Your Comprehensive

Medical Assistance

Guide

Published on
February 1, 2024
Last updated
February 1, 2024
Written by
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Katie Wilkinson
Reviewed by
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Quick Overview of Medical Assistance

Medical Assistance (MA) in Minnesota, also known as Medicaid, is a program designed for low-income individuals, encompassing many beneficiaries, including children and families, pregnant women, adults without children, seniors, and those who are blind or disabled. The program primarily delivers health care through health plans, allowing members to choose from available plans in their county. However, MA operates on a fee-for-service model for those not receiving care through a health plan, where healthcare providers bill the state directly for services rendered to MA members.

Benefits you get with Medical Assistance

Minnesota's Medicaid program, known as Medical Assistance (MA), covers various services and varying costs for members depending on their eligibility. Some services may be free, while others involve copays, deductibles, or spenddowns. Prior approval might be required for certain services and prescriptions. Coverage can also be retroactive, covering medical bills up to three months before the application date.

Here's a summary of the services covered:

  • Alcohol and Drug Treatment: Specialized treatment services for substance abuse.
  • Chiropractic Care: Services provided by licensed chiropractors.
  • Dental Care (Limited for Non-Pregnant Adults): Dental services with limitations for non-pregnant adults.
  • Doctor and Clinic Visits: General medical consultations and clinic services.
  • Emergency Room (ER) Care: Services received in emergency situations.
  • Eyeglasses: Prescription glasses as needed.
  • Family Planning Services: Assistance and services related to family planning.
  • Hearing Aids: Devices to assist with hearing impairments.
  • Home Care: Health services provided in a home setting.
  • Hospice Care: Care for individuals with terminal illnesses.
  • Hospital Services (Inpatient and Outpatient): Medical services received in a hospital.
  • Immunizations and Vaccines: Preventative immunizations and vaccines.
  • Interpreter Services: Language interpretation for non-English speaking patients.
  • Lab and X-ray Services: Diagnostic laboratory and radiology services.
  • Licensed Birth Center Services: Care provided by licensed birth centers.
  • Medical Equipment and Supplies: Necessary medical equipment and supplies.
  • Medical Transportation (Access, Ambulance, and Special): Transportation for medical purposes, including ambulance services.
  • Mental Health Care: Services addressing mental health conditions.
  • Nursing Homes and Intermediate Care Facilities for People with Developmental Disabilities (ICF-DD): Long-term care facilities for individuals with developmental disabilities.
  • Outpatient Surgery: Surgical procedures not requiring hospital admission.
  • Prescriptions and Medication Therapy Management: Medications and related therapy management.
  • Rehabilitative Therapy: Therapy to restore or improve skills and functioning.
  • Urgent Care: Care for non-life-threatening but urgent medical issues.

Additional forms may be required for specific long-term care services like nursing homes. More detailed information on covered services is available after application approval and can also be found in MA's online and printable summaries.

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Medical Assistance eligiblity rules

Eligibility requirements for Medicaid in Minnesota, known as Medical Assistance (M.A.), include several key criteria:

Residency

Applicants must be Minnesota residents.

Citizenship/Immigration Status

They must be U.S. citizens or qualifying noncitizens.

Social Security Number

A Social Security number is required for each individual applying for M.A. unless certain exceptions are met.

Income Limit

Eligibility depends on income limits, which vary based on age, household composition, and specific conditions such as pregnancy, blindness, or disability. Some individuals exceeding the income limit may still qualify through a spend-down process, similar to an insurance deductible.

Asset Limit

The consideration of assets (like cars, bank accounts, homes, and financial investments) varies:

  • There is generally no asset limit for parents, children under 21, and adults without children.
  • Parents and caretaker relatives eligible for M.A. with a spend-down have a specific asset limit.
  • Seniors and individuals aged 21 and older who are blind or disabled are subject to an asset limit.
  • Certain assets, including the applicant's primary residence, household goods, personal items, and some assets owned by American Indians, are exempt from the asset limit.

Other Insurance

Applicants with other health insurance or potential coverage through an employer or military service may still qualify for M.A. In some cases, M.A. may cover the cost of the other insurance to allow the individual to maintain that coverage.

These criteria provide a framework for determining eligibility for Medicaid in Minnesota, but specific situations may require additional consideration.

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How to apply for Medical Assistance

Applying for Medicaid in Minnesota, also known as Medical Assistance (MA), can be done through several methods, with the most common being through MNsure, Minnesota's health insurance marketplace.

Online Application via MNsure

The primary method for applying is online through MNsure. This platform is designed to streamline the application process and offers guidance for completing the application. It's beneficial for real-time updates and tracking the status of your application.

MNsure Paper Application

The MNsure paper application form DHS-6696 is available in PDF format for those who prefer or require a paper application. This form can be filled out and returned per the instructions on the form or MNsure's website.

Special Cases - Seniors and People with Disabilities

It's important to note that certain groups, typically seniors and individuals with disabilities, should not apply through MNsure. These groups may have different application procedures and requirements tailored to their needs.

Gather necessary documentation and information, such as income details and social security numbers, before starting the application process to ensure a smoother and more efficient application experience.

How to renew Medical Assistance

To renew Medicaid coverage in Minnesota, individuals can access the Minnesota Department of Human Services website, which provides detailed instructions and resources for the renewal process. The website offers specific guidelines on renewing coverage, including necessary forms and contact information for any assistance required.

Beneficiaries must follow these guidelines carefully to ensure continuous coverage and access to healthcare services under the Medicaid program. For complete details and instructions, please visit the Minnesota Department of Human Services website on renewing Medicaid coverage: Renew my coverage.

Additional programs through Medical Assistance

These programs are available to help family caregivers get paid for caring for loved ones on Medical Assistance.

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