Minnesota Medicaid

Centers for Medicare & Medicaid Services (CMS) in

Medicaid/Medicare


December 19, 2018

Overview

Medicaid provides health coverage to millions of Americans, including children, pregnant women, parents, seniors and people with disabilities. In some states the program covers all low-income adults below a certain income level.

Medical Assistance is Minnesota's Medicaid program. It is the largest of Minnesota's publicly funded health care programs, providing health care coverage to a monthly average of 1.1 million low-income Minnesotan. Of the total enrollment, about:

  • 65 percent are families with children
  • 17 percent are seniors and people with disabilities 
  • 18 percent are adults without children 


Most members get their health care through health plans. They can choose a health plan from those serving Medical Assistance members in their county. The rest of members  get care on a fee-for-service basis, with providers billing the state directly for services provided.

Medical Assistance pays for a variety of services, such as doctor visits, prescriptions and hospital stays. Some services and prescriptions may require prior approval.

For some members there is no cost for Medical Assistance. Others may have to to pay part of the cost of a service. This may include copays, deductibles, or spenddowns.

View a summary of covered services and costs.

Medical Assistance is funded with federal, state and county funds. The Minnesota Department of Human Services oversees the program statewide with eligibility also administered by county offices and tribes. The federal Centers for Medicare & Medicaid nationally.

Administration

Minnesota Medicaid is administered by Centers for Medicare & Medicaid Services (CMS).

Program Requirements:

To get coverage, you must:

  • Be a Minnesota resident 
  • Be a U.S. citizen or a qualifying noncitizen 
  • Provide a Social Security number for each person requesting coverage, unless an exception is met 
  • Meet income and asset limit 
  • Meet any other program rules. 


How much income you can have and qualify for coverage depends on your: 

  • Household size
  • Age
  • Pregnancy or disability status 
  • Effective July 1, 2018 to June 30, 2019 

In order to qualify, you must have an annual household income (before taxes) that is below the following amounts:

Household Size* Maximum Income Level (Per Year)
1 $16,146
2 $21,892
3 $27,637
4 $33,383
5 $39,129
6 $44,874
7 $50,620
8 $56,365

*For households with more than eight people, add $5,746 per additional person. Always check with the appropriate managing agency to ensure the most accurate guidelines.

 *A pregnant woman counts as two or more people 

Different limits apply to seniors and people who have disabilities. Read the full income and asset limits.

You may be able to get Medical Assistance coverage even if your income is more than the limit. Some people whose income is more than the limit may still get coverage using a spenddown. A spenddown lets you deduct certain medical expenses from your income. Medical Assistance will pay for covered services after your income is at or below the income limit after deducting these medical expenses. 

Application Details

You can apply for Medical Assistance in different ways depending on what type of coverage you need. Learn more about applying for coverage for: 

Contact:

The Medical Assistance page

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