If you have a disability, you might qualify for Medical Assistance, or MA, based on your income or your disability.
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. See common questions about MA below.
If you have a question that isn't answered here, learn more about your health coverage options under Your Options.
Download this handy checklist and tip sheet, (PDF) which spells out what you need when applying for health coverage. Print or save it for when you're ready to apply. Download this tracking sheet (PDF) to monitor your application status.
The Hub can help you connect with a lead agency or provider. Contact us to get started.
If you have a disability that has been certified by the Social Security Administration (SSA) or the DHS State Medical Review Team (SMRT), you will be assessed for Disability-based MA.
A spenddown is a cost-sharing approach that allows you to reduce your excess income by the amount of certain health care expenses. If your income is more than the allowed income limit, you may still qualify for health care coverage by meeting a spenddown.
A spenddown is similar to a health care deductible. You must pay (or incur) a certain amount of money toward your medical bills before MA will begin to cover medical expenses.
Your spenddown amount depends on many factors, such as your income, family size and disability status. The county or tribal worker assigned to your case will determine your eligibility and spenddown amount based on existing policy and guidelines.
To calculate what your countable income is, visit Disability-based MA: What You Pay, and navigate to the section titled "Your Countable Income".
If you have a disability and earn money from work, Medical Assistance for Employed Persons with Disabilities (MA-EPD) may be able to help you save money. See real-life examples of how to get ahead with MA-EPD (PDF).
After your application has been processed, you will receive a letter. The letter will tell you:
the amount of your counted income
the income limit for your family size
the amount of your spenddown
if you can get medical coverage by meeting a spenddown
If you think something is listed incorrectly on the letter, you can contact your county or tribal worker for further assistance.
You will get an Explanation of Medical Benefits (EOMB) each month. The EOMB will tell you what medical bills were used to meet your spenddown, who you must pay and how much you must pay them and what bills have been paid by the state.
Yes, it depends on what you are eligible for. For some programs, you pay your amount directly to the Minnesota Department of Human Services (DHS). For others, you may pay it to a specific medical provider. Talk with your county or tribal worker to determine what option would be best.
You must have medical bills/expenses equal to or greater than your determined spenddown amount. To meet your spenddown, you can use paid or unpaid medical bills, but you cannot use other household bills.
You can use bills like health and dental insurance premiums (including Medicare premiums), co-payments, medically necessary services and personal care attendant (PCA) services. You can talk with your county or tribal worker to discuss your situation.
If you don't have medical bills in the amount that will meet your spenddown in any month, you do not have to pay the full amount, however MA will not pay for any medical expenses in that month.
For example, Jamal has a $300 monthly spenddown. In March, he only has $50 in medical bills. He has to pay that himself, but he doesn't have to pay the whole $300 spenddown amount for March. MA will not pay any medical expenses for Jamal in March.
You may qualify for MA with a spenddown up to three months before the month you submitted your application.
For example, your application was submitted on 4/15/2022. You can request MA with a spenddown going back to 1/1/2022.
You must report all changes to your county or tribal worker. Your spenddown amount may be adjusted after your county or tribal agency receives proof of any changes in income.
There could be many reasons why MA would close. Consider these common reasons:
Your requested paperwork or information wasn't submitted on time (You should have received a letter in the mail explaining what was needed and by when.)
Your health care renewal was due, but it wasn't received on time or not received at all
You didn't report changes to your income, address or other household changes (If the local county or tribal agency doesn't have your address, you probably didn't receive the letter about needed paperwork or your renewal.)
To find out for sure, you might need to contact your eligibility worker at your local county or tribal agency. Or, contact the Hub and we'll help you figure out what's going on.
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