{"generated_at":"2026-10-09T21:35:14.801Z","sources":[{"id":"epm","name":"Minnesota Health Care Programs Eligibility Policy Manual","short_name":"EPM","publisher":"Minnesota Department of Human Services","official_origin":"https://hcopub.dhs.state.mn.us/epm/home.htm","sections":[{"id":"epm:1","number":"1","title":"Minnesota Health Care Programs","parent":null,"breadcrumb":"1 Minnesota Health Care Programs","summary":"The Minnesota Department of Human Services (DHS) administers a number of Minnesota Health Care Programs (MHCP). These programs include MinnesotaCare, Medicare Savings Programs, the Minnesota Family Planning Program and many types of Medical Assistance (Medicaid). This chapter provides policy information on topics that apply to all MHCPs.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:24:35.343847+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/1","official_origin":"https://hcopub.dhs.state.mn.us/epm/1.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/1","context":"EPM > 1 Minnesota Health Care Programs","text":"The Minnesota Department of Human Services (DHS) administers a number of Minnesota Health Care Programs (MHCP). These programs include MinnesotaCare, Medicare Savings Programs, the Minnesota Family Planning Program and many types of Medical Assistance (Medicaid). This chapter provides policy information on topics that apply to all MHCPs.\n\nMNsure administers eligibility policy for advance premium tax credits, cost sharing reductions and qualified health plans. Eligibility policy related to these programs is available from MNsure.\n\nTopics covered in this chapter are:\n\n1. [MHCP Overview](https://bot-corpus.mn-dhs.online/s/epm/1.1)\n\n2. [MHCP Applications](https://bot-corpus.mn-dhs.online/s/epm/1.2)\n1. [MHCP Application Forms](https://bot-corpus.mn-dhs.online/s/epm/1.2.1)\n\n2. [MHCP Application Submission](https://bot-corpus.mn-dhs.online/s/epm/1.2.2)\n\n3. [MHCP Date of Application](https://bot-corpus.mn-dhs.online/s/epm/1.2.3)\n\n4. [MHCP Processing Period](https://bot-corpus.mn-dhs.online/s/epm/1.2.4)\n\n5. [MHCP Retroactive Eligibility](https://bot-corpus.mn-dhs.online/s/epm/1.2.5)\n\n6. [MHCP Signature](https://bot-corpus.mn-dhs.online/s/epm/1.2.6)\n\n7. [MHCP Applications for Incarcerated Individuals Preparing for Release](https://bot-corpus.mn-dhs.online/s/epm/1.2.7)\n3. [MHCP Rights and Responsibilities](https://bot-corpus.mn-dhs.online/s/epm/1.3)\n1. [MHCP Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1)\n      1. [MHCP Appeals](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.1)\n\n      2. [MHCP Authorized Representative](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.2)\n\n      3. [MHCP Civil Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.3)\n\n      4. [MHCP Data Privacy](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.4)\n\n      5. [MHCP Notices](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.5)\n2. [MHCP Responsibilities](https://bot-corpus.mn-dhs.online/s/epm/1.3.2)\n      1. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n\n      2. [MHCP Cooperation](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.2)\n\n      3. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n\n      4. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n\n      5. [MHCP Overpayments](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.5)\n4. [MHCP State Residency](https://bot-corpus.mn-dhs.online/s/epm/1.4)\n1. [MHCP Interstate Residency Agreements](https://bot-corpus.mn-dhs.online/s/epm/1.4.1)\n\n2. [MHCP State Residency for Adoption Assistance and Foster Care](https://bot-corpus.mn-dhs.online/s/epm/1.4.2)\n\n3. [MHCP State Residency for People in an Institution](https://bot-corpus.mn-dhs.online/s/epm/1.4.3)\n\n4. [MHCP Temporary Absence](https://bot-corpus.mn-dhs.online/s/epm/1.4.4)\n5. [MHCP Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/1.5)\n\n6. [MHCP Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/1.6)"}]},{"id":"epm:1.1","number":"1.1","title":"Programs Overview","parent":"1","breadcrumb":"1 Minnesota Health Care Programs > 1.1 Programs Overview","summary":"Minnesota offers several public health care programs that help families and individuals access affordable health coverage. These programs provide health care services to eligible Minnesotans and are administered by state, county, and Tribal agencies under the supervision of the Minnesota Department of Human Services (DHS).","effective_date":"2026-10-01","last_modified":"2026-10-03T03:58:39.778139+00:00","version":4,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/1.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/1_1.htm","legal_citations":["Code of Federal Regulations, title 26, section 1.36B-1","Code of Federal Regulations, title 45, section 155.305","Code of Federal Regulations, title 45, section 155.340","Minnesota Statutes, section 256B","Minnesota Statutes, section 256L"],"chunks":[{"chunk_id":"epm:1.1#minnesota-health-care-programs","heading":"Minnesota Health Care Programs","url":"https://bot-corpus.mn-dhs.online/s/epm/1.1#minnesota-health-care-programs","context":"EPM > 1 Minnesota Health Care Programs > 1.1 Programs Overview > Minnesota Health Care Programs","text":"## Minnesota Health Care Programs\n\nMinnesota offers several public health care programs that help families and individuals access affordable health coverage. These programs provide health care services to eligible Minnesotans and are administered by state, county, and Tribal agencies under the supervision of the Minnesota Department of Human Services (DHS).\n\n### Medical Assistance\n\nMedical Assistance (MA) is Minnesota's name for the federal Medicaid program, which provides health care coverage for low-income adults, parents, children, pregnant women, elderly adults and people with disabilities. County and tribal servicing agencies administer MA.is funded by federal, state and county dollars fund MA. See the [MA](https://bot-corpus.mn-dhs.online/s/epm/2) chapter for more information.\n\n### MinnesotaCare\n\nMinnesotaCare is a publicly funded state health care program for eligible low-income individuals who do not qualify for Medical Assistance and do not have access to affordable and comprehensive employer-sponsored insurance and it is funded by federal and state dollars and enrollee premiums. See the [MinnesotaCare](https://bot-corpus.mn-dhs.online/s/epm/3) chapter for more information.\n\n### Medicare Savings Programs\n\nMedicare Savings Programs (MSP) help eligible Medicare beneficiaries pay for Medicare costs including premiums, deductibles, and co-payments. People may qualify for MSPs instead of, or in addition to, MA. See the MSP chapter for more information. See the [MSP](https://bot-corpus.mn-dhs.online/s/epm/4.2) chapter for more information.\n\n### Minnesota Family Planning Program\n\nThe Minnesota Family Planning Program (MFPP) provides coverage for family planning and related health care services. The program increases access to pre-pregnancy family planning services for low-income Minnesotans and helps reduce the number of unintended pregnancies. See the [MFPP](https://bot-corpus.mn-dhs.online/s/epm/4.1) chapter for more information."},{"chunk_id":"epm:1.1#other-insurance-affordability-programs","heading":"Other Insurance Affordability Programs","url":"https://bot-corpus.mn-dhs.online/s/epm/1.1#other-insurance-affordability-programs","context":"EPM > 1 Minnesota Health Care Programs > 1.1 Programs Overview > Other Insurance Affordability Programs","text":"## Other Insurance Affordability Programs\n\nMNsure administers eligibility for Minnesota’s advance premium tax credits, cost sharing reductions and unassisted qualified health plans. Eligibility policy related to these programs is available through [MNsure](http://www.mnsure.org/)."}]},{"id":"epm:1.2","number":"1.2","title":"Applications","parent":"1","breadcrumb":"1 Minnesota Health Care Programs > 1.2 Applications","summary":"The sections in this subchapter provide policy about applications for Minnesota Health Care Programs (MHCP). Topics covered in this chapter are:","effective_date":"2016-06-01","last_modified":"2026-10-02T15:12:40.850915+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/1.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/1_2.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:1.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.2","context":"EPM > 1 Minnesota Health Care Programs > 1.2 Applications","text":"The sections in this subchapter provide policy about applications for Minnesota Health Care Programs (MHCP). Topics covered in this chapter are:\n\n1. [Application Forms](https://bot-corpus.mn-dhs.online/s/epm/1.2.1)\n\n2. [Application Submission](https://bot-corpus.mn-dhs.online/s/epm/1.2.2)\n\n3. [Date of Application](https://bot-corpus.mn-dhs.online/s/epm/1.2.3)\n\n4. [Processing Period](https://bot-corpus.mn-dhs.online/s/epm/1.2.4)\n\n5. [Retroactive Eligibility](https://bot-corpus.mn-dhs.online/s/epm/1.2.5)\n\n6. [Signature](https://bot-corpus.mn-dhs.online/s/epm/1.2.6)\n\n7. [Applications for Incarcerated Individuals Preparing for Release](https://bot-corpus.mn-dhs.online/s/epm/1.2.7)"}]},{"id":"epm:1.2.1","number":"1.2.1","title":"Application Forms","parent":"1.2","breadcrumb":"1 Minnesota Health Care Programs > 1.2 Applications > 1.2.1 Application Forms","summary":"Many people may apply for Minnesota’s Insurance Affordability Programs (IAP) using the MNsure online or a paper application. However, there are different application forms designed to collect the information needed based on the applicant's situation. Applicants must not be asked to answer questions that are not applicable to determining their eligibility. Using the correct application form helps s","effective_date":"2025-07-02","last_modified":"2026-10-03T03:52:01.188505+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.2.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/1.2.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/1_2_1.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.907","Code of Federal Regulations, title 45, section 155.405","Code of Federal Regulations, title 45, section 155.310","Minnesota Statutes, section 256B.04","Minnesota Statutes, section 256B.08"],"chunks":[{"chunk_id":"epm:1.2.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.2.1","context":"EPM > 1 Minnesota Health Care Programs > 1.2 Applications > 1.2.1 Application Forms","text":"Many people may apply for Minnesota’s Insurance Affordability Programs (IAP) using the MNsure online or a paper application. However, there are different application forms designed to collect the information needed based on the applicant's situation. Applicants must not be asked to answer questions that are not applicable to determining their eligibility. Using the correct application form helps speed up the eligibility determination. When using a paper application form, it is important to choose the most appropriate form and to follow the instructions about where to send the form.\n\n### MNsure Online Application\n\nA secure, web-based application is at [MNsure.org](http://www.mnsure.org/). The online application for financial assistance in obtaining health care is a smart and dynamic application that asks questions based on an applicant’s response to previous questions. The online application displays all required information about an applicant's rights and responsibilities. It is the preferred application for IAPs because a real-time eligibility determination may be possible.\n\nApplicants using the [MNsure online](http://www.mnsure.org/) application have eligibility determined for all Minnesota Health Care Programs (MHCP) and advanced premium tax credits.\n\nEligibility is evaluated in the following order:\n\n1. Medical Assistance (MA) for Families with Children and Adults (MA-FCA)\n\n2. MinnesotaCare\n\n3. Advanced premium tax credit (APTC)\n\n4. Qualified health plan (QHP) without subsidy\n\nPeople who are eligible for MA are not eligible for MinnesotaCare or APTC. Likewise, people who are eligible for MinnesotaCare are not eligible for APTC. Eligibility for help getting health care is not a barrier to purchasing a QHP without financial help.\n\nApplicants who are potentially eligible for other types of MA are referred for a further eligibility determination.\n\n### MNsure Application for Health Coverage and Help Paying Costs ( [DHS-6696](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-6696-ENG))\n\nApplicants may use the paper version of the MNsure online application. Applicants submit DHS-6696 to their county or tribal servicing agency. It is available in [English](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-6696-ENG), [Hmong](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-6696-HMN), [Russian](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-6696-RUS), [Somali](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-6696-SOM), [Spanish](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-6696-SPA) and [Vietnamese](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-6696-VIE).\n\nApplicants using [DHS-6696](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-6696-ENG) must have eligibility determined for all Minnesota Health Care Programs (MHCP) and advanced premium tax credits.\n\nEligibility is evaluated in the following order:\n\n1. MA-FCA\n\n2. MinnesotaCare\n\n3. APTC\n\n4. QHP without subsidy\n\nPeople who are eligible for MA are not eligible for MinnesotaCare or APTC. Likewise, people who are eligible for MinnesotaCare are not eligible for APTC. Eligibility for help getting health care is not a barrier to purchasing a QHP without financial help.\n\nApplicants who are potentially eligible for other types of MA are referred for a further eligibility determination.\n\n### MHCP Application for Certain Populations ( [DHS-3876](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-3876-ENG))\n\nApplicants in households where everyone in the household is a member of one of the following populations use the MHCP Application for Certain Populations:\n\n- Age 65 or older\n\n- Blind or has a disability\n\n- Applying only for Medicare Savings Program\n\n- 21 years old or older, lives with no children under age 19, and has Medicare coverage\n\n- Receiving Supplemental Security Income (SSI)\n\n- Applying for MA for Employed Persons with Disabilities (MA-EPD)\n\nDHS-3876 is available in [English](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-3876-ENG), [Hmong](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-3876-HMN), [Russian](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-3876-RUS), [Somali](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-3876-SOM), [Spanish](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3876-SPA) and [Vietnamese](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3876-VIE). Applicants submit DHS-3876 to their county or tribal servicing agency.\n\n- The Supplement to the MHCP Application for Certain Populations ( [DHS-6696B](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-6696B-ENG)) must be completed when a submitted [DHS-3876](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3876-ENG) or [DHS-3417](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3417B-ENG) includes household members not listed above.\n\n### MHCP Application for Payment of Long-Term Care Services ( [DHS-3531](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-3531-ENG))\n\nThe Application for Payment of Long-Term Care Services (DHS-3531) is for MA applicants who have a basis of eligibility other than MA-FCA and:\n\n- live in a long-term care facility such as a (nursing home).\n\n- live in an intermediate care facility for people with developmental disabilities.\n\n- live in a nursing facility care in an inpatient hospital.\n\n- request Elderly Waiver (EW) services.\n\n- request Community Alternatives for Disabled Individuals (CADI) services.\n\n- request Community Alternative Care (CAC) services.\n\n- request Traumatic Brain Injury (TBI) services.\n\n- request Developmental Disabilities Waiver (DD) services.\n\nApplicants submit DHS-3531 to their county or tribal servicing agency. Applicants who are potentially eligible for MA-FCA are referred for a further eligibility determination.\n\n### Minnesota MA Application/Renewal Breast and Cervical Cancer ( [DHS-3525](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-3525-ENG))\n\nThe Minnesota MA Application/Renewal Breast and Cervical Cancer form is for people who were screened by the Sage Screening Program and have breast or cervical cancer and are seeking MA coverage. Enrollees also use this form to renew eligibility for coverage. Applicants submit DHS-3525 to their county or tribal servicing agency.\n\n### Minnesota Family Planning Program Application/Renewal ( [DHS-4740](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-4740-ENG))\n\nThis form is for applicants who are only seeking coverage under the Minnesota Family Planning Program (MFPP.) Applicants submit DHS-4740 to DHS Health Care Eligibility Operations. It is also available in [Spanish](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-4740-SPA)."