Disability Hub MN: Health
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Health coverage options
Health coverage — which many people refer to as simply health insurance — helps pay for medical costs.
We understand that health coverage options can be confusing. We want to help you get connected to the right information so you understand your options and can make the choice that's best for you.
Types of coverage
The best type of health coverage depends on your circumstances. If you're working, you might qualify for employer-based insurance. If not, you have other options. Use the tools and information below to understand basic options for health coverage.
Do you wonder which health coverage option is best? Use this interactive tool to
Find the right health coverage for you »
Medical Assistance (MA): Minnesota Medicaid program for people with low income
MA is Minnesota's Medicaid program for people with low income. MA serves children and families, pregnant women, adults without children, seniors, and people who are blind or have a disability. MA may be able to help you pay past medical bills (up to 3 months previous to your application).
MA pays for health care in a few ways:
- Health plans: county-based options or Special Needs BasicCare (county-based plans for people with disabilities)
- Fee-for-service: providers bill the state directly for the services they provide
MA covers many common medical services, including doctor and clinic visits and emergency department care. Some services or prescriptions require prior approval. For details, see this summary of services covered by MA from the Minnesota Department of Health. With certain types of MA, you may be able to use home and community-based service waivers to pay for additional services.
If you have other health insurance, you must report it on your application. MA may pay for expenses not covered by the other insurance (such as co-pays or premiums). For details, see how other health insurance may affect eligibility for Medical Assistance from the Minnesota Department of Human Services.
Under top topics, check out answers to common questions on MA.
Read more about Medical Assistance »
Medical Assistance for Employed Persons with Disabilities (MA-EPD): Minnesota's Medicaid program for people who work
Many people with disabilities fear if they return to work and start earning more money, they'll lose their Medical Assistance (MA) coverage. Medical Assistance for Employed Persons with Disabilities (MA-EPD) means that you don't have to be afraid of this happening. With MA-EPD, if you have a disability and work, you can earn any level of income, build more assets, and keep your MA coverage.
Most people on MA-EPD, pay a monthly premium that is based on their income. If you qualify, MA-EPD is cheaper than MA with a spenddown and can help you save money.
Under top topics, check out answers to common questions on MA-EPD.
Learn more about MA-EPD from Disability Benefits 101, or try the MA-EPD Premium Estimator to see what you might pay.
Learn more about MA-EPD and try the MA-EPD Premium Estimator to see what you might pay.
MA-EPD Premium Estimator »
Special Needs BasicCare (SNBC): Program for people who have MA and are 18 to 64
SNBC is a voluntary program for people with disabilities who have MA and are ages 18 to 64. If you enroll in SNBC, you'll have all the benefits of MA plus:
- A care coordinator who works with you one-on-one to help you access health care services
- Access to a 24-hour nurse phone line
- The option to join a health plan stakeholder group to provide feedback on health plan services
- Additional benefits and incentive programs, such as health club memberships, rewards and incentives for preventive care
If you have Medicare and want SNBC, you can choose a plan that combines your Medicare and MA into one integrated plan.
Read more about SNBC for people with disabilities from the Minnesota Department of Human Services or check out the SNBC page under top topics.
MA under the TEFRA option: Program that provides MA for children in families with incomes too high to otherwise qualify
The Tax Equity and Fiscal Responsibility Act, or MA under the TEFRA option, allows MA eligibility for children with disabilities who are age 18 or younger in families with incomes too high to qualify for MA. MA under the TEFRA option counts only the child's income when determining eligibility (rather than counting the total family income, as with MA).
Beginning July 1, 2023, parents are not required to pay a parental fee, unless their child is in out of home placement. Before July 1, 2023, some parents of children enrolled in MA under the TEFRA option had to contribute towards the cost of the child's care by paying a parental fee. If your child received services before July 1, 2023, you are responsible for any payments. You may receive paperwork requesting information for those services.
