- Are you considering Medicaid in Minnesota? Discover everything you need to know before applying, including what it is, eligibility criteria and how to apply.
Minnesotans who need help paying for medical treatment may be able to find assistance through Minnesota Medicaid. The program had more than 1.1 million people enrolled as of September 2020, and the state has expanded coverage to all low-income adults, meaning that more people than ever are eligible for help. Between the expanded coverage and targeted enrollment strategies, enrollment has increased by 29% since October 2013.
What Is Minnesota Medicaid?
Minnesota Medicaid is a program that helps low-income Minnesotans access health care. It's known as Medical Assistance (MA) and is overseen by the Department of Human Services (DHS). MA has different programs, including regular Medicaid, nursing home Medicaid and Home and Community Based Services (HCBS) waivers. These waivers provide targeted support for people with specific conditions, such as brain injuries or developmental disabilities.
Minnesotans may also hear two other medical insurance terms that are often confused with MA. The first is MinnesotaCare. This is a health insurance program for uninsured working residents. Although it also provides health care to low-income people, it isn't a Medicaid program. The other term is MNSure. This is Minnesota’s health insurance marketplace, where people can apply for MA, but it's not a health care program.
How Does Medicaid in Minnesota Work?
Most MA beneficiaries get health care through a health plan. Available plans differ between counties, but they all cover a wide range of health expenses, including doctors' visits, prescriptions, mental health services and home care. The full list of covered services can be found on the DHS website. Medicaid in Minnesota may pay for treatment received up to three months before the beneficiary applied for the program.
Some members of MA pay no costs, while others have to pay a portion of the cost of treatment, though this contribution is limited to 5% of the family income. Some services are also subject to an estate recovery program, meaning the cost of care is recovered upon the recipient’s death. This is limited to people who are permanent residents of a medical institution and older adults receiving long-term services.
Who Is Eligible for Medicaid in Minnesota?
In Minnesota, Medicaid coverage has been extended to all low-income adults, so it’s available to childless adults, parents and children, residents who are blind or have a disability and older adults. However, all applicants must meet financial and nonfinancial eligibility criteria.
Financial Eligibility Criteria
Financial eligibility is broken down into income and asset limits. Both of these limits are based on an applicant’s age, circumstances, the program they’re applying for and how many people are in their household.
Income limits are based on the Federal Poverty Guidelines (FPG) and change based on how many people are in the household. Current income limits are:
- Parents, caretaker relatives, children aged 19-20 and adults without children: 133% FPG
- Children 2-18 years old: 275% FPG
- Pregnant women: 278% FPG
- Infants under 2 years old: 283% FPG
- The elderly, blind and people with disabilities: 100% FPG
People applying for nursing home care or Medicaid waivers have different limits. For nursing home care, this is $1,064 per month for singles and $1,438 for married couples if both spouses are applying. For HCBS waivers, the limit is $2,382 per month for singles and $4,764 for married couples when both spouses are applying.
People who don’t meet these criteria may qualify with a spend-down, which means that the applicant is responsible for some medical bills before MA funds are available.
The asset limit or asset test doesn’t apply to parents, children under 21 and adults with no children in the home. Older adults, the blind and people with disabilities must meet asset limits. In addition, those receiving nursing home Medicaid or an HCBS waiver have an asset test.
The asset limits are the same for all programs. For singles, the limit is $3,000 and for a household of two, the limit is $6,000, plus $200 for each dependent. Not all assets are included when calculating for Medicaid. Assets that are countable include cash, stocks and investments. Noncountable assets include vehicles, personal belongings and a home that the applicant or their spouse lives in.
If you’re a married couple and only one person is applying, the income and asset limits for nursing home care or HCBS waivers are slightly different. The income limits are the same as for singles, but only the income of the person applying is counted. The applicant is also allowed to transfer some of their income to their spouse to help them continue to meet their expenses.
Nonfinancial Eligibility Criteria
All recipients must be a Minnesota resident and a U.S. citizen or qualifying noncitizen. In most cases, applicants must also provide a social security number for each person who will be receiving a benefit.
Some people may need to meet program-specific rules. These generally apply to HCBS waivers that cover different conditions, such as the Brain Injury Waiver and Elderly Waiver. The exact rules differ for each program, but often people receiving these waivers must need a nursing home level of care.
How Do I Enroll in Medicaid in Minnesota?
For most people, the easiest way to apply is online through MNSure. People that apply through MNSure will be advised if they qualify for MA or MinnesotaCare. Other application options include calling or visiting a county human service agency or mailing in a paper application. Paper applications can be requested by calling (651) 297-3862 or (800) 657-3672. Older adults and people with a disability shouldn’t apply through MNSure; they will receive a quicker response from their county office.
Minnesota has health insurance Navigators available in communities throughout the state to help people access health care. There is a directory of Navigators, and assistance is available in several languages.
Applicants generally find out if they’re eligible within 45 days. For pregnant women, the decision is made within 15 days; however, it can take 60 days to receive confirmation if a medical or disability assessment is required. Each MA recipient has their status reviewed every six months to ensure they’re still eligible.
Contact Information for Minnesota Medicaid
Medicaid in Minnesota can be contacted at (651) 431-2660 or toll free at (800) 657-3739. Alternatively, contact the local Department of Human Services office for further information about MA and other assistance programs.