},{"chunk_id":"epm:1.2.1#application-supplements","heading":"Application Supplements","url":"https://bot-corpus.mn-dhs.online/s/epm/1.2.1#application-supplements","context":"EPM > 1 Minnesota Health Care Programs > 1.2 Applications > 1.2.1 Application Forms > Application Supplements","text":"## Application Supplements\n\nA supplemental form may be required to collect additional information needed to determine or redetermine eligibility. Agencies may only require an applicant or enrollee to provide information necessary to make an eligibility determination and cannot require applicants or enrollees to provide information they already provided. Therefore, MHCP applicants and enrollees cannot be required to submit a new application unless their eligibility is denied or ends. Instead, a supplement is used to make a complete eligibility determination.\n\n### Supplement to MNsure Application for Health Coverage and Help Paying Costs ( [DHS-6696A](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-6696A-ENG))\n\nApplicants who submit their application through the MNsure online or paper application (DHS-6696) may need to provide additional information if their eligibility cannot be determined in METS or if further evaluation is needed to determine their eligibility for MA-ABD, long-term care services or Medicare Savings Programs. The MHCP Request for Information ( [DHS-3271](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3271-ENG)) must be sent to the applicant with the DHS-6696A when an applicant needs a subsequent determination.\n\nThis supplement is form is also used to gather the information needed to redetermine eligibility for current MA-FCA enrollees who have a change in circumstances and no longer qualify for their current MA basis of eligibility at or between renewals, or who request a determination under an MA-ABD basis of eligibility. The MHCP Request for Information to Determine Eligibility for Certain Populations ( [DHS-8431](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-8431-ENG)) must be sent to the enrollee with the DHS-6696A when an enrollee needs a new determination.\n\nThis paper supplement gathers information not requested on the MNsure application, needed to determeine eligibility for:\n\n- MA for people age 65 and older, people who are blind, or have a disability\n\n- MA for people receiving care and rehabilitation services from the Center for Victims of Torture\n\n- Refugee MA\n\n- MA with a spenddown\n\n- MA payment for long-term care facility services\n\n- MA payment for home and community-based waiver services\n\n- Medicare Savings Programs\n\nDHS-6696A is available in [English](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-6696A-ENG), [Hmong](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-6696A-HMN), [Russian](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-6696A-RUS), [Somali](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-6696A-SOM), [Spanish](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-6696-SPA) and [Vietnamese](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-6696A-VIE). Applicants submit DHS-6696A to their county or tribal servicing agency.\n\n### Supplement to the MHCP Application for Certain Populations [(DHS-6696B](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-6696B-ENG))\n\nWhen an applicant submits the MHCP Application for Certain Populations ( [DHS-3876](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3876-ENG)) and they do not meet the criteria to use DHS-3876, they must complete this short supplement to have an eligibility determination. The MHCP Request for Information ( [DHS-3271](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3271-ENG)) must accompany the DHS-6696B when an applicant needs a subsequent determination.\n\nThis form is also used to gather the information needed to redetermine eligibility for enrollees who lose their basis of eligibility at or between renewals, or who request a determination for a different MA basis of eligibility or program. The MHCP Request for Information to Determine Eligibility for Families with Children and Adults ( [DHS-8432](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-8432-ENG)) must accompany the DHS-6696B when an enrollee needs a new determination.\n\nThis paper supplement gathers information needed to determine eligibility for:\n\n- MA-FCA\n\n- MinnesotaCare\n\n- APTC\n\n- QHP without subsidy\n\nDHS-6696B is available in [English](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-6696B-ENG), [Hmong](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-6696B-HMN), [Russian](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-6696B-RUS), [Somali](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-6696B-SOM), [Spanish](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-6696B-SPA) and [Vietnamese](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-6696B-VIE). Applicants submit DHS-6696B to their county or tribal servicing agency.\n\n### MA Inpatient Hospital Coverage for Incarcerated People ( [DHS-6696G](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-6696G-ENG))\n\nThis form is for people who are incarcerated and in need of or have received inpatient hospital services.\n\nIf the person who is incarcerated is not a current MA enrollee, the DHS-6696G must be submitted with a MHCP application, either the MNsure Application ( [DHS-6696](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-6696-ENG)) or the MHCP Application for Certain Populations ( [DHS-3876](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3876-ENG)).\n\nIf the person who is incarcerated is already enrolled in MA, they do not need to complete another application and would only need to submit the DHS-6696G.\n\n### MHCP Individual Discharge Information Sheet ( [DHS-3443](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-3443-ENG))\n\nThis form gathers the information needed to determine or redetermine if a person leaving a correctional facility will qualify for health care coverage upon their release.\n\nThe form also helps verify:\n\n- The date of incarceration\n\n- The actual or anticipated release date from incarceration\n\nThe form is not a required document to determine MA eligibility. Other methods can be used to verify incarceration dates, as outlined in Section [2.5.5.1.1 Medical Assistance for People Who Are Incarcerated Applications](https://bot-corpus.mn-dhs.online/s/epm/2.5.5.1.1)."},{"chunk_id":"epm:1.2.1#other-forms","heading":"Other Forms","url":"https://bot-corpus.mn-dhs.online/s/epm/1.2.1#other-forms","context":"EPM > 1 Minnesota Health Care Programs > 1.2 Applications > 1.2.1 Application Forms > Other Forms","text":"## Other Forms\n\n### MHCP Payment of Long-Term Care Services for MA for Families with Children and Adults ( [DHS-3543A](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-3543A-ENG))\n\nMA enrollees using the Families with Children and Adults bases of eligibility use this form to request payment for services in a long-term care facility. Enrollees submit DHS-3543A to their county or tribal servicing agency.\n\n### MHCP Request for Payment of Long-Term Care Services ( [DHS-3543](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-3543-ENG))\n\nMA enrollees using the People Who are Age 65 or Older, Blind or Disabled bases of eligibility use this form to request payment for services in a long-term care facility or a home and community-based waiver program. Enrollees submit DHS-3543 to their county or tribal servicing agency.\n\n### MHCP Request to Reopen MA ( [DHS-5038](http://edocs.dhs.state.mn.us/lfserver/Legacy/DHS-5038-ENG))\n\nThis form is used to request MA coverage reopen after the person was incarcerated less than a year. Applicant submit DHS-5038 to the county or tribal servicing agency in which:\n\n- the applicant resided before entering the correctional system, or\n\n- the applicant plans to live if the previous county of residence is unknown or the person came from another state.\n\n### MNsure Appendix A - Health Coverage from Jobs ( [DHS-6696D](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-6696D-ENG))\n\nThis form request missing information about employer subsidized health insurance availability. People can take this form to their human resources department to be filled out. It is included in DHS-6696 and the MNsure online application. Applicants submit DHS-6696D to their county or tribal servicing agency.\n\n### MNsure Application for Health Coverage and Help Paying Costs Signature Page ( [DHS-6696C](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-6696C-ENG))\n\nThis form obtains a signature from a Minnesota Health Care Programs applicant or enrollee when the person fails to sign the application or renewal. Applicants submit DHS-6696C to their county or tribal servicing agency.\n\n### Request to Apply for MHCP ( [DHS-3417B](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-3417B-ENG))\n\nThis form sets the date of application. An applicant must submit a complete application within 30 days of the written request. Applicants submit DHS-3417B to their county or tribal servicing agency."}]},{"id":"epm:1.2.2","number":"1.2.2","title":"Application Submission","parent":"1.2","breadcrumb":"1 Minnesota Health Care Programs > 1.2 Applications > 1.2.2 Application Submission","summary":"An application filer may file an application for Minnesota Health Care Programs (MHCP). An application filer includes the following people:","effective_date":"2026-03-16","last_modified":"2026-10-02T15:12:41.028958+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.2.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/1.2.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/1_2_2.htm","legal_citations":["Code of Federal Regulations, title 26, section 1.36B-1","Code of Federal Regulations, title 42, section 435.603","Code of Federal Regulations, title 42, section 435.907","Code of Federal Regulations, title 42, section 435.908","Code of Federal Regulations, title 45, section 155.20","Code of Federal Regulations, title 45, section 155.300","Code of Federal Regulations, title 45, section 155.305","Code of Federal Regulations, title 45, section 155.310","Code of Federal Regulations, title 45, section 155.315","Code of Federal Regulations, title 45, section 155.330","Code of Federal Regulations, title 45, section 155.335"],"chunks":[{"chunk_id":"epm:1.2.2#who-can-file-an-application","heading":"Who Can File an Application","url":"https://bot-corpus.mn-dhs.online/s/epm/1.2.2#who-can-file-an-application","context":"EPM > 1 Minnesota Health Care Programs > 1.2 Applications > 1.2.2 Application Submission > Who Can File an Application","text":"## Who Can File an Application\n\nAn application filer may file an application for Minnesota Health Care Programs (MHCP). An application filer includes the following people:\n\n- The applicant\n\n- An adult who is in the applicant’s Medical Assistance (MA), MinnesotaCare, or tax household\n\n- An applicant’s minor parents who are in the applicant’s tax or MA household\n\n- The applicant’s spouse\n\n- An authorized representative. See the [MHCP Authorized Representative](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.2) policy for more information.\n\n- A minor who is applying for coverage who does not live with a parent, legal guardian, or an adult acting responsibly for the minor and who will not be claimed as a tax dependent\n\n- People acting responsibly for a child under the age of 18 including:\n  - An adult who lives with the child and who assumes primary responsibility for the minor\n\n  - A social services professional who is not an authorized representative or legal custodian\n\n  - Both custodial and non-custodial parents may file an application on behalf of a child. However, to have MA eligibility determined the child must apply with the parent with whom they live.\n- People acting responsibly for an incapacitated individual\n\n- People acting responsibly for a deceased individual, including but not limited to, the following:\n  - A guardian or conservator\n\n  - An executor or administrator of the deceased's estate\n\n  - The surviving spouse\n\n  - A surviving family member\n\nEmployees of, or entities contracted by health care providers who would receive MHCP payment cannot be application filers for a deceased individual.\n\nIndividuals who are not currently enrolled in a Minnesota Health Care Program but are a member of a household with MHCP enrollees may request coverage with or without submitting a new application form. Application filers may also request coverage for a non-applicant household member with or without submitting a new application form. An individual who does not submit a new application form may be required to provide additional information to complete an eligibility determination."},{"chunk_id":"epm:1.2.2#responsibilities-of-the-application-filer","heading":"Responsibilities of the Application Filer","url":"https://bot-corpus.mn-dhs.online/s/epm/1.2.2#responsibilities-of-the-application-filer","context":"EPM > 1 Minnesota Health Care Programs > 1.2 Applications > 1.2.2 Application Submission > Responsibilities of the Application Filer","text":"## Responsibilities of the Application Filer\n\nApplication filers:\n\n- May report changes on behalf of an applicant or enrollee.\n\n- May respond to requests for information regarding any person in their MA, MinnesotaCare, or tax household.\n\n- May make all attestations required for a determination on behalf of an applicant.\n\n- May attest to the joint filing status of their spouse.\n\n- May sign and return the annual renewal notice on an enrollee’s behalf.\n\n### Application Filer and Change in Circumstances\n\nAfter an application is submitted, the application filer may change due to a change in circumstance. Changes in circumstance that could cause the application filer to change include the application filer’s death or the application filer leaves the household. In these cases, a new person must assume the role and responsibilities of the application filer for that household’s application. When a new person assumes the role of the application filer, eligibility for any remaining MHCP enrollees in the household must be redetermined according to EPM 1.3.2.1 Change in Circumstances.\n\nAgencies may not require an MHCP enrollee to submit a new application or provide a written signature when assigning a new application filer due to a change in circumstance, including situations where:\n\n- The original application signer is no longer in the household.\n\n- One or more enrollees on an existing case are moved to a new case because they are no longer members of the existing case household."},{"chunk_id":"epm:1.2.2#assistance-with-the-application","heading":"Assistance with the Application","url":"https://bot-corpus.mn-dhs.online/s/epm/1.2.2#assistance-with-the-application","context":"EPM > 1 Minnesota Health Care Programs > 1.2 Applications > 1.2.2 Application Submission > Assistance with the Application","text":"## Assistance with the Application\n\nA person can choose anyone to help them with an application or renewal. However, only a person meeting the definition of an application filer or an authorized representative can submit the application or renewal on behalf of the applicant. The person is only able to sign the application or renewal if they are the application filer or authorized representative."}]},{"id":"epm:1.2.3","number":"1.2.3","title":"Date of Application","parent":"1.2","breadcrumb":"1 Minnesota Health Care Programs > 1.2 Applications > 1.2.3 Date of Application","summary":"The date of application for health care coverage is the date a county, tribal or state servicing agency receives a request for coverage or an application for health care during normal working hours. The date of application for a paper application or request for coverage submitted after normal working hours via a drop box or other method is the next business day.","effective_date":"2023-10-25","last_modified":"2026-10-02T15:12:41.11403+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.2.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/1.2.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/1_2_3.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.906","Code of Federal Regulations, title 42, section 435.907","Code of Federal Regulations, title 42, section 435.908","Minnesota Rules, part 9505.0015, subpart 5","Minnesota Statutes, section 256L.05"],"chunks":[{"chunk_id":"epm:1.2.3#paper-application","heading":"Paper Application","url":"https://bot-corpus.mn-dhs.online/s/epm/1.2.3#paper-application","context":"EPM > 1 Minnesota Health Care Programs > 1.2 Applications > 1.2.3 Date of Application > Paper Application","text":"## Paper Application\n\nThe date of application for health care coverage is the date a county, tribal or state servicing agency receives a request for coverage or an application for health care during normal working hours. The date of application for a paper application or request for coverage submitted after normal working hours via a drop box or other method is the next business day.\n\nThe date of application for an application completed by a certified assister is the date the certified assister enters in the \"application date\" box in Appendix C. The application date is set when the applicant signs the application in the presence of an assister, or the date the certified assister received a signed application."