Paul Sanchez
If you are seeking medical insurance in Minnesota, there are several options available to you. Firstly, you can explore MNsure, Minnesota's health insurance marketplace, which enables individuals and families to shop for, compare, and choose health insurance coverage that best suits their needs. MNsure also provides the only avenue to apply for financial assistance in lowering insurance costs. Additionally, you can look into Medical Assistance (also known as MA or Medicaid) and MinnesotaCare, which are health insurance programs tailored for individuals with low incomes. To qualify for Medical Assistance, specific criteria must be met, including citizenship status and possession of a Social Security number. Furthermore, Hennepin County offers health care assistance and provides transportation services for medical appointments for eligible individuals enrolled in certain programs.
| Characteristics | Values |
|---|---|
| Health insurance marketplace | MNsure |
| Health insurance programs for people with low incomes | Medical Assistance (also called MA or Medicaid) and MinnesotaCare |
| Provider of Medical Assistance and MinnesotaCare | HealthPartners |
| Eligibility for Medical Assistance | U.S. citizen or qualifying noncitizen, have a Social Security number (unless an exception is met), be a U.S. citizen or lawfully present in the U.S. |
| MSHO plan | Combines Medical Assistance and Medicare into one plan with no monthly premiums, copays, deductibles, or coinsurance for covered care or prescription drugs |
| Transportation to medical appointments | Minnesota Non-Emergency Transportation (MNET) |
| Application for certain populations | Minnesota health care programs (MHCP) |
| Application for medical assistance for long-term care services | Minnesota health care programs (MA-LTC) |
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What You'll Learn
Minnesota's health insurance marketplace, MNsure
MNsure is Minnesota's health insurance marketplace, where Minnesotans can purchase individual and family health coverage. It is the only place to get financial help to lower the cost of insurance, and most Minnesotans qualify for this financial aid. MNsure allows individuals and families to shop, compare and choose health insurance coverage that meets their needs.
MNsure is also the only place to apply for financial help with monthly insurance premiums and out-of-pocket costs. While most Minnesota residents are eligible to enrol in individual or family coverage through MNsure, eligibility for financial assistance (such as premium subsidies and cost-sharing reductions) depends on income. To qualify for financial assistance with your Marketplace plan, you must not be eligible to enrol in an affordable employer-sponsored health insurance plan.
MNsure can help you find, choose, and enrol in comprehensive health coverage. Certified assisters can help you apply and enrol in person, over the phone, or by virtual meeting. You can also use their online tool to shop and compare plans and see if you qualify for savings.
In Minnesota, you can sign up for ACA Marketplace coverage through MNsure, where five private insurers offer health insurance policies. People in Minnesota can also sign up for MinnesotaCare—Minnesota's Basic Health Program—or income-based Medical Assistance (Medicaid) through MNsure. The Minnesota Department of Commerce approves the rates for individual market products.
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Medical Assistance (Medicaid) and MinnesotaCare
Minnesota offers Medical Assistance (also known as Medicaid or MA) and MinnesotaCare as health insurance options for its residents with low incomes. These programs are administered by the Minnesota Department of Human Services (DHS) and are available to those who meet certain income and eligibility guidelines.
Medical Assistance (Medicaid)
Medical Assistance is a federal- and state-funded program that provides health coverage for very low-income Minnesotans. It is not to be confused with Medicare, which is a federal program for individuals over 65 or with certain disabilities. To qualify for Medical Assistance in Minnesota, individuals must be U.S. citizens or qualifying noncitizens with a Social Security number. There are exceptions to the Social Security number requirement.
MinnesotaCare
MinnesotaCare is a state-run health insurance program for uninsured working Minnesotans who meet income and other eligibility requirements. It is funded by state and federal taxes, provider taxes, and premiums paid by enrollees. MinnesotaCare does not cover past medical bills. Enrollees pay a monthly premium based on their income, family size, and the number of family members covered. Children under 21 who meet a lower-income guideline are charged a fixed premium of $4 per month.
Enrollment
To enroll in Medical Assistance, individuals can call or visit the human service agency in their county of residence. County agencies will review applications and determine eligibility. Similarly, for MinnesotaCare, individuals can apply by calling, mailing in a completed application, or applying in person at select county human service agencies or the Minnesota Department of Human Services office in downtown St. Paul.
Transportation Services
Minnesota Non-Emergency Transportation (MNET) provides transportation to medical appointments for individuals on Medical Assistance, pregnant women, and children on MinnesotaCare who lack alternative transportation options.
