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

May 30, 2025May 30, 2025

We incorporated information from Bulletins:

Into the following EPM sections.

May 27, 2025May 27, 2025

2.3.3.2.3 MA-ABD Excluded Assets

We included the following deductions to the Excluded Assets Regardless of Identifiability list.

Long-Term Services and Supports workforce incentive payments under the Minnesota Care Force Incentive program
Teacher stipends under the Minnesota READ Act

Appendix F

The following standards and guidelines are updated in Appendix F and become effective July 1, 2025.

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.

May 7, 2025May 7, 2025

2.3.3.3.2.4 MA-ABD Income Verification

We added the income verification portion of Bulletin #24-21-04 DHS Clarifies Minnesota Health Care Programs Income and Asset Verification Policies for Certain People into this new section.

April 29, 2025April 29, 2025

We made clarification is the following sections for consistency, no stating “Medical Assistance for People with Breast or Cervical Cancer (MA-BC).” The only change made was the addition of the phrase “for People with.”

2.3.1.3 MA-ABD Authorization to Obtain Information

New Authorization Required

We clarified the second bullet point that a new authorization is required when no record of a valid authorization is in the electronic or paper case file.

2.3.3.3.2.3 MA-ABD Excluded Income

We moved the references to Mille Lacs Band of Ojibwe income payments from the public assistance list and added it to the tribal payments list of income. We also added the Teacher stipends under the Minnesota READ Act as an excluded income source.

4.2.1.7 MSP Types of Medicare Savings Programs

QI and Medical Assistance

We clarified an MA enrollee’s coverage remains open when redetermining MA under another basis and is eligible for QI while being redetermined during that redetermination process. We also clarified that QI and MA coverage cannot overlap ongoing after the determination for retroactive MA or the redetermination under another basis is complete.

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 eligiblity 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.

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.