Fast Facts on Health Care Reform: MinnesotaCare

Overview

The Minnesota Legislature made several changes to Medical Assistance (MA) effective January 1, 2014. These changes affect how MinnesotaCare eligibility is determined. This fact sheet explains those changes.

Changes to MinnesotaCare Income Limits and Eligibility Groups

Effective January 1, 2014, MinnesotaCare’s new income limits are as follows:

Eligibility Group

Household Income Limit

Household Income Limit in Dollars—Household of 1

Household Income Limit in Dollars—Household of 3

Children ages 19-20

> 133%-200% of the federal poverty guideline (FPG)

$15,282/yr - $22,980/yr

$25,976/yr - $39,060/yr

Adults without children under age 65

> 133%-200% FPG

$15,282/yr - $22,980/yr

$25,976/yr - $39,060/yr

Parents and Caretakers

> 133%-200% FPG

$15,282/yr - $22,980/yr

$25,976/yr - $39,060/yr

Lawfully present noncitizens ineligible for MA because of immigration status

0%-200% FPG

$0/yr - $22,980/yr

$0/yr - $39,060/yr


Pregnant women and most children under age 19 will be eligible only for MA.

Changes to MinnesotaCare Income Methodology

Certain individuals will be subject to a new income methodology based on modified adjusted gross income (MAGI). MAGI is based on a household’s taxable income.

Elimination of Asset Test for Adults

The asset limit for adults is eliminated effective January 1, 2014.

Elimination of Insurance Barriers

The 4-month waiting period for individuals who had access to other coverage or who fail to pay a premium is eliminated. The 18-month waiting period for individuals who had access to employer-subsidized insurance is also eliminated.

Access to Affordable Employer-Sponsored Insurance

Individuals who have access to affordable employer-sponsored insurance are not eligible for MinnesotaCare. Coverage is affordable if it costs the individual no more than 9.5% of his or her income and the coverage pays for at least 60% of medical expenses.

MinnesotaCare Benefits and Cost-Sharing

The $10,000 annual limit and $1,000 maximum co-pay on inpatient hospital services for certain adults is eliminated.

MinnesotaCare Premiums

MinnesotaCare premiums are substantially reduced for many households and are assessed on an individual basis. Premiums range from $4/month to $50/month per covered individual, depending on household income.

Individuals Currently Enrolled in MinnesotaCare

Individuals currently enrolled in MinnesotaCare will receive a written notice in the coming weeks informing them of any changes to their MinnesotaCare eligibility. While some enrollees will remain in MinnesotaCare, others will be transitioned to Medical Assistance or advised to seek coverage via MNsure. They should continue to pay any co-pays or premiums they owe and report any changes to their MinnesotaCare worker.

Elimination of Choice between MA and MinnesotaCare

Individuals who are eligible for MA cannot choose to enroll in MinnesotaCare. For example, a pregnant woman must enroll in MA.

Applying for MinnesotaCare

Beginning October 1, individuals can apply for health care coverage on MNsure. MNsure is a new online marketplace where individuals, families and small businesses will be able to get quality and affordable health coverage. MNsure will offer an easy-to-use website where individuals can search and compare plans, learn if they qualify for tax credits, MinnesotaCare and Medicaid, and ensure that plans meet certain baseline benefit standards.

Individuals can also request a paper application from their county social services agency.


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