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

February 6, 2026February 6, 2026

2.2.2.1.2 MA-FCA Basis of Eligibility Pregnant Woman

For clarification we replaced the first bullet point in Basis to Eligibility with “Be currently pregnant or recently pregnant with an end date in the past 3 months”. We also clarified the Eligibility End Date to include eligibility is continuous regardless of household size.

2.3.7 MA-ABD 1619(a) and 1619(b)

We clarified for the special SSI status under sections 1619(a) and 1619(b) of the Social Security Act are eligible for MA without requiring verification of their income or assets.

2.3.3.2.6 MA-ABD Excess Assets

Reducing Excess Assets in Retroactive Months

We clarified that, when determining what is an acceptable medical bill for excess asset reduction, the same rules used to determine what is an allowable health care expense for medical spenddowns should be applied.

2.3.3.2.7.13 MA-ABD Tribal Payments and Interests

Individual Interest in Trust or Restricted Lands

We added the following clarification to this section: “In addition, up to $2,000 per year of income received by an individual tribal member that is derived from such trust or restricted land interests is excluded as income when determining eligibility for MA-ABD (25 USC § 1408).”

Alaska Native Claims Settlement Act (ANCSA) Payments

We added the following clarification to this section: “For the 5-year period beginning July 7, 2025 and ending July 7, 2030, an amount distributed from or benefit provided by a Settlement Trust to an Alaska Native or descendant of an Alaska Native who is an aged, blind, or disabled individual (as defined in section 1614(a) of the Social Security Act (42 U.S.C 1382c(a)).”

2.3.3.4.2 MA-ABD Health Care Expenses

Types of Health Care Expenses

We removed MA copayments as a non-reimbursable health care expense that are not covered by MA.

2.4.1.3.3 MA-LTC Transfer Penalty Exceptions and Hardship Waiver

Homestead Transfers

We clarified an uncompensated transfer of a homestead is exempt from a transfer penalty when the verifiable care allowed the person to remain at home rather than enter an LTCF or begin receiving services through a HCBS waiver, as long as all other requirements are met.

Appendix F Standards and Guidelines

We added the 2025 Tax Filing Income Threshold.

January 12, 2026January 12, 2026

2.4.1.3.4 MA-LTC Other Asset Transfer Considerations

We added a new subsection for Spousal Elective Share.

Appendix F Standards and Guidelines

We revised the IRS Mileage Rate that become effective January 1, 2026

December 12, 2025December 12, 2025

2.1.1.2.4 Referral for Other Benefits

We incorportated Bulletin #25-21-03 DHS Eliminates the Requirement for Certain MHCP Enrollees to Apply for Income Benefits into this section.

Appendix F Standards and Guidelines

We revised the following standards and guidelines that become effective January 1, 2026

Home Equity Limit
Maximum Monthly Income Allowance
Maximum Asset Allowance
Student Earned Income Exclusion

December 5, 2025December 5, 2025

We incorporated information from Bulletin #24-21-12 DHS Clarifies MHCP State Residency Requirements for Certain Children in Foster Care into the following EPM sections.

November 26, 2025November 26, 2025

2.3.1.2 MA-ABD Asset Verification Service (AVS)

We clarified that individuals with 1619(a) or 1619(b) status are not required to have a valid DHS-7823 form on file or an AVS ad-hoc request run at application or renewal.

2.3.3.2.8 MA-ABD Asset Verification

We incorporated Bulletin 24-21-04 DHS Clarifies Minnesota Health Care Programs Income and Asset Verification Policies for Certain People into this new EPM section.

Appendix F Standards and Guidelines

We revised the following standards and guidelines that become effective January 1, 2026

Clothing and Personal Needs Allowance
Pickle Disregard
Remedial Care Expense
Special Income Standard
Supplemental Security Income Maximum Payment Amount

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.

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.