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Effective: October 1, 2007 |
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25.05ar2 - MinnesotaCare Premiums (Archive) |
Archived: July 1, 2009 |
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.
Exception: County agencies pay the MinnesotaCare premium for Transitional MinnesotaCare enrollees. See Transitional MinnesotaCare – Premium Payment by County Agencies for more information.
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.