What Minnesota medical assistance programs are available?
There are a number of different medical assistance programs offered by the state of Minnesota. Each has its own qualification/eligibility criteria, payment requirements, and set of benefits and services. You do not have to apply for a specific program. Rather, when you submit a completed Minnesota Health Care Programs application to your county human services office, your caseworker will evaluate your application and determine which programs you are eligible for.
To obtain an application form, call or go to your local legal aid or county human services office, or call 651-431-2670 (Metro Area) or 800-657-3739 (outside TC Metro Area). The LinkAge Line at 800-333-2433 can assist in completing the application. Click on the following link to download the application.
The programs outlined below are:
- Medical Assistance (MA)
- General Medical Assistance (GAMC)
- Minnesota Care
Medical Assistance (MA)
The Medical Assistance (MA) program is Minnesota's Medicaid program. The program is administered at the county level. This program provides comprehensive health care coverage, including routine doctor visits, emergency services, inpatient and hospital care, hospice care, medical equipment and supplies, prosthetics, prescription drugs (with copay) and more. When authorized by the Department of Human Services, medical assistance provides home health care services, including equipment and supplies, home health aide, personal care assistant and private duty nursing. A number of additional services are available for persons, including children, with disabilities.
Medical Assistance can reach back 3 months to pay for medical bills incurred prior to the date that you apply.
To be eligible, you must:
- live in Minnesota, and
- be a US citizen or non-citizen lawfully residing in the US, or
- be a pregnant woman, regardless of immigration status, or
- be receiving care and services from the Center for Victims of Torture, regardless of immigration status, assets or income;
AND be in one of the following eligibility categories:
- under age 21
- over age 65
- a parent or caretaker of a dependent child
- a pregnant woman
- certified blind or disabled
Disability status is determined by the State Medical Review Team's (SMRT) five step analysis. For more information on the the five step analysis, see the following FAQ discussing disability determination. Income and asset limits apply and vary depending on the eligibility category. Income and asset limits can be obtained from the Department of Human Services.
It can, and usually does, take several months for an application to be processed. Once an application is approved, medical coverage can go back 3 months from the application date to pay for past medical bills. A participant may be able to keep their own medical insurance; MA may pay for medical expenses not covered by the participant's own insurance, and may also help pay premiums for other health insurance. Non-disabled recipients are assigned to a managed care network and must see providers within their network.
Click on the following link for more information on MA coverage and eligibility requirements.
General Assistance Medical Care (GAMC).
General Assistance Medical Care (GAMC) provides managed care health services for low income adults, ages 21 - 64, who have no dependent children under age 18 and who do not quality for federal health care programs.
To be eligible, you:
- must not be eligible for Medical Assistance
- must live in Minnesota for at least 30 days and intend to stay, and be a US citizen or non-citizen lawfully residing in the U.S.
Income and asset limits apply. There is no premium for those who meet the income limits. Click on the following links for more information on and other eligibility requirements.
There are two levels of coverage:
- The Comprehensive Benefit Package includes coverage on doctor visits, hospitalization, prescriptions, eye exams, dental care and more. A copay applies to drugs and some services under this package
- Hospitalization-only Coverage includes inpatient hospital coverage, including physician services. There is a co-payment for this coverage
MinnesotaCare
MinnesotaCare is a publicly subsidized program for Minnesota residents who don't have access to affordable health care coverage. Under this program income limits are higher for families than income limits for other programs. Asset limits apply to all individuals except pregnant women and children under 21. All enrollees pay monthly premiums that are determined according to a sliding-fee scale based on family size and income.
To be eligible:
- you must meet the income and asset limits for the program
- you must not have other health care coverage (although some children can have other health insurance and - also be eligible for MinnesotaCare)
- your employer must not offer a health insurance plan and pay least 50% of the premium
- you must be without health insurance for at least four months (there are exceptions to this rule for children)
Coverage is not retroactive, unless you were previously under MA or GAMC and your coverage just ended. Coverage includes doctor visits, hospitalization, prescriptions, mental health services, emergency room, eye care, dental care, and more. Copays apply to some services. MinnesotaCare recipients are assigned to managed care networks.
For specific eligibility, income and asset limits and other program information, see http://www.dhs.state.mn.us/healthcare, or call (651) 297-3862 (Twin Cities metro area) or (800) 657-3672 (outside Twin Cities metro area).
Not all counties will directly enroll applicants in MinnesotaCare, therefore, in addition to sending your completed application to your county human services agency, you must also send it to the MinnesotaCare office at
MinnesotaCare
P.O. Box 64838
St. Paul, MN 55164-0838
