Minnesota GA Application Information
Minnesota General Assistance Medical Care (often known as "Medical Assistance" or MA) provides health insurance coverage for wide range of low-income categories. This program can be used by families with underage children as well as low-income families without any children, senior citizens (over 65 years of age) as well as disabled individuals. You can find more information on this topic in the "eligibility requirements" section of this text.
Since Medical Assistance program is created to help people in need to get quality health care, the State of Minnesota created several subtypes of this program which are applicable to different social categories of potential users. For very-low income individuals, there are types of MA which are completely free, but for those who already got steady monthly income, there are types of MA which come with co-payments. We will explain all of these programs as well as the cost of MA covered benefits in each of those cases. In all of these cases, a potential user of MA health insurance coverage need to have a monthly income which is less than Federal Poverty Level (currently $931/month for a single person).
The first subtype of MA is called Medical Assistance with a spenddown. If your income is slightly greater than the current Federal Poverty Level (FPL) you'll need to pay a spenddown to get MA coverage. This is fixed amount of money that you'll need to pay for health care expenses before your local government starts paying for the rest of your health care bills. If your medical bills are less than the spenddown in a period of one month, than you'll get a chance to pay only one part of spenddown amount for that particular month. Since this program is created to help people in need of constant medical care, if your monthly medical bills are less than your spenddown for several months in a row, you'll lose the right to use this program.
If you're interested in the procedure of calculating your monthly spenddown, we'll explain it here. For example, let's say your monthly income is $1,000. This amount is slightly over the Federal Poverty Level ($931), so you'll first need to calculate how much 75% of the current FPL is. 75% percent of $931 is $698. Now you'll need to deduct this amount out of your monthly income amount: $1000 minus $698 is $302. This means that your monthly spenddown is $302 and that's the amount of money you'll need to pay each month to get the Medical Assistance.
Another MA type of medical coverage is the combination of MA program and SSI (Supplemental Security Income). This means that if you're using SSI as a monthly financial help, you can still use one type of Medical Assistance. This type of MA doesn't need any co-payments or monthly spenddowns.
There's also Medical Assistance for Employed Persons with Disabilities (MA-EPD). This is great way for people with disabilities (ages 16 an up) to get quality health care coverage. You'll need to pay a monthly premium which is calculated according to your income and household size. Minimum monthly premium can be $35, but there's no maximum amount which could be your monthly premium for MA-EPD.
Finally, there's one more MA program, which is created for people under the age of 19 with disabilities. This program is called MA-TEFRA, which stands for Medical Assistance - Tax Equity Fairness and Responsibility Act. MA-TEFRA help disabled persons under the age of 19, whose parents have too much income to qualify for any other kind of MA program. This coverage could be completely free, or you'll need to pay a monthly premium which is determined by your parents' monthly income.
You'll be also able to use Medical Assistance in combination with most of the other disability benefit programs as well as with private health care coverage.
If you're using private health care coverage, you can also apply for Minnesota Medical Assistance. If your private health care coverage turns out to be "cost effective", you can use MA programs to pay for premiums, co-payments or deductibles. Cost effective health care coverage is an insurance plan which provides services at a lower monthly price than what it would cost the state to pay for those same services. You can apply for cost effective evaluation by filling out this form:
If you'd like to know how to combine your current health care insurance with Medical Assistance program, you can call Disability Linkage Line at 1-866-333-2466 (Monday through Friday, 8:30am to 5:00pm).
Medical Assistance coverage offers wide range of possible medical services. Some of them are completely free, while for some you'll need prior authorization and you'll also need to pay a small amount of co-payment. You should also know that regardless of what type of MA coverage you're using, there are some cases in which you're exempt from any co-payments. These cases are:
- If you're younger than 21 years of age
- If you're pregnant
- If you're using a hospice care or if you're living in a nursing home
- If you're an MA Refugee enrollee and
- If you live in an Intermediate care facility for persons with developmental disabilities, also known as ICF/DD.
Most medical care services require very low co-payments which are usually from $1 to $2. For example, these are routine physicals, dental care, immunizations, emergency care services, hospital stay, transportation and many more. You can find a list of these services at:
Some services require a $3 of co-payment and those are: clinic and physicians' service for non-preventive care (these are health care services which are necessary for treating an illnesses, as opposed to preventing them), eye exams, eye glasses, chiropractic care and podiatry.
In case you need medication, you'll also need to pay a co-payments. You'll need to pay $3 for brand name drugs and $1 for generic drugs. Note that the maximum amount on prescription drug co-payments in one month are $12.
To be eligible for the MA coverage, you'll need to fulfill several requirements, which are:
- Have a basis of eligibility for the MA program
- Be a U.S citizen or registered alien
- Live in the State of Minnesota
- Fulfill certain asset as well as income requirements
You qualify for the Healthy and Well Kids Iowa program once all these requirements are met.
- A disabled person needs to have a proper documentation issued by the Social Security Administration (http://www.ssa.gov/) or by the State Medical Review Team, known as SMRT).
- You need to fulfill age requirement: younger than 21 or older than 54
- If you are a parent or legal caretaker of a dependent or disabled child
- You can also apply if you're currently pregnant
- Finally, you can apply if you've got income less than 75% of the Federal Poverty Guidelines.
You also need to be a U.S. citizen or to be legally residing in the U.S. There are a few exceptions, so for example you can apply for Medical Assistance if you're pregnant regardless of your immigration status.
Also note that you need to reside in Minnesota in order to apply for MA coverage. There's no timeframe which determines how long you need to be living within the state borders, since you simply need to currently reside here in order to apply.
One of the other eligibility requirements are asset requirements. These rules say that your assets need to be below MA asset limit. For example, if you're a parent or a legal guardian your assets can't be more than $20,000. If you're disabled or if you're a senior citizen, you need to have less than $3,000 in order to apply for MA ($6,000 for a family of two). Assets include the value of the home you live in, the car your own as well as all of the household and personal goods.
Finally, to be eligible for MA, you need to be in a category of low-income family. This is determined by the current Federal Poverty Guideline. So, if you're disabled, your income need to be below the FPG (which is $932 for an individual or $1,261 for a family of two). Also note that you can still use some of the MA services if your income in slightly over the limit of FPG, but you'll need to pay monthly premium. Still, only by paying a monthly premium you'll pay much less for medical services that you would pay if you're using private health insurance.
GA Application Instructions
To apply for Minnesota General Assistance Medical Care, you can use one of the following ways:
- Apply online via ApplyMN website: https://applymn.dhs.mn.gov/online-app-web/spring/public/
This is a web application used to fill out forms for various welfare and social programs.
- You can also find paper applications at many local medical clinics as well as at your local human services agency. A list of human services agencies in Minnesota could be found at:
- Finally, you can also have paper applications mailed to you by calling 1-800-657-3672.
When you apply for MA program, you'll also need additional documents such as:
- Your Social Security Number
- Proof of U.S. citizenship (you passport or an original birth certificate)
- Proof of identity (Minnesota driver's license or other type of ID card)
- Proof of income (you pay stubs from the last 30 days or a written statement from your employer)
- Proof of assets (any documents which show the value of your stocks, bonds or retirement or savings account)
Once you've submitted your application you should expect to receive an answer in a period no longer than 45-60 days. 45-day period is for kids, parents and caretakers while 60-day period is for individuals with disabilities.
You should also know that you'll need to verify your income every 6 months and your assets every 12 months in order to keep your MA coverage. You'll get a paper application by mail, which you'll need to fill out and return to your local human services agency.