Guide to Minnesota's Public Health Care Programs
What Public Programs Are Available?
This guide explains three publicly funded health care programs available to Minnesotans. All three programs have eligibility requirements. The three public programs are:
- Medical Assistance (MA)
- General Assistance Medical Care (GAMC)
- MinnesotaCare
What is Medical Assistance (MA)?
Medical Assistance pays for medical care for very low-income Minnesotans. There are eligibility requirements for the program. Federal and state dollars pay for MA. (This program is different from Medicare, which is a federal health insurance program for people over 65 and for certain people with disabilities.)
How do I apply for Medical Assistance?
To apply for MA, call or go to the human service agency in the county where you live. County agencies are listed toward the end of this brochure. You can apply even if you are not sure that you are eligible.
When you apply, you will fill out an application form and be asked for proof of some of the information you give. You also will talk with a person who works for the county agency. There are people at the county who can help you fill out the application. You can print a copy of the application from the Web at www.dhs.state.mn.us and send it in.
Your county agency will let you know if you are eligible for assistance within 45 days (60 days if they need a disability certification; 15 days for pregnant women). If a decision is not made in that time, the county agency will explain why in writing.
If you are found to be eligible, the county will enroll you in the MA program. Every six months a county financial worker will review your situation to see if you are still eligible for health care assistance. You must complete, sign, date and return all forms sent to you by your county agency. If you do not, you will lose your Medical Assistance.
Your financial worker may ask you to provide:
- your last checking or savings account statement and/or sign a release-of-information form for your bank
- proof of ownership for stocks, bonds, savings certificates, trust funds or other financial assets
- proof of current unearned income
- your pay stubs for all family members who are employed for the last 30 days and/or your most recent tax form
What is General Assistance Medical Care (GAMC)?
Low income Minnesotan's who are not eligible for other state or federal programs may be eligible to have General Assistance Medical Care pay for their medical care. GAMC is funded by state tax dollars.
How do I apply for GAMC?
The procedure for applying for GAMC is the same as for MA. Call or go to the human service agency in the county where you live. You can apply even if you are not sure that you are eligible. County agencies are listed toward the end of this brochure.
When you apply, you will fill out an application form and be asked for proof of some of the information you give. You also will talk with a person who works for the county agency who can help you fill out the application. Applications are also available from many health care providers or you can print an application from the Web at www.dhs.state.mn.us.
Your county agency will let you know if you are eligible for assistance within 45 days (60 days if they need a disability certification). If a decision is not made in that time, the county agency will explain why in writing.
Every six months a county financial worker will review your situation to see if you are still eligible for health care assistance. You must complete, sign, date and return all forms sent to you by your county agency. If you do not, you will lose your General Assistance Medical Care.
Your financial worker may ask you to provide:
- your last checking or savings account statement and/or sign a release-of-information form for your bank
- proof of ownership for stocks, bonds, savings certificates, trust funds or other financial assets
- proof of current unearned income
- your pay stubs for the last 30 days for all family members who are employed and/or your most recent tax form
General Assistance Medical Care (GAMC) Hospital Only
There are eligibility requirements for the GAMC Hospital Only program. It is for certain adults without children. To apply you must already be hospitalized or you may apply within 45 days of being hospitalized. Provides inpatient hospital coverage including physicians' services during hospitalization. There is a $1,000 copay for each hospital admission.
What is MinnesotaCare?
Minnesota Care is a health care program for uninsured working Minnesotans. MinnesotaCare does not pay for past medical bills. MinnesotaCare is for Minnesota residents who meet income and other eligibility guidelines. MinnesotaCare is paid for with state and federal tax dollars, provider taxes and premiums paid by people who are enrolled.
It takes 30-45 days to process the application. Enrollees pay a monthly premium based on family size, income and the number of people in their family who are covered. Children under age 21 who meet a lower income guideline pay a fixed premium of $4 a month. Coverage starts the first of the month after payment is received. Continued coverage depends on timely payment of premiums. MinnesotaCare enrollees must complete a new application every year.
How do I apply for MinnesotaCare?
You can apply for MinnesotaCare by mail. Call 651-297-3862 (Twin Cities Metro) or 1-800-657-3672 (toll-free) for an application. Many medical providers, schools, and social service agencies also have applications. You can print the application from the Minnesota Department of Human Services web site at www.dhs.state.mn.us and mail it in. You can apply for MinnesotaCare in person at some county social service agencies and at the state office in downtown St. Paul at 8 East Fourth Street.
Eligibility requirements for MinnesotaCare:
- Permanent Minnesota resident.
- Meet income guidelines.
- Not currently insured or covered by other health insurance within the last four months (this includes Medicare). Some exceptions apply for people coming from MA and children who meet a lower income guideline.
- No access to employer-paid insurance with a current employer where the employer pays 50 percent or more of the monthly premium. Does not apply to children who meet lower income guidelines.
- Current employer has not withdrawn employer-paid (50 percent or more) health insurance in the past 18 months.
- Asset limit of $10,000 for one person, $20,000 for two or more people. (Pregnant women and children under 21 years old have no asset limits.
- Applications require proof of income, such as federal 1040 tax forms, W-2 forms, wage statements or pay stubs.
Will the application information I give to the county or state stay private?
The information you give to the county or state agency is private. No one other than you and certain personnel at government agencies may see this information. You have the right to examine your file to see if the information is correct.
What if I don't qualify for any of the three programs?
There are several organizations listed in the Guide to Additional Health Care Resources that may be able to help you. Most programs and organizations listed in the guide have eligibility requirements. Take the time to read about the various services available and contact the programs that fit your present situation.
What assistance is available to help Medicare enrollees pay for Medicare?
- Medical Assistance for Qualified Individuals helps pay Medicare Part B premiums.
- Medical Assistance for Qualified Medicare Beneficiaries helps pay Medicare Part A and Part B premiums and Medicare deductibles, co-insurance and co-pays.
- Medical Assistance for Service Limited Medicare Beneficiaries helps pay Medicare Part B premiums.
Contact your county human services agency to determine if you are eligible.
What if I don't qualify for any of the three programs?
There are several organizations listed in the Guide to Additional Health Care Resources that may be able to help you. Most programs and organizations listed in the guide have eligibility requirements. Take the time to read about the various services available and contact the programs that fit your present situation.
What assistance is available to help Medicare enrollees pay for Medicare?
- Medical Assistance for Qualified Individuals helps pay Medicare Part B premiums.
- Medical Assistance for Qualified Medicare Beneficiaries helps pay Medicare Part A and Part B premiums and Medicare deductibles, co-insurance and co-pays.
- Medical Assistance for Service Limited Medicare Beneficiaries helps pay Medicare Part B premiums.
Contact your county human services agency to determine if you are eligible.
For more information contact the Minnesota Health Information Clearinghouse:
By telephone:
(651) 201-5178 or 1-800-657-3793
TDD: (651) 201-5797
By mail:
Minnesota Department of Health
Minnesota Health Information Clearinghouse
Compliance Monitoring Division
85 East Seventh Place, P.O. Box 64882
St. Paul, Minnesota 55164-0882
By e-mail:
clearinghouse@health.state.mn.us
By fax:
(651) 201-5179
Health Plan Options was created by the Minnesota Department of Health in collaboration with the Departments of Commerce and Human Services. The Minnesota Department of Health thanks everyone who reviewed and provided information for Health Plan Options.
Produced by the Minnesota Health Information Clearinghouse, Revised January 2005. If you require this document in another format, such as large print, Braille, or cassette tape, call (651) 201-5178 or 1-800-657-3793.
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