Medical Assistance coverage

Medical Assistance (MA) may pay for medical bills going back three months from the date we get your application.

The specific program or benefit set that you qualify for determines:

• Which health care services are covered
• If there are any limits on coverage
• What you have to pay, if anything

If you are enrolled in a health plan, you must get services from providers in your health plan's network.

If you are not enrolled in a health plan, you get services on a fee-for-service basis from providers who accept MA.

You can also print a summary of covered services (PDF) that includes both MA and MinnesotaCare.

• Alcohol and drug treatment
• Chiropractic care
• Dental care (limited for non-pregnant adults)
• Doctor and clinic visits
• Emergency room (ER) care
• Eyeglasses
• Family planning services
• Hearing aids
• Home care
• Hospice care
• Hospital services (inpatient and outpatient)
• Immunizations and vaccines
• Interpreter services
• Lab and X-ray services
• Licensed birth center services
• Medical equipment and supplies
• Medical transportation (access, ambulance and special)
• Mental health care
• Nursing homes and intermediate care facilities for people with developmental disabilities ICF-DD
• Outpatient surgery
• Prescriptions and medication therapy management
• Rehabilitative therapy
• Urgent care

Some services or prescriptions may require prior approval.

You may need to fill out a form before MA can pay for some long-term care services including nursing homes. Contact your county or tribal office or worker for more information.

For details about covered services:

• Call your health plan member services or refer to your health plan evidence of coverage.
• Call the Minnesota Health Care Programs (MHCP) Member Help Desk if you are not in a health plan, or refer to the MHCP evidence of coverage for fee-for-service members.

Some adults have the following deductible and copays:

• $2.95 monthly deductible
• $3 copay for nonpreventive visits (no copay for mental health visits)
• $3 or $1 copay for prescription drugs up to $12 per month (no copay on some mental health drugs)
• $3.50 copay on nonemergency ER visits

There are no deductibles or copays for:

• Children under 21
• Pregnant women
• People in nursing homes or ICF-DDs
• People receiving hospice care
• Refugees who have coverage through the Refugee Medical Assistance program
• People enrolled in the MA Breast and Cervical Cancer program
• American Indians who have ever received care from Indian Health Services

Monthly copays and deductibles are limited to 5 percent of family income.

If you are not able to pay a copay or deductible, your provider still has to serve you. Providers must take your word that you cannot pay. Providers cannot ask for proof that you cannot pay.

• Artificial ways to become pregnant, including in vitro fertilization and fertility drugs
• Autopsy
• Cosmetic surgery
• Dental services deemed to be cosmetic or not medically necessary
• Gender-reassignment surgery
• Investigational or experimental medications or devices
• Medical cannabis
• Medications used for weight loss or erectile dysfunction
• Missed appointments
• Vocational or educational services