STEP 2: Selecting a plan
It is important to pick the right health plan for you and your needs
What are my needs?
Every health plan is different. Knowing what your needs are will make it easier to select a plan with the right support for you. Make a list of the kind of support and services you need.
Do I need?...
- Access to a fitness club membership
- Help with transportation to medical appointments and pharmacies
- Medications
- To go to specific clinics and doctors
- Access to long-term service and supports
- Access to special services or therapies
- Care coordination
- In-home services
- Chronic condition management support
- Behavioral health case management
- Specialized equipment
- Additional benefits like dental or vision benefits
When going over your plan options, review your list to see if a plan will meet your needs.
What are my health plan options?
Your health plan options depend on where you live and whether you qualify for Medical Assistance (Medicaid) or Medicare combined with Medical Assistance. To find out exactly what plans are available in your area and what you qualify for, contact:
What are the different types of plans?
Medical Assistance (MA) is what the Minnesota Department of Human Services (DHS) calls Medicaid. Medical Assistance is a federal and state government health insurance program for people with low income and people with disabilities. Medical Assistance also offers benefits not normally covered by Medicare, including nursing home care and personal care services.
Special Needs BasicCare Plan (SNBC)
SNBC is a type of health plan provided by health insurance companies for people with disabilities who are 18 – 64 years old and qualify for Medical Assistance. SNBC plans:
- Pay for the small portion of a service's cost that you may have to pay (co-payment)
- Provide care coordination or care navigator services
- Cover additional benefits not available with a Medical Assistance fee-for-service plan
- Keep your disability waiver services
Medical Assistance fee-for-service
Medical Assistance fee-for-service (FFS) is provided directly by DHS.
- DHS pays your medical claims instead of a health insurance company
- If you choose to enroll in Medical Assistance FFS, you can change your mind and enroll in an SNBC plan at any time
If you will be earning money at a job as an adult, ask your county worker or Tribal office about the Medical Assistance for Employed People with Disabilities (MA-EPD) program. This program may allow you to remain on Medical Assistance while employed.
Employer provided plans
Employer Group plans offer health insurance funded by a person's employer and administered by a health plan company. Adults with employers that offer health insurance as a benefit will often be a member of an Employer Group plan. Generally speaking, individuals or family members who are enrolled in Employer Group Coverage are not eligible for Medical Assistance or Special Needs BasicCare plans. Out-of-pocket cost and coverage varies significantly by employer and could have limits in coverage for services important to people with disabilities (for example broad rehab therapies and home-based services).
Individual and family plans
Individual and family plans are health care coverage that you purchase independently on the MNsure insurance exchange or through an insurance broker. With these plans you will pay a monthly premium, a percentage of your care, co-pays and other fees. If you do not qualify for Medical Assistance, Medicare, your guardian’s health coverage or an employer’s provided plan, you can get coverage by purchasing an individual and family plan. You may qualify for financial assistance that can lower your monthly premium.