MinnesotaCare: Public health care program for people with low to middle income
MinnesotaCare is a public health care program for people with low to middle income who can't get affordable insurance through their jobs and aren't eligible for MA. There may be a monthly premium for MinnesotaCare coverage, depending on your income.
Read more about MinnesotaCare »
Medicare: National public health insurance program
Medicare is a national public health insurance program. When you work, you pay Medicare taxes. If you or your spouse pays enough in Medicare taxes, you'll qualify for Medicare at age 65, after you get Social Security Disability Insurance (SSDI) for two years, or if you have end-stage kidney disease or Lou Gehrig's disease (ALS).
Under top topics, check out answers to common questions on Medicare.
Employer-sponsored coverage: Typical option for people who work
If you work — or you're married and your spouse works, or you're younger than 26 and your parents work — you may qualify for employer-sponsored coverage. For details, check with the employer's Human Resources office.
Read more about employer-sponsored coverage »
Purchase your own coverage: Another way to get coverage if you don't qualify for other options
If none of the options described above are right for you, you might want to buy your own health insurance. You can do this through MNsure, Minnesota's online marketplace for health insurance. When you buy health coverage through MNsure, you may be eligible for tax credits to help reduce the cost of your coverage.
Read more about buying health coverage on MNsure »
Dental Coverage: Pay as you go, employer plans, MA, Medicare and more
Your dental health is about more than just your teeth. Making sure your teeth and mouth are healthy encourages overall physical health.
Pay as you go
If you don't have dental coverage but can afford to pay for dental care out of pocket, you might choose to pay as you go.
Employer-sponsored coverage
If you have dental insurance through your employer, make sure you know what's covered, what isn't and which providers you can use. If you have questions, check with your Human Resources office.
Medical Assistance (MA)
If you have MA, knowing what's covered and where to find providers can help you prevent unexpected bills for dental care. Check this comprehensive list of MA dental benefits for adults. In general, MA covers:
- A periodic exam and fluoride treatment once a year
- A comprehensive exam once every 5 years
- A set of partial or complete dentures every 6 years
- Extractions
- Fillings
Medicare
Original Medicare doesn't include dental coverage. To receive dental coverage with Medicare, you must enroll in a supplemental plan that includes dental coverage. Learn more from Medicare Interactive.
To find Medicare plans with dental coverage:
- Go to the Medicare site and log in to your MyMedicare.gov account
- See health care choices for Minnesotans on Medicare to read about plan details
- Call the Senior Linkage Line at 1-800-333-2433 for personalized insurance counseling
Free or sliding scale clinics
If none of these options are right for you, consider a free or sliding scale clinic. Find clinics in the Twin Cities metro area and in greater Minnesota.
Other resources for dental services
- Dental Lifeline Network. This organization provides access to dental care for people who can't afford it and have a permanent disability or are age 65 or older or medically fragile.
- Smiles Change Lives. This organization connects qualified children with orthodontists willing to provide low-cost braces or other orthodontic treatment.
- Special needs dental clinics. These five clinics in greater Minnesota are for people with developmental and intellectual disabilities, persistent mental illness and traumatic brain injuries.
Applying for coverage
State plans
If you have a disability (determined by the Social Security Administration or State Medical Review Team), are age 65 or older, and have Supplemental Security Income (SSI) and/or Medicare, submit a paper application through your local county or tribal agency.
MNsure
If you have low income with no disability determination, have children, and/or are younger than age 65, apply online through MNsure or submit a paper application to MNsure.
Employer-sponsored coverage
If you're employed and eligible for your employer's insurance plan, ask a Human Resources contact at your job how and when to enroll.
Keeping coverage
Reporting changes
To keep your health coverage through the state, you must report major life changes — including changes in income, address or household status — to your local county agency or tribe within 10 days of the change happening. This applies to MA, MA-EPD, MinnesotaCare and private insurance. Find phone numbers in this tribal and county directory.
If you don't report changes promptly, you may have to pay back any benefits that you received incorrectly. If you're not sure whether to report a change, call your local county agency or tribe and explain the situation.
