Insuring Minnesotans’ most important asset–their health
Minnesota’s health plans add to our state’s overall strength by providing excellent coverage and innovative programs to improve health. Health plans also build partnerships with doctors, clinics, hospitals, public health, community organizations, the state and other stakeholders.This collaborative work improves care, holds down costs and eliminates fraud. Here’s what you need to know.
Health plans help members, employers and providers:
- Save money by negotiating discounted rates with doctors, hospitals and other providers of care
- Better manage health conditions and improve health
- Stay healthy with preventive services, routine care and even health club discounts
- Limit financial loss
- Receive the best value for their health care dollar by creating new ways to pay for care that rewards the quality of services provided, not the quantity
- Detect and prevent health care fraud and abuse
- Assure quality care
- Reduce administrative costs by minimizing paperwork and increasing opportunities for electronic administrative transactions
MCHP members cover more than 4.2 million people.
The majority of enrollees (68 percent) are in privately funded health care coverage through employers and regulated by either state or federal law.
- Large businesses. About 40 percent of Minnesotans are covered by large businesses that self-insure. These companies hire insurers to administer their plans, which are governed by the federal ERISA law.
- Smaller and medium-sized employers. About 22 percent of Minnesotans are covered by small and medium-sized employers. State laws govern this coverage.
- Individual coverage. About 6 percent of Minnesotans have individual coverage. Individuals and self-employed people under 65 purchase these products for themselves and family members. State laws govern this coverage.
About 32 percent of Minnesotans have coverage provided, at least in part, by tax dollars.
- Medicare. Nearly 16 percent of Minnesotans have Medicare coverage offered through health plans. Medicare serves people 65 and older, and people who have disabilities. Medicare is federally funded.
- Medicaid. About 9 percent of Minnesotans of all ages are covered by Medical Assistance, the state’s Medicaid program for low-income residents. Medicaid coverage is provided directly by the state (fee-for-service) and through health plans and county-based purchasers (managed care.) This public-private partnership allows the state to set its budget and ensure people have doctors to care for them. Federal and state laws govern and fund Medicaid.
- MinnesotaCare. About 2 percent of Minnesotans have MinnesotaCare, offered through health plans and county-based purchasers for low-income working Minnesotans. MinnesotaCare is funded through premiums paid by enrollees and the state’s Health Care Access Fund.
In addition to Medicaid and MinnesotaCare, other publicly funded health care programs are designed to meet the needs of seniors and people with disabilities. These programs include the Minnesota Senior Health Options and Minnesota Senior Care Plus, Special Needs Basic Care and Preferred Integrated Networks.