},{"chunk_id":"epm:1.2.3#mnsure-online-application","heading":"MNsure Online Application","url":"https://bot-corpus.mn-dhs.online/s/epm/1.2.3#mnsure-online-application","context":"EPM > 1 Minnesota Health Care Programs > 1.2 Applications > 1.2.3 Date of Application > MNsure Online Application","text":"## MNsure Online Application\n\nFor MNsure online applications, the date of application is the date the application is submitted electronically."},{"chunk_id":"epm:1.2.3#request-to-apply","heading":"Request to Apply","url":"https://bot-corpus.mn-dhs.online/s/epm/1.2.3#request-to-apply","context":"EPM > 1 Minnesota Health Care Programs > 1.2 Applications > 1.2.3 Date of Application > Request to Apply","text":"## Request to Apply\n\nA person may set the date of application for Medical Assistance (MA) by submitting a Request to Apply (DHS-3417B). A request to apply must be written and contain the name of the applicant and a way to locate the applicant. The request does not need to state the name of a program as long as it is clear the person wants health care. A request to apply does not need to be signed to set the date of application. The applicant must submit a complete paper application and provide information needed to determine eligibility within 30 days of the written request. A request to apply only sets the date of application for applicants who later submit a paper application. Applicants who apply through MNsure.org must submit the online application in order to set the date of application."},{"chunk_id":"epm:1.2.3#setting-date-of-application---social-security-administration-application-for-extra-help","heading":"Setting Date of Application - Social Security Administration Application for Extra Help","url":"https://bot-corpus.mn-dhs.online/s/epm/1.2.3#setting-date-of-application---social-security-administration-application-for-extra-help","context":"EPM > 1 Minnesota Health Care Programs > 1.2 Applications > 1.2.3 Date of Application > Setting Date of Application - Social Security Administration Application for Extra Help","text":"## Setting Date of Application - Social Security Administration Application for Extra Help\n\nThe date the Social Security Administration (SSA) transmits the Extra Help application data to the state agency is the date of application for MA. Applicants have until the end of the processing period to complete an application. Applicants who complete and submit a paper application retain the SSA date of application. The date of application for those who apply through an online application is the date the application is submitted."},{"chunk_id":"epm:1.2.3#date-of-application---applicants-with-limited-english-proficiency","heading":"Date of Application - Applicants with Limited English Proficiency","url":"https://bot-corpus.mn-dhs.online/s/epm/1.2.3#date-of-application---applicants-with-limited-english-proficiency","context":"EPM > 1 Minnesota Health Care Programs > 1.2 Applications > 1.2.3 Date of Application > Date of Application - Applicants with Limited English Proficiency","text":"## Date of Application - Applicants with Limited English Proficiency\n\nApplicants with limited English proficiency (LEP) may receive help applying through the Multilingual Referral Line (MRL) service or county agencies. The date of the first contact with either the MRL service or the county agency is the date of application for LEP applicants using paper applications. The date of application for those who apply through an online application is the date the application is submitted."}]},{"id":"epm:1.2.4","number":"1.2.4","title":"Processing Period","parent":"1.2","breadcrumb":"1 Minnesota Health Care Programs > 1.2 Applications > 1.2.4 Processing Period","summary":"Applications must be processed as soon as possible and within the following number of days from the date of application:","effective_date":"2025-07-02","last_modified":"2026-10-02T15:12:41.19857+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.2.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/1.2.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/1_2_4.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:1.2.4#minnesota-health-care-programs-mhcp-applications","heading":"Minnesota Health Care Programs (MHCP) Applications","url":"https://bot-corpus.mn-dhs.online/s/epm/1.2.4#minnesota-health-care-programs-mhcp-applications","context":"EPM > 1 Minnesota Health Care Programs > 1.2 Applications > 1.2.4 Processing Period > Minnesota Health Care Programs (MHCP) Applications","text":"## Minnesota Health Care Programs (MHCP) Applications\n\nApplications must be processed as soon as possible and within the following number of days from the date of application:\n\n- 15 working days for a pregnant person\n\n- 60 days for people requesting an MA eligibility determination under a disability basis of eligibility\n\n- 45 days for all other applicants\n\nThe agency generally must process an application, obtain all pre-eligibility verifications, make a determination, and send an approval or denial notice within the processing period. The processing period cannot be used as a waiting period for people requesting health care or extended to provide agencies with additional time for processing. The processing period does not impact the time permitted for an applicant to provide requested information or paper documentation.\n\nThe processing period begins the date the online application is submitted or the county, tribal or state servicing agency receives a paper application. See the [MHCP Date of Application](https://bot-corpus.mn-dhs.online/s/epm/1.2.3) policy for more information."},{"chunk_id":"epm:1.2.4#mhcp-supplements-for-enrollees","heading":"MHCP Supplements for Enrollees","url":"https://bot-corpus.mn-dhs.online/s/epm/1.2.4#mhcp-supplements-for-enrollees","context":"EPM > 1 Minnesota Health Care Programs > 1.2 Applications > 1.2.4 Processing Period > MHCP Supplements for Enrollees","text":"## MHCP Supplements for Enrollees\n\nAn MHCP supplemental form is required to gather additional information to determine eligibility under a different MA basis or other Minnesota health care program.\n\nThe MHCP supplemental form must be processed by the county or tribal agency as soon as possible and within the following number of days from the date received:\n\n- 15 working days for pregnant people\n\n- 60 days for people requesting an MA eligibility determination under a disability basis of eligibility\n\n- 25 days for all other applicants and enrollees"},{"chunk_id":"epm:1.2.4#processing-period-extensions","heading":"Processing Period Extensions","url":"https://bot-corpus.mn-dhs.online/s/epm/1.2.4#processing-period-extensions","context":"EPM > 1 Minnesota Health Care Programs > 1.2 Applications > 1.2.4 Processing Period > Processing Period Extensions","text":"## Processing Period Extensions\n\nProcessing periods must be extended in the following circumstances:\n\n- When the applicant is cooperating with providing information or documentation needed to process the application\n\n- When a State Medical Review Team (SMRT) determination is pending, for people being determined under an aged, blind, or disabled basis of eligibility, if all other MHCP eligibility criteria are met\n\n- When the results of a MnCHOICES assessment are pending for people using the aged, blind, or disabled basis of eligibility if all other MHCP eligibility criteria are met\n\nLegal Citations\n\nCode of Federal Regulations, title 42, section 435.911\n\nCode of Federal Regulations, title 42, section 435.912\n\nCode of Federal Regulations, title 42, section 435.952\n\nCode of Federal Regulations, title 45, section 155.310\n\nMinnesota Rule, part 9505.0090\n\nMinnesota Statutes, section 256L.05\n\nMinnesota Statutes, section 256B.08"}]},{"id":"epm:1.2.5","number":"1.2.5","title":"Retroactive Eligibility","parent":"1.2","breadcrumb":"1 Minnesota Health Care Programs > 1.2 Applications > 1.2.5 Retroactive Eligibility","summary":"People may request retroactive eligibility for Medical Assistance (MA), Minnesota Family Planning Program (MFPP),  and the Service Limited Medicare Beneficiary (SLMB), Qualified Individual (QI) and Qualified Working Disabled (QWD) Medicare Savings Programs (MSP) for up to three months prior to the month of application. Retroactive eligibility is not available under MinnesotaCare.","effective_date":"2019-04-01","last_modified":"2026-10-02T15:12:41.28399+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.2.5","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/1.2.5","official_origin":"https://hcopub.dhs.state.mn.us/epm/1_2_5.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.915","Code of Federal Regulations, title 42, section 435.1200","Code of Federal Regulations, title 45, section 155.410","Code of Federal Regulations, title 45, section 155.420","Minnesota Statutes, section 256L.05","Minnesota Statutes, section 256B.061"],"chunks":[{"chunk_id":"epm:1.2.5#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.2.5","context":"EPM > 1 Minnesota Health Care Programs > 1.2 Applications > 1.2.5 Retroactive Eligibility","text":"People may request retroactive eligibility for Medical Assistance (MA), Minnesota Family Planning Program (MFPP),  and the Service Limited Medicare Beneficiary (SLMB), Qualified Individual (QI) and Qualified Working Disabled (QWD) Medicare Savings Programs (MSP) for up to three months prior to the month of application. Retroactive eligibility is not available under MinnesotaCare."},{"chunk_id":"epm:1.2.5#medical-assistance-and-minnesota-family-planning-program","heading":"Medical Assistance and Minnesota Family Planning Program","url":"https://bot-corpus.mn-dhs.online/s/epm/1.2.5#medical-assistance-and-minnesota-family-planning-program","context":"EPM > 1 Minnesota Health Care Programs > 1.2 Applications > 1.2.5 Retroactive Eligibility > Medical Assistance and Minnesota Family Planning Program","text":"## Medical Assistance and Minnesota Family Planning Program\n\nThe earliest possible begin date for MA, including MA with a spenddown, and MFPP coverage is the first day of the month three months before the month of application. When a person enrolled in MinnesotaCare or another Insurance Affordability Program reports a change in circumstance that results in MA eligibility, the earliest possible begin date for MA is the first day of the month three months prior to the month the change was reported.\n\nAn applicant may be eligible for some, but not all months in the retroactive period. The person may be eligible for each retroactive month they meet the MA or MFPP eligibility requirements and has paid or unpaid medical expenses that would be covered by MA.\n\nAn applicant does not need to be eligible for MA or MFPP in the application month to qualify for coverage in the retroactive months.\n\nEnrollees may add a request for retroactive MA or MFPP up to 12 months from the date of the original application. The original date of application determines the earliest possible date for MA and MFPP coverage."},{"chunk_id":"epm:1.2.5#medical-assistance-with-a-spenddown","heading":"Medical Assistance with a Spenddown","url":"https://bot-corpus.mn-dhs.online/s/epm/1.2.5#medical-assistance-with-a-spenddown","context":"EPM > 1 Minnesota Health Care Programs > 1.2 Applications > 1.2.5 Retroactive Eligibility > Medical Assistance with a Spenddown","text":"## Medical Assistance with a Spenddown\n\nEligibility for or enrollment in MinnesotaCare, Advanced Premium Tax Credits (APTC) or qualified health plans (QHP) without subsidy is not a barrier to eligibility for retroactive MA with a spenddown. A person may be eligible for MA with a spenddown in the same month they are or were eligible for or enrolled in MinnesotaCare, APTC, or QHP without subsidy."},{"chunk_id":"epm:1.2.5#medicare-savings-programs","heading":"Medicare Savings Programs","url":"https://bot-corpus.mn-dhs.online/s/epm/1.2.5#medicare-savings-programs","context":"EPM > 1 Minnesota Health Care Programs > 1.2 Applications > 1.2.5 Retroactive Eligibility > Medicare Savings Programs","text":"## Medicare Savings Programs\n\nSLMB or QI benefits are available for the three months before the month of application for people who meet all eligibility requirements.\n\nPeople eligible for Qualified Medicare Beneficiary (QMB) may receive SLMB for the three-month retroactive period and all processing months preceding the month QMB eligibility begins if all other eligibility requirements are met."}]},{"id":"epm:1.2.6","number":"1.2.6","title":"Signature","parent":"1.2","breadcrumb":"1 Minnesota Health Care Programs > 1.2 Applications > 1.2.6 Signature","summary":"The application filer or their authorized representative must sign the application. See 1.2.2 MHCP Application Submission, for a description of an application filer, and EPM 1.3.1.2 Authorized Representative, for a description of an authorized representative. A signature may be handwritten or it may be electronic if it meets certain criteria.","effective_date":"2025-07-02","last_modified":"2026-10-03T03:52:01.388941+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.2.6","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/1.2.6","official_origin":"https://hcopub.dhs.state.mn.us/epm/1_2_6.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.907","Code of Federal Regulations, title 42, section 435.916","Code of Federal Regulations, title 42, section 435.923","Code of Federal Regulations, title 45, section 155.230","Code of Federal Regulations, title 45, section 155.335","Minnesota Statutes, section 256L.05","Minnesota Statutes, section 524.5-313","Minnesota Statutes, section 524.5-417","Minnesota Statues, chapter 325L"],"chunks":[{"chunk_id":"epm:1.2.6#application-signature","heading":"Application Signature","url":"https://bot-corpus.mn-dhs.online/s/epm/1.2.6#application-signature","context":"EPM > 1 Minnesota Health Care Programs > 1.2 Applications > 1.2.6 Signature > Application Signature","text":"## Application Signature\n\nThe application filer or their authorized representative must sign the application. See [1.2.2 MHCP Application Submission](https://bot-corpus.mn-dhs.online/s/epm/1.2.2), for a description of an application filer, and [EPM 1.3.1.2 Authorized Representative](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.2), for a description of an authorized representative. A signature may be handwritten or it may be electronic if it meets certain criteria.\n\n- A person under 18 who does not live with a parent, relative caretaker, foster parent, or legal guardian may sign an application on their own behalf. This includes both minors with and without children."},{"chunk_id":"epm:1.2.6#renewal-signature","heading":"Renewal Signature","url":"https://bot-corpus.mn-dhs.online/s/epm/1.2.6#renewal-signature","context":"EPM > 1 Minnesota Health Care Programs > 1.2 Applications > 1.2.6 Signature > Renewal Signature","text":"## Renewal Signature\n\nThe enrollee, a person who qualifies as an application filer, or their authorized representative must sign a renewal form when a renewal signature is required.\n\n- A signature is required on paper renewal forms including the pre-populated renewal form.\n\n- No signature is required when eligibility is automatically renewed using information in an enrollee's case file and data provided by trusted electronic sources."},{"chunk_id":"epm:1.2.6#changes-in-application-filer","heading":"Changes in Application Filer","url":"https://bot-corpus.mn-dhs.online/s/epm/1.2.6#changes-in-application-filer","context":"EPM > 1 Minnesota Health Care Programs > 1.2 Applications > 1.2.6 Signature > Changes in Application Filer","text":"## Changes in Application Filer\n\nA new signature is not required when an application filer changes."},{"chunk_id":"epm:1.2.6#other-minnesota-health-care-programs-mhcp-eligibility-forms","heading":"Other Minnesota Health Care Programs (MHCP) Eligibility Forms","url":"https://bot-corpus.mn-dhs.online/s/epm/1.2.6#other-minnesota-health-care-programs-mhcp-eligibility-forms","context":"EPM > 1 Minnesota Health Care Programs > 1.2 Applications > 1.2.6 Signature > Other Minnesota Health Care Programs (MHCP) Eligibility Forms","text":"## Other Minnesota Health Care Programs (MHCP) Eligibility Forms\n\nRefer to the [Eligibility Forms that Require a Signature](https://hcopub.dhs.state.mn.us/epm/assets/docs/Signature_Forms.pdf) document for a quick reference guide to MHCP eligibility forms that require a signature."},{"chunk_id":"epm:1.2.6#electronic-signature","heading":"Electronic Signature","url":"https://bot-corpus.mn-dhs.online/s/epm/1.2.6#electronic-signature","context":"EPM > 1 Minnesota Health Care Programs > 1.2 Applications > 1.2.6 Signature > Electronic Signature","text":"## Electronic Signature\n\nA valid electronic signature may be used to sign MHCP applications, renewals, and other eligibility forms that require a signature.\n\nTo be considered a valid electronic signature, the signature must be:\n\n- gathered via software that complies with the Electronic Signatures in Global and National Commerce Act (ESIGN) and submitted with a certificate of completion, audit record, or similar audit trail; or\n\n- gathered or transmitted electronically and meet all of the following criteria:\n  - The signature must show the signor's intent to sign and be logically associated with or attached to a specific form.