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1619(b)

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A rule that lets people who stop getting Supplemental Security Income (SSI) benefits due to work income keep their Medical Assistance health coverage while earning up to $53,658 per year. 1619(b) also makes it easier to get SSI benefits started up again if your countable income goes below SSI's income limit. For 1619(b), you must continue to meet other SSI eligibility rules, such as the resource limit.

Note: If your earnings are over this limit and you have high medical expenses, you might still qualify for 1619(b). Ask your local Social Security office about the 1619(b) Individualized Earnings Threshold.

Applications for Minnesota Programs

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For most Minnesota programs, you have the choice of applying online or using a paper application. You can also apply in person at your local county human services agency. Note: If you need help completing an application, Chat with a Hub expert.

Online Applications

For non-health programs, such as Minnesota Supplemental Aid (MSA) or the Supplemental Nutrition Assistance Program (SNAP), use ApplyMN.

For Minnesota health care programs, such as Medical Assistance (MA), Medical Assistance for Employed Persons with Disabilities (MA-EPD), or MinnesotaCare, use MNsure.

Paper Applications

For non-health programs, print out the Combined Application Form and turn it in to your county human services agency.

For health programs, fill out a paper MNsure application and fax it to 1-651-431-7750 or mail it to the address listed on the form.

Asset Exclusions (MA)

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The following assets are excluded (not counted) when figuring out countable assets for disability-based Medical Assistance (MA):

  • The home you live in.
  • The car you drive to work.
  • Income in the month of receipt. Example: If you earn $4,000 in October, that income is not counted as an asset in October.
  • Household and personal goods including pets, furniture, clothing, jewelry, appliances, other tools and equipment used in the home.
  • Money in an ABLE account.

The following payments may also be excluded:

  • Payments made to people because of their status as victims of Nazi persecution. This includes reparation payments the Federal Republic of Germany makes to certain survivors of the Holocaust.
  • Payments resulting from an appeal of public assistance benefits.
  • Payments made under state or federal law for foster care and adoption assistance.
  • Disaster relief funds paid by state and local governments and disaster relief organizations such as Red Cross and Salvation Army.
  • State and federal tax rebates.
  • Netherlands' Act (WUV) payments.
  • Low Income Energy Assistance Program (LIHEAP) payments.
  • Payments for tribal land claim settlements listed in Tribal Land Settlements and Trusts.
  • Benefits from the Women, Infant, and Children (WIC) nutrition program.
  • Reimbursements from the Uniform Relocation Assistance and Real Property Acquisition Policy Act of 1970.
  • Payments received from youth incentive entitlement projects and youth community conservation and improvement projects.
  • Reparation payments to Aleut people and people of Japanese ancestry under Public Law 100 383.
  • Agent Orange payments to veterans and their dependents.
  • Payments made under the Radiation Exposure Compensation Act (Public Law 101 426).
  • Payments made by federal agencies under a presidential declaration of disaster including, but not limited to, individual and family grants from the Federal Emergency Management Agency (FEMA).
  • Title VII, Nutrition Program for the Elderly funds.
  • VISTA payments made to volunteers (not permanent staff salaries).
  • Accrued interest on assets if any excess is properly reduced at the eligibility recertification.
  • Payments from the Vietnamese Commandos Compensation Act.
  • Blood Product Litigation settlement payments.
  • Settlements to hemophiliacs under the Ricky Ray Hemophilia Relief Act of 1998.
  • Payments made to volunteers under the Domestic Volunteer Service Act of 1973.
  • Older Americans Act benefits.
  • Student financial aid should be excluded until the month following the last month of enrollment in classes. This includes funding from Pell Grants, SEOG, Perkins Loans, Student Educational Loan Funds, Guaranteed Student Loans, Minnesota State Student Loans, State Student Incentive Grants, Minnesota State Scholarships and Grants, Federal College Work-Study funds, any other financial aid funded in whole or in part by Title IV, and other educational funds.
  • Funds to replace lost, damaged, or destroyed assets.
  • The accumulation of clothing and personal needs allowance for people in long-term care facilities.
  • Funds used to meet real estate tax, insurance, and upkeep expenses for real property that are held in a separate account.
  • Some retroactive lump sum payments of RSDI and SSI Income.
  • Payments of SSI, RSDI and Special Veterans Benefits for the Elderly due to representative payee misuse.
  • Earned Income Tax Credit (EITC) refunds or payments.
  • Child Tax Credit (CTC) refunds or payments.
  • Proceeds from the sale of a homestead for three months if the funds are applied to the purchase of another home during that period.
  • Payments made to crime victims to compensate them for losses resulting from the crime.
  • Austrian social insurance payments based, in whole or in part, on wage credits granted under Paragraphs 500-506 of the Austrian General Social Insurance Act.
  • Volunteer payments under Corporation for National and Community Service (CNCS) Programs, including AmeriCorps (VISTA), University Year for ACTION (UYA), Special and Demonstration Volunteer Programs, Retired Senior Volunteer Program (RSVP), Foster Grandparent Program, Senior Companion Program.
  • Individual Development Account (IDA) - TANF funded.
  • Individual Development Account (IDA).
  • Payments made by the Department of Defense (DOD) to certain individuals who were captured and interned by North Vietnam.
  • VA benefits paid to or on behalf of Vietnam or Korea service veterans’ natural children suffering disability due to spina bifida or other certain birth defects.
  • Self-Support Assets.

