Blue Cross Blue Shield of Minnesota

Health Partners

Medica of Minnesota

In Minnesota, medical underwriting is allowed. There is no exclusion period allowed for preexisting conditions.

 

There is a high risk pool in Minnesota called MCHA. You are eligible for MCHA under your HIPAA rights or if you a Minnesota resident for 6 months, you have been denied health coverage by an individual carrier, you are over 65 but not eligible for Medicare, or you are eligible by Trade Adjustment Assistance, alternative Trade Adjustment Assistance, or Pension Benefit Guarantee Corporation, or you have one of the conditions listed on the MCHA application.

 

Coverage under MCHA includes Professional Service, Prescription Drugs and Pharmacy Services, Mail Service Prescription Drug Program, Hospital Services, Ambulance Services, Home Health Care, Outpatient Rehabilitation, Mental Health, Substance Abuse, Durable Medical Equipment and Prosthetics, Miscellaneous Medical supplies, Organ and Bone Marrow Transplant Services, Infertility Services, Reconstructive and Restorative Surgery, Skilled Nursing Facility Services, Hospice Services, Temporomandibular Joint Disorder (TMJ), Medical-Related Dental Services, Emergency Services 

In Minnesota, medical underwriting is allowed with plus or minus 25% of the indexed rate based on the health status of the group.  BCBS may have a 35%variation from the geographic rate. There

is a 6 month look back and 12 month exclusionary period limit for preexisting conditions for those without prior healthcare. 

Minnesota offers COBRA, the Consolidate Omnibus Budget Reconciliation Act of 1985. Many companies with 20 or more employees that offer health insurance are required to offer employees and their dependents continuation coverage for benefits that were lost due, for example, to job loss, reduction in hours worked, death, or divorce. 

Medicaid is a state/federal program that pays for medical and long-term care services for low-income pregnant women, children, certain people on Medicare, disabled individuals and nursing home residents. These individuals must meet certain income and other requirements.

Children

Children (ages 1-5)-150% of the Federal Poverty Level
Children (Ages 6-19)-150% of the Federal Poverty Level

 

Pregnant Women and Infants

Pregnant Women-275% of the Federal Poverty Level
Infants (ages 0-1)-280% of the Federal Poverty Level

 

Parents

Non-Working Parents-275% of the Federal Poverty Level
Working Parents-275% of the Federal Poverty Level

 

Other populations

Medically Needy Individuals- 67% of the Federal Poverty Level

Medically Needy Couples- 62% of the Federal Poverty Level

Supplemental Security Income Recipients- 70% of the Federal

Poverty Level

Aged, blind, and disabled- 95% of the Federal Poverty

Level

 

Covered Services
Clinic and physician services for preventive care, immunizations, ambulance, emergency room for emergency care, inpatient and outpatient hospital services, laboratory and x-ray, family planning, pregnancy related services, nurse midwife, medical equipment, hearing aids, therapy, transportation, mental health services, substance abuse treatment, prosthetics, nursing facilities, home health services, hospice, group homes for people who are mentally retarded, and prescription drugs. 

 

 

 

Co-payments vary. Pregnant women, children under age 21, individuals living in a nursing home or hospice, and refugees getting assistance from the Refugee Medical Assistance Program have no co-payments.

 

You may learn more about Minnesota Medicaid at http://www.dhs.state.mn.us/main/groups/healthcare/documents/pub/DHS_id_006254.hcsp. 

Minnesota offers the MinnesotaCare program to children whose family income is up to 280% of the Federal Poverty Level and parents whose income is up to 200% of the Federal Poverty Level. Applicants must be Minnesota residents, have a Social Security Number, and not have other health insurance, including Medicare, for the past 4 months. Please visit the MinnesotaCare website for more detailed information at   http://www.dhs.state.mn.us/main/groups/healthcare/documents/pub/dhs_Health_Care.hcsp.