Minnesota offers a variety of medical assistance (MA) and health insurance programs for those who qualify. While the process for applying is rather straightforward, only those who meet certain conditions will qualify for receiving these types of benefits.
There are four major types of medical assistance and insurance plans offered by the state of Minnesota:
- Income-Based Medical Assistance
- Disability-Based Medical Assistance
- Medical Assistance for Employed Persons with Disabilities (MA-EPD)
- MA-Waiver Programs
The requirements and qualifications for each can be found on the Minnesota Disability Benefits website. You can also see a quick breakdown of them below (please keep in mind that these are subject to change each year, so make sure to check Minnesota Disability Benefits website for the latest information).
Income-Based Medical Assistance
Income-Based MA allows a person or family to qualify for medical assistance based on their total income. For a single person, their income is only counted. For a family, the total income of the household is taken into account.
The requirements for Income-Based MA are:
- Be under 65 years old (or over 65 years if you are the parent or caretaker of a child)
- Be not eligible for Medicare (unless you are the parent or caretaker of a child)
- Be a U.S. citizen
- Have a family income that is at or 138% under Federal Poverty Guidelines
- Any child under the age or a pregnant woman may qualify if the family’s income is at or under 280% of the Federal Poverty Guidelines
Income that is counted includes most types of earned and unearned income but does not include Supplemental Security Income (SSI) benefits and certain contributions to requirement accounts.
Learn more about qualifying for Income-Based Medical Assistance in MN.
Disability-Based Medical Assistance
Disability-Based MA is for people who have a disability and a low income, meaning they cannot pay for the treatment or care related to their disability. Some people may also be on Disability-Based MA and Medicare at the same time.
The requirements for Disability-Based MA are:
- Be 65 years or older, OR
- Be determined to be blind or have a disability by the Social Security Administration (SSA) or by the State Medical Review Team (SMRT)
- Be a U.S. citizen
- Meet certain income limits
- Have assets fewer than $3,000 (for one person) or $6,000 (for a family of two). This limit increases by $200 for each family member
To qualify as having a disability, you must have:
- A physical or mental impairment or combination of impairments
- Your impairment/s limit your ability to work and earn a Substantial Gainful Income ($1,260 per month, or $2,110 per month if you’re blind), AND
- This condition has lasted or will be expected to last at least 12 months
Learn more about qualifying for Disability-Based Medical Assistance in MN.
Medical Assistance for Employed Persons with Disabilities (MA-EPD)
MA-EPD is for people who have a disability and can earn any level of income while working. You can also build assets, all while keeping your MA coverage. People who qualify for MA-EPD must pay a monthly premium for coverage.
The requirements for MA-EPD are:
- Be 65 years or older, OR
- Be determined to be blind or have a disability by the Social Security Administration (SSA) or by the State Medical Review Team (SMRT)
- Be a U.S. citizen
- Be employed
- Meet certain income limits
- Pay Medicare and Social Security taxes and earn at least $65 per month
- Have assets fewer than $20,000
Learn more about qualifying for MA-EPD in MN.
Medical Assistance Waiver Programs
MA-Waiver Programs are an addition to Medical Assistance programs like MA-EPD. They provide services to people with disabilities that help them live in the community rather than in an institution. There are four different types of Medical Assistance Waiver programs:
- The Community Alternative Care (CAC) Waiver
- The Community Access for Disability Inclusion (CADI) Waiver
- The Developmental Disabilities (DD) Waiver
- The Brain Injury (BI) Waiver
To qualify for a MA-Waiver program, the services must:
- Be necessary to protect your health and safety
- Help to develop or maintain skills used for day-to-day living
- Best meet your certain desires, interest and needs
- Help you avoid being institutionalized or function with greater independence
- Not be paid for by any other source (including private health coverage, Medicare or Medical Assistance, etc.)
To enroll in these programs, you must meet the following criteria:
- Qualify for Disability-Based MA or MA-EPD
- Be determined to be blind or have a disability by the Social Security Administration (SSA) or by the State Medical Review Team (SMRT)
- Be a U.S. citizen
- Meet certain age requirements (based on each program)
- Get a MnChoices assessment from your county human services agency
- Be able to make an informed choice about entering a program rather than being institutionalized or have an adult representative make the choice for you
- Have a plan of care (Community Support Plan) that ensures your health and safety
- Meet needs support criteria beyond those provided by MA or MA-EPD
Learn more about qualifying for MA-Waiver Programs.
If you need more information on any of these programs, see the Medical Assistance Overview on the Minnesota Disability Benefits website.
Disclaimer: this is for informational purposes only and is not intended to be legal advice. If you need legal counsel, please contact an attorney directly.