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Health Information Center

Health Insurance & Waiver Services

Medical Assistance is Minnesota’s Medicaid program and provides services to low-income senior citizens, families, children, and people with disabilities. There are income limits to qualify for this program, and you can apply through your local county human services office.

TEFRA (Tax Equity and Fiscal Responsibility Act of 1982) is a Medical Assistance (MA) program that provides services to children with disabilities who live at home with their families and meet ALL the eligibility criteria below. To receive TEFRA, children must:

  • live with at least one parent
  • be under age 19
  • be determined to have a disability by the State Medical Review Team, with information provided by the child's parent and doctors, including certification of disability by Social Security, if applicable
  • need a certain level of home health care to stay at home which compares to the level of care provided in a hospital, nursing home or an intermediate care facility persons with developmental disabilities
  • need home care that does not cost more than the cost for care in a medical institution

Home and Community Based Waiver Programs are for Minnesotans with disabilities or chronic illnesses that are enrolled in Medical Assistance and need care or services beyond what MA covers. These programs are designed to support children and adults with a disability or chronic illness in their home who might otherwise be in a hospital, nursing facility or intermediate care facility if they did not have this program. Usually, these services are for people with specific needs or diagnosis. There are some differences in the services and amount of money available in each waiver.

Children's Mental Health Collaboratives were established in Minnesota because children with severe emotional disturbances or who are at risk of such disturbances often require services from multiple systems. Through collaboratives, children with emotional disturbances and their families receive a coordinated, multi-agency response to their needs and participate in the design and implementation of a coordinated plan of care.

MinnesotaCare is a health care program sponsored by the state for people who live in Minnesota and do not have access to health insurance. There are income limits and other guidelines to qualify. Enrollees pay a monthly premium based on income and/or family size.

Supplemental Social Security Income (SSI) can pay monthly checks to people who are 65 or older, or blind, or have a disability and who do not own much or have a lot of income. SSI is not just for adults. Monthly checks can go to children who are disabled and/or blind. Income and resources of family members in the home are counted when determining eligibility for SSI for children with disabilities under 18. People who get SSI usually get food stamps and Medical Assistance.

To learn more about insurance and health services, contact PACER’s Health Information Center at (952) 838-9000 or (800) 537-2237.


Additional Information

father holding baby

DHS Minnesota Health Care Program Application Forms:

MnCHOICES

Are you someone who needs or knows someone that has a disability or needs long term services and supports to manage daily living? MN Choice is your answer.

State Medical Review Team Forms for Disability Determinations:

The state medical Review team completes disability determinations using the criteria defined by the Social Security Administration (SSA). The Criteria can be found in the SSA blue book.

TEFRA: A Potential Funding Option for Children with Disabilities and Special Health Care Needs – this archived webinar from PACER’s F2F HIC provides a full overview of TEFRA in Minnesota.

Health Reform Minnesota provides information about the state of Minnesota's health care reform activities

HealthCare.gov is a website produced by the federal government with information about preventative care and the new health reform laws and interactive tools. Information from HealthCare.gov is also available in Spanish at CiudadoDeSalud.gov.

PACER Insurance Handouts >>>
image of handout: Coverage of Dependents

Additional Resources

Bridge to Benefits can help you find out if you are eligible for public insurance and other programs

Managing Your Health Care is a guide from the office of the Minnesota Attorney General

Portico Healthnet is an organization that helps you find affordable health coverage and care

Disability Benefits 101, Programs

Disability Hub MN