MNsure

MNsure is a website Minnesotans can use to assess their eligibility for public health programs and private health insurance subsidies. MNsure is also referred to as Minnesota’s Health Insurance Marketplace, because it provides a “one-stop-shop” for comparing many different health insurance options (www.mnsure.org).

OPEN ENROLLMENT FOR PRIVATE HEALTH INSURANCE PLANS (excludes Medical Assistance and MinnesotaCare)

November 1, 2017 – January 14, 2018

Call (612) 373-2468 to schedule an appointment with a MAP Benefits Counselor

What can I apply for on MNsure?
The MNsure site contains a uniform application that assesses a person’s eligibility for Medical Assistance (MA), MinnesotaCare (MCRE), and subsidies that can be used toward purchasing a private health insurance plan. You can also enroll directly into a private health insurance plan on MNsure, regardless of your eligibility for a subsidy.

MNsure cannot be used to assess a person’s eligibility for the following:

  • Medicare Savings Programs
  • Medical Assistance for Employed Persons with Disabilities (MA-EPD)

For these programs, please use the Minnesota Health Care Programs Application for Certain Populations (DHS-3876).

  • General Assistance (GA)
  • Supplemental Nutrition Assistance Program (SNAP)
  • Emergency Assistance (EA)

For these programs, please use the Combined Application Form (DHS-5223).

When can I use MNsure?

MNsure may be used for enrollment in public programs at any time. These programs include Medical Assistance (MA) and MinnesotaCare (MCRE). MNsure may only be used for enrollment in private plans during specific periods of time:

  1. During open enrollment. The next open enrollment period is from November 1, 2017 through January 15, 2018.
  2. Within sixty days of a qualifying event. This period of sixty days is called a “Special Enrollment Period,” or SEP.  The following count as qualifying events:  
    • Adoption
    • Foster care
    • Birth of a child
    • Marriage
    • Gaining citizenship, national or lawfully present status
    • Loss of health insurance coverage*
    • Newly eligible or ineligible for tax credits or having a change in eligibility for cost-sharing reductions for individuals already enrolled on MNsure
    • Permanent address change which provides new health plan choices
  3. Exception: If you are a member of a federally recognized tribe, you may use MNsure at any time.

*This qualifying event allows access to MNsure only when you are no longer eligible for other health insurance (including as a result of leaving a job, losing Medical Assistance or MinnesotaCare, or losing coverage under a spouse’s plan). This does not include loss of coverage due to failure to pay premiums or opting out of available coverage.  If you know the date at which your current insurance will end, it may be possible to switch insurances early to prevent a gap in coverage. Please contact the Benefits Counseling Program at the Minnesota AIDS Project if you have questions about this process: (612) 373-2468.

Which populations can use MNsure?
The MNsure system was designed to assess eligibility for persons legally residing in the United States* who fall into one of the following categories:

  • children under the age of 21 not in foster care
  • adults without children
  • parents
  • adults with disabilities not yet eligible for Medicare
  • persons currently insured privately or through an employer

People who are privately insured or insured through their own, their spouse’s, or their parent’s employer are not required to use MNsure; however, they may use MNsure to compare alternative insurance options.

Which populations cannot use MNsure?

  • children in foster care
  • persons receiving SSI income
  • people applying for MA-EPD (Medical Assistance for Employed Persons with Disabilities)
  • persons eligible for Medicare
  • undocumented immigrants*

Individuals who are ineligible to use MNsure may apply for assistance using the Minnesota Health Care Programs Application for Certain Populations (DHS-3876).

*Undocumented immigrants are not eligible for most public assistance programs.  Undocumented immigrants living with HIV are, however, usually eligible for Program HH (the AIDS Drugs Assistance Program in MN). If you are undocumented and need insurance, contact the Benefits Counseling Program at the Minnesota AIDS Project for more information: (612) 373-2468. Your immigration status will be kept private and will only be used to determine program eligibility.

What to Expect when Using the MNsure Site: 3 Steps
Step 1:
To use MNsure, you first have to create an account on the MNsure website. You will be prompted to enter in some basic information about yourself, answer some security questions, and choose a username and password.

Step 2: Once you have created an account, you will be directed to a link entitled “Apply for Assistance.” What does it mean to apply for assistance? Basically, MNsure will ask you to enter in some household and income information to see which sorts of programs or subsidies you qualify for in the state of Minnesota. Using this information, the MNsure system will indicate that you have one of the four following types of eligibility:

1) Eligibility for Medical Assistance (MA)

2) Eligibility for MinnesotaCare (MCRE)

3) Eligibility for a subsidy (often referred to as a Premium Tax Credit) to purchase a private insurance plan on the Health Insurance Marketplace. Individuals that qualify for Premium Tax Credits may also qualify for something called a Cost-Sharing Reduction, which offers additional help with paying deductibles and co-pays on “silver level” plans.

4) Eligibility for enrollment without subsidies. Users that fall into this category are ineligible for public health insurance programs. They are also ineligible for private health insurance subsidies. They may, however, still enroll into a private plan on MNsure at full cost.