\n\n    A signature on a form meets this criterion.\n\n    A signature that is not on a form must be dated and include a short statement indicating intent and association. Acceptable statements include but are not limited to:\n    - \"I understand that I am signing the DHS-\\[form number\\] and I agree to all the terms and conditions of the form.\"\n\n    - \"I understand that I am signing \\[title of specific MHCP application or form\\] and I agree to all the terms and conditions of the form.\"\n  - The signature must identify the person who is signing.\n\n     A legible handwritten signature or typed or legibly printed name accompanied by a handwritten signature (legible or not) meets this criterion.\n\n  - The signature must be received in a form that is tamper-proof and cannot be modified\n\n### Examples of valid electronic signatures:\n\n- A signature on Minnesota Eligibility Technology System (METS) online application available on the MNsure website.\n\n- An image of legible handwritten signature transmitted electronically such as by fax, e-mail, or text message that is dated and includes an acceptable statement of intent.\n\n- A signature captured by a software product that complies with ESIGN, submitted with a completion certificate.\n\n### Examples of signatures that are not valid electronic signature:\n\n- A signature gathered electronically that is submitted along with a form but does not include an acceptable statement of intent.\n\n- An image of handwritten signature that is placed on a form by digitally copying and pasting it onto the document.\n\n- A typed name created by selecting a script of calligraphy font that has not been gathered via software that complies with ESIGN.\n\n- A signature gathered via software that complies with ESIGN that is not accompanied by a certificate of completion, audit record or audit trail."},{"chunk_id":"epm:1.2.6#special-circumstances","heading":"Special Circumstances","url":"https://bot-corpus.mn-dhs.online/s/epm/1.2.6#special-circumstances","context":"EPM > 1 Minnesota Health Care Programs > 1.2 Applications > 1.2.6 Signature > Special Circumstances","text":"## Special Circumstances\n\nThis section applies to MHCP applications, renewals, and other MHCP eligibility forms that require a signature.\n\nA person who is mentally competent but unable to sign due to physical limitations may:\n\n- Sign electronically, or\n\n- Sign by making a distinct mark, such as an X. Two witnesses must sign and date the application, renewal, or other MHCP form to verify that the person making the mark is indeed the MHCP applicant or enrolee.\n\nIf a person has a court or tribal court-appointed guardian, one of the following people must sign:\n\n- The guardian, or\n\n- An authorized representative designated by the guardian\n\nIf a person does not have a court-appointed guardian but does have a court-appointed conservator, any of the following people may sign:\n\n- The person\n\n- An authorized representative designated by the person or conservator\n\n- The conservator, if the court has not limited the conservator's powers in such a way that the conservator does not have the power to apply for health care assistance, services, or benefits available to the person\n\nIf a person is incapacitated and does not have a court-appointed guardian, court-appointed conservator, or an authorized representative appointed by either the guardian or conservator, any of the following people may sign the application, renewal, or other MHCP form:\n\n- An application filer acting responsibly for the incapacitated person. This does not apply to the Authorization to Obtain Financial Information (DHS-7823) form. Requirements for this form can be found in [2.3.1.3 Authorization to Obtain Information](https://bot-corpus.mn-dhs.online/s/epm/2.3.1.3)\n\n- An authorized representative designated by the county, tribal or state servicing agency. See EPM section [1.3.1.2 Authorized Representative](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.2) for more information."}]},{"id":"epm:1.2.7","number":"1.2.7","title":"Applications for Incarcerated People Preparing for Release (Archive)","parent":"1.2","breadcrumb":"1 Minnesota Health Care Programs > 1.2 Applications > 1.2.7 Applications for Incarcerated People Preparing for Release (Archive)","summary":"A person who is incarcerated and applying for Minnesota Health Care Programs (MHCP) before their release from a state prison, county detention facility, or city jail must apply using a paper application. Applying with a paper application ensures that eligibility dates for health care coverage are correct.","effective_date":"2020-09-01","last_modified":"2026-10-02T15:12:41.455262+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.2.7","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/1.2.7","official_origin":"https://hcopub.dhs.state.mn.us/epm/1_2_7.htm","legal_citations":["Minnesota Statutes, section 256B.055, subdivision 14","Minnesota Statutes, section 256G.01, subdivision 4","Minnesota Statutes, section 256G.02, subdivision 4 and 6","Minnesota Statutes, section 256G.08, subdivision 2"],"chunks":[{"chunk_id":"epm:1.2.7#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.2.7","context":"EPM > 1 Minnesota Health Care Programs > 1.2 Applications > 1.2.7 Applications for Incarcerated People Preparing for Release (Archive)","text":"A person who is incarcerated and applying for Minnesota Health Care Programs (MHCP) before their release from a state prison, county detention facility, or city jail must apply using a paper application. Applying with a paper application ensures that eligibility dates for health care coverage are correct.\n\nIncarcerated people who do not apply for MHCP before release follow all standard policies when applying for health care after release."},{"chunk_id":"epm:1.2.7#health-care-application","heading":"Health Care Application","url":"https://bot-corpus.mn-dhs.online/s/epm/1.2.7#health-care-application","context":"EPM > 1 Minnesota Health Care Programs > 1.2 Applications > 1.2.7 Applications for Incarcerated People Preparing for Release (Archive) > Health Care Application","text":"## Health Care Application\n\nPeople who are incarcerated preparing for release may receive application assistance from a discharge planner or facility staff when applying for MHCP.\n\nThere are two application paths for people who are incarcerated so health care coverage can begin on the day they are released.\n\n### Shortened Application Process for People Incarcerated for Less Than 12 Months\n\nPeople who are incarcerated for less than 12 months and who were MA enrollees at the time they were incarcerated may have their MA coverage reopened without a new MHCP application by submitting a Request to Re-Open MA ( [DHS-5038](http://edocs.dhs.state.mn.us/lfserver/Legacy/DHS-5038-ENG)) to their county or tribal servicing agency. DHS-5038 must be submitted no earlier than 45 days before release and no later than 10 calendar days after release.\n\n### New Application for People Incarcerated for 12 Months or More\n\nPeople who are incarcerated for 12 months or more must complete the appropriate MHCP application and the Individual Discharge Information Sheet (IDIS) ( [DHS-3443](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-3443-ENG)). Refer to [Section 1.2.1 MHCP Application Forms](https://bot-corpus.mn-dhs.online/s/epm/1.2.1) for more information. The application and DHS-3443 must be submitted no earlier than 45 days before release.\n\nThe date of incarceration and the actual anticipated release date from incarceration must be verified. The release date may be verified by any of the following:\n\n- The actual date of release from the Facility Section on DHS-5038\n\n- Phone or fax contacts with the facility\n\n- Official correspondence from the facility with the release date listed\n\n- Official Lists provided to the county agency by the facility containing the incarcerated individual's name and release date\n\n- Department of corrections Web site\n\n- Official jail roster."},{"chunk_id":"epm:1.2.7#servicing-agency-for-incarcerated-people-preparing-for-release","heading":"Servicing Agency for Incarcerated People Preparing for Release","url":"https://bot-corpus.mn-dhs.online/s/epm/1.2.7#servicing-agency-for-incarcerated-people-preparing-for-release","context":"EPM > 1 Minnesota Health Care Programs > 1.2 Applications > 1.2.7 Applications for Incarcerated People Preparing for Release (Archive) > Servicing Agency for Incarcerated People Preparing for Release","text":"## Servicing Agency for Incarcerated People Preparing for Release\n\nThe completed DHS-5038, or the completed MHCP application and DHS-3443, are submitted to the county or tribal servicing agency where the person lived immediately before entering the correctional facility. If the previous county of residence is unknown or the person lived in another state immediately before being incarcerated, the completed forms are sent to the county or tribal servicing agency where the person plans to live after release."},{"chunk_id":"epm:1.2.7#financially-responsible-agency-for-incarcerated-people-preparing-for-release","heading":"Financially Responsible Agency for Incarcerated People Preparing for Release","url":"https://bot-corpus.mn-dhs.online/s/epm/1.2.7#financially-responsible-agency-for-incarcerated-people-preparing-for-release","context":"EPM > 1 Minnesota Health Care Programs > 1.2 Applications > 1.2.7 Applications for Incarcerated People Preparing for Release (Archive) > Financially Responsible Agency for Incarcerated People Preparing for Release","text":"## Financially Responsible Agency for Incarcerated People Preparing for Release\n\nThe financially responsible agency is the agency in which the person resided immediately before entering the correctional facility. If the previous county of residence is unknown or the person lived in another state immediately before being incarcerated, the financially responsible agency is the county or tribe in which the facility is located."}]},{"id":"epm:1.3","number":"1.3","title":"Client Rights and Responsibilities","parent":"1","breadcrumb":"1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities","summary":"All Minnesota Health Care Programs (MHCP) applicants and enrollees have rights and responsibilities under various laws. Application forms, notices, and brochures include information on rights and responsibilities.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:24:35.343847+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/1.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/1_3.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:1.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.3","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities","text":"All Minnesota Health Care Programs (MHCP) applicants and enrollees have rights and responsibilities under various laws. Application forms, notices, and brochures include information on rights and responsibilities.\n\nThis subchapter provides policy information that applies to all Minnesota Health Care Programs. Topics covered in this sub chapter are:\n\n1. [MHCP Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1)\n1. [MHCP Appeals](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.1)\n\n2. [MHCP Authorized Representative](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.2)\n\n3. [MHCP Civil Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.3)\n\n4. [MHCP Data Privacy](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.4)\n\n5. [MHCP Notices](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.5)\n2. [MHCP Responsibilities](https://bot-corpus.mn-dhs.online/s/epm/1.3.2)\n1. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n\n2. [MHCP Cooperation](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.2)\n\n3. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n\n4. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n\n5. [MHCP Overpayments](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.5)"}]},{"id":"epm:1.3.1","number":"1.3.1","title":"Rights","parent":"1.3","breadcrumb":"1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights","summary":"All Minnesota Health Care Programs (MHCP) applicants and enrollees have rights under various laws. Application forms, notices, and brochures include information on rights.","effective_date":"2016-06-01","last_modified":"2026-10-02T15:12:41.627824+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/1.3.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/1_3_1.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:1.3.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights","text":"All Minnesota Health Care Programs (MHCP) applicants and enrollees have rights under various laws. Application forms, notices, and brochures include information on rights.\n\nTopics covered in this section are:\n\n1. [MHCP Appeals](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.1)\n\n2. [MHCP Authorized Representative](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.2)\n\n3. [MHCP Civil Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.3)\n\n4. [MHCP Data Privacy](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.4)\n\n5. [MHCP Notices](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.5)"}]},{"id":"epm:1.3.1.1","number":"1.3.1.1","title":"Appeals","parent":"1.3.1","breadcrumb":"1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.1 Appeals","summary":"Minnesota Health Care Programs (MHCP) applicants and enrollees have the right to appeal different types of decisions. This policy is about appealing MHCP eligibility decisions. This includes decisions about what health care program someone is eligible for and whether or not someone is eligible for payment of long-term care services.","effective_date":"2016-06-01","last_modified":"2026-10-02T15:12:41.711954+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/1.3.1.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/1_3_1_1.htm","legal_citations":["Code of Federal Regulations, title 42, section 431.10","Code of Federal Regulations, title 42, sections 431.200 to 431.246","Code of Federal Regulations, title 45, sections 155.500 to 155.555","Minnesota Rules, part 7700.0101","Minnesota Statutes, section 256.045","Minnesota Statutes, section 256.0451"],"chunks":[{"chunk_id":"epm:1.3.1.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.1","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.1 Appeals","text":"Minnesota Health Care Programs (MHCP) applicants and enrollees have the right to appeal different types of decisions. This policy is about appealing MHCP eligibility decisions. This includes decisions about what health care program someone is eligible for and whether or not someone is eligible for payment of long-term care services.\n\nApplicants and enrollees receive written notice of their appeal rights whenever an action affects their health care coverage under MHCP. The notice also explains how to file an appeal. They may appeal when they believe that the county, tribal or state servicing agency made an incorrect decision or took an incorrect action about their application. People are not penalized for filing an appeal.\n\nOnly an [application filer](https://bot-corpus.mn-dhs.online/s/epm/1.2.2), for example an applicant, enrollee, former enrollee or their authorized representative, can file an appeal. See the [MHCP Authorized Representative](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.2) policy for more information about authorized representatives. Providers and navigators do not have the right to appeal health care eligibility determinations.\n\nThere is no cost to filing an appeal. Applicants and enrollees may be reimbursed for reasonable and necessary expenses to attend in-person hearings or telephone hearings held at a location other than their home."},{"chunk_id":"epm:1.3.1.1#deadlines-for-appeals","heading":"Deadlines for Appeals","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.1#deadlines-for-appeals","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.1 Appeals > Deadlines for Appeals","text":"## Deadlines for Appeals\n\nThe applicant or enrollee must request the appeal hearing within 30 days after receiving a notice of action, or within 90 days after receiving the notice with good cause.\n\nThey must show good cause for making a late request if they submit the appeal request within 31-90 days after the notice. The Minnesota Department of Human Services (DHS) appeals office determines good cause along with the other issues at the hearing."},{"chunk_id":"epm:1.3.1.1#continuation-of-benefits","heading":"Continuation of Benefits","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.1#continuation-of-benefits","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.1 Appeals > Continuation of Benefits","text":"## Continuation of Benefits\n\nDifferent actions have different advanced notice requirements. See the [MHCP Notices](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.5) policy for more information about notice timelines.\n\nMHCP enrollees who receive 10 days or more advance notice can automatically have their benefits continued if they file their appeal by the effective date of the action on the advance notice. MinnesotaCare enrollees must continue to pay premiums in order to get coverage.