Medical Assistance (MA) vs. MinnesotaCare vs. MNSure and Public Assistance

MNsure

• MNsure is Minnesota’s official health insurance marketplace (MNsure – Minnesota’s health insurance marketplace / MNsure). It’s a place to shop and compare health insurance plans.
• Anyone in the state can apply for insurance through MNsure.
• When you apply for insurance through MNsure, there are two different applications you can chose from:
  • Apply for insurance WITHOUT financial help. A person would pick this option if they don’t need or want financial assistance paying for their insurance premiums and just want to buy insurance and pay for 100% of the premiums themselves.
    • Most common for those who are self-employed or have jobs that don’t have employee sponsored health insurance BUT they still make decent money and their income won’t qualify them for financial assistance.
    • May also be used by those who have employee sponsored health insurance but the premiums are really high or the coverage is bad and the person wants to find a different health insurance option.
    • This type of application is basically the same as calling up BlueCross or United Health and buying a health insurance plan through them directly.
    • Obtaining insurance through MNsure without financial help is NOT considered “public assistance” in family court cases. 
  •  Apply for insurance WITH financial help. A person would pick this option if they want financial assistance paying for their healthcare and believe they meet the income requirements.
    • Most common for lower income families, self-employed individuals who maybe don’t make that much on paper, families that maybe have moderate income but have a lot of children
    • This type of application allows people to access the two programs that offer financial assistance for health insurance: MinnesotaCare and Medical Assistance (MA)
    • Obtaining insurance through MNsure WITH financial help IS considered “public assistance” in family court cases. 

MinnesotaCare

A program for Minnesotans with low incomes who do not have access to affordable health care coverage. MinnesotaCare may require you to pay a monthly premium, and it is based on your household size and income. MinnesotaCare members may have small co-pays. The MinnesotaCare Premium Estimator Table (PDF) will help you estimate your premium amount.

• People can apply for MinnesotaCare through MNsure (as noted above) and also may be able to apply directly through their County Human Services Office.
• Those qualifying for MinnesotaCare generally have higher income levels than those eligible for Medicaid.
• May also be referred to as a PMAP or Prepaid Medical Assistance Program (although they are slightly different, but doesn’t matter)
• If a person/family is on MinnesotaCare, they would be on “public assistance” for family court cases. 

Medical Assistance (MA)

Is Minnesota’s Medicaid program for people with low income, older adults, and people with disabilities. MA does not require you to pay a monthly premium. MA members have small co-pays for some services, usually $1 – $3.

• It is much less common for someone to be on MA than it is for them to be on MinnesotaCare.
• People can apply for MA through MNsure (as noted above), but they can also apply directly with the County Human Services agency, and this tends to be more typical with MA than MinnesotaCare
• MA usually requires some type of disability or little/no income.
• People frequently use the term MA to refer to MinnesotaCare. These two things are technically different, but both are considered “public assistance” for family court cases.
• May also be referred to as “straight MA”‘
• It is possible for someone to have health insurance through their employer or parent and have MA as a secondary insurance, but this is uncommon and would usually only occur in cases where someone has significant disabilities.
• If a person/family is on Medical Assistance, they would be on “public assistance” for family court cases.

How to know what type of health insurance a client has if they aren’t sure whether it is “public assistance”

1. Ask if they pay for their health insurance or if it is covered by the state/county
2. Ask if they have a case worker through the County that helps with their healthcare
3. Ask if they’ve ever had a court hearing regarding child support (if they have public assistance for children, but are not living with the other parent, the County may have gotten involved to establish child support, which includes a medical support obligation for the MinnesotaCare or MA)
4. Ask them to provide documentation regarding their healthcare
5. Ask them to provide copies of their health insurance cards
6. Call the County Human Services and ask to speak to someone about confirming whether a client is receiving MinnesotaCare or MA (they may request you provide a cert of rep prior to releasing information)

If a family or children have MinnesotaCare or MA, child support CANNOT be reserved in a stipulation. The county will want reimbursement from the parents for the healthcare the county/state is subsidizing.