MNCare

By Lavender January 17, 2008

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It does seem odd to start an article on health insurance by referencing the Bible, but the case can be made that there are parallels to Jeremiah 8:11 (“Peace, peace, ‘But there is no peace’”) with the chant that seems to come from the presidential campaign trail when voters are asked what their concerns are: “Health care, health care, but there is no health care…or at least any that’s affordable”.
The State of Minnesota attempted to solve this issue starting in the early 1990s with the formation of the Minnesota Health Care Commission. This group, which totaled nearly 30 members, was made up of labor union members, representatives of health insurance companies, consumers, health care providers, and people appointed by organizations as specified under the Commission’s governing legislation (Minnesota Statute 62J.05).

Among the Commission’s goals were universal coverage for all Minnesotans, increased availability of coverage despite a person’s state of health, and improved access to services, with an implementation date set of July 1997. In March of that year, citing both successes and failures, the commission requested that Governor Arne Carlson disband the group, which he did.

John Gunyou, committee chair, stated at the time, “This is not to say that the work on health care is finished. Rather, commission members believe that the important work that remains to be done on long-term care, un-insurance, and health technology should be done in different venues.”

Although universal health care may not yet have been achieved, one thing that had come out of the commission’s work was the MinnesotaCare program.

Originally known as the HealthRight Program, MinnesotaCare is funded by a combination of member premiums, and money from the federal government, a 2 percent state-wide tax on health care services (which some might see as counter productive to keeping health care costs down). It is aimed at uninsured Minnesotans who meet the following requirements:

• Minnesota residency (with different requirements for single adults, children under the age of 21, and pregnant women).

• The ability to provide a Social Security number or proof of immigration status.

• Lack of any insurance coverage for 4 months (known as the ”4 Month Rule”) and lack of Employers Subsidized Insurance (ESI) within the previous 18 months (the ”18 Month Rule”).

• Be within certain income guidelines (although there are some exceptions for pregnant women). Families must be at or below 275 percent of Federal Poverty Guidelines (FPG), while adults without children must have an income below 175 percent of FPG.

• User’s ability to make copayments on prescription drugs, inpatient hospital stays, etc.

Applications for MinnesotaCare must be sent via mail (applications are available online). Once received, the application is time stamped, and must be processed within the next 30 days. Also, information given to MinnestoaCare is private, but part of the application process releases this information to the Minnesota Departments of Revenue, the Department of Jobs and Training, the Department of Health, child support enforcement agencies, county human services departments, healthcare providers, and within MinnesotaCare.

Once approved, clients choose from approved providers, and then will receive two coverage related cards, one from Minnesota Health Care Program and another from their medical provider. These cards must be presented whenever clients receive care.

Premium amounts will depend on a number of factors. For example, a single, childless adult making between $1,000 and $1,500 a month would be eligible for MinnesotaCare, and have monthly payments between $30 and $80. A family of three with the same monthly income would also quality, but their payments would be between $18 and $42.

Coverage must be paid for in the previous month, which means a premium due on January 15, 2008 would go toward 2008 coverage. Coverage will be cancelled if payment hasn’t been received by noon of the last working day of the month (in the above case, January 31, 2008).

When this occurs, the “4 Month Rule” goes into effect, and the client missing payment would be unable to reapply for coverage until the four months have passed, plus, they would then have to make up payments for missed months.

When coverage is stopped, MinnesotaCare will send info regarding this 10 days prior to loss of benefits. If the person in question makes a written request to prevent termination within 10 days of notification, their coverage would continue. However, they would need to continue to make premium payments on time, with the provison that they make timely payments

If a MinnesotaCare client decides that he or she no longer wants coverage, the person must contact the program as soon as possible.

Further information on MinnesotaCare is available at <http://www.dhs.state.mn.us>, or by phone at (651) 297-3862 (Twin Cities metro area), (800) 657-3672 (Greater Minnesota), and (800) 627-3529 (TTY).

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