Minnesota Health Care Programs

Eligibility Policy Manual

Welcome to the Minnesota Department of Human Services (DHS) Minnesota Health Care Programs Eligibility Policy Manual (EPM).The manual contains the official DHS eligibility policies for the Minnesota Health Care Programs including Medical Assistance and MinnesotaCare. It does not provide procedural instructions or system information. Minnesota Health Care Programs policies are based on the state and federal laws and regulations that govern the programs. See Legal Authority section for more information. See the Legal Authority section for more information.

Updates

Beginning June 1, 2023 policy clarifications and policy additions are announced through an Email Subscription. Anyone can sign up to receive the Email Subscription.

Recent Updates

March 26, 2025March 26, 2025

2.1.1.2.3 MA Cost Sharing

Parental Fees

We remove the reference to out of home placement parental fees and clarified that effective July 1, 2024, parents are no longer assessed parental fees for children who have a developmental disability, a physical disability, or emotional disturbance in 24-hour care outside the home. Parents are still responsible for parental fees assessed for these children before June 30, 2024.

2.3.5.2.1 MA-EPD Bases of Eligibility

Changing Basis of Eligibility after Age 65

We added a list of assets that remain excluded for MA-EPD enrollees who meet the criteria and are determined eligible for MA-ABD after turning 65.

February 27, 2025February 27, 2025

2.3.3.3.2.3 MA-ABD Excluded Income

We clarified excluded income also includes:

Long-Term Services and Supports workforce incentive payments under the Minnesota Care Force Incentive program
Mille Lacs Band of Ojibwe General Welfare Assistance Program for Band Members Who Are Age 65 or Older and Band Members Who Are Blind or Have a Disability

2.3.3.2.7.9.7 MA-ABD Supplemental Needs Trust

Evaluation of Trust Assets

We clarified In the Limitation on Unavailability section that a supplemental needs trust, established on or after July 1,1983, is unenforceable when all the conditions listed are met. If the trust is found unenforceable, it must be evaluated as a third party established and funded trust.

February 10, 2025February 10, 2025

2.3.3.2.7.13 MA-ABD Tribal Payments and Interests

We added the Tribal General Welfare section to clarify policy about tribal general welfare payments.).

2.3.3.4.1 MA-ABD Spenddown Type

Monthly Spenddown

We clarified for a person to use a monthly spenddown they only need to meet the spenddown in any one month of the application processing period, or any one retroactive month.

December 20, 2024December 20, 2024

4.1.4.2 Minnesota Family Planning Program (MFPP) Renewals

We clarified the Reconsideration Period policy for MFPP renewals

DHS discontinued the use of manual letters to announce policy clarifications and policy additions effective June 1, 2023. You can see a list of manual letters published between June 1, 2016 to June 1, 2023 in the EPM Archive Manual Letters. As of June 1, 2023 this home page is no longer archived, since it does not contain eligibility policy.

Bulletins

DHS bulletins provide information about policy changes and direction to county and tribal health and human services agencies and other DHS business partners. According to DHS policy, bulletins more than two years old are obsolete. Anyone can subscribe to the Bulletins mailing list.

A DHS Bulletin supersedes information in this manual until incorporated into this manual. The following bulletins have not yet been incorporated into the EPM:

COVID-19 Emergency Bulletins: These bulletins announce temporary policy modifications, which supersede policies in this manual, during the COVID-19 emergency. Because these bulletins provide temporary guidance, they will not be incorporated into this manual.

Prior versions of EPM sections are available upon request. This manual consolidates and updates eligibility policy previously found in the Health Care Programs Manual (HCPM) and Insurance Affordability Programs Manual (IAPM). Prior versions of policy from the HCPM and IAPM are available upon request.

Contact Us

Direct questions about the Minnesota Health Care Programs Eligibility Policy Manual to the DHS Health Care Eligibility and Access (HCEA) Division, P.O. Box 64989, 540 Cedar Street, St. Paul, MN 55164-0989 or fax (651) 431-7423.

Health care eligibility workers must follow agency procedures to submit policy-related questions to HealthQuest.

Legal Authority

Many legal authorities govern Minnesota Health Care Programs, including but not limited to:

Title XIX of the Social Security Act;
Titles 26, 42 and 45 of the Code of Federal Regulations;
Minnesota Statutes chapters 256B and 256L, and
Certain federal regulations from the Centers for Medicare & Medicaid Services (CMS).

Each topic in the EPM includes applicable legal citations at the bottom of the page.

DHS has made every effort to include all applicable statutes, laws, regulations and other presiding authorities; however, erroneous citations or omissions do not imply that there are no applicable legal citations or other presiding authorities. The EPM provides program eligibility policy and should not be construed as legal advice.

EPM Subscription

After you set up an account, you will have the opportunity to scroll down to select Minnesota Health Care Programs Eligibility Policy Manual, which will provide an update or all sections, or you can select which individual sections of the EPM you want to be notified when an update occurs.You can change your subscriber preferences at any time by logging into your account.