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Low-cost health insurance options
Minnesota residents can access low-cost health insurance through MNsure, the state's official health insurance marketplace. MNsure allows individuals and families to shop for, compare, and choose from a range of health insurance options. It is also the only place where Minnesotans can obtain financial assistance to lower the cost of insurance. Most residents qualify for such assistance.
MNsure provides access to Medical Assistance and MinnesotaCare. Medical Assistance is available to those who meet certain criteria, such as being 21 or older with no dependents and having Medicare coverage, or requiring long-term care services. MinnesotaCare is another option for low-income residents who do not qualify for Medical Assistance. It is important to note that decisions regarding Medical Assistance or MinnesotaCare must be appealed within 30 days of the eligibility notice, or within 90 days if there is a valid reason for late filing.
Additionally, Minnesota offers the Prepaid Medical Assistance Program (PMAP) and managed care plans. PMAP is available through providers like HealthPartners, although their acceptance of new enrollees may vary over time. Managed care plans require enrollees to choose a health provider from within their network. These plans often provide transportation assistance for medical appointments.
To find low-cost health insurance options, residents can refer to the MN Low-Cost Health Care Directory, where they can locate community health centers that cater to individuals with limited access to care. These centers provide medical, dental, and behavioural health services.
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HealthPartners' MSHO plan
If you live in Minnesota, you can use MNsure to find, choose, and enrol in comprehensive health coverage. MNsure is the only place to get financial help to lower the cost of insurance.
One health insurance option in Minnesota is the HealthPartners MSHO plan, which is a program for Minnesota residents 65 years old or older that combines Medical Assistance and Medicare benefits into one plan. The HealthPartners MSHO plan has several benefits, including:
- No monthly premium
- $0 charge for covered services if you go to an in-network doctor or provider
- $0 copay for covered prescription drugs
- An annual over-the-counter (OTC) allowance of up to $300, which is given in quarterly instalments of $75 that can be used to buy health, dental and well-being items through a catalog
- No-cost extras, including home-delivered meals and care support after a hospital stay or surgery, a SilverSneakers® exercise program, and support for caregivers
- A care coordinator to assist with benefits and well-being, including setting health goals, ensuring care providers are in contact, and assisting with prescription drugs and refills
- Coverage for urgent and emergency care throughout the U.S.
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Managed health care plans
Minnesota has several options for obtaining medical insurance. One of the options is MNsure, which is Minnesota's health insurance marketplace. MNsure helps individuals and families find, choose, and enrol in comprehensive health coverage. It is also the only place to receive financial aid to lower insurance costs. Certified assistants are available to help with applications and enrolments in person, over the phone, or via virtual meeting.
Another option is Minnesota Health Information Clearinghouse, which provides an overview of health coverage options, information on individual and family plans, and small employer plans licensed to sell in Minnesota. It also provides information on COBRA and Minnesota continuation coverage, prescription drug coverage, Medicare coverage, and long-term care insurance.
Additionally, Minnesota has a program called MinnesotaCare, a public program where individuals pay a premium based on family size and income. MinnesotaCare recipients must enrol in a health plan and receive their medical care through that plan. This may include choosing a primary care clinic that will coordinate all their care and obtaining referrals from the primary care clinic before seeing a specialist.
For those who are 21 years of age or older, with no dependents, and have Medicare coverage, there is the option to apply for Minnesota health care programs (MHCP). MHCP also offers applications for medical assistance for long-term care services (MA-LTC) for individuals who need assistance with nursing home or in-home care services.
Furthermore, Hennepin County offers health care assistance and resources for residents. They provide information on managed health care plans, transportation assistance for medical appointments, and guidance on reimbursement for mileage and parking expenses.
It is important to note that specific details and requirements may vary, and it is recommended to refer to official websites and resources for the most up-to-date and accurate information regarding managed health care plans in Minnesota.
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Frequently asked questions
MNsure is Minnesota's health insurance marketplace where individuals and families can shop, compare, and choose health insurance coverage that meets their needs.
Medical Assistance (also called MA or Medicaid) and MinnesotaCare are health insurance programs for people with low incomes. To qualify for Medicaid, you must be a U.S. citizen or a qualifying non-citizen and have a Social Security number.
The Minnesota Health Information Clearinghouse provides an overview of health coverage options, including individual and family plans, small employer plans, COBRA, and Minnesota continuation coverage.
You can download the Minnesota Health Care Programs (MHCP) application and submit the completed application to Hennepin County if you are 21 years of age or older with no dependents and have Medicare coverage.
