Jeffrey Wade
Minnesota's health insurance marketplace, MNsure, offers a range of health coverage options for individuals and families. Short-term health plans, or skinny plans, are available for up to six months to bridge unexpected gaps in coverage, while comprehensive medical plans have a limited enrollment period. Minnesota also offers long-term care insurance and COBRA continuation coverage for those who experience a qualifying event, such as job loss. The state's health care programs cater to low-income adults and children, with subsidies available for those who qualify.
| Characteristics | Values |
|---|---|
| Short-term health plan duration | 6 months or 185 days |
| Maximum duration of short-term health plans within a 555-day period | 365 days or 12 months |
| Annual enrollment period for comprehensive medical plans | Not specified |
| Special enrollment period qualification criteria | Loss of qualifying health insurance in the past 60 days or expected loss of coverage in the next 60 days |
| Continuation coverage | Provided by COBRA and Minnesota continuation coverage |
| Portability | Available when changing jobs or health plan companies |
| Qualifying events for continuation coverage | Quitting work, being laid off, retiring, getting fired (not for gross misconduct), reduction in work hours, etc. |
| Grandfathered plans | Plans in effect on March 23, 2010, when the ACA was signed into law |
| Loss of grandfathered plan status | Significant changes in benefits, copayments, coinsurance, employer contributions, or change in insurance companies |
| Individual and small group health insurance | Qualified Health Plans (QHPs) offered on MNsure |
| Subsidies | Available for lower-income individuals who don't qualify for Minnesota health care programs |
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What You'll Learn
Short-term health plans
In Minnesota, short-term health plans are limited by statute to a duration of 185 days or six months, and they are non-renewable. However, individuals can purchase additional short-term plans as long as their total coverage does not exceed 365 days (12 months) within a 555-day (18-month) period. It is important to note that as of August 2023, no insurance carrier in Minnesota offers new short-term limited-duration health plans. Fixed indemnity policies, which are not the same as short-term coverage, are still available.
It is worth mentioning that short-term health plans may not be suitable for everyone. They do not cover pre-existing conditions and may not provide the same level of coverage as comprehensive plans. Additionally, individuals with specific needs, such as maternity care or prescription drugs, may find that short-term plans do not adequately meet their requirements. Before enrolling in a short-term plan, it is essential to carefully review the policy's exclusions and limitations to understand the extent of the coverage.
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Special enrollment periods
Minnesota's health insurance marketplace is called MNsure. It is the only place to get financial help to lower the cost of insurance. MNsure offers special enrollment periods (SEPs) that allow individuals to enroll in or make changes to their private coverage outside the annual open enrollment period.
To qualify for a SEP, an individual must have experienced certain life events, such as having a baby, getting married, moving to a new area, or losing health coverage. These life events typically include qualifying changes that impact an individual's or their household's coverage or savings within the past 60 days or are expected to do so in the next 60 days. For example, losing health coverage through an employer or a family member's employer, including losing dependent status, may qualify an individual for a SEP. However, choosing to drop coverage as a dependent alone does not qualify an individual for a SEP. A decrease in household income or a change in previous coverage that affects eligibility for savings on a Marketplace plan is also required in such cases.
Additionally, gaining or losing a dependent through events such as marriage, birth, adoption, or foster care may qualify an individual for a SEP. Moving to or from a different state or territory, or from a foreign country, can also be considered a qualifying life event for a SEP, as long as the move is not solely for medical treatment or vacation. Individuals who experience the death of someone on their Marketplace plan, resulting in a loss of their current health plan, also qualify for a SEP.
It is important to note that SEPs are not limited to specific enrollment periods, and individuals can enroll in a short-term plan at any time. However, comprehensive medical plans offered in the Minnesota individual health insurance market have limited time frames for enrollment, and individuals should refer to the MNsure website for specific annual enrollment periods.
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Grandfathered plans
In Minnesota, short-term health insurance plans, also known as limited duration health plans, are available to bridge brief gaps in healthcare coverage during times of transition. These plans typically last for up to six months, or 185 days or less, and cannot be renewed. However, individuals can purchase another short-term plan after the first one expires, allowing coverage for up to 365 days (12 months) within a 555-day (18-month) period.
