Common Pitfalls
Thinking you don’t qualify because you didn’t in the past
The eligibility rules for Medical Assistance (MA) and MinnesotaCare are different than they used to be:
- They no longer have asset limits
- Income-based MA has a much higher income limit than it did before 2014
- MinnesotaCare doesn’t require you to have been uninsured for months prior to your application
These are just a few of the big changes. If you applied for one of these programs in the past and were rejected, try again, because these programs are accepting many more people than they used to.
Thinking you can’t get MA or MinnesotaCare because you have too much money in the bank
It used to be that MA and MinnesotaCare had limits on how much your family could have in assets, including things like your money in the bank, the value of your cars, or other investments. They don’t anymore.
No matter how much your family has in assets, you can get MA or MinnesotaCare if you meet other program requirements and your income is at or below 138% of the Federal Poverty Guidelines (FPG) for MA or at or below 200% of FPG for MinnesotaCare.
| Your family size: | |
Income limits for your family: | |
| Income-based MA, adults (138% FPG) | |
| Income-based MA, children/pregnant women (280% FPG) | |
| MinnesotaCare (200% FPG) | |
| Subsidized private plans, reduced fees (250% FPG) | |
| Subsidized private plans (no income limit) | -- |
If your family's income is at or below the limit for a program, you may qualify if you meet other program rules.
Notes:
| |
Not getting health coverage because you think it will be too expensive
In the past, some people found it impossible to find health coverage that was affordable and met their needs. Now, there should be an option for almost everybody, even if you have a disability. The exact health coverage that will be right for you will depend on things like your family’s income, whether you have access to employer-sponsored coverage, your age, where you live, if you use tobacco products, and whether you have a disability.
If you do not have the option of employer-sponsored coverage, you may be able to get government help through tax credits paying for an individual plan on MNsure. If you cannot afford private individual coverage, your best options will be public programs, like Medical Assistance, MinnesotaCare, or Medicare, if you qualify.
Note: It is very important to have health coverage, but starting in 2019 there is no tax penalty if you don't have coverage.
Not comparing MA-EPD’s premium to premiums for MinnesotaCare and individual coverage
If you do not have the option of employer-provided coverage, you may qualify to get MinnesotaCare or get government help paying for an individual plan on MNsure. If you qualify for MinnesotaCare or tax subsidies to get an individual plan, the premiums for those options may be lower than the premium for MA-EPD, depending on your situation.
You may be eligible for MinnesotaCare if your family’s income is at or below 200% of the Federal Poverty Guidelines (FPG) ($29,160 per year for an individual; $60,000 for a family of four). If you get MinnesotaCare, your monthly premium will be $28 per family member or less. There is no premium for children and American Indians. Read DB101’s MinnesotaCare article.
You may be eligible for government help paying for an individual health plan on MNsure. Read DB101’s Buying Individual Coverage on MNsure article.
| Your family size: | |
Income limits for your family: | |
| Income-based MA, adults (138% FPG) | |
| Income-based MA, children/pregnant women (280% FPG) | |
| MinnesotaCare (200% FPG) | |
| Subsidized private plans, reduced fees (250% FPG) | |
| Subsidized private plans (no income limit) | -- |
If your family's income is at or below the limit for a program, you may qualify if you meet other program rules.
Notes:
| |
Not going back to work because you fear losing your coverage
In the past, people feared that if they got a job while on public health coverage, like Medical Assistance (MA) or MinnesotaCare, they’d lose that coverage, because they would no longer have low enough income to qualify.
Now, if you lose one health coverage option, there should be another one you can get. If you lose your current coverage, you should either become eligible for employer-sponsored coverage, another public coverage program, or private individual coverage. And, if you can’t afford the individual coverage, the government may help you pay for it through tax credits.
The bottom line: There is a coverage option for almost everybody. Do not worry that getting a job will leave you without health coverage.
Not looking into how to get MA as a person with a disability
If you have a disability, there are additional ways to qualify for MA. You may be able to earn more money without losing your MA coverage or get additional services, like Home and Community-Based Services (HCBS). Learn more about the different ways of qualifying in DB101's MA overview.
Turning down coverage offered by your job
If your employer offers affordable coverage for you and your family, you will not be eligible for MinnesotaCare nor will you be able to get subsidies to purchase individual coverage on MNsure. That means that if your employer offers coverage, it is probably your best option.
The only programs that might help you even if your employer offers coverage are Medical Assistance (MA) and Medicare. To learn more about the relationship between those programs and employer-sponsored coverage, read DB101’s article about employer-sponsored health coverage.
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