\n\nMHCP enrollees who receive notice five days or less in advance of the effective date of the action must file an appeal within 15 days from the date of the notice to continue benefits.\n\nIf an MHCP enrollee does not want benefits to continue, they must submit a request to their county, tribal or state servicing agency."},{"chunk_id":"epm:1.3.1.1#filing-an-appeal","heading":"Filing an Appeal","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.1#filing-an-appeal","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.1 Appeals > Filing an Appeal","text":"## Filing an Appeal\n\nApplicants and enrollees must file an appeal in writing or by phone. There are several ways to file an appeal. People can:\n\n- Complete the online Appeal to State Agency form ( [DHS-0033](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-0033-ENG)) or write a letter and\n  - Mail to DHS State Appeals Office, PO Box 64941, St. Paul, MN 55155-0941,\n\n  - Mail to county, tribal or state servicing agency or\n\n  - Deliver to DHS Information Desk at 444 Lafayette Road North, St. Paul, MN 55101.\n- Visit [MNsure](http://www.mnsure.org/) and log into their account to access an appeals form.\n\n- Fill out the [Appeal Request Form](https://www.mnsure.org/assets/MNsure-Appeals-Request-Form_tcm34-182055.pdf) on MNsure and:\n  - Mail to MNsure, 81 East 7th Street, Suite 300, St. Paul, MN 55101-2211, or\n\n  - Email it to [dhs.mnsureappealsindexing@state.mn.us](mailto:dhs.mnsureappealsindexing@state.mn.us).\n- Call the MNsure contact center toll-free at 1-855-366-7873.\n\nCounty, tribal and state servicing agencies must forward appeals for MHCP coverage to the DHS Appeals Office."},{"chunk_id":"epm:1.3.1.1#medical-emergency-appeals","heading":"Medical Emergency Appeals","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.1#medical-emergency-appeals","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.1 Appeals > Medical Emergency Appeals","text":"## Medical Emergency Appeals\n\nApplicants and enrollees have a right to request an emergency expedited appeal if there is an immediate need for health services and failure to act could seriously jeopardize life, health, or ability to attain, maintain, or regain maximum function. DHS must take final action within three working days of receiving a request from a person that meets the criteria of an expedited appeal."},{"chunk_id":"epm:1.3.1.1#local-resolution","heading":"Local Resolution","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.1#local-resolution","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.1 Appeals > Local Resolution","text":"## Local Resolution\n\nApplicants and enrollees may request an agency conference including a supervisor or the agency director, before the scheduled appeal hearing. The conference may be a phone conference or a face-to-face conference. People are not required to try to resolve an issue at the local level before filing an appeal. A person should request to withdraw the appeal if a conference or other informal means resolves the appeal, by sending a letter to the DHS Appeals Office. The county, tribal or state servicing agency must promptly submit an appeal request to the DHS Appeals Office while concurrently attempting to resolve issues locally."},{"chunk_id":"epm:1.3.1.1#appeal-hearings","heading":"Appeal Hearings","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.1#appeal-hearings","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.1 Appeals > Appeal Hearings","text":"## Appeal Hearings\n\nPeople who file an appeal receive a notice by mail informing them of the date and time of the hearing. The notice provides a phone number or a location. The Appeal Hearings Information ( [DHS-2811](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-2811-ENG)) pamphlet explains details about the hearing."},{"chunk_id":"epm:1.3.1.1#other-types-of-appeals","heading":"Other Types of Appeals","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.1#other-types-of-appeals","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.1 Appeals > Other Types of Appeals","text":"## Other Types of Appeals\n\nIn addition to eligibility appeals, the DHS [Appeals and Regulations Division](http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=id_008649) conducts fair hearings when related to covered services.\n\nThe [Office of the Ombudsman for State Managed Care Programs](http://mn.gov/dhs/people-we-serve/adults/health-care/health-care-programs/programs-and-services/ombudsman-for-managed-care.jsp) provides information and assistance with the managed care grievance and appeal process available through the health plan and the state. An ombudsman is a neutral investigator who helps people enrolled in a managed care health plan. The ombudsman helps enrollees get needed health care and resolve billing problems."}]},{"id":"epm:1.3.1.2","number":"1.3.1.2","title":"Authorized Representative","parent":"1.3.1","breadcrumb":"1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.2 Authorized Representative","summary":"Minnesota Health Care Programs (MHCP) applicants and enrollees may designate an authorized representative at the time of application or at any other time. An authorized representative is a person or organization authorized by an applicant or enrollee to apply for a MHCP and to perform the duties required to establish and maintain eligibility.","effective_date":"2022-03-01","last_modified":"2026-10-02T15:12:41.799155+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/1.3.1.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/1_3_1_2.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.923","Code of Federal Regulations, title 45, section 155.227","Minnesota Statutes, section 524.5-310","Minnesota Statutes, section 524.5-313","Minnesota Statutes, section 524.5-417","Minnesota Rules, part 9505.0085, subpart 2"],"chunks":[{"chunk_id":"epm:1.3.1.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.2","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.2 Authorized Representative","text":"Minnesota Health Care Programs (MHCP) applicants and enrollees may designate an authorized representative at the time of application or at any other time. An authorized representative is a person or organization authorized by an applicant or enrollee to apply for a MHCP and to perform the duties required to establish and maintain eligibility."},{"chunk_id":"epm:1.3.1.2#responsibilities-of-an-authorized-representative","heading":"Responsibilities of an Authorized Representative","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.2#responsibilities-of-an-authorized-representative","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.2 Authorized Representative > Responsibilities of an Authorized Representative","text":"## Responsibilities of an Authorized Representative\n\nIn most cases, authorized representatives have the same responsibilities and rights as applicants or enrollees.\n\nAuthorized representatives have the responsibility and right to:\n\n- Contact the county, tribal or state servicing agency, including talking with the worker without additional consent\n\n- Contact the help desks, without additional consent\n\n- Have access to eligibility information in the applicant’s or enrollee’s case file\n\n- Complete and sign forms, such as applications and renewals, for the applicant or enrollee\n\n- Provide documentation\n\n- Appeal agency decisions\n\n- Receive forms and notices\n\n- Pay premiums\n\n- Act on behalf of the applicant or enrollee in all other matters with the county, tribal or state servicing agency\n\n- Maintain the confidentiality of any information regarding the applicant or enrollee provided by the county, tribal or state servicing agency"},{"chunk_id":"epm:1.3.1.2#who-can-be-an-authorized-representative","heading":"Who Can Be an Authorized Representative?","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.2#who-can-be-an-authorized-representative","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.2 Authorized Representative > Who Can Be an Authorized Representative?","text":"## Who Can Be an Authorized Representative?\n\nAuthorized representatives must:\n\n- Be at least 18 years old,\n\n- Have access to required information and ability to verify eligibility requirements, and\n\n- Agree in writing to accept the responsibilities of an authorized representative."},{"chunk_id":"epm:1.3.1.2#who-cannot-be-an-authorized-representative","heading":"Who Cannot Be an Authorized Representative?","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.2#who-cannot-be-an-authorized-representative","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.2 Authorized Representative > Who Cannot Be an Authorized Representative?","text":"## Who Cannot Be an Authorized Representative?\n\nThe following people cannot be an authorized representative for a client on their caseload:\n\n- County, tribal or state servicing agency employees who determine eligibility\n\n- Regional Treatment Center (RTC) reimbursement officers for MA enrollees\n\n- Certified assisters (navigators)\n\nAn incarcerated individual can have an authorized representative, but the authorized representative cannot enroll the inmate without his or her consent."},{"chunk_id":"epm:1.3.1.2#designating-an-authorized-representative","heading":"Designating an Authorized Representative","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.2#designating-an-authorized-representative","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.2 Authorized Representative > Designating an Authorized Representative","text":"## Designating an Authorized Representative\n\nAny applicant or enrollee who is not incapacitated may designate an authorized representative. People who are incapacitated cannot designate an authorized representative. An incapacitated person is someone who a court has determined lacks understanding or capacity to make reasonable personal decisions and is not able to meet their own needs for medical care, nutrition, clothing, shelter, or safety. A court makes a finding of incapacitation when appointing a guardian. A person may also have executed a durable power of attorney that establishes an agent for handling personal affairs in the event of incapacity.\n\nDesignations by an applicant or enrollee must be in writing and must include the applicant or enrollee's signature unless the applicant or enrollee is unable to sign due to physical limitations. See [1.2.6 MHCP Signature](https://bot-corpus.mn-dhs.online/s/epm/1.2.6) for more information.\n\nA designation may be made by submitting one of the following forms or a written statement containing signatures of both applicant or enrollee and the person specified to act on their behalf:\n\n- A completed Authorized Representative Designation attached to any MHCP application\n\n- A completed Giving Permission for Someone to Act on My Behalf ( [DHS-3437](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3437-ENG)) or Minnesota Family Planning Program (MFPP) - Giving Permission for Someone to Act on My Behalf ( [DHS-3437A](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3437A-ENG))\n\n- A written statement that clearly indicates the applicant or enrollee is giving permission to a specified person to act on their behalf in the health care application or eligibility process, including the name, address, and phone number of the person designated to act on their behalf.\n\nIn lieu of a form or written statement designating an authorized representative, documentation of legal authority to act on behalf of the applicant or enrollee serves as the designation. The following documents show legal authority to act on behalf of the applicant or enrollee:\n\n- A court or tribal court order establishing legal guardianship\n\n- A court or tribal court order establishing a conservatorship with the power to apply for assistance on behalf of the person subject to conservatorship.\n\n- A valid Power of Attorney\n  - A Power of Attorney is a legally binding document that authorizes a person or corporation to act on behalf of the named person, known as the principal, in financial matters.\n\n  - The Power of Attorney may or may not operate when the named person becomes incapacitated. If the agent can act in the event of incapacity of the principal, the Power of Attorney is considered a durable Power of Attorney.\n\n- The agency should contact its County Attorney if there is a question about the interpretation or validity of legal documentation.\n\n- ### Designations Involving Guardians and Conservators\n\n- If an applicant or enrollee has a court or tribal court-appointed guardian, the applicant or enrollee may not designate an authorized representative on their own behalf. The guardian is the authorized representative unless a court has also appointed a conservator. The guardian must provide a copy of the court order establishing the guardianship as evidence of authority to act on behalf of the protected person.\n\n- If an applicant or enrollee has both a guardian and a conservator with the power to apply for assistance on behalf of the person subject to conservatorship, the conservator is the authorized representative. The conservator must provide a copy of the order establishing the conservatorship as evidence of authority to act on behalf of the person subject to the conservatorship.\n\n- If an applicant or enrollee does not have a guardian but has a conservator, the applicant or enrollee may designate an authorized representative on their own behalf.\n\n- ### Organization Designated as Authorized Representative\n\n- An organization may be designated as an authorized representative. If an organization is named as authorized representative, an employee with authority to act on behalf of the organization must sign the authorized representative designation. The organization has the authority to exercise the rights of, and must carry out the responsibilities of the authorized representative.\n\n### Servicing Agency Designation of an Authorized Representative\n\nThe county, tribal or state servicing agency must appoint an authorized representative if the client is not able to do so and is not able to provide information necessary to determine eligibility. This could be a relative or friend who is able to provide the necessary information.\n\nThe agency must appoint a social service professional as the applicant or enrollee’s authorized representative if no qualified person is available to act as an authorized representative.\n\nPotential authorized representatives for children in foster care or pre-adoptive placement include, but are not limited to, social workers or other representatives of the agency that has legal custody and control of the child."},{"chunk_id":"epm:1.3.1.2#how-long-does-the-designation-last","heading":"How Long Does the Designation Last?","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.2#how-long-does-the-designation-last","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.2 Authorized Representative > How Long Does the Designation Last?","text":"## How Long Does the Designation Last?\n\nThe applicant or enrollee may change the authorized representative designation at any time. The designation remains in place until:\n\n- Revoked by the applicant or enrollee\n\n- Revoked by the authorized representative\n\n- The legal authority to act on the applicant or enrollee’s behalf changes\n\n- The authorized representative is disqualified\n\n- The applicant or enrollee dies"},{"chunk_id":"epm:1.3.1.2#disqualification-of-an-authorized-representative","heading":"Disqualification of an Authorized Representative","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.2#disqualification-of-an-authorized-representative","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.2 Authorized Representative > Disqualification of an Authorized Representative","text":"## Disqualification of an Authorized Representative\n\nServicing agencies may disqualify authorized representatives who:\n\n- Knowingly provide false information\n\n- Are unable to provide required information\n\n- Refuse to provide required information\n\nOnly a court or tribal court can disqualify a guardian or conservator.\n\nWhen a county, tribal or state servicing agency disqualifies an authorized representative, the applicant or enrollee can designate a new one.\n\nIf a servicing agency disqualifies an authorized representative, it must determine whether a vulnerable adult referral to social services is needed."},{"chunk_id":"epm:1.3.1.2#authorized-representative-receipt-of-forms-and-notices","heading":"Authorized Representative Receipt of Forms and Notices","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.2#authorized-representative-receipt-of-forms-and-notices","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.2 Authorized Representative > Authorized Representative Receipt of Forms and Notices","text":"## Authorized Representative Receipt of Forms and Notices\n\nUnless the applicant or enrollee indicates otherwise, the authorized representative must be sent all of the forms and copies of eligibility and premium notices. See [EPM 1.3.1.5 Notices](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.5) for a list of required notices."