Medical Assistance (MA) Eligibility

MA helps people with low income pay for their visits to the doctor, hospital stays, prescription drugs, medical equipment, and other medical services. Most people who qualify for SSI and MSA can also get MA.

To get MA, you have to meet certain rules. These rules can seem confusing because there are big changes when you turn 19. The biggest rules changes involve:

  • How much income you can have and still get MA
  • Whether there might be an asset limit for qualifying for MA
  • Whose income and assets are counted when MA decides if your income and assets are low enough for you to get benefits

This section on MA eligibility is divided into two parts:

How to Apply for MA

After you learn about eligibility, you can apply for MA:

Note: If you get SSI, you should apply at your county human services agency.

If you apply online, MNsure will only check to see if you might qualify for disability-based MA if you answer "yes" to at least one of these questions:

  • 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?

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.

MA if You Are 18 or Younger

If you are 18 or under, there are 2 common ways to get MA. You can qualify:

  1. If your family has low income, whether or not you have a disability, or
  2. If you are disabled and you have low income

There is no asset limit either way.

Income-based MA eligibility

Whether or not you have a disability, when you apply for MA, MA will first check to see if you qualify based on your income and your parents’ income. If you are a child 18 or younger and your family’s income is at or below 280% of the Federal Poverty Guidelines (FPG) ($70,280 per year for a family of four), you may qualify for MA. Use this tool to check whether your family's income is low enough for you to get income-based MA:

Health Coverage Income Limits for Your Family

Disability-based MA eligibility

If you do not qualify for income-based MA, MA will check to see if you qualify for disability-based MA. To qualify, you must be determined disabled by the Social Security Administration (SSA) or the State Medical Review Team (SMRT). The rules about disabilities are different if you are under the age of 18 than if you are 18 or older. You can read more about differences in the definition of disability for children and adults on this article's SSI page.

If SSA or SMRT says you have a disability, MA will only look at your income when deciding whether you qualify, and will not look at your parents’ income. This makes it much easier for you to qualify for disability-based MA. The countable income limit for people with disabilities is 100% of FPG, or $12,140 per year. For people with disabilities, countable income is not the same as total income, so use this little tool to see whether your countable income is under the limit:

Your Countable Income:

There is no asset limit. In other words, if you are a child with a disability and don't work full-time, you'll probably be able to get disability-based MA, no matter how much your parents make and how much your family has in assets.

Note: If you are 18 or under and have a disability, your parents’ income won’t impact your eligibility for disability-based MA, but they might have to pay a monthly parental fee for your MA coverage, due to a rule called TEFRA. Get an estimate of how much the fee might be for your family and read more about TEFRA and parental fees. If this fee is very high, it might be cheaper for your family to get a private health plan on MNsure instead.

SSI 1619(b)

If you’re on Supplemental Security Income (SSI), there is a rule called 1619(b) that lets you keep your MA coverage even if your earned income becomes too high for you to keep getting an SSI cash benefit. With 1619(b), you can make up to $53,154 per year without losing your MA.

While 1619(b) means that you can get MA while earning way more than the program’s normal income limit, your assets have to stay below SSI’s $2,000 asset limit. If your assets go above that limit, you should consider MA-EPD. Learn more about MA-EPD.

MA if You Are 19 or Older

The biggest change when you turn 19 is that you must meet the eligibility rules for adults, not for children. As with the rules for people under 19, there are two main ways that you may qualify for MA:

  1. If you have low income, whether or not you have a disability, or
  2. If you are disabled and you have low income and low assets
    • Note: The asset limit for people with disabilities only applies if you are 21 or older.

The income limits are different for these two ways of qualifying and how MA counts your income is also different, so depending on your situation and whether your disability meets SSA's standards, you may qualify by one of these sets of rules and not the other.

Income-based MA eligibility

Whether or not you have a disability, when you apply for MA, MA will first check to see if you qualify for income-based MA. If you are 19 or older and your family’s income is at or below 138% of FPG ($16,753 per year if you are single) , you may qualify. If you are pregnant, you can have income up to 280% FPG ($46,088 per year if you are single and pregnant with your first child; the baby counts as a family member according to MA). There is no asset limit for income-based MA.

Use this tool to check whether your family's income is low enough for you to get income-based MA:

Health Coverage Income Limits for Your Family

Disability-based MA eligibility

If you do not qualify for income-based MA, MA will check to see if you qualify for disability-based MA. To qualify, you must be determined disabled by the Social Security Administration (SSA) or the State Medical Review Team (SMRT). Both SSA and SMRT use SSA's adult definition of disability for anybody 18 or older.

The monthly countable income limit for adults with disabilities is 100% of FPG ($1,012 for an individual, $1,372 for a family of two).Countable income is not the same as your total income, so use this little tool to see whether your countable income is under the limit:

Your Countable Income:

Note: If you are living with others, some of their income may be counted when your application is reviewed for disability-based MA. If you are in that situation, you should use DB101's Benefits and Work Estimator to see whether you qualify for MA.

A major change when you turn 21 is that you must meet an asset limit in order to get disability-based MA. The asset limit is $3,000 if you are single ($6,000 for couples). Disability-based MA doesn’t have the same asset limit as SSI, so if you get both, be sure to stay below SSI’s limit as well ($2,000 for individuals, $3,000 for couples).

Note: Income-based MA does not have an asset limit. If you are currently on disability-based MA and your income rises, you may be able to switch to income-based MA or to MA-EPD (described on this article's next page).

MinnesotaCare and individual plans on MNsure

If you don’t qualify for MA or MA-EPD, there are other health coverage options you may be able to get on MNsure. To learn more, read DB101’s articles on MinnesotaCare and Buying Health Coverage on MNsure.