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How much does coverage cost?
Many people will not pay premiums and will have few or no copays. Costs that you may have to pay depend on what program you qualify for.
Most programs have copays for prescriptions and certain other services. Your provider will tell you if you owe a copay. There are no copays for:
• Pregnant women
• Children under 21
• People living in a nursing home or other long-term care facility for more than 30 days
• People receiving hospice care
• Services covered by Medicare (unless Medicare has a copay)
• Refugees who have coverage through the Refugee Medical Assistance Program.
Copays and limits are different for different programs and benefit sets. Some programs have a limit on specific services. This means Minnesota Health Care Programs will only pay up to a certain amount for a service.
The Minnesota Health Care Programs benefit summary (PDF) gives you an idea of costs you may have to pay.
Most MinnesotaCare enrollees pay a premium. A premium is the monthly payment enrollees must pay to start and keep health care coverage. Premiums are based on household size, income and the number of people getting coverage.
This MinnesotaCare premium table (PDF) can give you an estimate. The actual premium amount cannot be determined until your application or renewal is reviewed.
People who do not pay a premium include:
• Children in households with income below certain limits
• Certain children leaving foster care or juvenile residential correctional facilities
• Households with an American Indian enrollee
• Some military families. Military families may be able to get coverage without a premium for up to 12 months if a family member completed a military tour of duty within two years of being approved for coverage. This benefit is available to members of the Army, Navy, Air Force, Marines, Coast Guard, National Guard and Reserves.
Most MA-EPD enrollees pay a premium. You can estimate the amount by using the MA-EPD premium estimator. The actual premium amount cannot be determined until your application or renewal is reviewed. American Indian enrollees are not required to pay a premium.
Some people who have more income than the MA limit allows can qualify by “spending down” (PDF) to the income limit. A spenddown is similar to an insurance deductible. This means you are responsible for some medical bills before MA would pay.
For some children with disabilities, parents’ income is not counted when determining if the child qualifies. However, parents may have to pay a monthly fee. Parental fees (PDF) are based on income and other factors. You can estimate the amount you may have to pay using the online parental fee estimator.
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