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

October 21, 2026October 21, 2026

Appendix H

We clarified the definition of lawfully present noncitizen with an updated list of individuals considered lawfully present for MHCP eligibility.

October 1, 2026October 1, 2026

Appendix F

The following standards and guidelines are updated effective October 1, 2026, in Appendix F based on corrected figures we received.

Utility Allowance increased from $667 to $690
Electricity Allowance increased from $235 to $243
Telephone Allowance increased from $62 to $64

1.1 MHCP Programs Overview

We clarified the descriptions of the MHCP programs and the funding sources.

1.3.2.1 MHCP Change in Circumstances

We incorporated Bulletin #25-21-01 DHS Simplifies Certain Requirements for Medical Assistance for Employed Persons with Disabilities (MA-EPD). MA-EPD enrollees have 30 days to report changes and no longer have a six-month income review

2.5.7 Refugee Medical Assistance

We clarified the existing policy, updated the RMA eligibility period to eight-months, and increased the income standard to 200% FPG.

August 27, 2026August 27, 2026

Appendix F

The following standards and guidelines are updated in Appendix F:

IRS Mileage Rate
Utility Allowance
Electricity Allowance
Telephone Allowance

August 19, 2026August 19, 2026

2.1.4.1 M edical Assistance Begin and End Dates

Coverage End Date

We remove incarceration status as a reason to end MA coverage.

2.2.3.4 MA-FCA Income Methodology

We clarified that unemployment compensation that is counted based on the annual amount a person expects to receive during the 12 month certification period is only when the unemployment compensation is from seasonal income.

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.

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.