Disability and aging in Minnesota: SSI, Medicare Savings Programs, Extra Help, waivers and long-term care

Where this sits: Benefits › Topics › Disability and aging. Related: Minnesota Supplemental Aid, Medical Assistance, General Assistance.

The map

SSI recipients apply for MA and MSA through the county; most qualify for MA. People in the community use the MHCP Application for Certain Populations (DHS-3876) for MA and the Medicare Savings Programs; people in a nursing facility or seeking a waiver use DHS-3531. For services at home, a MnCHOICES assessment from the county or Tribe is a required step.

SSI

SSI is a monthly federal cash payment for needy aged, blind and disabled people. Social Security decides and pays it. In May 2024, 88,749 Minnesotans received it.

Who qualifies: people 65 or older, blind (20/200 vision or a field of 20 degrees or less) or disabled (an impairment that prevents substantial gainful activity and has lasted or is expected to last at least 12 months or result in death; children have their own test). After disregarding the first $20 of most income and the first $65 of earnings plus half the rest, income must be below the maximum SSI benefit. Countable assets must be at most $2,000 for one person or $3,000 for a couple; the home, a car used for transportation and household goods don't count. People living in a public institution generally can't get it.

Amount: the maximum benefit minus countable income, cut by a third for someone living in another person's household. The maximum rises each January: in 2026 it is $994.00 a month for one person ($1,491.00 for a couple) in their own home, and $662.67 ($994.00) in the home of another. Social Security can make emergency payments to applicants in desperate need who are probably eligible, and can appoint a representative payee for someone who can't manage the money.

How it connects: Minnesota uses at least one Medicaid rule for people who are aged, blind or disabled that is stricter than SSI's, and SSI recipients have a basis for MA but are not automatically eligible; SSI recipients apply for MA, and for the state top-up Minnesota Supplemental Aid, through the county. Most qualify for MA, and people who are blind or severely disabled and work may keep MA when their earnings end SSI. When everyone in a household gets SSI, the household is automatically eligible for SNAP. General Assistance can pay while an SSI claim is pending; it is repaid from the SSI back payment.

Noncitizens (from legal aid's fact sheet, updated September 2026): people who came to the US, or became permanent residents, after August 22, 1996 can get SSI only with 40 quarters of Social Security-covered work, as a US veteran or active-duty service member or their spouse, minor child or unremarried widow(er), as a COFA citizen, or as a refugee, asylee or person granted withholding, and then only for 7 years from the grant. Whether the 2025 federal law changed SSI for noncitizens is not known to this site.

Help with Medicare costs

For people with Medicare (QMB and SLMB can be combined with MA; QI generally can't, and QWD can't):

• QMB: pays Part A premiums (for those who owe one) and Part B premiums, and Medicare deductibles, coinsurance and copays. Starts the month after eligibility is decided. MA enrollees on SSI who turn 65 are deemed eligible.
• SLMB: pays the Part B premium; can be retroactive.
• QI: pays the Part B premium; limited funds, first come, first served; generally not together with MA.
• QWD: may pay Part A premiums for working people under 65 who are blind or disabled, lost premium-free Part A, and aren't otherwise eligible for MA.

QMB, SLMB and QI don't require a disability, and each brings Extra Help automatically.

Limits in Minnesota: income up to 100% of the federal poverty guidelines (QMB), 120% (SLMB), 135% (QI) or 200% (QWD), counted with MA's rules for people who are aged, blind or disabled (including a $20 deduction). Assets up to $10,000 for one person or $18,000 for two or more ($4,000 and $6,000 for QWD). For comparison, Medicare.gov's national 2026 figures are $1,350 a month (QMB), $1,616 (SLMB) and $1,816 (QI) for one person, with lower asset limits; it notes states may allow more.

With QMB, Medicare providers may not bill for Medicare-covered services, apart from a small Medicaid copay where one applies. With an MSP, Extra Help caps drug costs at $12.65 per covered drug in 2026. QI must be renewed every year. People not on an MSP or MA can apply to Social Security for Extra Help online or at 1-800-772-1213 (TTY 1-800-325-0778).

Apply: sign up for Medicare with the federal government, and apply for an MSP at the county, Tribal or state agency with DHS-3876 (or DHS-3531 for people in a nursing facility or seeking a waiver). A letter from Social Security about Medicare costs isn't needed. Agencies must check MSP eligibility when someone applies for MA, renews or becomes eligible for Medicare.

Noncitizens: the 2026-10-01 federal change to who can get federally funded MA by immigration status also covers the Medicare Savings Programs. See immigration status and benefits.

Care at home: waivers and Alternative Care

Over 114,000 people were estimated to use waivers in 2025. Alternative Care serves people 65 and older who need nursing facility level care, choose to live in the community and aren't yet financially eligible for MA: Minnesota residents who are citizens, nationals or qualified noncitizens, able to pay any fee, assessed through MnCHOICES, and whose income and assets wouldn't cover 135 days of nursing facility care. AC follows MA's transfer penalty and estate claim rules.

To qualify for a waiver: be eligible for MA, choose services in the community, meet the waiver's level of care, and need more than regular MA covers. For the disability waivers: be certified disabled by Social Security or the State Medical Review Team; ask the county or Tribe for a MnCHOICES assessment (they have 45 days from the request to complete it); and qualify for disability-based MA or MA-EPD (no need to confirm this before asking for the assessment). The county, Tribe or managed care organization then provides case management and authorizes services in a support plan. CADI requires being under 65 when first opened to the waiver. The DD waiver has a waiting list; for people with immediate or defined needs, or leaving an institution, the target is 45 days from assessment to funding approval.

What waivers pay for: services to live at home or in the community, such as caregiver expense reimbursement, household help, meal delivery and some assistive technology. Not rent or a mortgage. Consumer-directed community supports (CDCS) let people hire and manage their own workers.

MA for long-term care looks back 60 months for assets given away or sold for less than their value, which can cause a penalty period.

Changes: the four disability waivers are to become two, with budgets based on each person's needs, phasing in from 2027-01-01 ("Waiver Reimagine"; a 2025 source, not confirmed in 2026). From 2026-10-01, DHS said, people without an MA-eligible immigration status would no longer have waiver, Alternative Care and personal care (PCA/CFSS) services covered.

Not covered here

SSDI, MA-EPD, personal care (PCA/CFSS) in detail, nursing home payment and spousal rules, estate recovery, guardianship, Minnesota Aging Pathways and Disability Hub MN services, and vocational rehabilitation.