What You Pay
If you get Medical Assistance for Employed Persons with Disabilities (MA-EPD), you need to pay a monthly premium. However, you don't have to pay any copayments or other fees when you get medical care or a prescription drug!
Premiums
The monthly premium for MA-EPD is based on your earned and unearned income and your household size. The higher your income, the higher your premium will be. Your premium will be at least $35. There is no maximum premium. In some cases, it may be cheaper to get an individual plan through MNsure than to pay for MA-EPD. See DB101’s article about Buying Coverage on MNsure to learn more.
Note: Your spouse's income will not be counted when your premium is calculated.
To get MA-EPD, each month you will have to pay:
- An amount based on your gross income. The minimum amount will be $35 per month, with a sliding scale for people with gross income at or below 300% of the Federal Poverty Guidelines (FPG). If your income is greater than 300% of FPG, you will have to pay 7.5% of your gross income for coverage.
- An additional fee that is equal to 0.5% of your unearned income. You pay this fee no matter how low your gross income is.
Your total MA-EPD premium will be the combined amount.
Use this tool to estimate how much you will have to pay each month.
| Are you married? | |
| If you are married, is your spouse applying for or already on MA-EPD? | |
| How many children do you have under age 21 that live with you? | |
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| Household Size for Premium Estimate: | |
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How much monthly gross income do you get from each of the following sources? | |
| Earnings from all jobs (leave out spouse's income) | $ |
| SSDI | $ |
| Unemployment Compensation | $ |
| Child Support Payments | $ |
| Alimony | $ |
| Other unearned income | $ |
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| Total Income: | |
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| Sliding Fee Premium: | |
| Unearned Income Obligation: | |
| Total Premium: | |
To get a better idea of whether you qualify for MA-EPD and how much your premium might be, use the MA-EPD Estimator.
Note: If you are an American Indian, you do not have to pay a premium for MA-EPD coverage.
When Can My Premium Change?
The county will review your eligibility and premium for MA-EPD every 12 months:
- If your income goes up, or if your household size goes down, your premium will go up.
- If your income drops, or if your household size goes up, your premium will go down.
Be sure to report any changes in income or household size to your local county or tribal human services office within 30 days of when the change occurs.
Billing
You must pay your premium before you get coverage. After you’ve applied, the county will collect the first premium. From then on, the state will send you a bill every month.
You can pay your ongoing monthly premiums:
- Online by checking account withdrawal or credit card
- By mail if you send a check or money order with the stub from your premium notice to:
PO Box 64835
St. Paul, MN 55164-0835
If you mail your payment, make sure you send it early enough so that it arrives by the due date and that you include your portion of the billing statement that shows your customer number. Do not mail cash.
If you have questions about billing, be sure to contact your county or tribal human services office.
If You Can't Pay Your Premium
Tell your county worker right away if you can't pay your MA-EPD premium because of something out of your control, like:
- You lose your job
- You go on medical leave from your job
- You had an unexpected serious physical or mental illness and you can't work
- A natural disaster causes you to lose your belongings or be out of work
- Your income changed unexpectedly
In situations like these, you can ask the Department of Human Services (DHS) if any of your premiums can be waived, so that you don’t have to pay. This is called “requesting a Good Cause” for not paying your premium.
Or you may qualify for a lower premium and up to four months of MA-EPD eligibility without working through a Job Loss Extension or Medical Leave Extension.
To request a Good Cause:
- Fill in the MA-EPD Good Cause Request Form
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Send the form:
- Online, by pressing the “Submit” button at the end of the form, or
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By printing it and either faxing it to 1-651-431-7563 or mailing it to:
DHS MA-EPD Good Cause
P.O. Box 64967
St. Paul MN, 55164-0967
Good Cause does not include:
- Your initial premium. You won't get MA-EPD coverage until your first premium is paid. You can't ask to pay your initial premium late, or not pay it at all.
- Paying other household expenses instead of your MA-EPD premium. If you do not pay your premium because you had other bills, your MA-EPD will end because of non-payment. You can pay your premium to get MA-EPD back. You might have to apply again.
If you have any questions or need help, Chat with a Hub expert.
Retroactive Coverage
MA-EPD allows new enrollees to request coverage retroactively. This means that you can ask to have your MA-EPD coverage begin three months before the month you apply. So if you enroll in MA-EPD in April but have unpaid medical bills from the previous three months (January, February, and March), you could pay the MA-EPD premium for those months you have unpaid bills from and have MA-EPD pay for those unpaid bills. So, if you had unpaid bills from January, but not February or March, you could just pay the January premium.
Many people who qualify for MA-EPD may also qualify for disability-based MA with a spenddown, especially if they are employed, their monthly countable income is above 100% of the Federal Poverty Guidelines ($1,255) and their assets are below $3,000.
MA-EPD and disability-based MA with a spenddown cover the exact same services, but MA-EPD will usually cost you less. With MA with a spenddown, you must pay medical expenses with your own money until all you are left with 100% of FPG ($1,255 each month for your other expenses if you are single). Compared with the amount you would have to “spend down,” MA-EPD’s monthly premium is usually a smaller portion of your income.
For an estimate on what your MA-EPD premium or MA spenddown amount would be, use the MA-EPD Estimator.
Example: If you have countable earned income of $1,455 and no unearned income, when you sign up for MA with a spenddown, you have to pay the first $200 of your medical bills each month before MA starts paying for your medical expenses. With MA-EPD, you would just pay a $158 monthly premium.
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