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Medical Assistance is Minnesota’s Medicaid program and provides services to low-income senior citizens, families, children, and people with disabilities. There are income limits to qualify for this program, and you can apply through your local county human services office. Starting March 1, 2011: Adults who do not have children and who meet income limit qualifications are eligible to receive MA. People enrolled in GAMC and some enrolled in MinnesotaCare will automatically be moved to MA.
TEFRA is a Medical Assistance (MA) program for children with disabilities that provides Medical Assistance to children with disabilities who meet eligibility criteria and 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 19
- determined to have a disability by the State Medical Review Team, with information provided by the child's parent and doctors Information provided should include certification of disability by Social Security if applicable.
- 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 is not more than the cost for care in a medical institution
TEFRA Parental Fees Worksheet – MN law states that families may have to pay a parental fee based on income and family size. Please use the DHS Parent Fees Worksheet to calculate a monthly parental fee estimate.
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.
Developmental Disability (DD) Waiver, formerly called Mental Retardation and Related Conditions (MR/RC) Waiver, is for children or adults 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) Waiveris for a person with a disability or chronic illness 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 in 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) Starting March 1, 2011: Adults who do not have children and who meet income limit qualifications are eligible for MA. All GAMC enrollees will automatically be moved to MA starting on March 1. The GAMC and the four Coordinated Care Delivery Systems will be terminated on February 28, 2011. See the Minnesota Medical Assistance expansion fact sheet for more information.
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 based on income and/or family size. Starting March 1, 2011: Adults who do not have children and who meet income limit qualifications are eligible for MA. Some adults will move from MinnesotaCare to MA between March 1, 2011 and August 31, 2011. You will remain enrolled in MinnesotaCare if you do not receive a letter before August 31, 2011, from the Minnesota Department of Human Services stating that you will move to MA. See the Minnesota Medical Assistance fact sheet for more information.
Supplemental Social Security Income (SSI) can pay monthly checks to people who are 65 or older, or blind, or have a disability and who do not own much or have a lot of income. SSI is not just for adults. Monthly checks can go to children who are disabled and/or blind. Income and resources of family members in the home are counted when determining eligibility for SSI for children with disabilities under 18. People who get SSI usually get food stamps and Medical Assistance.
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 is sometimes referred to as Minnesota's "high risk pool" for health insurance or health insurance of last resort.
Who Pays? Taking the MAZE out of Funding – a helpful resource developed by the Minnesota Children and Youth with Special Health Needs (MCYSHN) division of the Minnesota Department of Health (MDH)
Portico Healthnet is a nonprofit health and human services organization that helps uninsured Minnesotans access affordable health coverage and care.
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.
Bridge to Benefits – This is a Web-based eligibility screening tool for public insurance options for families in Minnesota.
Managing Your Health Care – guide from the office of the Minnesota Attorney General.
The Consumer Guide to Getting and Keeping Health Insurance in Minnesota 
- From Georgetown University’s Health Policy Institute. This guide offers some practical ideas for obtaining Health Insurance in Minnesota.
Letter of Medical Necessity – The following links provide information on how to write and samples of letters of medical necessity and insurance appeals letters:
- Utah Collaborative Medical Home Project - Writing Letters of Medical Necessity for Professionals and Appealing Funding Denials
- Writing the Letter of Medical Necessity or the Cover Letter for the Appeals Packet
- Minnesota Children and Youth with Special Health Needs division of MDH, “Who Pays? Taking the MAZE Out of Funding”, pg. 152
- Letter of Medical Necessity for Assistive Technology by National Assistive Technology Technical Assistance Partnership (NATTAP)
HeatlhCare.gov – A website produced by the federal government with the following:
- Interactive tool to find and price insurance options
- Information about preventative care and the new health reform laws
- A Compare Care Quality tool to compare health care from hospitals, nursing homes, home care, and dialysis facilities
Information from HealthCare.gov is also available in Spanish at CiudadoDeSalud.gov.
To learn more about insurance and health services, contact PACER’s Family-to-Family Health Information Center at (952) 838-9000 or (800) 53-PACER, toll free in Minnesota.
PACER's site offers many PDF files for download, which require