With MA-EPD, you must also notify your county or tribal eligibility worker if you lose your job, are laid off or are applying for Good Cause (which you can request if an event out of your control affects your ability to pay your MA-EPD premium). The Hub can help you submit the online Good Cause request form. You and your county or tribal eligibility worker will be notified if your request is approved or denied.
Reporting access to other insurance
When you apply for health coverage, it's important to report any other health insurance you have or that might be available to you (such as through an employer, spouse or parent). You must also report when you become eligible for Medicare. If you have a cost-effective health coverage option, you may need to use it.
Why coverage closes
Health coverage can close if you:
- Don't turn in required paperwork or verification
- Don't complete renewals on time
- Earn more than the income limit
- Don't report changes in income, address or other household status
- Move out of Minnesota
- Leave your job
- Ask for it to close
Getting help
MNsure navigator
MNsure navigators can help you fill out health coverage applications, enroll in health coverage, complete renewals and report changes to your account. They can't give you advice about choosing a plan, but they can help you understand your options through MNsure.
Local county or tribal agency
If you have questions about the status of your application, contact your local county or tribal agency. Just make sure to give them at least a week or two to receive the application and start processing it. The maximum processing time is 60 days from the date of submission, but you might find out sooner if you're in a priority group.
MNsure broker
MNsure brokers are insurance professionals licensed by the state of Minnesota and certified by MNsure. Brokers can help you understand your private health insurance options and give you advice about picking a plan to meet your needs.
Disability Hub MN
We're here to help you understand your options and navigate the system. We can help you call the appropriate agency to check the status of your application and work through potential solutions for any health coverage challenges you might face.
Managing your health
Health isn't just about your health insurance and what it covers — it's about what you can do to stay physically, mentally and socially healthy.
At the Hub, we care about you and helping you live your best life. If you have health goals you want to work toward, we're here to help. To get started, check out this collection of helpful resources.
Healthy living
- Everyday healthy living. Get the basics on nutrition, physical activity, mental health and relationships, sexual health and safety.
- Physical activity. See how to be physically active while social distancing, plus tips for physical activity at any age.
Finding the right health care team
- Find a doctor or other health care provider. Find doctors and other health care providers who accept Minnesota Health Care Programs (MHCP) coverage.
Crisis lines and substance abuse support
- Peer to peer telephone support. If you're experiencing emotional distress, speak with peers who are there to listen. Call 1-844-739-5369 from 5 pm to 9 am.
- Crisis Text Line. The Crisis Text Line is available 24/7. Text MN to 741741.
- 988 Suicide & Crisis Lifeline. Free, confidential support is available by calling 988.
- Online Intergroup of Alcoholics Anonymous. Get help for a drinking problem now, or browse a directory of online AA meetings and resources.
Youth and health
Part of being an adult is taking care of your health — and explaining your needs to others.
As you get older, you can choose people to be part of your health care team. You can find a health care provider who understands your disability and can help you manage any special health care needs. Together, you can make sure you're taking the right steps to stay healthy today and into the future.
Your health care provider can help you understand why you're taking certain medications, how to take them correctly and how to manage side effects.
You can ask questions when you don't understand something. While you're learning about your health, you can ask for help from loved ones or others who support you.
Resources to help you take charge of your health
At 18, you may begin to manage your Medical Assistance (MA) benefits and make medical decisions on your own. To get ready for the transition, check out these helpful resources:
How the Hub can help
Whether you have questions about working with your health care team or paying for health care services, count on the Hub to help you find answers.
The Hub team can help you:
- Understand your health coverage options, including Medical Assistance and Medicare
- Manage health care transitions
- Resolve issues around accessing and using health care
- Find in-network providers and get answers about covered services
- Navigate county systems
- Keep your public health insurance while working and see how work might impact health coverage benefits
- Learn about services to help you remain in your home, such as personal care assistance
- Understand health services covered by waivers