MinnesotaCare, the Children’s Health Insurance Program in Minnesota is open to children up to age 21, pregnant women, and parents or caretakers. To qualify, residents must be residents of Minnesota who do not qualify for Medical Assistance, and meet the income requirements for coverage. Residents will not be found eligible if they receive employer-sponsored coverage that pays for at least half of the cost, however, this rule may not apply to some children. The program is funded by a state tax on hospitals and health care providers, federal Medicaid matching funds, and the premiums paid by members.
Most individuals and families who are enrolled in MinnesotaCare pay a premium, which varies based on your income level. The program makes certain exceptions for some military families and American Indians who do not have to pay any premiums. Children up to age 21 do not have any restriction on family income to qualify, nor is there an asset limit. All MinnesotaCare programs are available through health plans, and administered by the state. Health insurance carriers in the State such as Medica and HealthPartners offer plans to eligible residents, and care is coordinated through these entities.
MinnesotaCare Income Guidelines
Below are the current income guidelines for the MinnesotaCare program. Only children under age 21 may qualify, which is much more lenient than other states where coverage ends at age 19. Additionally, pregnant women with income over the limits for Medical Assistance may qualify for MinnesotaCare. Only children whose income exceeds the stated limits can receive coverage.
Services covered by the MinnesotaCare program include a full range of medical, dental, and vision services from preventative care to major medical care. Children with special health needs may be eligible for even more services than those listed below, as considered medically necessary. There are no copays, deductibles, or inpatient limits for pregnant women and children through MinnesotaCare. The follow are some of the benefits MinnesotaCare plans are likely to cover for their enrolled members.
- Ambulance and emergency room care
- Chiropractic care
- Dental care
- Diagnostic, screening, and preventative services
- Eye exams and eyeglasses
- Family planning
- Hearing aids
- Home health care
- Hospice care
- Inpatient and outpatient hospital care
- Interpreter services
- Licensed birth center services
- Medical equipment and supplies
- Medical transportation
- Medication Therapy Management Services
- Nurse practitioners
- Orthodontic services
- Outpatient lab and X-rays
- Outpatient mental health care
- Personal care and case-management services
- Physical, occupational, and speech therapy
- Physician and clinic visits
- Pregnancy care
- Public health nursing services
- Routine physicals
- Substance abuse treatment
Children with income less than or equal to 150% of the federal poverty level pay $4 per month.
Children whose household income exceeds 275% of the federal poverty level pay monthly premiums based on how many children per family are enrolled. Below are the current premiums for MinnesotaCare members with such income.
Sliding Scale Premiums
MinnesotaCare members under age 21 with income over 150% of FPL and all adult members pay a sliding scale premium. This amount is determined by household size, income, and number of people covered.
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Saint Paul, MN 55155
Twin Cities: 651-297-3862
Toll Free: 800-657-3672