},{"chunk_id":"epm:1.3.1.2#authorization-to-release-information","heading":"Authorization to Release Information","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.2#authorization-to-release-information","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.2 Authorized Representative > Authorization to Release Information","text":"## Authorization to Release Information\n\nThe General Consent/Authorization for Release of Information ( [DHS-3549](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3549-ENG)) allows the county, tribal or state servicing agency to share information about the applicant or enrollee with the person or organization specified on the form. These forms do not appoint the person to be an authorized representative."}]},{"id":"epm:1.3.1.3","number":"1.3.1.3","title":"Civil Rights","parent":"1.3.1","breadcrumb":"1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.3 Civil Rights","summary":"The Minnesota Department of Human Services (DHS), MNsure and county and tribal servicing agencies cannot treat people differently because of their race, color, national origin, sex, sexual orientation, age, creed, religion, political beliefs, disability or status with regard to public assistance. Applicants and enrollees have the right to file a complaint when they believe they were treated in a d","effective_date":"2016-06-01","last_modified":"2026-10-02T15:12:41.884324+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/1.3.1.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/1_3_1_3.htm","legal_citations":["Code of Federal Regulations, title 28, sections 42.401 to 42.415","Code of Federal Regulations, title 45, sections 80.1 to 80.13","Code of Federal Regulations, title 45, sections 84.51 to 84.55","Code of Federal Regulations, title 45, sections 86.1 to 86.9","Code of Federal Regulations, title 45, sections 90.1 to 90.62","Minnesota Statutes, section 363A","Patient Protection and Affordable Care Act of 2010, Pub. L. No. 111-148, section 1557, 124 Stat. 119"],"chunks":[{"chunk_id":"epm:1.3.1.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.3","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.3 Civil Rights","text":"The Minnesota Department of Human Services (DHS), MNsure and county and tribal servicing agencies cannot treat people differently because of their race, color, national origin, sex, sexual orientation, age, creed, religion, political beliefs, disability or status with regard to public assistance. Applicants and enrollees have the right to file a complaint when they believe they were treated in a discriminatory way by a state or local human services agency. All Minnesota Health Care Programs (MHCP) application forms notify people of their civil rights. Applicants and enrollees can contact any of the following agencies directly to file a civil rights complaint."},{"chunk_id":"epm:1.3.1.3#minnesota","heading":"Minnesota","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.3#minnesota","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.3 Civil Rights > Minnesota","text":"## Minnesota\n\nSomeone who believes they have been discriminated against by DHS or a county or tribal servicing agency because of race, color, national origin, religion, creed, sex, sexual orientation, public assistance status, age, or disability, they have the right to file a complaint with:\n\nMinnesota Department of Human Services (DHS) Equal Opportunity and Access\n\nP.O. Box 64997, St. Paul, MN 55164-0997\n\n651-431-3040 (voice) 711 or 800-627-3529 (MN Relay)\n\nor\n\nMNsure Accessibility and Equal Opportunity Office\n\n81 7th Street East, Suite 300, St. Paul, MN 55101-2211.\n\nEmail [AEO@MNsure.org](mailto:AEO@MNsure.org) 855-366-7873 (voice or relay).\n\nor\n\n[Minnesota Department of Human Rights](http://mn.gov/mdhr/) Freeman Building\n\n625 Robert Street North, St. Paul, MN 55155\n\n651-539-1100 (Voice) 800-657-3704 (Toll Free) 651-296-1283 (TTY)"},{"chunk_id":"epm:1.3.1.3#us-department-of-health-and-human-services","heading":"U.S. Department of Health and Human Services","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.3#us-department-of-health-and-human-services","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.3 Civil Rights > U.S. Department of Health and Human Services","text":"## U.S. Department of Health and Human Services\n\nThe U.S. Department of Health and Human Services’ Office for Civil Rights prohibits discrimination in its programs because of race, color, national origin, age, disability and sex, including sex stereotypes and gender identity. If an applicant or enrollee believes they have been discriminated against, they have the right to file a complaint directly with the federal agency.\n\n[U.S. Department of Health and Human Services Office for Civil Rights](http://www.hhs.gov/ocr/office/index.html), Region V\n\n233 North Michigan Avenue, Suite 240, Chicago, IL 60601\n\n312-886-2359 (Voice) 800-368-1019 (Toll Free) 800-537-7697 (TTY)\n\nUnlike state law, federal law does not protect people from discrimination based on marital status, sexual orientation, or receipt of public assistance. People who feel they were discriminated under one or more of these bases must file their complaints with one of the state agencies listed above."},{"chunk_id":"epm:1.3.1.3#limited-english-proficiency-lep","heading":"Limited English Proficiency (LEP)","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.3#limited-english-proficiency-lep","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.3 Civil Rights > Limited English Proficiency (LEP)","text":"## Limited English Proficiency (LEP)\n\nA person with limited English proficiency or “LEP” is not able to speak, read, write or understand the English language well enough to allow them to interact effectively with health and social services agencies and other providers. No person should be denied access to DHS program information or programs because they do not speak English fluently. County, tribal and state servicing agencies must provide appropriate language assistance services.\n\nMHCP application forms and notices contain translation information in Arabic, English, Hmong, Khmer (Cambodian), Lao, Oromo, Russian, Serbo-Croatian (Bosnian), Somali, Spanish and Vietnamese. For more information, see the DHS Limited English Proficiency Plan ( [DHS-4210](http://edocs.dhs.state.mn.us/lfserver/Legacy/DHS-4210-ENG)).\n\nMHCP application forms are available in the six most commonly spoken languages in Minnesota. See the [MHCP Application Forms](https://bot-corpus.mn-dhs.online/s/epm/1.2.1) policy for links to all application forms.\n\nSeveral forms used by MHCP enrollees are available in six languages as well. Select “All languages” or choose an individual language on the DHS [eDocs](http://mn.gov/dhs/general-public/publications-forms-resources/edocs/index.jsp) search web page for available translations."}]},{"id":"epm:1.3.1.4","number":"1.3.1.4","title":"Data Privacy","parent":"1.3.1","breadcrumb":"1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.4 Data Privacy","summary":"Applications and other forms collect sensitive information on an individual that is needed to determine eligibility. Individuals can be harmed by the reckless disclosure of information about them, and, accordingly, there are significant penalties under both state and federal law for government agencies that violate laws designed to protect individuals and groups from such disclosure of information","effective_date":"2026-06-12","last_modified":"2026-10-03T03:52:01.739704+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/1.3.1.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/1_3_1_4.htm","legal_citations":["Code of Federal Regulations, title 45, section 155.310","Code of Federal Regulations, title 45, section 155.1210","Code of Federal Regulations, title 45, section 164.502","Code of Federal Regulations, title 45, section 164.508","Health Insurance Portability and Accountability Act, Public Law 104-191, 110 Stat. 1936 (1996)","Minnesota Rules, part 1205.0500","Minnesota Rules, part 1205.1500","Minnesota Statutes, chapter  5B","Minnesota Statutes, chapter 13","Minnesota Statutes, section 138.17","Minnesota Statutes, sections 144.341 to 144.347","Minnesota Statutes, section 256B.056"],"chunks":[{"chunk_id":"epm:1.3.1.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.4","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.4 Data Privacy","text":"Applications and other forms collect sensitive information on an individual that is needed to determine eligibility. Individuals can be harmed by the reckless disclosure of information about them, and, accordingly, there are significant penalties under both state and federal law for government agencies that violate laws designed to protect individuals and groups from such disclosure of information.\n\nAll Minnesota Health Care Programs (MHCP) application forms include a Notice of Privacy Practices."},{"chunk_id":"epm:1.3.1.4#sharing-of-information","heading":"Sharing of Information","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.4#sharing-of-information","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.4 Data Privacy > Sharing of Information","text":"## Sharing of Information\n\nState, county and tribal servicing agencies will only share information about applicants and enrollees as needed and as allowed or required by law.\n\n### Information sharing with providers\n\nA provider can obtain the following information about MHCP enrollees without a release form from the enrollee:\n\n- Major program\n\n- Prepaid health plan\n\n- Spenddowns\n\n- Special transportation\n\n- Copay\n\n- Hospice\n\n- Waiver eligibility\n\n- Minnesota Restricted Recipient Program (MRRP)\n\n- Other health insurance coverage\n\n- Medicare coverage\n\n- Fee-for-service benefit limits\n\nLong-term care providers can also obtain the following without a release form from an applicant or enrollee:\n\n- Confirmation that the person has applied for MA\n\n- Effective date of MHCP approval, denial or termination"},{"chunk_id":"epm:1.3.1.4#information-sharing-with-applicants","heading":"Information sharing with Applicants","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.4#information-sharing-with-applicants","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.4 Data Privacy > Information sharing with Applicants","text":"## Information sharing with Applicants\n\nInformation about an adult applicant cannot be shared without the individual's consent, even with the application filer. This includes spouses, children and attorneys. In certain situations, another individual may have the legal authority to access the applicant's data or act on their behalf, such as an authorized representative, guardian, navigator, or persons with a power of attorney. State, tribal and county servicing agencies should request a copy of the legal document to verify that the legal relationship exists. If there is no legal relationship, consent must be obtained from the applicant either verbally or through the [DHS-3549 General Consent/Authorization for Release of Information.](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3549-ENG)"},{"chunk_id":"epm:1.3.1.4#information-sharing-about-children","heading":"Information sharing about Children","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.4#information-sharing-about-children","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.4 Data Privacy > Information sharing about Children","text":"## Information sharing about Children\n\nParents generally have the right to access their child's private information. State, tribal and county servicing agencies can disclose information about minors to their parents, except in the following four circumstances:\n\n- If the minor is emancipated\n\n- If state law provides the minor with the right to obtain treatment without parental consent\n\n- If the agency has a reasonable belief that a minor has been, or may be subject to, abuse or neglect , or that the disclosure of private information could endanger the minor\n\n- If the child asks the agency to deny parental access to their information. In this scenario, the agency can decide whether to honor the request for privacy.\n\n- ## Safe at Home Address Confidentiality Program\n\nThe [Safe at Home (SAH) Address Confidentiality Program](https://sos.state.mn.us/safe-at-home/) helps survivors of violence by providing a substitute address for individuals and their children who move to a new location unknown to assailants or probable assailants. SAH participants can apply for MHCPs using their SAH address. The Minnesota Secretary of State, who administers this program, assures that participants receive their mail.\n\nA person is not required to provide proof of participation in the SAH program. A court order is required to release a SAH participant’s information, including confirming or denying program participation.\n\nSafe at Home program participants are granted good cause for not cooperating with medical support if they verify participation in the program with the ID card. SAH participants may also request and be granted good cause for late premium payments and for late submission or completion of renewals. See the [MA Medical Support](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.2) policy for more information.\n\nMHCP enrollees participating in the Safe at Home program must notify their county, tribal or state servicing agency of their county of residence, but do not have to provide their address. Managed care enrollment and county of financial responsibility are determined by county of residence."},{"chunk_id":"epm:1.3.1.4#immigration-information","heading":"Immigration Information","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.4#immigration-information","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.4 Data Privacy > Immigration Information","text":"## Immigration Information\n\nImmigration information applicants and enrollees provide to state, county and tribal servicing agencies is private. Immigration information is only used to determine MHCP eligibility. Immigration information is only shared when the law allows it or requires it, such as to verify identity. In most cases, applying for health coverage will not affect an applicant’s immigration status unless they are applying for payment of long-term care services. See the [U.S. Immigration and Customs Enforcement (ICE), Clarification of Existing Practices Related to Certain Health Care Information](http://www.ice.gov/doclib/ero-outreach/pdf/ice-aca-memo.pdf) document for more information.\n\nPeople do not have to provide immigration information when they are:\n\n  - Applying for Emergency MA (EMA) or MA for people receiving services at the Centers for Victims of Torture (MA-CVT)\n\n  - Helping someone else apply\n\n  - A pregnant person living in the United States without the knowledge or approval of the United States Citizenship and Immigration Services (USCIS)\n\n  - Not an applicant"},{"chunk_id":"epm:1.3.1.4#data-practices-violations","heading":"Data Practices Violations","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.4#data-practices-violations","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.4 Data Privacy > Data Practices Violations","text":"## Data Practices Violations\n\nWillful violation of data privacy laws by a public employee is just cause for dismissal or suspension without pay. It is also a crime.\n\nAn individual affected by an agency’s violation of data privacy laws can seek several remedies under state and federal law. Applicants and enrollees may also file a lawsuit under the Minnesota Government Data Practices Act. They may also send a written complaint to the county, tribal or state servicing agency, the provider, or the federal civil rights office at:\n\nU.S. Department of Health and Human Services\n\nOffice for Civil Rights, Region V\n\n233 N. Michigan Avenue, Suite 240\n\nChicago, IL 60601\n\n312-886-2359 (Voice)\n\n800-368-1019 (Toll Free)\n\n800-537-7697 (TTY)\n\n312-886-1807 (Fax)\n\nIf an applicant or enrollee thinks that DHS violated their privacy rights, they may send a written complaint to the U.S. Department of Health and Human Services at the address above or to:\n\nMinnesota Department of Human Services\n\nAttn:  Privacy Official\n\nPO Box 64998\n\nSt. Paul, MN 55164-0998"},{"chunk_id":"epm:1.3.1.4#hipaa","heading":"HIPAA","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.4#hipaa","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.4 Data Privacy > HIPAA","text":"## HIPAA\n\nThe federal Health Insurance Portability and Accountability Act of 1996 (HIPAA), provides for the protection of individually identifiable health information that is transmitted or maintained in any form or medium. The privacy rules affect the day-to-day business operations of all organizations that provide medical care and maintain personal health information.\n\nApplicants and enrollees are informed of their rights under HIPAA at application, renewal or any other time information is requested.\n\nHIPAA also creates uniform methods to bill and share health information electronically between health care providers, payers and other organizations involved with health care delivery and payment.