For details on these asset exclusions, including the timeframes within which they can be claimed, Chat with a Hub expert.

Asset Limit

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The maximum amount of assets you're allowed to own while maintaining eligibility for a particular disability benefits program. Most benefits programs do not count everything you own, including the home you live in and one car you own. For Supplemental Security Income (SSI), the first $100,000 in an ABLE account is not counted as assets. For Medical Assistance, SNAP (formerly Food Support/Food Stamps), and some other programs, none of the money in an ABLE account is counted.

Also called a "resource limit."

Assets

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Things that you own, like a car or a house. You can only own a certain amount in assets and still qualify for many health care and disability benefit programs. The home you live in and the car you drive to work are exempt under most Social Security and state disability benefit programs. For Supplemental Security Income (SSI), the first $100,000 in an ABLE account is not counted as assets. For Medical Assistance, SNAP (formerly Food Support/Food Stamps), and some other programs, none of the money in an ABLE account is counted.

Also called "resources."

Basis of Eligibility

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A set of characteristics such as your age, income, disability status, or family status that allows you to be eligible for Medical Assistance (MA).

Benefits Expert

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A trained professional who can help you understand disability benefit programs and how they are affected by work. Their goal is to help you avoid financial complications while developing a sustainable plan for the future.

Chat with a Hub expert.

Budget Period

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The amount that will elapse before your eligibility for a Minnesota health care program will be reviewed.

Copayment

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A set amount you have to pay when you receive medical services. For example, you may have to pay $30 every time you visit the doctor or $20 to get a prescription refilled. This is also known as a "copay."

Cost-Effective Health Coverage

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A "cost-effective" determination means that it is cheaper for MA to pay for your health insurance premium, copayments, deductibles, and other related costs than it would be for MA to pay directly for the health care services you require. Generally, if the services paid for by your health insurance are more than double the premium amount, it will be cost-effective for MA to pay your portion of the premium.

Countable Income

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The amount of income that Social Security or the state counts when figuring out if you qualify for benefits and, if so, the level of benefits you should get. Not all of your income counts.

Example: Supplemental Security Income (SSI) counts most unearned income, but a bit less than half of earned income. So, if you have $500 in unearned income and $500 in earned income, your countable income for SSI would be just $697.50, even though your total income would be $1,000. Other programs, such as disability-based Medical Assistance and Medicare Savings Programs often use calculations similar to SSI's.

