*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016. Please refer to the EPM for current health care program policy information. ***

Chapter 07 - Applications

Effective:  June 1, 2012

07.05 - How to Apply

Archived:  June 1, 2016 (Previous Versions)

How to Apply

Clients must complete and submit an application form to apply for Minnesota Health Care Programs (MHCP). There are several ways to request and submit applications. A client may submit a written request for coverage to set the date of application for MA before submitting an application.

Note:  See Adding a Household Member for information on adding a person to a household already active on MHCP.

Requesting an Application.

How to Apply.

Help for Clients Applying.

County and MinnesotaCare Agencies.

Minnesota Community Application Assistance (MNCAA) Program.

Application Assistors.

Senior LinkAge Line®.

Incarcerated Individuals.

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Requesting an Application

A client may request an application for MHCP:

l  by phone.

Mail an application no later than the next work day.

n  Send the application that is appropriate for the client’s situation.

n  Encourage the client to return the application as soon as possible.

n  Explain that the client may choose to complete the application at the agency.

n  Explain that the client may send in a written request to set the date of application for MA before submitting the application.

l  in person.

The client may request an application while in the office. Give the client an application on the same day.

n  Explain that the client may choose to complete the application at the agency or may set the date of application by completing a request for coverage for MA while in the office and submitting the application later.

l  in writing or by fax or email.

Mail an application no later than the next work day.

Advise clients that they can apply online at www.applymn.dhs.mn.gov or print a HCAPP at www.dhs.state.mn.us/healthcare.

Note:  Provide Minnesota Health Care Programs (DHS-3182), which describes Minnesota's health care programs and Domestic Violence Information (DHS-3477), which provides information on domestic violence, with the application. Applicants using ApplyMN may view the DHS-3182 online and must confirm that they have reviewed the DHS-3477.

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How to Apply

Clients must provide a completed application, required information and verifications to an enrollment site to have their eligibility determined. Clients may submit the completed and signed application to the enrollment site in any of the following ways:

l  Electronically complete and submit with ApplyMN.

l  Mail.

l  Fax.

l  Email scanned copy.

Note:  Due to data privacy concerns, do not continue e-mail correspondence with the client.

l  Hand-deliver to the enrollment site.

Note:  Accept and process photocopied, faxed and scanned applications. Do not require the client to submit the original application.

Note:  Clients who apply for Extra Help with Medicare Part D costs through the Social Security Administration (SSA) may choose to have their application data transmitted to initiate an application for Medicare Savings Programs or MA. See Applications for Health Care Programs - SSA Data as a Request for MHCP for more information.

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Help for Clients Applying

Clients may receive help with completing the application process, which includes help filling out the application and contacting third parties to get needed information or verifications in the following ways:

County Agencies and MinnesotaCare Operations

Help clients who have difficulty completing the application process or provide information on where and how they can receive help.  

Minnesota Community Application Agent (MNCAA) Program

The Minnesota Community Application Agent (MNCAA) Program helps people enroll in Minnesota Health Care Programs (MHCP) by providing outreach and application assistance through participating community organizations. People can go to any participating site that serves residents of the county where the applicant lives. See Minnesota Community Application Agent (MNCAA) Program for more information.

Application Assistors

Application assistors may include organizations, providers, relatives, friends, school officials or other people the applicant chooses to help with the application process. Application assistors help clients complete the application but cannot sign the application unless they have been designated as authorized representatives by the applicant. Agencies cannot share information with an application assistor without a signed General Consent/Authorization for Release of Information (DHS-3549) from the client.

Senior LinkAge Line®

The Senior LinkAge Line® helps clients who request MHCP through SSA. DHS creates a daily list of the Medicare beneficiaries transmitted by SSA for staff at the Senior LinkAge Line®. Senior LinkAge Line® staff attempt to call all individuals referred by SSA to offer assistance with completion of the HCAPP. Senior LinkAge Line® staff will assist all applicants referred by SSA, not just those who are elderly.

Incarcerated Individuals

There are special procedures for some incarcerated individuals applying for MHCP before discharge. See MHCP and Incarcerated Individuals for more information.

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