1. What is General Assistance Medical Care (GAMC)? General Assistance Medical Care is a state-funded health care program for very low-income adults, who are not raising children. Effective June 1, 2010, major changes were made to the GAMC program. Under the new rules, GAMC is no longer a traditional health insurance program that provides a full set of health care services. GAMC enrollees now receive care through hospitals called Coordinated Care Delivery Systems (CCDSs).
2. Who can get GAMC? You must be an adult between ages 21-64 and have: no dependent children under the age of 18 living with you, meet certain income standards, have less than $1,000 in assets, and lived in Minnesota for at least 30 days and intend to stay. You must also be a U.S. citizen or have an acceptable immigrant status to get GAMC.
Undocumented immigrants cannot get GAMC. Also, you cannot get GAMC if
you are eligible for Medical Assistance (MA).
3. What is an asset?
Assets include money in a checking or savings account or
other items of value. Not all
assets are counted toward the $1,000 asset limit for GAMC. Commonly counted assets include cash,
checking and saving accounts, certificates of deposit or stocks and bonds,
recreational vehicles (snowmobiles, campers, boats, etc) and land or houses
that you do not live on or in.
Assets that are not counted include the home you live in, household and
personal goods such as clothing and furniture, a car, capital and operating
assets of a business.
4. How does a Coordinated Care Delivery System (CCDS) work?
A CCDS is run by a hospital. The hospital may include area clinics and other providers as
part of its coordinated care delivery system. The CCDS will manage your health care and determine the
necessary medical services you can receive. You will be able to
choose your CCDS and you must go to that hospital (or its affiliated clinics and providers) to get care unless it is an
emergency. CCDSs will ask you to
select a primary care physician or clinic that is part of its system. GAMC will only pay for non-emergency
care that you receive from your chosen CCDS.
5. Which hospitals are CCDSs?
Four hospitals in Minnesota have met the criteria and been
contracted as a CCDS. They
are: University of Minnesota
Medical Center, Fairview; North Memorial Medical Center; Hennepin County
Medical Center (HCMC); and Regions Hospital in St. Paul. Other hospitals may elect to become a CCDS as the program continues.
6. What services can I receive from my CCDS?
CCDSs cover many health care services, but not all. In
addition, covered services can be different at different CCDSs. Typically, a CCDS will cover services
such as doctor visits, emergency care and hospital stays. A list of the CCDSs and the services
they cover can be seen here.
7. Are prescription drugs covered? Yes. Any GAMC enrollee can receive outpatient prescription drugs from any pharmacy that accepts Minnesota Health Care Programs coverage. There is a preferred drug list for the GAMC program and some small copays may be required.
Medical supplies, such as diabetic testing supplies, are not included as a GAMC drug benefit. Your CCDS may be able to provide medical supplies. You should check with your CCDS about how to get them.
8. Are there any fees for services through the CCDS?
Yes. You must
pay a $25 fee for a nonemergency visit to an emergency room (ER) and a $3 or $1
fee per prescription drug (up to $7 per month).
9. Do I have to pay a monthly premium payment for GAMC? No. There are no premium payments.
10. What if I get services at a different hospital or clinic that is not part of my CCDS?
If it is an emergency and you go to another hospital for care, the
CCDS is required to pay the other hospital for your services. If it is not an emergency, the CCDS will decide if they will pay for your care or any part of your care. You may be responsible for costs if you elect to get care at
a hospital or clinic that is not a part of your CCDS. You should check with your CCDS before receiving care.
11. What if there isn't a CCDS in my county?
You can enroll in any CCDS even if it isn’t located in your county. However, current CCDSs are located in
the metro area and may not be convenient for all GAMC enrollees.
12. Do I have to enroll in a CCDS? No, you do not have to enroll in a CCDS. However, the health care services you can receive will be limited.
If you decide not to enroll in a CCDS, you will still be able to get outpatient prescription drugs (with a small copay) from any pharmacy that accepts Minnesota Health Care Programs coverage. However, you may have to pay for other medical services, such as the doctor visit, to get the prescription.
If you don't select a CCDS, you may be able to get alcohol or drug treatment services through the Consolidated Chemical Dependency Treatment Fund. You will need to call your county worker to find out if you can receive these services. You may also be able to receive free or low-cost care from a local community clinic or hospital. Call 1-866-489-4899 to find a community clinic near you or click here.
13. Do I get an enrollment card from the CCDS?
No. You need to
present your Minnesota Health Care Programs Identification card that you
receive when you are accepted into the program. You will show this card whenever you receive services.
14. Is there another program I can enroll in other than GAMC?
MinnesotaCare offers coverage for adults without children in their households. This is another option
for many adults who are eligible for GAMC. MinnesotaCare does require a monthly premium payment but
that payment could be as low as $4 a month. MinnesotaCare does provide a full set of health care benefits and offers
providers and clinics in all areas of the state. For more information on MinnesotaCare, click here.
15. How do I apply for GAMC?
You should complete the Minnesota Health Care Programs Application. This is the same application used to
apply to other health care programs.
You can get an application at your county human services office or you
can download one from this website by clicking here. You should send or deliver your application to your
local county human services office. When you apply, you will be given an
opportunity to choose between GAMC and MinnesotaCare. If you choose to enroll in GAMC you will be given the
opportunity to select a CCDS.
16. Will GAMC pay for any past medical bills? No, you cannot get coverage for past months. Your coverage begins on the date you apply and meet all eligibility rules.
17. How often do I need to renew coverage for GAMC? Every six months. You will get a “Renewal Form” in the mail that asks
you questions. Fill it out, sign your name, and mail it back. If you move, be
sure to let a GAMC worker know your new address so that you will get your renewal forms. At renewal time, you can chose to switch to MinnesotaCare. Check with your worker to find out how to do this.
