*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016. Please refer to the EPM for current health care program policy information. ***

Chapter 22 - Standards and Guidelines

Effective:  September 1, 2012

22.20 - MinnesotaCare Premium Amounts

Archived:  June 1, 2016 (Previous Versions)

MinnesotaCare Premium Amounts

The MinnesotaCare Premium Table (DHS-4139) approximates a household’s monthly premium amount based on the number of people covered in the household and the household’s gross monthly income.

l  MMIS calculates the official MinnesotaCare premium amounts.

l  The MinnesotaCare maximum premium amounts are on the last page of the DHS-4139.

The maximum premium amounts are used when calculating employer-subsidized insurance (ESI) for people who receive cash benefits from their employer to purchase insurance. See Determining ESI - Cash Benefits for more information on how to use the maximum premium amount in the calculation.

The MinnesotaCare maximum premium amounts, based on household size, are:

Effective Dates

Household Size

One

Two

Three or More

July 1, 2012 - June 30, 2013

$467

$934

$1,401

July 1, 2011 - June 30, 2012

$509

$1,018

$1,527

July 1, 2010 - June 30, 2011

$480

$960

$1,440

July 1, 2009 - June 30, 2010

$411

$822

$1,233

July 1, 2008 - June 30, 2009

$392

$784

$1,176

July 1, 2007 - June 30, 2008

$350

$700

$1,050

July 1, 2006 - June 30, 2007

$325

$650

$975

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