Step 3: If you qualify for Medical Assistance or MinnesotaCare (MCRE), you have finished the MNsure application. If you qualify for a subsidy or do not qualify for financial assistance at all, the next step is to choose a health plan. People on Program HH may qualify for help paying their MNsure premiums. Program HH will only help pay the premiums for certain plans, however, so before enrolling please contact the Benefits Counseling Program at the Minnesota AIDS Project: (612) 373-2468. If you are not eligible for Program HH or not HIV+, the Minnesota AIDS Project has a separate program that may be able to help you choose a plan: (612) 373-2466.

What to Expect When You’ve Finished Your Application

If you qualify for Medical Assistance
Upon completing the MNsure application, your information will be sent to the county you live in.  You will be notified by mail of your coverage, which should take effect on the first day of the month in which you applied (for example, if you applied on May 21st, your coverage would backdate to May 1st). You will also be notified by mail if there is any additional information the county needs in order to process your application; for example, the county will likely request proof of income or proof of your immigration status. In all cases, it is best to return any requested documentation to the county as soon as possible after receiving the request.

It usually takes at least two weeks for the county to process a person’s eligibility for MA. Expect to wait at least that long before you receive any paperwork in the mail from them. If you’ve waited more than two weeks and have questions about your coverage, or if you need to use your benefits right away, please call the DHS Member Helpdesk: (651) 431-2670 or the Benefits Counseling Program at MAP: (612) 373-2468.

Certain individuals may be given the opportunity to pick a Medical Assistance plan, or Managed Care Organization (MCO). An MCO is a private insurance company that contracts with the county to help administer your Medical Assistance benefits. Examples of MCOs (also referred to as PMAPs or Pre-paid Medical Assistance Plans) are Blue Plus, Health Partners, and Medica. If you are given the opportunity to choose an MCO, check to make sure your doctors are in network and that the medications you are taking are on the plan’s formulary. If you would like assistance in choosing the best plan for you, please contact the Benefits Counseling Program at the Minnesota AIDS Project: (612) 373-2468.

If you qualify for MinnesotaCare (MCRE)
Upon completing the MNsure application, your information will be sent to the MinnesotaCare state office. You will be notified by mail of your coverage. You will also be notified by mail if there is any additional information MinnesotaCare needs in order to process your application; for example, it is not uncommon for MinnesotaCare to request proof of income or proof of your immigration status. In all cases, it is best to return any requested documentation to MinnesotaCare as soon as possible after receiving the request.

It usually takes at least two weeks for MinnesotaCare to process a person’s application. Expect to wait at least that long before you receive any paperwork in the mail. If you’ve waited more than two weeks and have questions about your coverage, or if you need to use your benefits right away, please call MinnesotaCare: (651) 297-3862, the DHS Member Helpdesk: (651) 431-2670, or the Benefits Counseling Program at MAP: (612) 373-2468.

You will pay a monthly premium for your MinnesotaCare coverage. The premium cannot exceed $80, and will likely be less, depending on your income. To get an idea of what your premium will be, you can use the MinnesotaCare Premium Estimator Table. Typically, MinnesotaCare coverage starts the month after you pay your first premium. In the event that MinnesotaCare falls behind in sending invoices, however, your coverage will start the month after enrollment, regardless of whether you’ve been able to pay. If you have questions about your MinnesotaCare coverage, please call MinnesotaCare: (651) 297-3862, the DHS Member Helpdesk: (651) 431-2670, or the Benefits Counseling Program at MAP: (612) 373-2468.

MinnesotaCare will give you the option to choose a Managed Care Organization (MCO). An MCO is a private insurance company that contracts with the county to help administer your MinnesotaCare benefits. Examples of MCOs are Blue Plus, Health Partners, and Medica. When you are given the opportunity to choose an MCO, check to make sure your doctors are in network and that the medications you are taking are on the plan’s formulary. If you would like assistance in choosing the best plan for you, please contact the Benefits Counseling Program at MAP: (612) 373-2468.

If you qualify for enrollment in a private plan, with or without a subsidy
If you are eligible for Program HH and have enrolled in a private plan on MNsure, Program HH will need your plan information in order to pay your monthly premium. Specifically, Program HH will need to know your MNsure ID number, the plan you’ve selected, and what your monthly premium amount will be. You will receive a premium invoice in the mail from the insurance carrier you selected with this information.  During Open Enrollment and Special Enrollment Periods, you must enroll by the last day of the previous month and submit payment for your first month’s premium by the 15th of the previous month for your coverage to take effect on the 1st. If you have questions about how to get this information to Program HH or would like assistance, please contact the Benefits Counseling Program at MAP: (612) 373-2468.

In addition to a premium invoice, the insurance carrier you selected will send you a health insurance card you can bring with you to appointments and to the pharmacy. If you are eligible for Program HH, Program HH will need a copy of the information you receive from your carrier and a copy of your insurance card for their records. If you have questions about how to get this information to Program HH or would like assistance, please contact the Benefits Counseling Program at MAP: (612) 373-2468.

If you have not received information in the mail from your carrier, have questions about your benefits, or have trouble using your benefits, please contact your carrier or the Benefits Counseling Program at MAP: (612) 373-2468.