Frequently Asked Questions

We’ve been listening to your questions and have some answers for you. If your question isn’t below, be sure to ask us.

General Questions

  • What is MNsure? What will it do?
    MNsure is a new online marketplace where individuals, families and small businesses will be able to get quality, affordable health coverage that fits your budget. You may even qualify for a low-cost or free plan. 

    MNsure will offer: 
    • an easy-to-use website where you can search and compare plans 
    • a hotline you can call to talk with someone about your options 
    • and places where you can sign up in your community 
    MNsure will do many things. It will:
    • Be a one-stop place to shop for health insurance plans
    • Lay out plan options side-by-side for easy comparison
    • Ensure that plans meet certain baseline benefit standards
    • Let you know if you qualify for tax credits or financial assistance
    • Let you know if you qualify for a low-cost or free plan
    • Allow you to apply and enroll online in health benefit plans 
    • Show you what your potential cost will be
    • Give you examples of average costs for common health services
    • Show you quality ratings for hospitals and clinics in your community

  • When does MNsure open?

    Enrollment starts October 2013. Health plan coverage begins January 1, 2014.

  • Who can use MNsure?

    Initially, individuals who are not covered under an employer’s plan and small businesses with up to 50 employees can use MNsure. Large employers may be allowed to participate in 2017.

  • Will other kinds of insurance such as life, long-term care or disability be sold through MNsure?

    There are no plans to add such products to MNsure.  Any expansion of product offerings would have to come from direction set by policymakers.

  • Will health plans contain alternative medicine options?

    It depends on whether the benchmark plan (Essential Health Benefit package) contains "alternative medicine options."  That decision has not been made.

  • What does bronze, silver and gold mean?

    They indicate different levels of coverage. A Bronze level plan will cover roughly 60% of the costs of services it offers. Silver will cover roughly 70%, Gold will cover roughly 80% percent, and Platinum will cover roughly 90% of the costs of the benefits provided. A “Catastrophic Plan” will also be offered. It can help those who would not be required to purchase coverage because the premium exceeds 8% of their income.

Individuals and Families

  • Does everyone have to purchase health insurance?

    Yes. Beginning January 1, 2014, all U.S. citizens and legal residents will be required to obtain health insurance coverage. Many will be covered by an employer plan, some will qualify for health programs, and others will purchase it themselves.

  • What happens if I don’t buy coverage?
    Starting in 2014, you will pay a tax penalty. The penalty will increase over time:
    • In 2014, it will be the greater of $95 per adult or 1 percent of taxable income.
    • In 2015, it will be the greater of $325 per adult or 2 percent of taxable income.
    • In 2016, it will be the greater of $695 per adult or 2.5 percent of taxable income.
    • After 2016, the tax penalty increases annually based on a cost-of-living adjustment.
    • A person will only pay one-twelfth of the total annual penalty for each month without coverage.
    • The penalty for a child is half that of an adult.
    • A maximum penalty would be calculated based on premiums for plans offered through MNsure.
  • Are there exceptions?
    Yes.  The law will provide exceptions for:
    1. Individuals and families below a certain income 
    2. People who cannot afford the coverage that is available 
    3. Individuals who have been uninsured for less than three months 
    4. Members of American Indian tribes 
    5. People who do not obtain coverage because of religious objection
  • Can I lower my cost?

    Maybe. You may qualify for a low-cost or free plan. Tax credits (called advanced premium tax credits) are available to individuals making $43,320 or less and a family of four making $88,200 or less. The amount of assistance is based on a sliding scale, so the higher your income, the lower the amount of assistance. Use our calculator  to estimate your savings and see examples of how the tax credit will work.

  • I have a pre-existing condition. Can I buy insurance through MNsure?

    Definitely. Starting in 2014, no insurer can deny anyone health insurance based on health status, inside or outside of MNsure.

  • Can I buy health insurance somewhere other than through MNsure?

    Yes.  However, tax credits (advanced premium tax credits) for individual and family buyers can only be obtained if you purchase your health coverage through MNsure.

  • What happens if I live in MN but work in WI or vice versa; which state exchange would I get my insurance from?

    If you or your family are buying your plan on your own (not through an employer) and want to use MNsure, you must be a resident of Minnesota. We are working with neighboring states on how to handle cross-border employment situations.

  • I am young and healthy. Why should I buy health insurance?

    Accidents or sickness can happen to anybody. The average cost for a broken arm using hospital emergency services is $2,500. Who wants to be stuck with that kind of bill or other unexpected health care costs? Everybody uses the health care system at some point in his or her life. It’s a smart move to plan ahead and be prepared.

  • I am worried that I won't have access to my doctors if I buy a plan on MNsure.

    Insurers who offer plans outside MNsure will also offer plans onMNsure, and their network of doctors will likely be the similar to what’s in place today. It all depends on which plan you choose whether your doctor is part of the network. You will be able to look for your doctor in the offered plans and choose the option that works best for you.

  • Will Medicare eligible individuals be able to purchase supplemental coverage?

    At this time, supplemental coverage plans are not planned for the first year of operation.

  • I buy insurance through a broker. Do I have to use MNsure?

    No. You can purchase a plan outside MNsure if you’d like. Keep in mind, however, that tax credits (advanced premium tax credits) for individual and family buyers can only be obtained if you purchase your health coverage through MNsure. Many agents/brokers will also be able to offer you a plan listed with MNsure.

  • Will my personal information be secure with MNsure?

