Medical Assistance (MA)

Medical Assistance (MA) is Minnesota's Medicaid program. It helps pay medical expenses for people with low income. If you meet eligibility requirements, MA will help pay for your visits to the doctor, hospital stays, prescription drugs, medical equipment, and other medical services.

MA Prescription Benefits

Most MA enrollees pay a small copayment for their prescription drugs:

  • $3 for brand name drugs
  • $1 for generic drugs

If you are on MA, the most you have to spend on prescription drug copayments in a single month is $12. There is no copayment on some mental health drugs.

If you’re under 21, pregnant, or in a long-term care facility, you won’t have to pay a copayment for your prescription drugs.

Medicare Part D and MA

If you are a senior or the Social Security Administration says you have a disability, you may be able to get disability-based MA and Medicare at the same time. If you are eligible for Medicare Parts A and B, you have to be enrolled in them in order to enroll in disability-based MA.

This is a good deal for you because Medicare Part A is usually free, and disability-based MA will usually pay your Medicare Part B premium (and your Part A premium, if you have one) for you and for Medicare copayments. Since MA covers many services that Medicare does not, by having both you’ll have better health care coverage and will pay less. To learn more about how MA interacts with Medicare Parts A and B, read the DB101's Medicare article.

If you are eligible for Medicare Parts A and/or B, you are also eligible for prescription drug coverage through Medicare Part D. You will automatically be enrolled in a Medicare Part D benchmark plan if you haven't already signed up for a plan on your own and are also:

There are different options for benchmark plans. If you do not choose one, you will be given one automatically. To get help finding a plan that covers the medications you need:

Being enrolled in disability-based MA or MA-EPD and Medicare at the same time automatically qualifies you for the Part D Low Income Subsidy. This means you won’t have to pay a monthly premium for your Part D or pay any deductibles, including the donut hole. If you have the Low Income Subsidy, all you pay for your prescription drugs are copayments that range from $1.25 to $8.50.

Note: If you don’t sign up for Part D coverage, you won’t have any prescription drug coverage. MA cannot pay for your prescriptions if you decline Part D coverage.

If you have both MA with a spenddown and Medicare

If you have MA with a spenddown and Medicare at the same time, the rules are a bit different. You aren't automatically put into a Part D benchmark plan and are not automatically eligible for the Part D Low Income Subsidy until you meet your spenddown. Once you meet your spenddown for one month in the year, you automatically qualify for the Low Income Subsidy for the rest of the year and you’re automatically enrolled in a benchmark plan, if you have not already signed up for a plan on your own and otherwise qualify for automatic enrollment. . At that point, your only prescription costs for the rest of the year would be copayments of $1.25 – $3.40 for generics and $3.80 – $8.50 for brand name prescription drugs.