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Disability-Based MA

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    Disability-Based MA

    Frequently Asked Questions

    You should sign up for Medical Assistance (MA) at your county or tribal human services office if you:

    If you are not in one of those situations, there are three ways to apply for health coverage:

    MNsure will check to see if you might qualify for disability-based MA if you answer "yes" to at least one of these questions when you fill out your MNsure application:

    • Are you blind or do you have a physical, mental, or emotional health condition that limits your activities (like bathing, dressing, daily chores, etc.)?
    • Do you need help staying in your home or help paying for care in a long-term care facility such as a nursing home?
    • Do you want help from Medical Assistance (MA) to pay for medical bills from the last three months?

    MNsure will also check for disability-based MA eligibility if you say you're on Medicare.

    If you have a disability and don't answer these questions correctly, you might not get the best health coverage for you. If you have any questions about applying, Chat with a Hub expert.

    No. You can continue to get the Medical Assistance (MA) benefits you currently get.

    In most cases, no. The actual medical coverage you get from MA will basically be the same, no matter how you qualified. Generally speaking, the big difference is that people with disabilities have extra ways to qualify and if you have a disability and start working, you can earn more while still getting MA coverage.

    DB101 has four articles about different ways to get MA:

    • DB101's MA overview compares the different ways of qualifying.
    • The income-based MA article explains the most common way to qualify, which does not require you to have a disability.
    • The disability-based MA explains a common way that people with disabilities who have low incomes can qualify.
    • The MA-EPD article explains a way that people with disabilities can get MA coverage by paying a premium, no matter how high their income.

    If you are not sure how you qualified for MA, you can ask your local county or tribal human services office.

    No, it is not the same as how much you make. When many public programs look at your income to figure out if you should qualify, they don’t always count all of your income. What they do count is called “countable income.” This benefits you, because it means that you might have more income than the income limit for a program, but still qualify.

    When your income is reviewed for disability-based Medical Assistance (MA), only about half of your earned income (money you get from work you do) is counted. For example, if you make $2,000 per month at a job and have no other income, that’s only $957.50 in countable monthly income.

    Your Countable Income:

    Note: Countable income is used to see if you qualify for disability-based MA. If you do not have a disability, income-based MA will count all of your earned income. See DB101’s income-based MA article for more information.

    It depends on how you qualified for Medical Assistance (MA). Income-based MA has no asset limit. However, some people with disabilities and seniors may qualify for disability-based MA or MA-EPD, which do have asset limits. If there's an asset limit, you must approve the use of the Account Validation Service (AVS) so that MA can make sure your assets are below the limit.

    DB101's MA overview compares the different ways of qualifying.

    Yes. If you're getting SSI, you probably qualify for MA as well, but you have to apply for SSI and MA separately. Apply for MA at your county or tribal human services office and for SSI at your local Social Security office.

    If you’re on SSI and MA and your monthly SSI cash benefit drops to zero because your earned income goes up, Social Security’s 1619(b) provision will let you keep your MA coverage, without having to pay a spenddown. Minnesotans with a disability on 1619(b) can have up to $74,611 in earned income and still keep their MA coverage as long as their assets don’t go above the SSI asset limit ($2,000 for an individual, $3,000 for a couple).

    MA: You may qualify for income-based MA or disability-based MA, depending on your situation. You also qualify for MA if you qualify for SSI’s 1619(b) provision.

    MA with a spenddown: You "spend down" your income by paying the first part of your medical costs. The amount you are responsible to pay before disability-based MA starts paying is the difference between your countable income and the "income standard." The income standard is 100% of the Federal Poverty Guidelines (FPG) ($1,255 for an individual, $1,704 for a family of two). Note: Usually, if you qualify, MA-EPD will be a better option than MA with a spenddown.

    Medical Assistance for Employed Persons with Disabilities (MA-EPD): You pay a monthly premium based on your income and household size. Generally, if you are certified disabled by the Social Security Administration or the State Medical Review Team (SMRT) and are working you will qualify for MA-EPD.

    DB101's MA overview compares these different ways of qualifying for MA.

    Yes. If your family’s income is low enough for you to qualify for Medical Assistance (MA), you may do so even if your job offers insurance. If you are in this situation, you must tell your county or tribal human services office about the insurance your employer offers. If your employer-sponsored plan is considered cost-effective, MA will pay your portion of the private plan’s monthly premium. If you have questions about this, Chat with a Hub expert.

    Note: If your job offers you affordable insurance, you and your family cannot get MinnesotaCare or get subsidies for purchasing an individual health plan through MNsure.

    Yes. In most cases it makes sense to enroll in both private health coverage and MA, if you qualify because:

    • You’ll get better coverage if you have both private insurance and MA.
    • If the county determines that your private coverage is cost-effective, MA will even pay the premiums, copayments, and deductibles for your private coverage.

    If the county determines that your private policy is not cost-effective, you should decide whether enrolling in MA, private coverage, or both best meet your medical and financial needs.

    If you have questions, Chat with a Hub expert.

    Disability-based MA covers many services that Medicare doesn’t. If you have both MA and Medicare, you’ll have better health coverage. If you are eligible for Medicare Parts A and B, you have to keep them in order to enroll in MA. In most cases, MA will pay the Medicare premiums for you. With Medicare Part D, you’ll likely have cheaper prescription drug costs by enrolling in both programs.

    Note: You usually cannot qualify for income-based MA if you get Medicare.

    • Undocumented immigrants do not qualify for full Medical Assistance (MA) coverage, though in some cases they may qualify for MA coverage for emergencies.
    • Some noncitizens who have legal immigration status in the United States do not qualify for full MA coverage. However, if their income is below 200% of the Federal Poverty Guidelines (FPG), they may qualify for MinnesotaCare, a different public program.
    • Immigrants who have been legal residents for 5 years or longer and some other noncitizens with legal immigration status qualify for all of the same programs that citizens can get.

    Learn more

    Medical Assistance (MA): Overview

    MA is public health coverage. There are different ways to qualify.

    Income-Based MA

    For people with and without disabilities who have low income.

    MA-EPD

    For people with disabilities who work. No income limit.