Countable Income (Medical Assistance)

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The following disregards and cash payments are deducted (subtracted) when figuring out your countable gross income for disability-based Medical Assistance (MA) or MA with a spenddown. They are not, however, deducted in this estimator:

  • Disabled Widow/Widower Disregard
  • Widow/Widower Disregard
  • Pickle Disregard
  • Disabled Adult Child Disregard
  • RSDI COLA Disregard
  • PASS Deduction
  • Blind Disabled Student Child Disregard
  • Supplemental Security Income (SSI)
  • Minnesota Supplemental Aid (MSA)
  • Minnesota Family Investment Program (MFIP)
  • General Assistance (GA)
  • Diversionary Work Program (DWP)
  • Refugee Cash Assistance (RCA)

If you qualify for any of these disregards or if you're on any of these cash payment programs (e.g., SSI or MSA), you can likely earn a higher income and keep access to MA. Similarly, your spenddown for MA will probably be lower than what's shown in the estimator.

Note that participation in many cash payment programs results in access to MA.

If you have questions about disability-based MA, Chat with a Hub expert.

Deeming Rules

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Rules used by Social Security and Medical Assistance (MA) that determine an individual’s eligibility when living with a non-disabled spouse. If the individual is a minor, deeming rules apply to the parents.

Disability Determination

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An agency ruling that you have a disability and are therefore entitled to benefits. To qualify for disability benefits, the Social Security Administration or the State Medical Review Team (SMRT) must review your situation and determine that you have a disability. If you're on SSI, SSDI, or any Minnesota disability benefits program, you've already been determined disabled by Social Security or SMRT.

Dual-Eligibles

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A term used to describe individuals eligible for both Medicare and Medical Assistance.

Earned Income (EI)

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Salaries, wages, tips, professional fees, and other amounts you receive as pay for physical or mental work you perform. This can include things you get in exchange for work instead of wages, such as food, shelter, or other items. Funds received from any other source are not included. (Contrast: unearned income.)

Eligibility Category

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A way to qualify for Medical Assistance (MA) health coverage. There are several different ways to qualify, each with specific requirements. An individual may be eligible for more than one category.

Federal Poverty Guidelines (FPG)

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Monthly and annual income amounts used to determine financial eligibility for state and federal benefit programs.

Each year, the U.S. Department of Health and Human Services (HHS) issues the Federal Poverty Guidelines (FPG) in the Federal Register. The current FPG for one person is $12,490 per year; for two people, it's $16,910. Add $4,420 for each additional person.

Note: Different state and federal programs adopt the new Federal Poverty Guidelines on different dates each year.

Free Medical Assistance (MA)

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Free MA covers all medically necessary health care services at no charge or for a small fee. If you meet eligibility requirements, including income limits, you will qualify for the program. If you qualify because of disability, asset limits may apply also.

If you get SSI, you will likely qualify for MA. You must apply for it separately though (you can't apply for it at Social Security).

Home Care Services

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Home care services can be given to people on Medical Assistance (MA) if the services are medically necessary, ordered by a doctor, and given according to a written service plan. Home care services are given in a person's home or outside the home if normal life activities take them there. They are not provided in hospitals or nursing facilities.

Home care services covered by MA include:

  • Equipment and supplies (e.g., wheelchairs)
  • Home health aide
  • Personal Care Assistant (PCA) services
  • Private duty nursing
  • Skilled nursing visits
  • Occupational, physical, respiratory and speech therapies

Income in the Month of Receipt

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Income from work or other sources in the month that you receive it. Minnesota health care programs do not count your income in the month of receipt when determining your assets. So if you receive $2,000 in May from work, that $2,000 is not counted as an asset in May, but may be counted as an asset in June.

Income Limit

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The highest income you can have while still qualifying for a particular benefits program.

Joint Assets

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Assets you own with someone else. If you own a boat, for example, and the title is in your name and your spouse's name, it's considered a joint asset.

MA-TEFRA

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MA-TEFRA is a way for children with disabilities to get Medical Assistance (MA) health coverage if they would not otherwise qualify for MA due to their parents' income. MA-TEFRA does not count parental income for a child's eligibility purposes, but may charge a monthly parental fee based on the parents' income.

To learn more about MA-TEFRA, Chat with a Hub expert.

MA-Waiver Programs

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Some people require additional services beyond what's covered under standard Medical Assistance (MA). Minnesota's MA-Waiver Programs are designed to serve these people and provide the services necessary to allow them to live in the community.

