Written by a parent, not a doctor. Nothing here is medical advice.

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Minnesota program

Free health insurance for your child (Medical Assistance)

Minnesota’s Medicaid plan for children. Ordinary Medical Assistance can sit behind insurance you already have.

What it is

Minnesota’s Medicaid plan for children. Ordinary Medical Assistance can sit behind insurance you already have.

Medical Assistance covers eligible children without a monthly premium or child copays. The county or tribe checks your child’s household and current monthly income. Work insurance generally fits alongside it, but the upper-income infant band needs a separate check.

Who can qualify
  • Minnesota children under 19 use these child income bands. Ordinary Medical Assistance generally allows other insurance. The CHIP-funded infant band above 275% of the poverty guideline requires the child to be uninsured, so an insured child under 2 needs a separate category check.
  • The July 1, 2026–June 30, 2027 table has separate age bands. For four people, the published monthly limits are $7,782 under age 2 and $7,562 for ages 2–18.
  • For three people, those limits are $6,442 and $6,260. For two people with a child ages 2–18, the published limit is $4,959.
  • If your income is just over the line, the county adds an allowance of 5% of the poverty level before deciding, so a family slightly over can still qualify.
  • The state decides who belongs in the child’s financial household and which income counts. Annual income divided by 12 is only an estimate after a change in pay.
  • Children under 21 have no Medical Assistance asset test. Ages 19 and 20 have a separate ordinary 133%-of-poverty category before any spenddown or disability-route review.
If your child already has insurance
  • Ordinary Medical Assistance can sit behind work insurance, which is billed first. An infant’s coverage category needs its own check.
  • The county can also review whether paying your work-plan premium would save Medical Assistance money.
  • For covered care from a clinic enrolled in Medical Assistance, the clinic generally cannot charge your child the work plan’s deductible, copay or coinsurance. Coverage dates and required approvals must be met. This protection can apply even when Medical Assistance pays nothing extra.
Before changing coverage
  • Ask the financial counselor to compare your exact plans, cancer team, pharmacy and planned treatment.
  • Ask payroll what removing a child would save and when the child could rejoin the plan.
What you get
  • No monthly premium or child copays for covered hospital care, chemotherapy, clinic visits and prescriptions.
  • Dental and vision care, plus help getting to covered appointments.
  • Nursing and personal support at home when your child’s care needs meet the separate rules.
What the help includes
  • Children under 21 can get any medically necessary care Medicaid can cover, through Minnesota's Child and Teen Checkups rule. If the plan says a service is not covered, ask the team to request it under that rule.
  • Home nursing needs its own assessment. Approval for insurance does not establish how many nursing hours your child needs.
  • This protection covers care that Medical Assistance covers, from a clinic enrolled with it. It does not wipe out your work plan's deductible for other care, and a spenddown amount is still yours.
  • If a clinic asks you to sign a private-pay agreement before a service, that service is outside the protection. Ask billing to check any unexpected charge before paying.
  • Worked example: the work plan allows $5,000, pays $2,000 and leaves $3,000 to your deductible. Medical Assistance pays $0 on top. The clinic writes off the $3,000, and you owe $0.
If you decide to apply
  1. Ask the social worker whether Medical Assistance could help and how it would fit with current insurance.
  2. If you decide to pursue it, the financial counselor can help with MNsure. The application needs identity and Social Security information, a Minnesota address, current income, insurance details and earlier bills.
  3. The counselor can compare the exact cancer team, hospital and pharmacy in each plan and check temporary hospital coverage.

MNsure: 651-539-2099 or 855-366-7873. Your county or tribal human services agency decides eligibility. · Official page ↗

After you ask
  • The usual application decision period is 45 days, or 60 days when disability is involved. Documented exceptions can extend processing; these are not promised payment dates.
  • A participating qualified hospital can start temporary coverage for an eligible child through age 20. Coverage begins on the hospital’s decision date. A full application by the last day of the following month keeps the temporary period open until the full decision; without it, temporary coverage ends at that month’s end. Normally only one hospital presumptive period is available in 12 months.
  • For applications in 2026 or 2027, Minnesota can cover qualifying child medical bills from up to three months before the application month. For applications on or after January 1, 2028, that becomes two months. Eligibility is checked for each earlier month; the application month is separate.
  • Once approved, a child under 6 keeps coverage until the month of their sixth birthday, and an older child keeps it for 12 months, even if your income rises.
  • A county eligibility decision and a health-plan service decision use different appeal routes. The notice identifies the route and deadline. The social worker can help distinguish an appeal from a request to keep an existing service while it is reviewed.
  • For a Medical Assistance health-plan decision, the usual appeal window is 60 calendar days. Standard resolution is within 30 days, or 72 hours when urgent. A limited extension of up to 14 days is possible under the applicable conditions.
  • Keeping an already authorized service requires an express continuation request and appeal by the later of 10 calendar days after the notice is sent or the change’s effective date. The existing authorization and other continuation conditions must still hold. This does not approve a new service.
  • If the health plan says no to something, you have 60 days to appeal to the plan, and then 120 days to ask the state for a hearing. To keep a service running while you appeal, ask within 10 days of the notice. The social worker can help with both. (replace items[4] to [8] with this one bullet)
  • If the plan misses required decision procedures, exhaustion rules may allow a state hearing without waiting longer. County eligibility appeals generally have a separate 30-day notice-based window, with up to 90 days for good cause where that rule applies.
Good to know

Work insurance is billed first when your child has both plans. For an infant, the county also checks which coverage category applies.

