SSDI Does Count as Income for MinnesotaCare, but the Rules Are Specific

Yes, Social Security Disability Insurance (SSDI) counts as income when you explore for or renew MinnesotaCare. Minnesota's health insurance program for low-income residents looks at your total monthly income, and SSDI payments are included in that calculation. However, MinnesotaCare has higher income limits than many other programs, and the way SSDI is counted can work in your favor in some situations.

The key difference from other programs like Medicaid is that MinnesotaCare allows you to earn more and still stay covered. If you receive SSDI, you may still be within the income range for MinnesotaCare even though you would not be for other information programs. The exact limit depends on your household size and changes each year.

Key Takeaways

  • MinnesotaCare counts your full SSDI payment as income when determining whether you meet the income limit.
  • MinnesotaCare's income limits are higher than Medicaid's, so you may may have access to for MinnesotaCare even if SSDI disqualifies you from other programs.
  • If you work and receive SSDI, both your wages and your SSDI payment count toward the income limit, but work incentive programs can reduce the amount counted.
  • You must report your SSDI income on your MinnesotaCare process or renewal form, and changes to your SSDI payment must be reported within 30 days.

MinnesotaCare Income Limits and How SSDI Fits In

MinnesotaCare sets income limits based on the federal poverty level. For 2024, the program covers individuals and families with income up to roughly 275% of the federal poverty level, though this percentage can shift. For a single person, that means you can earn significantly more than the Medicaid limit and still be covered.

Because SSDI payments are counted as income, you need to know your monthly SSDI amount before you explore. If your SSDI payment alone puts you above the limit, you will not be covered. However, most people receiving SSDI fall well below MinnesotaCare's income threshold, so SSDI recipients often may have access to without difficulty.

Your household size matters. If you live with family members, their income counts too. MinnesotaCare looks at your entire household's combined income, not just your own SSDI payment.

Reporting SSDI Income on Your MinnesotaCare process

When you explore for MinnesotaCare through MNsure (Minnesota's health insurance marketplace) or directly through the state, you will be asked to list all sources of income. You must include your monthly SSDI payment. The process will ask for your Social Security number and may verify your SSDI amount directly with Social Security.

You will need your most recent Social Security statement or a copy of your award letter showing your current monthly payment. If your SSDI amount has changed recently, bring documentation of the new amount. MNsure can usually pull your income information electronically, but having documents ready speeds up the process.

When you renew your MinnesotaCare coverage each year, you must report your current SSDI income again. If your SSDI payment changes between renewals, you are required to report the change within 30 days. Failing to report changes can result in your coverage being terminated or your premium being adjusted retroactively.

How Work Incentives Affect Your MinnesotaCare Income Calculation

If you work while receiving SSDI, both your wages and your SSDI payment count as income for MinnesotaCare purposes. However, Social Security's work incentive programs can reduce the amount of your earnings that counts toward your SSDI benefit — and in some cases, this can also help with MinnesotaCare's income calculation.

The Plan to Achieve Self-Support (PASS) program allows you to set aside income and resources for a specific work goal without losing SSDI or affecting your MinnesotaCare coverage. If you have an approved PASS plan, the income you set aside does not count toward MinnesotaCare's income limit. Similarly, Impairment Related Work Expenses (IRWE) — costs directly related to your ability to work — may reduce your countable income.

These work incentives are complex and require approval from Social Security. If you are working or planning to work, contact your local Work Incentives Planning and information (WIPA) project or your Social Security representative to learn whether a work incentive could help you keep MinnesotaCare coverage while earning more.

What Happens If Your SSDI Income Changes

Social Security adjusts SSDI payments each year for cost-of-living increases, usually in January. These increases are automatic and do not require you to report anything — MinnesotaCare will see the change when it verifies your income. However, if your SSDI payment increases or decreases for any other reason, you must report it.

If your SSDI payment increases and pushes your household income above MinnesotaCare's limit, your coverage will end. You will receive notice of the termination and may be able to switch to another health plan through MNsure or explore Medicaid if you become newly may be able to access for it. If your payment decreases, you should report it when ready so your MinnesotaCare coverage is not interrupted.

Keep copies of any letters from Social Security showing changes to your payment amount. These documents are proof of your income and will help if there is a dispute about your MinnesotaCare status.

MinnesotaCare Premiums and Cost-Sharing When You Receive SSDI

MinnesotaCare premiums are based on your income. The higher your income, the higher your premium. Because SSDI counts as income, your SSDI payment directly affects what you pay each month for coverage.

MinnesotaCare also has cost-sharing — copayments and deductibles — that vary by income level. People with lower incomes pay less out of pocket. If your SSDI payment is your only income and it is relatively low, you may may have access to for MinnesotaCare's lowest cost-sharing tier, meaning you pay little or nothing when you see a doctor or fill a prescription.

Some SSDI recipients also become may be able to access for Medicare after two years of receiving SSDI. If you have both Medicare and MinnesotaCare, MinnesotaCare acts as a secondary payer, covering costs that Medicare does not. This combination can significantly reduce your out-of-pocket costs.

Frequently Asked Questions

If I receive SSDI and my income is above MinnesotaCare's limit, what other health coverage options do I have?

You may be covered by Medicare if you have been receiving SSDI for 24 months. You can also shop for private health plans through MNsure, though these may be more expensive. Some people with SSDI income above MinnesotaCare's limit but below the federal poverty level may still be may be able to access for Medicaid in limited circumstances — contact your county human services office to check.

Do I have to report my SSDI payment every time I renew MinnesotaCare?

Yes. Even though your SSDI amount may not change much, MinnesotaCare requires you to report your current income at each renewal. You can renew online through MNsure, by mail, or by phone. Having your most recent Social Security statement handy makes the process faster.

What if Social Security overpaid me and I have to repay it — does that affect my MinnesotaCare income?

No. A repayment to Social Security does not reduce your countable income for MinnesotaCare. Your MinnesotaCare income is based on the SSDI payment you receive each month, not on what you keep after repayment. However, if Social Security reduces your monthly payment to recover an overpayment, that reduced amount is what counts as your income going forward.

Can I use a PASS plan to lower my income for MinnesotaCare if I am not working?

No. A PASS plan requires you to be working toward a specific vocational goal. If you are not working, you cannot set up a PASS plan. PASS is designed to help people transition from benefits to work, not to reduce income while remaining inactive.

If my SSDI payment increases and I lose MinnesotaCare, can I get it back later?

Only if your income drops back below the limit. MinnesotaCare coverage ends when your income exceeds the limit, and you can reapply if your circumstances change. If you lose coverage due to an income increase, you will receive a notice explaining your options, including whether you may be may be able to access for other programs.