\n\nState, county and tribal servicing agencies must follow HIPAA provisions as follows:\n\n  - If a provision of the HIPAA privacy regulations conflicts with a state law, whichever offers more privacy protection governs.\n\n  - If HIPAA and state law do not conflict, both state and federal privacy laws are followed."},{"chunk_id":"epm:1.3.1.4#record-retention-policy","heading":"Record Retention Policy","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.4#record-retention-policy","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.4 Data Privacy > Record Retention Policy","text":"## Record Retention Policy\n\nState, county and tribal servicing agencies maintain data in accordance with state and federal law. Information provided in an application for coverage is subject to the False Claims Act and may be retained for up to ten years. After the appropriate period, data is destroyed in a manner that prevents their contents from being determined, including the shredding of paper files and permanently removing electronic data to prevent the possibility of recovery. County servicing agencies must follow the County Human Services General Records Retention Schedule."},{"chunk_id":"epm:1.3.1.4#data-review","heading":"Data Review","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.4#data-review","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.4 Data Privacy > Data Review","text":"## Data Review\n\nMHCP applicants and enrollees may review private data that contain information about them. Both private and public data is shown to the subject of the data upon request."},{"chunk_id":"epm:1.3.1.4#release-of-information","heading":"Release of Information","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.4#release-of-information","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.4 Data Privacy > Release of Information","text":"## Release of Information\n\nAn applicant or enrollee can complete the General Consent/Authorization for Release of Information ( [DHS-3549](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3549-ENG)) to authorize the release of their information. In addition, they can authorize the release of their information to a Long Term Care Facility on the Long-Term Care/County Communication Form ( [DHS-3050](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3050-ENG))."}]},{"id":"epm:1.3.1.5","number":"1.3.1.5","title":"Notices","parent":"1.3.1","breadcrumb":"1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.5 Notices","summary":"Minnesota Health Care Programs (MHCP) applicants and enrollees must receive written notice of decisions affecting their case. The notice provides eligibility information and information about how to appeal decisions if the applicant or enrollee disagrees.","effective_date":"2024-06-11","last_modified":"2026-10-02T15:12:42.054796+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.5","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/1.3.1.5","official_origin":"https://hcopub.dhs.state.mn.us/epm/1_3_1_5.htm","legal_citations":["Code of Federal Regulations, title 42, section 431.210","Code of Federal Regulations, title 42, section 431.211","Code of Federal Regulations, title 42, section 431.213","Code of Federal Regulations, title 42, section 431.214","Code of Federal Regulations, title 42, section 435.916","Code of Federal Regulations, title 42, section 435.918","Code of Federal Regulations, title 45, section 155.230","Code of Federal Regulations, title 45, section 155.515","Minnesota Rules, part 9505.0100","Minnesota Rules, part 9505.0125","Minnesota Statutes, section 256B.056"],"chunks":[{"chunk_id":"epm:1.3.1.5#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.5","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.5 Notices","text":"Minnesota Health Care Programs (MHCP) applicants and enrollees must receive written notice of decisions affecting their case. The notice provides eligibility information and information about how to appeal decisions if the applicant or enrollee disagrees."},{"chunk_id":"epm:1.3.1.5#required-notices","heading":"Required Notices","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.5#required-notices","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.5 Notices > Required Notices","text":"## Required Notices\n\nThe following notices are required:\n\n- Approval of MHCP eligibility\n\n- Application processing delays\n\n- Denial of MHCP eligibility\n\n- Ending MHCP coverage\n\n- Change in premium\n\n- Change in spenddown\n\n- Change in eligibility for payment of long-term care services"},{"chunk_id":"epm:1.3.1.5#advance-notice","heading":"Advance Notice","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.5#advance-notice","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.5 Notices > Advance Notice","text":"## Advance Notice\n\n### 10-Day Advance Notice\n\nUsually, a 10-day advance notice must be sent when taking an adverse action. Adverse actions include:\n\n- Ending coverage\n\n- Reducing eligibility (For example, increasing a premium or a spenddown)\n\n- Reducing covered services\n\nWhen a change in an eligibility factor is known in advance the notice may be sent earlier to allow more time to resolve any issue or questions.\n\n### Five-Day Advance Notice\n\nUsually, a five-day advance notice is required before ending coverage, reducing eligibility, or reducing covered services if there is probable fraud as determined by a fraud investigator. See the [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3) policy for more information."},{"chunk_id":"epm:1.3.1.5#adequate-notice","heading":"Adequate Notice","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.5#adequate-notice","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.5 Notices > Adequate Notice","text":"## Adequate Notice\n\nSometimes an advance notice is not required before ending coverage, reducing eligibility, or reducing benefits. The county, tribal or state servicing agency must send an adequate notice no later than the date of action if:\n\n- the enrollee sends a written and signed statement clearly indicating that they want coverage ended. However, if the enrollee requests cancellation orally and does not submit a written statement, a 10-day notice is required.\n\n- the enrollee is eligible for another Minnesota Health Care Program with better benefits or less cost sharing.\n\n- the enrollee is eligible for Medicaid (MA) in another state for the same period.\n\n- the enrollee’s whereabouts are unknown. Whereabouts unknown means the post office returned mail directed to the person with no forwarding address, and there is no information, such as a telephone number, as an alternate way to contact the person. When the person's whereabouts are unknown, the agency must send the adequate notice of closure to the person's last known address.\n\n- the enrollee’s eligibility changes as the result of a renewal.\n\n- the enrollee provides a signed, written statement acknowledging that the result will be reduction or closure.\n\n- the enrollee is admitted to a city, county, state, or federal correctional and detention facility where they are ineligible for further services or coverage."},{"chunk_id":"epm:1.3.1.5#notice-content","heading":"Notice Content","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.5#notice-content","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.5 Notices > Notice Content","text":"## Notice Content\n\nAll notices must include the following information:\n\n- Action taken\n\n- The reason for the action\n\n- Which household members the action affects\n\n- Effective date of the action\n\n- The legal authority for the action\n\n- The right to appeal and instructions for filing an appeal\n\n- In cases of an action based on a change in law, the circumstances under which a hearing will be granted\n\nAdditionally, notices for processing delays must include:\n\n- The reason the application is not yet processed\n\n- Anything the applicant or enrollee must do to complete the process\n\nAdditionally, notices related to MA with a spenddown must include:\n\n- Completed income computation worksheet\n\n- The monthly amount of the enrollee spenddown"},{"chunk_id":"epm:1.3.1.5#retroactive-notice","heading":"Retroactive Notice","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.1.5#retroactive-notice","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.1 Rights > 1.3.1.5 Notices > Retroactive Notice","text":"## Retroactive Notice\n\nIn some situations, neither advance nor adequate notice is required before ending coverage, reducing eligibility, or reducing covered services. Instead, a written notice is mailed the next available business day.\n\nNotices of ending coverage, reduction of eligibility, or reduction of services may be sent after the effective dates of the action in the following situations:\n\n- When a case opening is processed after the end of an eligibility period, such as after a six-month spenddown period, and a case is opened and closed the same day\n\n- When a LTC spenddown must be adjusted for past months to reflect actual income or deductions\n\n- When the spenddown type changes from a medical spenddown to an LTC spenddown\n\n- When a enrollee’s death has been verified\n\n- When an enrollee requests retroactive MA and is denied coverage for the retroactive months"}]},{"id":"epm:1.3.2","number":"1.3.2","title":"Responsibilities","parent":"1.3","breadcrumb":"1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.2 Responsibilities","summary":"All Minnesota Health Care Programs (MHCP) applicants and enrollees have responsibilities under various laws. Application forms, notices and brochures include information on responsibilities.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:24:35.343847+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/1.3.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/1_3_2.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:1.3.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.2","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.2 Responsibilities","text":"All Minnesota Health Care Programs (MHCP) applicants and enrollees have responsibilities under various laws. Application forms, notices and brochures include information on responsibilities.\n\nTopics covered in this subchapter are:\n\n1. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n\n2. [MHCP Cooperation](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.2)\n\n3. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n\n4. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n\n5. [MHCP Overpayments](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.5)"}]},{"id":"epm:1.3.2.1","number":"1.3.2.1","title":"Change in Circumstances","parent":"1.3.2","breadcrumb":"1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.2 Responsibilities > 1.3.2.1 Change in Circumstances","summary":"Minnesota Health Care Programs (MHCP) enrollees must report changes that may affect their eligibility. County, tribal and state servicing agencies must act on reported changes. Changes that people may be required to report include, but are not limited to:","effective_date":"2026-10-01","last_modified":"2026-10-03T03:58:41.951719+00:00","version":4,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/1.3.2.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/1_3_2_1.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.916","Code of Federal Regulations, title 42, section 435.919","Code of Federal Regulations, title 42, section 435.1200","Code of Federal Regulations, title 42, section 457.350","Code of Federal Regulations, title 45, section 155.330","Minnesota Rules, part 9505.0115, subpart 1","Minnesota Statutes 256B.057"],"chunks":[{"chunk_id":"epm:1.3.2.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.2 Responsibilities > 1.3.2.1 Change in Circumstances","text":"Minnesota Health Care Programs (MHCP) enrollees must report changes that may affect their eligibility. County, tribal and state servicing agencies must act on reported changes. Changes that people may be required to report include, but are not limited to:\n\n- Household composition, including household members moving in or out, births, deaths and marriages\n\n- Household tax filing and tax dependent status\n\n- Access to other health insurance, including Medicare\n\n- Pregnancy\n\n- Address\n\n- Assets\n\n- Income"},{"chunk_id":"epm:1.3.2.1#reporting-changes","heading":"Reporting Changes","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1#reporting-changes","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.2 Responsibilities > 1.3.2.1 Change in Circumstances > Reporting Changes","text":"## Reporting Changes\n\nApplicants and enrollees must report changes to their county, tribal or state servicing agency. They may report changes via:\n\n- Phone\n\n- Mail\n\n- In person\n\n- Using a renewal form\n\n### Inconsistent Information\n\nChanges are discovered in other ways, such as:\n\n- Changes reported by another person or agency\n\n- Changes reported by an enrollee to another program, such as the Supplemental Nutrition Assistance Program (SNAP)\n\n- Information reported by electronic matches\n\n- Upcoming or potential changes that the agency has been tracking\n\nAny of these changes may be inconsistent information. See [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4) policy for more information."},{"chunk_id":"epm:1.3.2.1#reporting-deadline","heading":"Reporting Deadline","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1#reporting-deadline","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.2 Responsibilities > 1.3.2.1 Change in Circumstances > Reporting Deadline","text":"## Reporting Deadline\n\nMA (except for MA-EPD), MFPP and Medicare Savings Program enrollees have 10 days to report changes to their county, tribal, or state servicing agency.\n\nMinnesotaCare enrollees have 30 days to report changes.\n\nMA-EPD enrolees have 30 days to report changes."},{"chunk_id":"epm:1.3.2.1#eligibility-redetermination","heading":"Eligibility Redetermination","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1#eligibility-redetermination","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.2 Responsibilities > 1.3.2.1 Change in Circumstances > Eligibility Redetermination","text":"## Eligibility Redetermination\n\nWhen an MHCP enrollee reports a change in circumstances, eligibility must be redetermined with the new information. This includes changes in household composition. Eligibility for MHCP enrollees no longer included in the household composition must be redetermined on a new case without requiring a new application.\n\n### Medical Assistance\n\nWhen an MA enrollee reports a change in circumstance that maintains MA eligibility but results in a beneficial outcome, such as additional benefits or lower cost sharing, the new MA eligibility begins the first day of the month in which the change occurred.\n\nWhen an MA enrollee reports a change in circumstances that maintains MA eligibility but results in an adverse outcome, such as lesser benefits or higher cost sharing, the date the new MA eligibility begins depends on when the change occurred. A 10-day advance notice is required for adverse changes. See the [MHCP Notices](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.5) policy for more information.\n\nWhen an MA enrollee reports a change in circumstance that results in the loss of their current MA basis of eligibility, they must be redetermined under all MA bases they are potentially eligible for, without interruption in their coverage. If an enrollee is no longer eligible for MA under any basis, eligibility must be redetermined for\n\n- MinnesotaCare\n\n- Advance Premium Tax Credits\n- Qualified Health Plan\n\nThe agency must send the relevant MHCP supplemental form (DHS-6696A or DHS-6696B) to the enrollee when additional information is required to determine eligibility under another MA basis or a different health care program. See the [MHCP Application Forms](https://bot-corpus.mn-dhs.online/s/epm/1.2.1) policy for more information.\n\nWhen additional information is required to determine eligibility under another basis:\n\n- The enrollee must remain eligible under their current MA basis without interruption in their coverage until the eligibility redetermination is complete.\n\n- The enrollee has 35 days to provide the relevant supplemental form and an additional 35 days to provide requested proofs.\n\nWhen a MA enrollee reports a change in circumstance that results in the loss of MA eligibility under all possible bases of eligibility, MA coverage ends the last day of the month for which advance notice can be given. Generally, 10-day advance notice is required to end MA coverage. See the [MHCP Notices](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.5) policy for more information.\n\nWhen a person enrolled in MinnesotaCare, Advance Premium Tax Credits or Qualified Health Plan reports a change in circumstance that results in MA eligibility, MA begins the first day of the month the change was reported, if the person does not need or is not eligible for retroactive coverage. The earliest possible begin date for MA is the first day of the month three months prior to the month the change was reported. A person may add a request for retroactive MA coverage up to 12 months from the month the person became eligible for MA. The person may be eligible for each retroactive month they meet the MA eligibility requirements and have paid or unpaid medical expenses that would be covered by MA in each month.