Applicants who want a quick determination of MN Medicaid benefits eligibility can apply online to obtain the fastest results. By following Medicaid application guidelines and applying online, candidates can avoid a long waiting period. Applicants may be notified right away if they qualify for Medical Assistance in Minnesota or if they will have to pay for health care coverage. If an applicant is denied for MA benefits, the state will provide reasoning for its decision. Those who qualify for Medicaid benefits will receive an official letter with a response that lists eligible members of the household. The letter will also offer information on how to have the application reviewed if the candidate does not agree with the determination that was made. Candidates can also apply by mail, but the process does take longer.
“What is Medicaid eligibility?” This question may be on your mind if you are new to the program. MN Medicaid eligibility is generally determined by the income level of the individual or household applying for Medical Assistance (MA). Individuals and families that fall within the allowable income range are eligible to receive benefits. In order to qualify for the program all applicants must meet all income and any other requirements.
A “Welcome to Medicare” packet is mailed out a few months before you turn 65. If you are not yet 65 but receive disability benefits from the Social Security Administration, or receive certain disability benefits from the Railroad Retirement Board, then you become eligible for Medicare as soon as you enter into the 25th straight month of receiving those benefits.
Private managed care programs for Medicare beneficiaries are particularly popular in Minnesota. Fifty-six percent of all Minnesota Medicare enrollees were enrolled in private Medicare plans in 2017, as opposed to a national average of 33 percent. Minnesota has by far the largest share of its Medicare population enrolled in private plans; the next closest state is Hawaii, where 45 percent of Medicare beneficiaries have private coverage.
Make note, the Medically Needy Pathway does not assist one in spending down extra assets for Medicaid qualification. Said another way, if one meets the income requirements for Medicaid eligibility, but not the asset requirement, the above program cannot assist one in “spending down” extra assets. However, one can “spend down” assets by spending excess assets on ones that are non-countable, such as home modifications to improve safety and make the home wheelchair accessible. Examples include adding wheelchair ramps, stair lifts, pedestal sinks, roll-in showers, widening the doorways, and replacing carpet with vinyl or laminate flooring. One may also use excess assets to prepay funeral and burial expenses and pay off debt. As mentioned above, one cannot simply give away assets or sell them for significantly less than their value, as Minnesota has a 5-year Medicaid Look-Back Period that prevents applicants from doing so. If one is found in violation of the look-back period, this may result in a period of ineligibility.
The Initial Enrollment Period is a limited window of time when you can enroll in Original Medicare (Part A and/or Part B) when you are first eligible. After you are enrolled in Medicare Part A and Part B, you can select other coverage options like a Medigap (Medicare Supplement) plan from approved private insurers. The best time to buy a Medigap policy is the six month period that starts the first day of the month that you turn 65 or older and enrolled in Part B. After this period, your ability to buy a Medigap policy may be limited and it may be more costly. Each state handles things differently, but there are additional open enrollment periods in some cases.

Only one switch during this time frame is allowed each year — you can change your mind multiple times during the enrollment period in the fall, but can only switch to a different Medicare Advantage plan (or back to Original Medicare) once in the first quarter of the new year. But if you sign up for a Medicare Advantage plan in the fall and then decide you don’t like it once it takes effect in January, you have until the end of March to make a change.

MA enrollees who qualify for Medicare must enroll in Parts A and B as a condition of their MA eligibility. When an MA eligible person does not qualify for automatic payment of Medicare premiums, the person may be required to enroll in Medicare if the premiums are found to be cost effective. See Referrals to Medicare to determine who must be referred to apply for Medicare and the steps in the referral process.
But a Star Tribune review of January enrollment data shows zero-premium plans have been much less popular in Minnesota, with only about 5 percent of state residents who enrolled in a Medicare health plan opting for the coverage. Greiner said her group's analysis of federal data came to the same conclusion; the relatively low interest in zero-premium plans showed up again in recently released figures for February, she said.
Local HMO plans may require referrals to see a specialist, but some Local HMO Medicare Advantage plans include a point-of-service self-referral option, which gives you some flexibility with going to out-of-network providers. Point-of-Service (POS) plans have an option that allows visits to out-of-network providers at an additional cost. If the POS plan offers Medicare Part D coverage, enrollees must get it from the POS plan. If you enroll in a stand alone plan, you will be disenrolled from the Local HMO Medicare Advantage plan.
Medicare Savings Programs help people on Medicare pay for some of their out-of pocket Medicare costs. The costs paid depend upon your income but can include Medicare Part A and B premiums, co-insurance, copayments, and deductibles. You need to have countable income that is 135% of the Federal Poverty Guidelines (FPG) or less ($1,366/month for an individual, $1,852/month for couples) to qualify for a Medicare Savings Program.
Just because a person is able to answer the question “what are the requirements for Medicaid in MN?” it does not mean that he or she will meet the Medicaid eligibility requirements in Minnesota. Visiting Medicaid offices around Minnesota and talking to a member of staff will clear up any misunderstanding about Medicaid qualifications and Medicaid requirements. 

