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

September 20, 2024September 20, 2024

We incorporated Bulletin #20-21-01 DHS Announces a Change in Service Delivery for Medical Assistance Applicants and Enrollees Temporarily Absent from Minnesota into the following pages. This change incorporates information that health care services will be delivered through fee-for-service rather than managed care when a person is temporarily absent for the state for more than 30 days.

1.4.4 Minnesota Health Care Programs (MHCP) Temporary Absence

2.2.4.1 MA-FCA Health Care Delivery

2.2.2.1.2 MA-FCA Basis of Eligibility

Eligibility Begin Date

We clarified that a pregnant person must be eligible for MA in the month the pregnancy ends to receive the 12-month postpartum period. People determined retroactively eligible for MA as a pregnant person are entitled to the 12-month postpartum period.

September 10, 2024September 10, 2024

1.2.6 Minnesota Health Care Programs (MHCP) Signature

Special Circumstances

We clarified the MHCP Signature applies to applications, renewals and other MHCP eligibility forms, except for the Authorization to Obtain Financial Information (DHS-7823) form.

2.1.2.2.2 Medical Assistance (MA) Immigration Status

MA Eligibility for Noncitizen Children under Age 21 and Pregnant People

We included additional clarification that undocumented and DACA pregnant people are ineligible for MA.

Qualified Immigration Statuses Without a Five-Year Waiting Period

We updated the dates for the Ukrainian and Afghan parolees.

2.3.3.2.7.7 Medical Assistance for people Who Are Age 65 and Older, Who Are Blind or Have a Disability (MA-ABD) Automobiles and Other Vehicles Used for Transportation

Equity Value of an Automobile

We clarified JD Power or Kelley Blue Book should be the source used to verify vehicle values.

2.3.5.1.3 Medical Assistance for Employed Persons with Disabilities (MA-EPD) Work Requirements

We clarified Employment Income requirements for Wage, Self-Employment, and Seasonal Employment income.

August 28, 2024August 28, 2024

2.2.2.1.3 Medical Assistance for Families with Children and Adults (MA-FCA) Former Foster Care Youth Basis of Eligibility

We incorporated Bulletin #23-21-24 DHS Expands Medical Assistance for Former Foster Care Youth with this new page.

2.2.3.5. MA-FCA Income Verification

Educator Expenses

We updated the maximum anticipated adjustment for the self-attestation amount to $300 for one educator and $600 when both spouses are educators.

Appendix F Standards and Guidelines

Utility Allowance

We update the amounts for the following allowances:

Utility allowance
Electricity allowance
Telephone allowance

The updated amounts become effective October 1, 2024.

August 7, 2024August 7, 2024

2.3.3.2.3 Medical Assistance for People Who Are Age 65 or Older or People Who Are Bland or Have a Disability (MA-ABD) Excluded Assets

Excluded Assets Regardless of Identifiability

We updated the list of excluded assets to include: Consolidated Appropriations Act (CAA) recovery rebate payments, Coronavirus Aid, Relief, and Economic Security (CARES) Act payments, COVID-19 Relief Payments, and RentalHelpMN Assistance.

2.3.3.2.4 MA-ABD Countable Assets

Shared Ownership of Countable Assets

We moved the following information from EPM section 2.3.3.2.4.1.1 MA-ABD Shared Ownership, which is now retired.

A jointly owned asset is unavailable when all of the following criteria are met:

The permission of a joint owner is required to sell or dispose of the asset;
The joint owner is not a member of the household or financially responsible relative whose assets are deemed to the person; and
The joint owner refuses to allow the sale or disposal of the asset.

2.3.5.4.1 MA-ABD for Employed People with a Disabilities (EPD) Medicare

Payment for Medicare Part B Premiums

We clarified policy to include two new forms.

MA-EPD enrollees who become newly eligible for agency reimbursement of their Medicare Part B premiums must receive the Eligible for Manual Reimbursement for Medicare Part B Premiums for MA-EPD Enrollees Form (DHS-8555).

MA-EPD enrollees who become newly ineligible for agency reimbursement of their Medicare Part B premiums must receive the Ineligible for Manual Reimbursement for Medicare Part B Premiums for MA-EPD enrollees Form (DHS-8556).

June 11, 2024June 11, 2024

In the following EPM sections we clarified the eligibility requirements for people with Medical Assistance for Families and Children with a Spenddown basis who request payment for long-term care services (MA-LTC) while in a long-term care facility (LTCF).

2.3.6 Medical Assistance Under the TEFRA Option

We removed the reference to EPM section 2.3.6.1.2 TEFRA Parental Fees

May 30, 2024May 30, 2024

We incorporated the name change of the Asset Validation System to the Asset Verification Service announced in Bulletin #24-21-03 DHS Explains Electronic Verification of Certain Assets into the following EPM sections.

2.1.1.2.3 Minnesota Health Care Programs Cost Sharing

We incorporated DHS Bulletin #23-21-21 DHS Eliminates Parental Fees for Children Receiving MA under the TEFRA Option and HCBS Waivers. Parental Fees for Children receiving MA under the TEFRA Option and HCBS Waivers.

Effective July 1, 2023, DHS will no longer assess a parental fee for TEFRA and for children accessing HCBS disability waivers.

2.5.3.2 Emergency Medical Assistance (EMA) Non-Financial Eligibility

EMA Renewal

We clarified EMA should remain open, even when the medical emergency has ended.

Appendix F Standards and Guidelines

We updated the amounts for the following allowances:

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

The updated amounts become effective July 1, 2024

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.