STEP 2: Selecting a plan

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
• Covers 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

Compare UCare's SNBC plan to Medical Assistance fee-for-service

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.

Medicare is a national health insurance program run by the Centers for Medicare and Medicaid Services (CMS). It provides health insurance for Americans aged 65 and older. It also provides health insurance for people under 65 with disabilities. For people with disabilities, Medicare eligibility is determined by SSDI.

Medicare Advantage plans

Medicare Advantage plans provide Medicare Part C coverage, which combines Part A (hospital coverage) and Part B (physician coverage). Sometimes, it also includes Part D (medication coverage), but this may need to be purchased separately.

• Does not include Medical Assistance (MA) benefits
• May offer additional support, like care coordination, disease management and service navigation
• May offer additional benefits, like fitness programs, preventive care incentives and education programs

Medicare fee-for-service

Medicare fee-for-service is what most people know as "Original Medicare" or "Medicare." It is government-provided Parts A and B. Medicare fee-for-service:

• CMS pays your medical claims instead of a health insurance company
• Gives access to any health care provider who accepts Medicare
• Depending on service needed, you will have to pay for some portion of the service provided
• Need to purchase Part D coverage
• May provide limited dental and vision coverage
• Does not cover transportation to medical appointments and pharmacies

Note: Twenty-four months after you are approved for SSDI, you are automatically put on Medicare. This means you will have Medical Assistance and Medicare. Having both means that you will have even more benefits and options. If you have both, you may want to look for a health plan that can provide coverage under both programs through a single plan. (See "Combined Medical Assistance and Medicare Plans" below.)

Health plans that provide both your Medical Assistance and Medicare plans can make it easier for you to manage your health coverage and provide additional benefits. To be eligible, you need to qualify for both Medical Assistance and Medicare.

Special Needs BasicCare (SNBC) integrated

Integrated SNBC plans combine Medical Assistance and Medicare benefits into a single health plan. Integrated SNBC plans:

• Are designed for people with disabilities ages 18 – 64
• Include all the benefits provided by an SNBC plan and all the benefits of Medicare, all managed under one company
• Offer additional support, like care coordination, disease management and service navigation
• May offer additional benefits, like fitness programs, preventive care incentives and education programs
• Have one number to call for all your health plan needs
• Require minimal need for authorizations and no referrals necessary
• Keep your disability waiver services

Shop and compare UCare SNBC plans

Note: Twenty-four months after you are approved for SSDI, you are automatically put on Medicare. This means you will have Medical Assistance and Medicare. Having both means that you will have even more benefits and options. Choosing a plan that combines your Medical Assistance and Medicare may make it easier for you to manage your health care coverage.

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 is 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.

Shop and compare UCare Individual and Family Plans