Monday, March 23, 2015

Minnesota Care Income Eligibility Guidelines

MinnesotaCare helps keep Minnesotans healthy.


MinnesotaCare, administered by the Minnesota Department of Human Services (DHS), provides subsidized health-care coverage to eligible Minnesotans. Income limits set by MinnesotaCare are based on a percentage of federal poverty guidelines. In addition to household income, the DHS considers the applicant's residency, need and assets to determine eligibility for MinnesotaCare.


Limits on Income


Adults and children living in the same household may receive benefits under MinnesotaCare if the gross household income is not greater than 275 percent of the federal poverty guidelines (FPG). Adults without children may be eligible if their household income does not exceed 250 percent of FPG. Parents, foster parents and legal guardians are ineligible for the program if their gross annual income is more than $50,000. Current federal poverty guidelines may be found at the U.S. Health and Human Services Assistant Secretary for Planning and Evaluation (ASPE) website (see Resources).


Asset Limitations


MinnesotaCare also imposes an asset limit on adult applicants and enrollees who are not pregnant. Households of one person may not own more than $10,000 in net assets. For households of two or more people, the maximum net assets may not total more than $20,000. Your home, household goods, cars and assets owned by children are not considered assets by MinnesotaCare for the purpose of determining financial eligibility.


After Enrollment


If household income exceeds program limits after enrollment, participation in the program will be terminated. However, children may continue receiving MinnesotaCare benefits if 10 percent of their gross household income is less than the annual premium charged for the $500-deductible health insurance policy offered by the Minnesota Comprehensive Health Association (MCHA). The latest MCHA premium information is available at the MCHA website (see Resources).


Health Insurance Ineligibility


Applicants may not have employer-subsidized health insurance currently or 18 months before application or reapplication for MinnesotaCare. Exempt from the above requirement are children from households earning less than 150 percent of FPG and children enrolled in Children Health Plan as of Sept. 30, 1992. Applicants may not have Medicare or any other type of health insurance or have had any form of health coverage for the four months preceding application or renewal.


Co-pay and Premiums


Parents and non-pregnant adults pay 10 percent of paid charges for inpatient hospital services, not to exceed $1,000 per year. There is a $3.00 co-payment per prescription and a $25.00 co-payment for eyeglasses. Non-preventive visits require a co-payment of $3.00, and non-emergency visits to an emergency room require a $6.00 co-payment.


Monthly premiums for coverage under MinnesotaCare are on a sliding scale, based on percentage of income. A $4.00 per child minimum monthly premium is charged if the household income is not greater then 150 percent of FPG.