How to Sign Up for ACA Health Insurance in Minnesota

En español | Most Minnesotans are eligible to buy health insurance through MNsure, the state’s Affordable Care Act (ACA) marketplace, during open enrollment in the fall.

Residents who experience a qualifying life event, such as a marriage, divorce, the birth of a child, a move or lost health insurance, may be eligible to buy or change coverage outside of open enrollment. This is called a special enrollment period.

Most people enrolled in ACA marketplace plans have seen their premiums go down because the 2021 American Rescue Plan Act (ARPA) increased tax credits for insurance premiums and expanded the number of households that qualify for them. Every household that pays more than 8.5 percent of its income qualifies for federal tax credits to help afford health insurance. These enhanced subsidies are available through 2025.

Before the new law, such tax credits were available only to people earning less than a certain salary ($54,360 for one person). Most Americans with a marketplace plan can save an average of about $800 per year, according to the federal government.

• Minnesota residents, including legal immigrants, are eligible to buy insurance through MNsure, regardless of whether they are insured. But you'll have to wait until open enrollment begins, unless you experience a qualifying life event. More information about who can enroll, along with details about eligibility, is on the MNsure website.

• You may also qualify for Medical Assistance, the state’s Medicaid plan, which has no monthly premium. Or for MinnesotaCare, which offers low-cost coverage to Minnesotans with lower incomes. Both plans allow for year-round enrollment. When you apply for coverage through MNsure, you'll find out if you qualify for one of these no- or low-cost insurance options. You can also see what you might qualify for by looking at the state's income level guidelines.

• MNsure open enrollment for 2023 health insurance coverage has closed. It opens in the fall for 2024 insurance coverage.

• You can enroll outside of open enrollment if you experience a qualifying life event, but in most situations you only have 60 days from that event to enroll. Qualifying events include certain moves, births and adoptions, loss of employer-provided coverage, marriage, divorce and other special circumstances.

• Year-round enrollment is open to Minnesotans who qualify for Medical Assistance or MinnesotaCare, and to members of a federally recognized American Indian tribe.

You apply for coverage and choose your plan at the same time. As soon as you submit an application with MNsure, you'll learn what coverage you're eligible for. If you qualify for private coverage, you can shop for plans and continue the enrollment process immediately. If you're eligible for a public plan, Medical Assistance or MinnesotaCare, information about next steps will come from the Minnesota Department of Human Services, your county or your tribal agency.

If you enroll in a private plan or for MinnesotaCare, your coverage will not begin until you've paid your first monthly premium. There is no monthly premium for Medical Assistance.

To apply and enroll: 

• Online: Go to MNsure's website to apply and enroll.

• By phone: You can call MNsure's contact center at 651-539-2099 (855-366-7873 outside the Twin Cities) between 8 a.m. and 4 p.m., Monday through Friday.

• In person: You can find someone to assist you or visit a broker enrollment center for help. Or you may want to check out one of the enrollment events in your area.

Certified brokers, for private plans, and navigators, for public plans, offer free help exploring plans and answering questions and are available virtually, by phone or in person. MNsure's website makes it easy to find help near you.

All MNsure health coverage plans cover basic dental services for children, but adults who want dental insurance must add it to their policy. Deductibles and out-of-pocket costs vary between plans; enrolling in a family plan can cut costs.

Coverage and cost depend on where you live, the type of plan you choose, your household income, use of tobacco and the age and disability status of you and your members of your family.

If you qualify for Medical Assistance or MinnesotaCare, you will be able to get free or low-cost coverage and may not need to worry about premiums or copays, depending on your level of income.

All MNsure plans cover 10 “essential” benefits, including:

• Emergency services and hospitalization
• Maternity and newborn care
• Mental health services (including counseling)
• Chronic disease management
• Pediatric care, including dental and vision
• Prescription drugs

Insurance companies cannot deny coverage because of preexisting conditions. When you apply, you can identify your medical needs and choose a plan that makes financial sense for you and your family. If you have any questions about your coverage, you should call your insurance company.

All MNsure health coverage plans cover basic dental services for children, but adults who want dental insurance must add it to their policy. Deductibles and out-of-pocket costs vary between plans; enrolling in a family plan can cut costs.  

Every eligible household that pays insurance premiums that exceed 8.5 percent of annual income qualifies for federal tax credits for insurance premiums through 2025.

According to Megan O’Reilly, AARP vice president of government affairs for health and family, subsidy recipients ages 50 to 64 have seen average annual savings of over $950. 

Yes. If you qualify for a premium tax credit, you may also qualify for a cost-sharing reduction that would help you pay for such out-of-pocket expenses as deductibles and copays. You must enroll in a Silver-level plan to get this assistance.

Most MNsure plans are organized into four categories:

• Bronze plans have the lowest monthly premiums and the highest deductibles and copays. They cover roughly 60 percent of care costs.

• Silver plans have moderate monthly premiums, deductibles and copays. They cover about 70 percent of care costs and potentially more, if you come from a lower-income household and qualify for cost-sharing reductions —
  a subsidy only available through silver plans.

• Gold plans have higher monthly premiums and lower deductibles and copays, and cover roughly 80 percent of care costs.

• Platinum plans have the highest monthly premiums and the lowest deductibles and copays. They cover roughly 90 percent of care costs. These are for people who have significant health care needs and are willing to pay the highest premiums.

Minnesotans under 30, and others who qualify for a hardship exemption, can also apply for a catastrophic health plan, which offers a low monthly premium and a very high deductible and exists to protect customers in worst-case scenarios.

MNsure’s Shop and Compare tool helps you estimate costs and benefits of various plans and check whether you might qualify for financial assistance.

If you already have coverage through your employer or directly through an insurance provider but are eligible for lower premiums, you can switch to MNsure. But you may need to wait until open enrollment, and you may not qualify for tax credits if you opt out of your employer’s plan — unless those premiums exceed a certain portion of your household income. The premiums would need to be more than 9.12 percent of your household income for individual coverage.

If you lose your COBRA coverage, you may be able to sign up for a MNsure plan during a 60-day special enrollment window. Try to apply and select your plan through MNsure before your COBRA coverage ends to make sure there’s no gap in coverage. 

If you already have a marketplace plan and want to adjust your coverage, you'll need to wait until the next open enrollment period opens this fall, unless you experience a qualifying life event.

That depends. Major insurance providers — including BlueCross BlueShield Minnesota, Health Partners, Medica, Quarts and UCare — offer MNsure plans, but not all doctors accept them. Before you select a plan, you may want to check if your doctor is in the insurance company's network or contact the insurance company to learn more about available providers.

Most families can enroll in the same plan. But in some cases, the needs of family members may vary — and so might their access to subsidies. If you're not sure what makes the most sense for your family, MNsure encourages you to contact a broker for guidance.

This guide was updated on Feb. 3, 2023, with information about open enrollment.

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