Not all people with disabilities will qualify for a MA-Waiver program; each program serves a different target population and has its own set of eligibility criteria. Here are four MA-Waiver programs available to Minnesotans with a disability:

The Community Alternative Care (CAC) Waiver provides services to people who are chronically ill and need the level of care provided in a hospital.

The Community Access for Disability Inclusion (CADI) Waiver serves people with disabilities who need the level of care offered in a nursing facility.

The Developmental Disabilities (DD) Waiver provides services to people with developmental disabilities or related conditions.

The Brain Injury (BI) Waiver provides services to people with brain injuries.

Each of these programs offers a different set of services based on the population it serves. All of these programs offer Personal Care Assistant services, extended home health aide and nursing services, extended homemaker services, medical equipment and supply services, and increased transportation services.

To apply for a MA-Waiver program, contact your county human services agency.

Medical Assistance (MA)

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A state-run health care program that pays medical expenses for people who are disabled, young, elderly, poor, or pregnant. If you meet program requirements, MA will help pay for a variety of medical services including visits to the doctor, hospital stays, medical equipment, home care services, and prescription drugs. To apply for MA, visit your county human services agency.

Medical Assistance (MA) Services

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You get the same health coverage with free Medical Assistance (MA), Medical Assistance for Employed Persons with Disabilities (MA-EPD), and MA with a spenddown. All three plans pay for a broad range of medical services, often more than private coverage. The following are covered by all three plans:

  • Physician and health clinic visits
  • Medical equipment services (e.g. – wheelchairs)
  • Mental health services
  • Inpatient and outpatient hospital services
  • Personal Care Assistant (PCA) services
  • Physical, occupational, and speech therapy
  • Transportation services
  • Case management services
  • Home care services

Other services covered include immunizations, lab and x-ray work, family planning and pregnancy services, alcohol and drug treatment, hospice care, and nursing care.

Some services may require a small copayment ($1 - $3). This includes prescription drugs (unless you're on Medicare) as well as dental, vision, chiropractic, and podiatry care.

To apply for free MA, MA-EPD, and MA with a spenddown, contact your county human services agency.

Medical Assistance (MA) with a Spenddown

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If you have countable income that is greater than the income limit for disability-based MA, you may need to pay a spenddown to maintain disability-based MA coverage. A spenddown is the amount of money you have to pay for health care expenses each month before MA starts to pay for the rest of your health care bills. You do not have to pay the full spenddown amount if your medical bills are less in any month. If, however, your monthly medical bills average less than your spenddown for several months, you will likely lose eligibility for the program at your next six-month review.

Once you have paid your spenddown amount, you won't have to pay any more for health care received in that month. For this reason, if you plan all your non-urgent medical and dental appointments in the same month, you may pay less.

To apply for Medical Assistance (MA), contact your county human services agency.

Medical Assistance for Employed Persons with Disabilities (MA-EPD)

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A program that gives Medical Assistance (MA) health coverage to employed people with disabilities. To qualify you must:

MA-EPD covers the same services as standard MA, but lets you have higher income without losing your coverage.

Medicare Savings Program (MSP)

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Medicare Savings Programs help people on Medicare pay for some of their out-of pocket Medicare costs. The costs paid depend upon your income but can include Medicare Part A and B premiums, co-insurance, copayments, and deductibles. You need to have countable income that is 135% of the Federal Poverty Guidelines (FPG) or less ($1,366/month for an individual, $1,852/month for couples) to qualify for a Medicare Savings Program.

There are three different Medicare Savings Programs you may qualify for:

  • Qualified Medicare Beneficiary (QMB), if your countable income is 100% of FPG or less ($1,012/month for an individual, $1,372/month for couples)
  • Service Limited Medicare Beneficiary (SLMB), if your countable income is 120% of FPG or less ($1,214/month for an individual, $1,646/month for couples)
  • Qualified Individual (QI), if your countable income is more than 120% of FPG, but at or below 135% of FPG ($1,366/month for an individual, $1,852/month for couples)

Minnesota Supplemental Aid (MSA)

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A state program that provides a monthly cash benefit to people who are aged, blind or disabled and who get Supplemental Security Income (SSI). Some people who don't get SSI may still be eligible for MSA if their income is low enough and they meet other program criteria.

