Assistance.
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Medical Assistance (MA)
In Minnesota, Medical Assistance (MA) is a public program that helps eligible individuals and families with their medical expenses. MA is Minnesota's Medicaid program, and it is available to those with low to no income. The basis of eligibility for MA includes factors such as age, disability, household composition, income, and assets.
There are different types of MA, including income-based MA, disability-based MA, and MA-EPD. Income-based MA is for individuals and families with low incomes, including those with and without disabilities. Disability-based MA is specifically for individuals with disabilities and low incomes. MA-EPD allows individuals with disabilities who are working to pay a monthly premium for MA coverage, regardless of their income.
MA covers various medical expenses, including doctor visits, hospital stays, prescription drugs, personal care assistance, medical equipment, and other services deemed Essential Health Benefits (EHBs) by the government. For those with disabilities, MA may also cover additional services through MA-Waiver programs.
In addition to the standard MA program, there is also Emergency Medical Assistance (EMA), which provides coverage for undocumented Minnesotans who do not have an immigration status that qualifies for standard MA. EMA covers medical conditions that would place the individual's health in serious jeopardy if left untreated within 24-48 hours.
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MinnesotaCare
In the state of Minnesota, health insurance is mandatory for all residents. Those who are not covered by an employer group plan, Medical Assistance (MA), Medicare, or other public insurance are required to purchase health insurance or pay a penalty.
To find out if you qualify for MinnesotaCare, you must apply through MNsure, Minnesota's health insurance marketplace. MNsure will determine if you qualify for a subsidy to help pay for the insurance. Subsidies are only available for shoppers using the MNsure website.
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Medicare
In the state of Minnesota, health insurance is mandatory for all residents. Those who are not covered by an employer group plan, Medical Assistance (MA), Medicare, or other public insurance are required to purchase health insurance or pay a penalty.
Minnesota residents who are eligible for Medicare can seek help from the Senior Linkage Line to understand their options and enrol. Medicare beneficiaries are generally not eligible to purchase insurance through MNsure, Minnesota's health insurance marketplace. However, if they opt for a private plan through MNsure instead of Medicare, they may be subject to a late enrolment penalty for Medicare later on.
MNsure does not offer Medicare Advantage plans, Medicare Part D prescription drug plans, or Medigap policies. If one is already enrolled in a private plan through MNsure and becomes eligible for Medicare, their private coverage will not be automatically terminated, but they can choose to end it at any time.
Other Health Insurance Options in Minnesota
For those with low to no income, Minnesota's public health care programs, such as Medical Assistance (MA) and MinnesotaCare, provide health care coverage. MA is Minnesota's Medicaid program, while MinnesotaCare is a premium-based program for those who earn too much to qualify for MA but too little to afford private insurance.
Qualified Health Plans (QHPs) are available for individuals and small groups on MNsure. These plans are offered in four "metal" levels—bronze, silver, gold, and platinum—indicating the percentage of costs covered by the plan. Subsidies are available for eligible shoppers to help pay for insurance premiums.
Short-term health coverage is another option for those in need of temporary insurance, such as those between jobs or waiting for group coverage to start. However, it is important to note that pre-existing health conditions are not covered under short-term plans.
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Small Business Health Options Program (SHOP)
The Small Business Health Options Program (SHOP) is a program that helps small businesses provide health coverage to their employees. SHOP is generally available to employers with 1-50 full-time equivalent employees (FTEs). In Minnesota, small businesses can purchase coverage through SHOP on the health insurance marketplace "MNsure". MNsure also determines if individuals with lower incomes qualify for a subsidy to help pay for insurance.
If your business has fewer than 25 employees, you may qualify for the Small Business Health Care Tax Credit, which can cover up to 50% of your premium costs. This tax credit is generally available only when an employer enrolls in a SHOP plan. You can use the Small Business Health Care Tax Credit Estimator to determine if you qualify and how much you can save.
SHOP insurance gives you control over the coverage you offer and how much you pay toward employee premiums. You can choose from high-quality private health insurance plans that meet the specific needs of your business and employees. As an employer, you have two options for enrolling in SHOP insurance:
- Offer one or more SHOP insurance options to your employees: You can choose the amount you contribute to employee premiums, and your employees choose a plan offered by SHOP and pay any remaining premium costs.
- Select a single SHOP insurance plan for your employees: You choose a plan offered by SHOP and contribute a fixed dollar amount or a percentage toward employee premiums. Your employees then have the option to enroll in the plan and pay any remaining premium costs.
SHOP is a valuable resource for small businesses to provide health coverage for their employees. It offers flexibility in choosing coverage options and allows employers to contribute to their employees' health care costs.
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Frequently asked questions
Yes, health insurance is mandatory in Minnesota. However, starting in 2019, there is no tax penalty for individuals who don't have coverage.
MNsure is Minnesota's health insurance marketplace where individuals and families can shop for, compare, and choose from a range of health insurance coverage options.
There are several options for health insurance coverage in Minnesota, including employer-provided group plans, individual plans purchased through MNsure, public programs such as Medical Assistance (Minnesota's Medicaid program) and MinnesotaCare, and short-term health coverage.
MinnesotaCare is a public program that provides insurance to Minnesota residents with low incomes who do not qualify for Medical Assistance but cannot afford private insurance. Eligibility is based on income and family size, and there is no asset limit.
There are several resources available for individuals seeking help with health insurance in Minnesota. These include connecting with a navigator in your community, calling the DHS Health Care Consumer Support, reaching out to your local county or tribal office, and visiting the websites of the Minnesota Department of Health and the Minnesota Department of Human Services.
