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Public and Private Health Insurance Information

Medical Assistance (MA) is available to low-income senior citizens, children, families, and people with disabilities. There are income limits to qualify for this program.

TEFRA is a Medical Assistance (MA) program for children with disabilities that provides Medical Assistance to certain disabled children who live at home with their families.

To qualify for TEFRA, a child must meet ALL of the following conditions:

  • live with at least one parent
  • be under 18
  • be certified blind or disabled
  • determined to be disabled by the State Medical Review Team, with information provided by the child's parent and doctors
  • need a certain level of home health care to stay at home which compares to the level of care provided in a hospital, nursing home or an intermediate care facility for the mentally retarded
  • the cost for home care must not be more than the cost for care in a medical institution

TEFRA Parental Fees Notice

Home and Community Based Waiver Programs are for Minnesotans with disabilities or chronic illnesses who are enrolled in Medical Assistance and need care or services beyond what MA covers. These programs are designed to support a person with a disability or chronic illness in their home who might otherwise be in a hospital, nursing facility or intermediate care facility if they did not have this program. Usually, these services are for people with specific needs or diagnosis. There are some differences in the services and amount of money available in each waiver and the amount of money.

Mental Retardation and Related Conditions Waiver (MR/RC) is for persons with mental retardation or a related condition who need the level of care provided in an intermediate care facility for persons with mental retardation or related conditions (ICF/MR).

Community Alternative Care (CAC) Waiver for chronically ill individuals who need the level of care provided in a hospital.

Community Alternatives for Disabled Individuals (CADI) Waiver for people with disabilities who require the level of care provided a nursing facility.

Traumatic Brain Injury (TBI) Waiver or people with traumatic or acquired brain injuries who need the level of care provided in a nursing home or neurobehavioral hospital.

General Assistance Medical Care (GAMC) is a program which pays for medical care for low-income Minnesotans who don't qualify for Medicaid or other state or federal health care programs -- primarily low-income adults between the ages of 21 and 64, who don't have dependent children.

Children's Mental Health Collaboratives are for children with or at risk for severe emotional disturbances who may require services and supports from multiple service systems.

MinnesotaCare is a health care program sponsored by the state for people who live in Minnesota and do not have access to health insurance. There are income limits and other guidelines to qualify.

  • Enrollees pay a monthly premium for their health coverage.
  • The premium is based on income and family size.
  • Enrollees get all their services from a health care plan, which they choose when they enroll in the program.
  • Coverage includes medical care (clinic and hospital), dental care, mental health and chemical dependency services, and prescription drugs.

Minnesota Comprehensive Health Association (MCHA) is individual health insurance for Minnesota residents who have been turned down for health insurance because of a pre-existing health conditions. MCHA sometimes referred to as Minnesota's "high risk pool" for health insurance or health insurance of last resort.

Supplemental Social Security Income (SSI) can pay monthly checks to people who are 65 or older, or blind, or have a disability and who don't own much or have a lot of income. SSI isn't just for adults. Monthly checks can go to children who are disabled and/or blind. People who get SSI usually get food stamps and Medical Assistance, too.

The Minnesota Health Care Plans Providers Manual - This manual provides information about covered services under Medical Assistance and other state funded health programs.

Covering All Families - a Web-based eligibility screening tool for public insurance options for families in Minnesota.

Managing Managed Health Care - guide from the office of the Minnesota Attorney General.

The Consumer Guide to Getting and Keeping Health Insurance in Minnesota pdf icon - From Georgetown University’s Health Policy Institute. This guide offers some practical ideas for obtaining Health Insurance in Minnesota.

Minnesota Statutes related to Health Insurance

Minnesota Health Care Programs (MHCP) Individualized Education Program (IEP) Services: Information for Families

What Should Be in A Letter of Medical Necessity - This is a helpful guide for families and physicians when filing an insurance appeal related to assistive technology.

Visit PACER's other sites: National Parent Center Network (ALLIANCE) | Kids Against Bullying | Project C3 | FAPE Project | Minnesota SEACs

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