MinnesotaCare

What's covered?

If you have questions about your health care program, covered services or cost sharing, you can:

  • call your worker
  • call your health plan member services
  • ask your provider

Your provider must get approval for some health care services before you get them. The services must be medically necessary.

More about MinnesotaCare Contact your local county or Tribal office Health plan member services

Children under 19 and pregnant adults 19 and over

MinnesotaCare covers these things for children under 19 and pregnant adults 19 and over:

  • Acupuncture
  • Child and Teen Checkups (C&TC)
  • Chiropractic care (for children under age 21)
  • Dental services
  • Diagnostic services – lab tests and X-rays
  • Doctor and other health services
  • Early Intensive Developmental and Behavioral Intervention (EIDBI) Services (for children under age 21)
  • Emergency medical services and post-stabilization care
  • Family planning services
  • Hearing aids
  • Home care services
  • Hospice
  • Hospital services, inpatient and outpatient
  • Immunizations and vaccines
  • Interpreter services
  • Lab and X-ray services
  • Medical equipment and supplies
  • Medical transportation to and from medical services (covered only for MinnesotaCare members under age 19)
  • Mental health services
  • Obstetrics and gynecology (OB/GYN) services
  • Optical services
  • Prescription drugs
  • Rehabilitation therapies
  • Substance use disorder services
  • Surgery
  • Telemedicine services
  • Urgent care

Parents, caretakers, adults without children, and children who are 19 or 20 years old

Coverage is the same as MinnesotaCare for children under 19 and pregnant adults 19 and over, except these services are limited:

  • Medical transportation (emergency only)

Also, these services are not covered:

  • Care in an intermediate care facility
  • Nursing home care
  • Orthodontic services
  • Personal care assistance (PCA) services
  • Private duty nursing

Cost sharing and limits

There is no cost sharing for the following members:

  • Children younger than 21 years old
  • Pregnant adults
  • American Indians who receive services from an Indian health care provider or through a referral from the Indian Health Services (IHS) Contract Health Services
  • American Indians enrolled in a federally recognized tribe

Some people 21 years old or older pay cost sharing.1 Cost sharing means the amount you pay toward your medical costs. You must pay your copay directly to your provider. Some providers require that you pay the copay when you arrive for medical services. MinnesotaCare enrollees pay no family deductible. Cost sharing is as follows:

  • $100 copay for ER2 visits
  • $28 copay for non-preventive visits; no copay for mental health visits
  • $250 per inpatient hospital admission
  • $0 ambulatory surgery
  • $0 outpatient hospital
  • $10 copay for eyeglasses
  • $10 (generic) or $25 (brand) copay for prescription drugs up to $70 per month; no copay for some mental health drugs
  • $45 per visit for radiology services
  • $0 per visit for dental services
  • $0 copay for durable medical equipment
  • $0 monthly deductible
  • $100 Emergency room visit for toothache or other nontraumatic dental condition

1 American Indians who are members of a federally recognized tribe are exempt from cost sharing. You must pay your copay directly to your provider. Some providers require that you pay the copay when you arrive for medical services.

2 ER copay does not apply for visits that lead to an inpatient admission.