How is a Private Health Plan Different from MinnesotaCare?

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Transitioning from a public program, like Medical Assistance or Minnesota Care, to a private plan can be confusing. Likely, you have qualified for a public program for some amount of time, but your gross income now exceeds the program limits. The Department of Human Services has informed you that your coverage is being terminated and you need to meet with broker to “pick a plan.”

When moving from a public program to a private plan (with or without discounts, depending on your income) it is helpful to be cognizant of a few points:

  1. You are now qualified for a Special Enrollment period, based on when your MA or MinnesotaCare coverage ended. This means that you have 60 days to enroll into a new private plan from the date your MA or MinnesotaCare ended. If you miss the 60 day enrollment window, you will have to wait until the next Open Enrollment (beginning in November) to sign up for coverage.

  2. Whereas MA and MinnesotaCare allow for dental, vision and medical coverage — these plans will now have to purchased separately. Both medical and dental plans are available through the MNsure site, and a broker can guide you through your different options.

  3. The Department of Human Services determined that you were no longer qualified for a public program by calculating your annual Modified Adjusted Gross Income (MAGI). If you submitted income proof to them recently, the MAGI was estimated using the pay-stubs/bank statements/etc. that you provided to DHS. After looking over the income guideline chart, you may think that DHS has projected an income that is too high — if this is the case, it is best to call your county or submit a “Life Event Change” (any update to your application) through MNsure.


  4. MA is a public program without any premium, and MinnesotaCare is public program with a small monthly premium. The monthly payment for your new private plan may be higher, but if you qualify for discounts/tax credits, the amount can be lessened greatly. A broker will help to verify you tax credit eligibility, and explain the details (the deductible, out-out-pocket maximum, network) of any plans that may be a good fit for your family.