MinnesotaCare Premiums (Archive)

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.

Types of Premiums.

Combination of Premium Types in One Household.

Related Topics.

Top of Page

Types of Premiums

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.

Top of Page

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.

Top of Page

Related Topics

Information regarding specific MinnesotaCare premium policy can be found in the following sections:

Initial, Ongoing and Changes to MinnesotaCare Premiums.

MinnesotaCare Premium Payment Options.

Four-Month Penalty.

Forgiving Premiums.

MinnesotaCare Reinstatement.

MinnesotaCare Premium Credits and Refunds.

Top of Page