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 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

June 23, 2026June 23, 2026

2.1.1.2.1.2 MA Liens

Populations Affected by Liens

We added clarification to include medical assistance enrollees who have eligiblity under the families with children and adults (FCA) population that have a long term care spenddown are subject to estate recovery.

Other DHS Recoveries

We added this new section to clarify sources of assets MA funds may be recovered from.

June 12, 2026June 12, 2026

1.3.1.4 MHCP Data Privacy

We removed the reference to DHS-2667 because the form is obsolete.

Data Privacy Violations

We removed MNsure as an agency to send a data privacy written complaint. All complaints should be sent to the Minnesota Department of Human Services.

2.1.2.2.2 Medical Assistance Immigration Status

We clarified which immigration statuses qualify for MA (Medical Assistance) without a five-year waiting period. We also added two new sections to better explain the five-year waiting period:

Exceptions to the Five-Year Waiting Period for MA Eligibility
Begin Date of the Fire-Year Waiting Period for MA Eligibility

2.3.3.2.3 MA-ABD Excluded Assets

Self-Employment Excluded Assets

We clarified that a tax return can be used to determine net earnings from self-employment and to verify that a trade or business exists. We also added clarification of how to determine the existence of a trade or business when it has operated for a year or less.

Excluded Assets Regardless of Identifiability

We clarified that a term life insurance policy is excluded only if it does not have a cash surrender value (CSV).

2.4.2.3.1 MA-LTC Home and Community-Based Services Waivers for People with Disabilities

We clarified that children and youth in certain MA eligibility groups can continue using their current basis of eligibility even if they are determined disabled and receive HCBS. They are not required to switch to a disability-based eligibility category.

June 3, 2026June 3, 2026

We incorporated information from

Into the following EPM sections:

2.2.2.1 MA-FCA Bases of Eligibility

We clarified the eligibility bases for Former Foster Care Youth.

2.3.3.2.1 MA-ABD Asset Limits

People with No Asset Limit

We clarified Medical Assistance for Employed Persons with Disabilities (MA-EPD) enrollees do not have an asset limit under the MA-ABD program.

2.3.3.2.7.2 MA-ABD Retirement Funds and Retirement Plans

Evaluation of Retirement Plans

We clarified a delay in payment of retirement plan funds for reasons beyond the individual’s control, such as processing time, does not mean that the funds are unavailable. The retirement plan funds are available because the individual can legally withdraw the funds. The distributed funds that are retained will be an asset in the months after the month of receipt.

2.3.3.2.7.4.1 MA-ABD Homestead Real Property

We clarified the requirements for continuing to exclude the homestead when the enrollee resides in an LTCF. We also clarified that easements and public rights-of-way (e.g., utility lines, roads) do not separate other land from the home plot.

Homestead Real Property Exclusion for Long-Term Care

We clarified the requirements for when a person intends to return home and continue to claim the homestead exclusion while residing in a long-term care facility.

2.3.3.3.2.1 MA-ABD Countable Income

Availability of Income

We clarified crowdfunding account deposits and direct cash withdrawals from countable unearned income are not part of availability of income.

Rental Income

We clarified that rental income is payment to a property owner for the use of their property (real or personal).

Appendix A Types of Assets

We updated the list of assets to include:

Consolidated Appropriations Act (CAA) recovery rebate payments,
Coronavirus Aid, Relief, and Economic Security (CARES) Act payments,
COVID-19 Relief Payments, Federal Pandemic Unemployment Compensation (FPUC) payments,
RentalHelpMN Assistance, and
Child Tax Credit Payments.

April 27, 2026April 27, 2026

Appendix F Standards and Guidelines

The following standards and guidelines are updated in Appendix F and become effective July 1, 2026.

Basic Shelter Allowance
Minimum Monthly Income Allowance
Home Maintenance Allowance
Special Income Standard for Elderly Waiver Maintenance Needs Allowance
Remedial Care Expense
Statewide Average Payment for Skilled Nursing Facility Care

March 26, 2026March 26, 2026

4.2.1.7 MSP Types of Medicare Savings Programs

We clarified eligibility of the Medicare Savings program is based on income and assets. There is not a basis of eligibility requirement for MSP eligibility.

March 16, 2026March 16, 2026

1.2.2 MHCP Application Submission

Who Can File an Application

We clarified situations when a household member is not required to submit a new application to begin MA coverage.

2.3.3.4.1 MA-ABD Spenddown Types

Client Option Spenddown

This update clarifies the 18-month reconciliation process for participants in the Client Option Spenddown.

Two new sections were also added to clarify:

Enrollment in Medical Spenddowns for Minnesota Senior Health Options and Special Needs BasicCare Enrollees.
Disenrollment for Unpaid Spenddowns.

2.3.4.2.1 MA-ABD Ex Parte Renewals

We added this new page to incorporate the following bulletins into the EPM.

2.3.5.1.2 MA-EPD Premiums

Premium Calculation

We clarified how to calculate an MA-EPD budget for months when a person has no income due to a four-month medical leave or job loss.

Appendix C Medicare Cost Sharing Amounts

We updated the Medicare Cost Sharing Amounts for 2025 and 2026.

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. This page does not contain eligibility policy and stopped being archived after June 1, 2023.

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.

Bulletin #23-21-26 DHS Implements Mitigation Plan 2.0 and Clarifies Post Renewal Policies

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.