The MSA benefit you get depends on your living arrangements, the amount you get in SSI (if you get an SSI benefit), and whether or not you have any special needs expenses. The current monthly MSA benefit for many individuals is $81 ($111 for couples). To apply for MSA, visit your county human services agency.

Noncitizen

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A person currently in the United States who has not attained U.S. citizenship by birth or naturalization. This includes asylees, lawful permanent residents, nonimmigrants, refugees, and undocumented people.

Premium (General)

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A regularly scheduled payment to an insurer or health care plan.

Proof of Identity

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Any document that the state will accept as proof of your identity. Click here for a listing.

Reporting Agencies

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Agencies to which you need to report any changes in your income or living situation, if you get public benefits.

If you're on Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI), call Social Security at 1-800-772-1213 or 1-800-325-0778 (TTY), or visit your local Social Security office, and ask what's the best way for you to report. Note: Reporting rules for SSI and SSDI are different and if you get both benefits, you must report income for them separately.

If you're on Medical Assistance (MA), Minnesota Supplemental Aid (MSA), General Assistance (GA), Housing Support (formerly Group Residential Housing), or any other state health care or cash assistance programs, report any changes in earnings to your county human services agency.

Retroactive Eligibility

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Eligibility for a particular program that is granted for months prior to the month of application. Some state health care programs, for example, allow you to begin your health coverage three months prior to the month you apply.

Spenddown

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If you have countable income that is greater than the income limit for disability-based Medical Assistance (MA), you may need to pay a spenddown to get MA coverage. A spenddown is the amount of money you have to pay for health care expenses each month before MA starts to pay for the rest of your health care bills.

You do not have to pay the full spenddown amount if your medical bills are less than the spenddown in any month. If, however, your monthly medical bills average less than your spenddown amount for several months, you will likely lose eligibility for the program at your next six-month review.

Once you have paid your spenddown amount, you won't have to pay any more for health care received in that month.

State Medical Review Team (SMRT)

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A group within Minnesota's Department of Human Services (DHS) that decides whether or not the state considers you blind or disabled for state benefits programs. SMRT uses a standard process to decide whether people who are not already considered disabled by the Social Security Administration (SSA) meet the state's disability standards.

If you already get benefits from Social Security based on your disability, such as Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI), your disability automatically meets the state’s standards and you do not need to be reviewed again by SMRT.

Contact your local county human services agency to request a SMRT review.

Supplemental Nutrition Assistance Program (SNAP)

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A county-run, federal program that helps people with low incomes buy food. Formerly called Food Support (in MN) or Food Stamps.

Supplemental Security Income (SSI)

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A Social Security Administration program that gives cash benefits to people with disabilities who have limited income and resources. The amount you get in SSI benefits is based on your financial need and your living situation. The maximum monthly SSI benefit is $771 for individuals and $1,157 for eligible couples.

U.S. Citizen

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A person who is:

  • Born in one of the 50 states, Washington D.C., Puerto Rico, Guam, Northern Mariana Islands, U.S. Virgin Islands, American Samoa, or Swain’s Island
  • Born outside of the U.S. to at least one parent who is a U.S. citizen
  • Granted citizenship status by U.S. Citizenship and Immigration Services (USCIS)

When applying for benefits, contact the agency you are applying to to find out what documents are acceptable for proving citizenship.

Under-insured

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For the purposes of the Sage program, being "under-insured" includes having insurance that does not cover breast or cervical cancer screening, insurance with unmet deductibles or copayments, and Medicare coverage that won't pay for  office visits related to breast/cervical cancer, pap smears, or mammograms.

Unearned Income (UI)

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Funds received from sources for which no paid work activity is performed. Disability benefits such as SSDI, SSI, short-term disability insurance, and long-term disability insurance; VA benefits; Workers' Compensation; income from a trust or investment; spousal support; dividends, profits, or funds received from any source other than work are all usually considered unearned income.