    Yes. It is protected by state and federal laws, rules and regulations related to the storage, collection, use and dissemination of private or confidential information. Beyond the necessity to comply with applicable laws, Minnesota takes the obligation to keep personal information private very seriously. Besides putting all privacy requirements into the IT systems, we are ensuring that it is an integral part of the business operations culture. Our personnel will be able to access only the information that is necessary for them to perform their job.

  • How can I get help now?

    We’ve put together some options for you.

  • How can share my ideas and suggestions?
    Public input is welcomed and encouraged: 

Small Employers

Consumer Assistants

  • How will the navigator/assister program work?

    The Navigator and Agents/Brokers Work Group has discussed options and forwarded their report to the Advisory Task Force. Their findings will inform a policy bill that will be presented to the legislature for review and action in early 2013. Agents/brokers doing business with the MNsure exchange/marketplace will not be state employees but will remain independent. They will be required to complete specialized training.


  • Will the MNsure eliminate agents/brokers from the health insurance marketplace?

    No. A continued role is envisioned for agents/brokers both through MNsure and in the outside marketplace. However, what exact role they play, what certification standards may apply, and what the terms of compensation will be, have yet to be decided. From the initial planning stage, we have been working with agents, brokers and other stakeholders to discuss options. We will continue to seek suggestions and ideas.


  • Will MNsure sell other insurance products such as life, long-term care or disability?

    There are no plans to incorporate such products and the Advisory Task Force has not addressed the issue. An expansion of MNsure's range of product offerings would have to come from future direction set by policymakers.

  • Will MNsure be open to larger employers in the future?

    Possibly. That decision will be determined by future legislation. When it launches in 2014, the MNsure exchange/marketplace will serve employers with 50 or fewer employees.


American Indians

  • Who will be included in the definition of Indian used for MNsure? Will this cover only individual Indians, or will it include Indian households?
    The Affordable Care Act (ACA) includes several different, although similar, definitions of “American Indian;” we don’t know at this time whether one definition will be selected or, if so, which definition will be chosen. 

    Under the proposed regulations, different methods for determining eligibility will apply for different programs. Medicaid eligibility is determined for each person, using information about themselves and individuals in their household. Unlike Medicaid, eligibility for tax credits will be determined for a household, as it is for MinnesotaCare. Minnesota has elected to apply the premium exemption for Indians in MinnesotaCare to an entire household when at least one member is an Indian; it is not clear whether this will change under MNsure.
  • What type of proof will be required to establish an American Indian identity?

    To determine eligibility for cost-sharing protections, the ACA allows MNsure to verify AI/AN status using documentation of citizenship and electronic data sources approved by the Secretary of HHS or documents currently accepted by Medicaid showing tribal membership. Minnesota has suggested that IHS data should be included in the planned “data hub,” that would allow exchanges to access data from a number of federal sources to assist in enrolling people into insurance plans, and also that tribal data sources be considered.

  • What does “exempt from cost sharing” mean and who is exempt?

    Under the ACA, plans within MNsure may require the payment of deductibles or co-pays. To increase access to care, American Indians with incomes below 300% federal poverty levels, and all Indians who obtain services from or receive a referral from I/T/U providers, will be exempt from cost-sharing requirements.

  • Most tribal health clinics have Benefits Coordinators; can they be MNsure navigators?
    Yes. According to proposed MNsure regulations, Indian tribes, tribal organizations, and urban Indian organizations can be navigators, along with state or local human service agencies. 

    Benefits Coordinators understand the health needs of their communities and, with appropriate training, would be well-equipped to help tribal members determine their best coverage options, including QHPs through MNsure or other available programs. The tribe chooses which employees would receive the navigator training.

    Tribes and other Indian health care providers also believe that they should be allowed to have navigators who serve only American Indians without running into conflict of interest. This does not prevent other navigators from serving American Indians, but rather acknowledges that tribes and IHS are prohibited from serving non-Indians in their federally-funded programs.

  • What is a health coverage sponsorship?
    Minnesota supports the proposed rule that permits Indian tribes, tribal organizations and urban Indian organizations to pay premiums on behalf of American Indians who obtain health insurance through MNsure. 

    IHS presented to tribal leaders about the Basic Health Program. IHS stated that this program is a state insurance coverage for people that don’t meet Medicaid eligibility and are between 133% and 200% of the Federal Poverty Level. Which program is this? 
    The Basic Health Plan appears to be similar to the MinnesotaCare program in who would be covered and what benefits would be included. However, regulations for Basic Health Plans have not been developed, so we cannot say exactly what the differences will be. 

  • How will tribal health care providers be included inMNsure? How do they become Qualified Health Providers in the coverage plans?
    The proposed regulation requires health insurance networks to include “a sufficient number” of Essential Community Providers (ECP). Minnesota has advocated for requiring inclusion of all ECPs in insurers’ networks. Minnesota also raised the topic of requiring that tribes be offered contracts that include a “Tribal Addendum” so that they are appropriate for tribes. 

    Although Indian Health Service (IHS), tribal, and urban Indian health care providers may be ECPs, the designation is not automatic and must be renewed periodically. Because of this, tribes have suggested that insurers be required to offer network provider contracts to I/T/U providers, whether they are designated as ECP or not. 
  • Will Tribes and the IHS be paid in the same manner under MNsure?

    MNsure is not intended to change the way the state’s health care programs operate or the ways states pay health care providers. In Minnesota, we expect to continue to pay IHS and tribal health care providers using the same methods that are currently used.