The state was the first to participate in a demonstration program to pilot Medicare Cost plans in the 1970s, and the plans have remained popular over the decades. They didn’t catch on in many other states, however, and Medicare + Choice came on the national scene in the 1990s, replaced by Medicare Advantage in 2003 (there are still Medicare Cost plans in Arizona, California, Colorado, District of Columbia, Florida, Iowa, Maryland, North Dakota, Nebraska, New York, South Dakota, Texas, Virginia, and Wisconsin, but their total enrollment was only about a third of the 625,072 people who had Medicare Cost plans in 2018 — the other two-thirds were in Minnesota).
A “Welcome to Medicare” packet is mailed out a few months before you turn 65. If you are not yet 65 but receive disability benefits from the Social Security Administration, or receive certain disability benefits from the Railroad Retirement Board, then you become eligible for Medicare as soon as you enter into the 25th straight month of receiving those benefits. 

Once you feel fully informed about how to qualify for Medicaid in MN and how to follow the application guidelines for Medicaid, all that will be left to do is apply and enroll. Missing out on the marketplace’s open enrollment period does not mean that beneficiaries will be lacking insurance for long, because if qualifying events occur, Special Enrolment Periods (SEP) may launch. Minnesota shares Medicaid benefit requirements with other states that allow enrollment during SEPs, in the sense that the triggering events for SEPs are the same.

Medical assistance benefits are available to a wide variety of low-income individuals and families within the United States. However, all Medicaid applicants must meet the established eligibility requirements, which range from income limits to citizenship qualifications. To find out if you or your family is eligible to receive Medicaid benefits, download our comprehensive and complimentary guide.

From Oct. 1 through March 31, we take calls from 8 a.m. to 8 p.m. CT, seven days a week. You’ll speak with a representative. From April 1 to Sept. 30, call us 8 a.m. to 8 p.m. CT, Monday through Friday to speak with a representative. On Saturdays, Sundays and federal holidays, you can leave a message and we’ll get back to you within one business day.

Since 1997, Minnesota has provided Medicare coverage for approximately 35,000 Medicare-Medicaid eligible individuals over age 65 through the Minnesota Senior Health Options (MSHO) program. Today, the Minnesota demonstration recognizes this program stability and is focused on administrative flexibility rather than developing a new capitated system. The current demonstration will be evaluated for its ability to further promote integration. However, the longevity of the MSHO program provides for unique data analysis opportunities. MSHO claims data are a rich resource for researchers to analyze the impact of integrated care on health care outcomes for Medicare-Medicaid eligible.  To that end, the Office of the Assistant Secretary for Planning and Evaluation (ASPE) published Minnesota Managed Care Longitudinal Data Analysis which highlights the importance of providing integrated options for Medicare-Medicaid eligible individuals. It may be found at this link: https://aspe.hhs.gov/report/minnesota-managed-care-longitudinal-data-analysis
It’s important to note that Minnesota has a Medicaid Look-Back Period. This is a period of 60 months (5 years) that dates back from one’s Medicaid application date. During this time frame, Medicaid checks to ensure no assets were sold or given away under fair market value. If one is found to be in violation of the look-back period, a period of Medicaid ineligibility will ensue.
Enrollment issues can also be classed as a qualifying event for Medicaid benefits in MN. To avoid delays and confusion regarding the requirements for Medicaid, it might be worth paying for a short-term health insurance policy until enrolment for Medicaid application guidelines opens again. So long as beneficiaries are aware of how to qualify for Medicaid in Minnesota, financial woes and health worries can become a thing of the past.

Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.
×