Cost Overview

Over one million Minnesotans are expected to access health care coverage through MNsure — 1 out of every 5 Minnesotans. The marketplace will offer Qualified Health Plans (QHPs) for individuals and families who currently buy health insurance on their own, are looking for a more affordable plan, or are uninsured.

Qualify for a Free or Low-Cost Plan

You may qualify for MA or MinnesotaCare, or for a tax credit and payment assistance to lower your cost.

  • Individuals with annual incomes of up to $15,282 qualify for MA
  • All children and pregnant women up to 275 % of the federal poverty level are eligible for MA
  • Individuals with annual incomes of $15,282 to $22,980 qualify for MinnesotaCare. MinnesotaCare has its own premium estimator.
  • Individuals with annual incomes of $22,981 to $45,960 qualify for tax credits that can be used immediately to lower your premiums

The amount of tax credit available to individuals and families depends on modified adjusted gross income, age and geographic area. Premium assistance is calculated based on where an individual’s annual income falls on the Federal Poverty Level (FPL) table. Below is the FPL scale for 2014 that shows the income limits.

FPL-chart.jpg

Tax credits may be applied to all individual plans except catastrophic plans.


Tax Credits 

The Advanced Premium Tax Credit (APTC) is only available when you purchase health insurance through MNsure. You may be eligible for this benefit, based on your income and family size.  

If you make less than the dollar amounts below, you could qualify:

FAMILY SIZE YEARLY INCOME
1 $45,960
2 $62,040
3 $78,120
4 $94,200

If you qualify for the tax credit, you can choose which way you want to get it:

  • in advance to reduce your health care plan costs each month
    • you can begin receiving the tax credit when your coverage becomes effective
  • apply for it when you file your federal tax return 

The amount of the credit is based in part on the premium for a standard plan in your area. In many counties, the premium for the standard plan is low enough that tax credits will not apply. 

Cost Sharing Assistance

What do we mean by cost sharing assistance?

You may also qualify for additional savings through cost-sharing assistance which reduces the amount you pay at the time of medical care, commonly called out-of-pocket costs.

With cost sharing assistance:  

  • co-pays, co-insurance, and deductibles are lowered 
  • the maximum amount you would pay each year is capped 

The amount of out-of-pocket cost reductions will depend on the plan you choose. 

This benefit is provided for health plan members by the federal government. It is available to those who meet certain income guidelines, but generally to:

  • Individuals earning up to $28,725
  • Families of 4 earning up to $58,875

MNsure plans pricing

Rates for MNsure plans vary depending on your age, the region in which you live, whether you use tobacco, and the level of coverage you choose.