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Effective: December 1, 2006 |
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25.05ar1 - MinnesotaCare Premiums (Archive) |
Archived: October 1, 2007 |
All MinnesotaCare enrollees must pay a premium to establish and maintain coverage. The MinnesotaCare program pays the remainder of the enrollee's cost of coverage through the Health Care Access Fund.
This section provides information on the types of premiums used to calculate a household MinnesotaCare premium amount.
Combination of Premium Types in One Household.
There are two types of premiums:
l Fixed premiums.
Children with household income equal to or less than 150% FPG pay a fixed monthly premium of $4 per enrolled child.
l Sliding scale premiums.
Children with household income over 150% FPG and all adult enrollees pay a sliding scale premium.
The MinnesotaCare sliding scale premium is calculated by MMIS based on three factors:
n Household size.
n Income.
n Number of people covered. Sliding scale premiums change depending on whether one, two or three or more people are covered.
Example:
Alan and May apply for MinnesotaCare for their two children. Their income is over 150% FPG.
Action:
The children have a sliding scale premium based on a household size of four with two people covered because the household income is greater than 150% FPG.
Two months later Alan and May are added to coverage for themselves.
Action:
The premium is calculated based on a household size of four with three or more people covered.
Alan and May have a baby who is added to coverage.
Action:
The premium is calculated based on a household size of five with three or more covered.
Combination of Premium Types in One Household
Households with income at or below 150% FPG, who are applying for adults and minor children in the household, have the premium calculated on both the sliding scale and fixed premium.
Example:
Jean and Stuart apply for MinnesotaCare for themselves and their three children. Their income is under 150% FPG.
Action:
The children will have a fixed premium of $4 per child for a total amount of $12.
Jean and Stuart's sliding scale premium will be based on a household size of five with two people covered.
The family's total monthly premium will be the sliding scale amount for Jean and Stuart plus $12 for the children.
Jean and Stuart's sliding scale premium is calculated to be $28.
Action:
The family's total premium is $40.
Information regarding specific MinnesotaCare premium policy can be found in the following sections:
Initial, Ongoing and Changes to MinnesotaCare Premiums.
MinnesotaCare Premium Payment Options.