In Minnesota, as in many other states, your health insurance options are somewhat dependent on your health status. Even if you are sick, however, the laws protect you in the following ways.
- Coverage under your group health plan (if your employer offers one) cannot be denied or limited, nor can you be required to pay more because of your health status. This is called nondiscrimination.
- All group health plans in Minnesota must limit exclusion of pre-existing conditions. There are rules about what counts as a pre-existing condition and how long you must wait before a new group health plan will begin to pay for care for that condition. Generally, if you join a new group health plan, your old coverage will be credited toward the pre-existing condition exclusion period, provided you did not have a long break in coverage.
- When you buy individual health insurance there are limits on what you can be charged because of your health status, age, or where you live.
- Your health insurance cannot be canceled because you get sick. All health insurance is guaranteed renewable.
- If you leave your job, you may be able to remain in your old group health plan for a period of time. This is called COBRA continuation or state continuation coverage. It can help when you are between jobs or waiting for a new health plan to cover your pre-existing condition. There are limits on what you can be charged for this coverage.
- If you lose coverage under a fully insured group health plan in Minnesota, you can buy conversion coverage. There are rules about what conversion coverage must cover and limits on premiums that can be charged. You cannot be required to face a new pre-existing condition exclusion period.
- If you lose your group health plan and meet other qualifications, you will be HIPAA eligible. If so, you can buy coverage from the Minnesota Comprehensive Health Association (MCHA) high risk pool. You will not face a new pre-existing condition exclusion period. There are limits on what you can be charged for MCHA coverage.
- You can also buy coverage from MCHA if you have a serious health condition or if you have been turned down by a health insurance company. In this case you may face a new pre-existing condition exclusion period.
- If you are a small employer buying a fully insured group health plan, you cannot be turned down because of the health status, age, or any factor that might predict the use of health services of those in your group. This is called guaranteed issue.
- If you are a small employer buying a fully insured group health plan, there are limits on what you can be charged because of health status, age, or other characteristics of those in your group.
- If you have low or modest household income, you may be eligible for free or subsidized health coverage for yourself or members of your family. The Minnesota Medicaid program offers free or subsidized health coverage for pregnant women, families with children, elderly and disabled individuals with very low incomes. Also, if you cannot afford health insurance and you meet other income requirements, you can buy discounted coverage for yourself and your family from MinnesotaCare.
- If you believe that you may be at risk for cancer, you may be eligible for free screening and treatment. The Sage Screening Program provides free breast and cervical cancer screenings for qualified women residents of Minnesota. Some women diagnosed with breast or cervical cancer through this program may be eligible for medical care through Medicaid.
- If you lost your health insurance and are receiving benefits from the Trade Adjustment Assistance (TAA) Program, you may be eligible for a federal income tax credit to help you pay for new health coverage. This credit is called the Health Coverage Tax Credit (HCTC), and is equal to 65% of the cost of qualified coverage, including COBRA and coverage offered through the Minnesota Comprehensive Health Association.
- If you are a retiree aged 55-65 and receiving benefits from Pension Benefit Guarantee Corporation (PBGC), then you may be eligible for the HCTC.
