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
We incorporated information from Bulletin #23-21-07 DHS Clarifies MA Eligibility Policy and Coverage Suspension for People who are Incarcerated into the following EPM sections.
- 1.2.1 MHCP Application Forms
- 1.2.7 MHCP Applications for People Who Are Incarcerated Preparing for Release (This section has been removed)
- 2.1.2.4 MA Living Arrangement
- 2.1.4.1 Medical Assistance Begin and End Dates
- 2.5.5 MA for People Who Are Incarcerated
- 2.5.5.1 MA for People Who Are Incarcerated General Requirements
- 2.5.5.1.1 MA for People Who Are Incarcerated Applications
- 2.5.5.2 MA for People Who Are Incarcerated Non-Financial Eligibility
- 2.5.5.3 MA for People Who Are Incarcerated Financial Eligibility
- 2.5.5.4 MA for People Who Are Incarcerated Post-Eligibility
- 2.5.5.4.1 MA for People Who Are Incarcerated Health Care Delivery
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.
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:
- Bulletin #23-21-18C Corrected #23-21-18: DHS Announces a Simplified Renewal Process for Certain MA-ABD Enrollees
- Bulletin #23-21-25 DHS Revises the Application for Health Coverage and Help Paying Costs and Supplement Form
- Bulletin #23-21-27 DHS Implements Continuous Medical Assistance Eligibility for Children Under Age 19
- Bulletin #24-21-01 DHS Explains Certain MA Enrollees Must Provide Verification of Assets at Renewal
- Bulletin #24-21-02 DHS Implements Individual-Level Eligibility Renewals for Medical Assistance and MinnesotaCare
- Bulletin #24-21-04 DHS Clarifies Minnesota Health Care Programs Income and Asset Verification Policies for Certain People
- Bulletin #24-21-05C Corrected #24-21-05: DHS Announces Minnesota Health Care Programs Post-Unwinding Eligibility Policies
- Bulletin #24-21-06 DHS Modifies Ex Parte Renewal Process for MA-ABD and MSP Enrollees
- Bulletin #24-21-07 DHS Resumes Monthly Premiums for Certain MinnesotaCare Enrollees for July 2024 Coverage
- Bulletin #24-21-08 DHS Simplifies Access to Help Paying Medicare Costs for SSI Beneficiaries
- Bulletin #24-21-09 DHS Revises the Application for Health Coverage and Help Paying Costs and Supplement Form
- Bulletin #24-21-10 DHS Expands MinnesotaCare Eligibility to Include Undocumented Individuals
- Bulletin #24-21-11 DHS Expands Continuous MA Eligibility for Children Up to Age 6, and for Children Ages 19 and 20
- Bulletin #24-21-12 DHS Clarifies MHCP Residency Requirements for Certain Children in Foster Care
- Bulletin #25-21-01 DHS Simplifies Certain Requirements for Medical Assistance for Employed Persons with Disabilities (MA-EPD)
- Bulletin #25.21-02 DHS Extends Temporary Changes to Deadlines for Medical Assistance and MinnesotaCare Eligibility Appeals 02/21/25
- Bulletin #25-21-03 DHS Bulletin: DHS Eliminates the Requirement for Certain MHCP Enrollees to Apply for Income Benefits 02/21/25
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 #20-21-02, DHS Announces Temporary Policy Changes to Minnesota Health Care Programs During the COVID-19 Peacetime Emergency
- Bulletin #20-21-03, DHS Announces Medical Assistance for COVID-19 Testing of Uninsured Individuals
- Bulletin #20-21-05, DHS Explains Treatment of Federal Pandemic Unemployment Compensation Payments for Minnesota Health Care Programs
- Bulletin #20-21-10, DHS Announces Updates to Temporary Policies for Minnesota Health Care Programs during the COVID-19 Public Health Emergency
- Bulletin #23-21-12 DHS Cancels Unpaid MinnesotaCare Premiums and Temporarily Waives Premiums for all Enrollees
- Bulletin #20-21-13, DHS Announces a Change to Processing PARIS Interstate Matches for MHCP Enrollees During the COVID-19 Public Health Emergency
- Bulletin #21-21-02, DHS Explains Treatment of Coronavirus Response Payments under the American Rescue Plan Act of 2021, for MHCP
- Bulletin #21-21-03, DHS Explains Treatment of PUA and PEUC for Minnesota Health Care Programs
- Bulletin #21-21-04, DHS Explains Redetermination and Closure of MHCP for Enrollees Not Validly Enrolled due to Fraud or Agency Error
- Bulletin #21-21-06 DHS Announces MinnnesotaCare Premium Reductions for 2021 and 2022
- Bulletin #21-21-07 DHS Explains Redetermination and Closure of MHCP for Enrollees Not Validly Enrolled due to Abuse
- Bulletin #22-21-11 DHS Announces Temporary Policy to Accept Minnesota Address Updates on USPS Returned Mail for Minnesota Health Care Programs
- Bulletin #23-21-05 DHS Announces Temporary Policy to Accept Contact Information Updates from MCOs for MHCP
- Bulletin #23-21-08 DHS Announces Key MHCP Eligibility Policies during the Unwinding Period
- Bulletin #23-21-09 DHS Announces the Resumption of Minnesota Health Care Programs Annual Eligibility Renewals
- Bulletin #23-21-14 DHS Explains Transition from COVID-19 Temporary MA-EPD Policies to Standard MA-EPD Policies
- Bulletin #23-21-17 DHS Explains Handling Renewal-Related Returned Mail During the Unwinding Period
- Bulletin #23-21-19 DHS Announces Temporary Asset Disregard and Other Asset Policies for Certain MHCP Enrollees
- Bulletin #23-21-20 DHS Announces Temporary Changes to Deadlines for Medical Assistance and MinnesotaCare Eligibility Appeals
- 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.