Now, onto the topic of 'Grandfathered plans'.
Grandfathered health plans are individual health insurance policies purchased on or before March 23, 2010. These plans were sold directly by insurance companies, agents, or brokers, rather than through the Marketplace. Grandfathered plans are exempt from certain provisions of the Affordable Care Act and may not offer the same rights and protections as other Marketplace plans.
Losing Grandfathered Status
Enrolling in a Grandfathered Plan
For job-based grandfathered plans, individuals can still be enrolled after March 23, 2010, and maintain their grandfathered status as long as the plan hasn't substantially cut benefits or increased costs. Additionally, the plan must have continuously covered at least one person since the aforementioned date. On the other hand, individual grandfathered plans cannot enrol new people after March 23, 2010, and have that new enrollment considered a grandfathered policy.
Switching from a Grandfathered Plan
If an insurance company decides to discontinue a grandfathered plan, they must provide notice at least 90 days in advance and offer alternative coverage options. Individuals can switch to a Marketplace plan during the yearly Open Enrollment Period, which starts on January 1, or during a Special Enrollment Period if they qualify due to specific life events, such as losing health coverage or having a baby.
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Continuation coverage
Minnesota's health insurance marketplace is called MNsure. It 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.
Under federal law, an employee who becomes disabled while employed can continue coverage for up to 29 months. Under Minnesota law, an employee who becomes totally disabled while employed can remain in the group health plan indefinitely. However, the employee will be required to pay the entire cost of the premium, including any premium formerly paid by the employer.
If an employee covered by a self-insured plan becomes disabled, they may keep their coverage for the original 18 months, plus an additional 11 months. For the additional 11 months, the employer may increase the cost of the plan to 150% of the total cost of coverage.
If an employee dies, Minnesota law requires fully-insured group plans to continue coverage for the surviving spouse and children. Coverage must continue until the spouse and children are covered by another group policy or the coverage would have naturally ended. The premiums for survivors' coverage cannot exceed 102% of the cost of the plan for other employees, including any portion paid by the employer. Under a self-insured plan, the surviving spouse and dependents may continue coverage for up to 36 months or until they are covered by another plan.
Federal continuation coverage will end if the individual becomes eligible for Medicare. Minnesota continuation coverage will end if the individual becomes enrolled in Medicare or is covered through another group health plan.
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MinnesotaCare
To be eligible for MinnesotaCare, you must be a U.S. citizen or a qualifying non-citizen, have a Social Security number (unless you meet an exception), and meet income and asset guidelines. You must also not be currently insured or covered by other health insurance within the last four months (with some exceptions applying for people coming from MA and children who meet a lower-income guideline).
To apply for MinnesotaCare, you can request an application by calling (651) 297-3862 (Twin Cities Metro) or 1-800-657-3672 (toll-free). You can also print the application from the Minnesota Department of Human Services website or apply in person at some county human service agencies or the Minnesota Department of Human Services office in downtown St. Paul at 540 Cedar Street, 8:30 a.m. to 4:00 p.m., Monday through Friday.
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Frequently asked questions
MNsure is Minnesota's health insurance marketplace. It is the only place to get financial help to lower the cost of insurance.
If you lose your coverage, you may qualify for a 60-day special enrollment period to avoid a gap in health care coverage.
A short-term health plan, or a "skinny plan," can help bridge a brief, unexpected gap in your health care coverage. For example, these plans can provide temporary minimum health coverage if you are waiting for coverage to begin at a new job. A short-term plan is limited to six months and cannot be renewed.
COBRA is a way to continue your health care coverage. In some circumstances, Minnesota law provides for a longer continuation time than COBRA.
Grandfathered plans were in effect on March 23, 2010, when the federal Affordable Care Act (ACA) was signed into law. The intent was to allow individuals, families, and employers to keep the coverage they had. Grandfathered plans are subject to some ACA reforms but are not required to offer essential benefits.
