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MNsure Facts and Eligibility

MNsure is an online marketplace where you as a Minnesotan can find, compare and choose quality health care coverage that best fits your needs and budget. The health insurance available through the MNsure marketplace is income based, so depending on your income you may qualify for free or low-cost options. It is also the only place you can purchase private coverage and be eligible for a tax credit.

We’re here to help
Our Navigators are here to help you find the best coverage for you and your family based on your income. Navigators can assist you individually by answering your questions and by helping you with applications, follow-ups and renewals. All Navigator assistance is free of charge.

We offer MNsure presentations to small or large groups. We are also available to have a table at your events.

About MNsure
Think of MNsure as an on-line store that offers the following programs:

  • Medical Assistance for adults and children at zero cost per month for premiums and copays of $1 to $3 per prescription and service.
  • MinnesotaCare for adults at $0 to $80 per month/per person premiums and copays as little as $15 to $25 for most services, and $6 to $20 per prescription.
  • Private insurance coverage paid for with premiums reduced by Advanced Premium Tax Credits and/or Cost Sharing Reductions.
  • Private insurance without Advanced Premium Tax Credits and Cost Sharing Reductions.
    The plan you choose affects the total amount you’ll likely spend for health benefits during the year.

Coverage
Most providers accept the plans offered through the Public Health Care Programs of Medical Assistance (MA) and Minnesota Care (MNCare). Public Health Care Program services include, but are not limited to:

  • Alcohol and Drug treatment
  • Chiropractic care
  • Dental care (limited for non-pregnant adults)
  • Doctor/Clinic visits
  • Emergency room care (ER)
  • Eyeglasses
  • Family Planning Services
  • Hearing Aids
  • Home care
  • Hospital services
  • Immunizations and vaccines
  • Interpreter services
  • Lab and X-Ray
  • Licensed birth center services
  • Medical equipment and supplies
  • Medical transportation (access, ambulance and special)
  • Mental Health care
  • Nursing homes and ICF-DD facilities
  • Outpatient surgery
  • Prescriptions and Medication Therapy Management
  • Rehabilitative therapy
  • Urgent care

If you do not qualify for Medical Assistance, or MinnesotaCare, you may qualify for:

  • Advanced Premium Tax Credit (APTC)—This is a tax credit to help individuals afford health coverage purchased only through the MNsure marketplace.  If you qualify, your APTC can be used right away to lower your monthly premium. You may choose how much of the APTC you wish to apply to your insurance premiums every month, up to the maximum APTC you are awarded.
    • If the amount of APTC you get for the year is less than the tax credit you are due, you will get a difference as a refundable credit when you file your federal income tax return.
    • If your advance payments for the year are more than the amount of your credit, you must repay the excess advance payments with your tax return (also called premium tax credit).
  • Cost Sharing Reduction—This discount lowers the amount you have to pay out-of- pocket for deductibles, coinsurance and copayments. You can get this reduction if:
    • You get health insurance through the MNsure marketplace.
    • Your income is below a certain level.
    • And, you choose a health plan from the Silver plan category.
  • If you are a member of a federally recognized tribe, you may qualify for additional cost sharing benefits.

What to bring to your appointment
When coming to an appointment for enrollment, bring the following with you:

  • Household Income:
    • Know your household income for the coming year—a household is everyone who files taxes together.
    • Your best estimate of your household’s gross income (before taxes) from all sources. We can work with a two-week, monthly or annual income estimate. It is very helpful if you bring 30 days of paystubs for all employment income.
    • Bring last year’s Federal 1040 tax form if you have it.
  • Social Security Numbers: You’ll need to enter the Social Security numbers (or document numbers for documented immigrants) for anyone applying for coverage.
  • Employer Coverage Information: Know if your employer (or an employer of your spouse) offers health coverage for you or your family and what the premium cost is to you for individual coverage, even if you don’t accept it.
  • A Photo ID: This is needed for the main applicant only.

MNsure Success Stories

Married couple, Rita and Thomas
Rita and Thomas were about to lose their employer sponsored insurance, so they visited Community Action Duluth to get help applying for MNsure from a Navigator. They liked their coverage before, but they were paying about $250/month. Their household income was about $26,700 a year, which qualified them for MinnesotaCare and brought their total payment to $66/month for insurance. For Thomas, the monthly saving was like getting an extra paycheck each month. For Rita, having MinnesotaCare meant knowing her heart and lung conditions will continue to be covered by insurance.

David and his wife, Nancy
David and Nancy own and operate a business that provides a modest income. They were paying $1,100/month for health insurance. By exploring MNsure, they found that they qualified for $534/month in tax credits and a 73 percent cost sharing reduction. They chose a plan that cost $819/month—however, with the tax credit in place, they pay only $285/month. Both were very relieved because Nancy, who was recovering from breast cancer, would likely face barriers finding adequate coverage if not for the Affordable Care Act and MNsure.

Kris and John
Kris and John had a combined income of $46,000/year. They were paying about $1,000/month for commercial insurance because their employers didn’t offer insurance benefits. Using MNsure, they received $385/month in tax credits. They chose a plan that even included dental coverage, and are now paying only half of what they were before MNsure.

Beth
Beth had employer sponsored insurance at a cost of $600 per month while she was working. However, she could no longer afford the insurance after she retired. In fact, she went without insurance for a while until she applied for MNsure. Her household income was $1,621 per month. She found out that she was eligible for MNCare at $33 per month and was very grateful for the affordable coverage.

Jeannie
Jeannie, a 19-year- old full-time college student, worked part time and was uninsured. After applying for insurance through MNsure she learned she qualified for MNCare. Because she was under the age of 21, she paid nothing for her MNCare insurance coverage. She now has the assurance of health insurance and can concentrate on getting her degree.

Kathy
Kathy a 38-year- old single mother with a 6-year- old, used MNsure to look for more affordable health insurance. Her employer sponsored health insurance was costing her almost $300 per month and she was paying over 9.5 percent of her income for insurance. Through MNsure she learned that her 6-year- old would be eligible for Medical Assistance at zero cost and that she would be able to select a plan that she could afford using her Advanced Premium Tax Credit to help her pay for the coverage.