Other details
  • TEFRA is a separate route for a child with a disability when parents’ income exceeds the ordinary limit. It requires a care assessment.
  • Your hospital, cancer team and pharmacy need to accept the exact coverage. A plan’s name alone does not settle access to every service.

Federal background: Medicaid and Medicaid as second insurance.

Official sources
Ask your social worker

“Could Medical Assistance help with our child’s treatment costs? What are the benefits and drawbacks alongside any insurance we have, and would you help us apply if it makes sense?”

Why I’m asking: I want to understand whether this could reduce treatment bills and how two insurance plans would work together.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

File through MNsure today with this month's income and any insurance. Name the months that already have bills, and choose a plan the oncology group is in.

Your social worker

The oncology social worker or financial counsellor helps you file, asks the hospital about temporary coverage that day, and follows the 45-day decision.

The care team

Nothing for ordinary child coverage. Medical records are needed only for the disability route.

Who decides
The county or tribal human services agency decides. The health plan you choose runs the coverage.
Ask your social worker
“Can you help me file through MNsure today and ask about temporary hospital coverage while we wait? Can we list the bills from the three months before, and check the hospital and oncology group take the plan?”

How to apply

First step: Apply at mnsure.org or call 651-539-2099 this week. Ask the hospital counsellor today about temporary coverage while the county decides.

  1. Apply through MNsure this week and ask the hospital counsellor today about temporary coverage.
  2. List the months that already have bills so the backdating covers the admission.
  3. Pick a health plan the hospital and the oncology group are both in.

Official application / program page ↗

Where it starts: Apply at mnsure.org or by phone. Ask the hospital financial counsellor the same day whether it can open temporary coverage while the county decides.

What to gather

  • Child's birth certificate or identity document and Social Security number
  • Minnesota address
  • This month's income for each parent in the tax household
  • Insurance cards, if any
  • Hospital bills from the three months before you apply

How long: The county has 45 days from the application, or 60 days when the decision runs on disability. Temporary hospital coverage can start the same day. Once approved, coverage can reach back up to three months.

What a yes looks like

A notice with coverage dates and a choice of health plan. Check the hospital and the oncology group are in that plan before you choose.

What a no looks like, and the next move

Read whether the county said no on income, on a document or on a category. If it is income, ask for the TEFRA option by name and appeal by the date on the notice.

Watch out

  • Minnesota's limits are high. A home of four is under the line for a school-age child up to $7,562 a month before taxes.
  • Your child can keep private insurance and have this too. Do not cancel the work plan to apply.
  • If the county says the income is too high, ask in the same application about the TEFRA option, which leaves parents' income out.

Dates that change this

2026-07-01: The income limits are the state's table for July 1, 2026 to June 30, 2027. They change again on July 1, 2027.

2028-01-01: Minnesota state funding preserves up to three prior eligible months for child applications through December 31, 2027. Child applications from January 1, 2028 use two prior months; the application month is separate. (not yet confirmed against the final rule)

2026-01-01: Eligible young children generally keep coverage through their sixth-birthday month, then eligible older children receive 12-month periods. Temporary hospital coverage and spenddown categories have separate rules. The agency confirms current exceptions under Bulletin 26-21-01. (not yet confirmed against the final rule)

The numbers and the rules

The arcane layer, kept on purpose. Checked September 11, 2026.

What it is worth

Full Medical Assistance with no premium and no child copays. For a home of four the monthly limits are $7,782 under age 2 and $7,562 for ages 2 to 18.

  • $7,782/month — Under age 2, home of 4, published line (283 percent of the poverty guideline)
  • $7,562/month — Ages 2 to 18, home of 4, published line (275 percent)
  • $6,260/month — Ages 2 to 18, home of 3, published line (275 percent)
  • $6,442/month — Under age 2, home of 3, published line (283 percent)
  • $4,959/month — Ages 2 to 18, home of 2, published line (275 percent)

Covers: Hospital and clinic care · Chemotherapy and prescriptions · Anything medically necessary for a child under 21 (Child and Teen Checkups) · Home care nursing and personal support when approved · Rides to appointments · Dental and vision

Legal protection: No monthly premium and no copays for a child · Coverage keeps running to the end of the sixth-birthday month, then twelve months at a time

What it costs the family: No premium. No copays for children.

The eligibility facts, as published

Age
under 19
Age max exclusive
19
Income
MAGI budget group; base lines 283 percent of the poverty guideline under age 2 and 275 percent for ages 2 to 18, with five points disregarded when it changes the answer
Insurance status condition
Ordinary Medical Assistance generally allows other insurance. The CHIP-funded infant band above 275% FPL has an uninsured requirement; the agency checks the correct category.
Residency
Minnesota
Continuous eligibility
through the month of the sixth birthday, then 12 months
Retroactive months
3 through 2027; 2 for children from January 1, 2028
Processing standard
45 days, or 60 days when the decision runs on disability

Decisions this site cannot make: County or tribal MAGI determination through MNsure · Hospital presumptive eligibility at a qualified hospital

Expect friction on: Choosing a health plan the oncology group is in

The trap: Minnesota's limits are among the highest in the country: a family of four is under the line for a school-age child up to $7,562 a month. Do not assume you earn too much, and do not cancel private insurance to apply.

Where I read this

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