\n\nThe Asset Verification Service (AVS) must be used when a person enrolled in MA for Families with Children and Adults (MA-FCA), MinnesotaCare, or another Insurance Affordability Program reports a change in circumstances that results in eligibility for MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) or Medicare Savings Programs (MSP). However, the eligibility determination for MA-ABD must not be delayed by the 10-day AVS processing period.\n\n### MinnesotaCare\n\nWhen a MinnesotaCare enrollee reports a change in circumstance that maintains MinnesotaCare eligibility but results in a different premium or cost sharing amount such as a change in income, the effective date of the premium change depends on whether it is a premium decrease or premium increase. A premium decrease is effective the month after the change was reported. A premium increase is effective for the month billed with the next regular billing cycle.\n\nWhen a MinnesotaCare enrollee reports a change in circumstances that results in MA eligibility, MinnesotaCare eligibility ends the day before MA eligibility begins.\n\nWhen a MinnesotaCare enrollee reports a change in circumstances that results in Advance Premium Tax Credit eligibility, MinnesotaCare eligibility and coverage ends the last day of the month for which advance notice can be given. Generally, 10-day advance notice is required to end MinnesotaCare coverage. See the [MHCP Notices](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.5) policy for more information.\n\nWhen a MinnesotaCare enrollee reports a change in circumstances that results in loss of all health care eligibility, MinnesotaCare eligibility and coverage ends the last day of the month for which advance notice can be given. Generally, 10-day advance notice is required to end MinnesotaCare coverage. See the [MHCP Notices](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.5) policy for more information.\n\nWhen a person enrolled in MA reports a change in circumstances that results in MinnesotaCare eligibility, MinnesotaCare eligibility begins no earlier than the first day of the month following the month MA ends. When a person enrolled in another Insurance Affordability Program reports a change in circumstance that results in MinnesotaCare eligibility, the earliest possible begin date for MinnesotaCare eligibility is the month the change was reported. MinnesotaCare coverage generally begins the first day of the month after the month in which eligibility is approved and a first premium payment is received, if the person is required to pay a premium. The coverage begin date for a person who is not required to pay a premium is the first day of the month after the month in which eligibility is approved. See MinnesotaCare Begin and End Dates for more information and exceptions for a person added to an existing MinnesotaCare household.\n\n### Medicare Savings Programs\n\nWhen a Medicare Savings Program (MSP) enrollee reports a change in circumstances that results in a change to a more beneficial MSP program, the new MSP eligibility begins the first day of the month in which the change occurred.\n\nWhen a MSP enrollee reports a change in circumstances that results in a change to a less beneficial MSP program, the date the new MSP eligibility begins depends on when the change occurred. A 10-day advance notice is required for adverse changes. See the [MHCP Notices](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.5) policy for more information.\n\nWhen a MSP enrollee reports a change in circumstances that results in the loss of MSP eligibility, MSP coverage ends the last day of the month for which advance notice can be given. Generally, 10-day notice is required to end MSP coverage. See the [MHCP Notices](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.5) policy for more information."},{"chunk_id":"epm:1.3.2.1#exceptions","heading":"Exceptions","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1#exceptions","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.2 Responsibilities > 1.3.2.1 Change in Circumstances > Exceptions","text":"## Exceptions\n\nChanges in circumstances do not affect eligibility in the following situations:\n\n- Most income increases between renewals do not change MA for Employed Persons with Disabilities (MA-EPD) monthly premiums. MA-EPD premiums may change at each six-month renewal. See the [MA-EPD Premium](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.2) policy for more information.\n\n- Changes in income, assets and household composition do not change eligibility for Refugee Medical Assistance (RMA). See the [RMA](https://bot-corpus.mn-dhs.online/s/epm/2.5.7) chapter for more information.\n\n- Income and household composition changes only change eligibility for the Minnesota Family Planning Program at renewal or when the person fails to report a change at renewal. See the [MFPP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4.1) policy for more information."}]},{"id":"epm:1.3.2.1.1","number":"1.3.2.1.1","title":"Death of an Applicant or Enrollee","parent":"1.3.2.1","breadcrumb":"1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.2 Responsibilities > 1.3.2.1 Change in Circumstances > 1.3.2.1.1 Death of an Applicant or Enrollee","summary":"Minnesota Health Care Programs (MHCP) applicants and enrollees must report changes that may affect their eligibility. County, tribal and state servicing agencies must act on reported changes. Death of an applicant, enrollee or household member is one of the changes that must be reported. Eligibility and coverage continue for the deceased enrollee through the end of the day the person died. When an","effective_date":"2025-07-02","last_modified":"2026-10-03T03:41:37.199792+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/1.3.2.1.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/1_3_2_1_1.htm","legal_citations":["Code of Federal Regulations, title 42, section 431.231","Code of Federal Regulations, title 42, section 435.916","Minnesota Statutes, section 144.225"],"chunks":[{"chunk_id":"epm:1.3.2.1.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1.1","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.2 Responsibilities > 1.3.2.1 Change in Circumstances > 1.3.2.1.1 Death of an Applicant or Enrollee","text":"Minnesota Health Care Programs (MHCP) applicants and enrollees must report changes that may affect their eligibility. County, tribal and state servicing agencies must act on reported changes. Death of an applicant, enrollee or household member is one of the changes that must be reported. Eligibility and coverage continue for the deceased enrollee through the end of the day the person died. When an agency receives a substantiated report that an applicant, enrollee or other household member has died, they must redetermine eligibility for the remaining household members. If an application filer dies, a new person must assume the role and responsibilities of the application filer for that household’s application. See EPM [1.2.2 MHCP Application Submission](https://bot-corpus.mn-dhs.online/s/epm/1.2.2) for more information."},{"chunk_id":"epm:1.3.2.1.1#substantiated-report-of-death","heading":"Substantiated Report of Death","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1.1#substantiated-report-of-death","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.2 Responsibilities > 1.3.2.1 Change in Circumstances > 1.3.2.1.1 Death of an Applicant or Enrollee > Substantiated Report of Death","text":"## Substantiated Report of Death\n\nThere are three ways a report of death can be substantiated:\n- Information received from an acceptable electronic data source Information that an MHCP applicant, enrollee or household member has died received directly from the Social Security Administration (SSA), the Minnesota Department of Health (MDH) Office of Vital Records, or the [MDH Minnesota Death Search](https://www.health.state.mn.us/people/vitalrecords/deathsearch/dthSearch.html) is considered substantiated.\n- Report from a “first party” Information that an MHCP applicant, enrollee or household member has died received from a “first party” is considered substantiated. A first party is a competent adult family member, or agent, such as a former power of attorney, or an authorized representative.\n- Report from a “third party” confirmed by an electronic data source or first party Information that an MHCP applicant, enrollee or household member has died received from a “third party” must be confirmed by an acceptable electronic data source or a first party to be considered substantiated. A “third party” is anyone who is not a “first party.” Confirmation is required before the agency acts on a report of death from a third party. If no record of death is available from an accepted electronic data source, the agency must confirm the death with a first party before acting on the information.\n\nIf a person’s MHCP is closed based on information from a first party or an electronic data source, and the agency later learns that the person has not died, eligibility must be redetermined and coverage restored for any partial or full months which the person was eligible."}]},{"id":"epm:1.3.2.2","number":"1.3.2.2","title":"Cooperation","parent":"1.3.2","breadcrumb":"1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.2 Responsibilities > 1.3.2.2 Cooperation","summary":"Applicants and enrollees must comply with various requirements for Minnesota Health Care Program (MHCP) eligibility. This includes general requirements, such as providing information and mandatory verifications, and specific requirements such as applying for Medicare. Clients who fail to cooperate with requirements may lose their health coverage.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:56:38.180133+00:00","version":3,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.2.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/1.3.2.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/1_3_2_2.htm","legal_citations":["Code of Federal Regulations, title 42, sections 433.135 to 433.154","Minnesota Statutes, section 256L.04, subdivision 2"],"chunks":[{"chunk_id":"epm:1.3.2.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.2.2","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.2 Responsibilities > 1.3.2.2 Cooperation","text":"Applicants and enrollees must comply with various requirements for Minnesota Health Care Program (MHCP) eligibility. This includes general requirements, such as providing information and mandatory verifications, and specific requirements such as applying for Medicare. Clients who fail to cooperate with requirements may lose their health coverage.\n\nSee the [Medical Assistance Cooperation](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.2) policy and the [MinnesotaCare Cooperation](https://bot-corpus.mn-dhs.online/s/epm/3.1.2.1) policy for more information."}]},{"id":"epm:1.3.2.3","number":"1.3.2.3","title":"Fraud","parent":"1.3.2","breadcrumb":"1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.2 Responsibilities > 1.3.2.3 Fraud","summary":"This policy covers the definition of fraud and referrals for investigation. The Minnesota Office of the Attorney General or the appropriate county attorney may prosecute or recover wrongfully obtained Minnesota Health Care Programs eligibility through a criminal action, a civil action, or both.","effective_date":"2016-06-01","last_modified":"2026-10-02T15:12:42.39583+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/1.3.2.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/1_3_2_3.htm","legal_citations":["Minnesota Statutes, section 256.98","Social Security Act Section 1917b"],"chunks":[{"chunk_id":"epm:1.3.2.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.2 Responsibilities > 1.3.2.3 Fraud","text":"This policy covers the definition of fraud and referrals for investigation. The Minnesota Office of the Attorney General or the appropriate county attorney may prosecute or recover wrongfully obtained Minnesota Health Care Programs eligibility through a criminal action, a civil action, or both.\n\nFraud exists when:\n\n- People willfully or intentionally provide a false statement or withhold, conceal or misrepresent information to receive or attempt to receive coverage for which they are not eligible\n\n- People plan with or knowingly help another person to fraudulently seek or obtain assistance\n\nBy signing the application, an applicant or enrollee acknowledges that:\n\n- Their information will be shared for fraud investigations and audits as stated in the Notice of Privacy Practices\n\n- Their information may be shared with fraud investigators\n\n- Their consent does not end after one year for records given to fraud investigators"},{"chunk_id":"epm:1.3.2.3#suspected-fraud","heading":"Suspected Fraud","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3#suspected-fraud","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.2 Responsibilities > 1.3.2.3 Fraud > Suspected Fraud","text":"## Suspected Fraud\n\n- Anyone can report suspected fraud on the DHS [How to report fraud](https://mn.gov/dhs/about-us/about-human-services/terms-rights-access/report-fraud/) web page\n\n- The county, tribal or state servicing agency should refer suspected fraud to the appropriate fraud investigators\n\n- Health Care Eligibility Operations (MinnesotaCare) should refer suspected fraud to the MinnesotaCare Fraud Investigation Team"},{"chunk_id":"epm:1.3.2.3#minnesotacare-disqualification","heading":"MinnesotaCare Disqualification","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3#minnesotacare-disqualification","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.2 Responsibilities > 1.3.2.3 Fraud > MinnesotaCare Disqualification","text":"## MinnesotaCare Disqualification\n\nPeople who are age 65 or older are eligible for MinnesotaCare using state funds. They can be disqualified for MinnesotaCare if they are found to have committed an Intentional Program Violation (IPV) through any of the following:\n\n- A state or federal court conviction\n\n- A disqualification consent agreement\n\n- A pre-trial diversion\n\n- An Administrative Disqualification Hearing (ADH), or a waiver of an ADH\n\nPeople disqualified from MinnesotaCare cannot receive coverage for the following time periods:\n\n- 12 months for the first offense\n\n- 24 months for the second offense\n\n- Permanently for the third offense"}]},{"id":"epm:1.3.2.4","number":"1.3.2.4","title":"Inconsistent Information","parent":"1.3.2","breadcrumb":"1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.2 Responsibilities > 1.3.2.4 Inconsistent Information","summary":"The county, tribal or state servicing agency must evaluate and pursue resolution of inconsistent information when the information provided by the applicant or enrollee is inconsistent with other information.","effective_date":"2024-03-30","last_modified":"2026-10-03T03:24:35.343847+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/1.3.2.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/1_3_2_4.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.952","Minnesota Statutes, section 256B.061"],"chunks":[{"chunk_id":"epm:1.3.2.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.2 Responsibilities > 1.3.2.4 Inconsistent Information","text":"The county, tribal or state servicing agency must evaluate and pursue resolution of inconsistent information when the information provided by the applicant or enrollee is inconsistent with:\n- Other information the agency has\n- The applicant or enrollee’s own statements\n- Information collected for purposes of a case review, audit, fraud investigation or over payment analysis\n- Information obtained from electronic sources\n\nThe county, tribal or state servicing agency must evaluate and pursue resolution of information that is inconsistent with documentation or information on file, if all of the following conditions exist:\n- The information is necessary to determine at least one of the following:\n  - Eligibility\n  - Premium amount\n  - Spenddown\n- The information is inconsistent with at least one of the following:\n  - Other information the agency has\n  - A client's own statements\n- The client cannot satisfactorily explain an inconsistency\n\nEnrollees must provide information and proofs within 10 days when:\n- inconsistent information is received or discovered between renewals.\n- an unreported account is received through the Asset Verification Service (AVS) for the person, their spouse, or their sponsor.\n\nAn enrollee’s health coverage may end if they fail to respond to an inquiry regarding inconsistent information.\n\nSee the [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3) policy if there is reason to suspect an applicant or enrollee is withholding, concealing or misrepresenting information."}]},{"id":"epm:1.3.2.5","number":"1.3.2.5","title":"Overpayments","parent":"1.3.2","breadcrumb":"1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.2 Responsibilities > 1.3.2.5 Overpayments","summary":"Overpayments occur when an enrollee receives more Minnesota Health Care Programs (MHCP) benefits than they were entitled to as a result of fraud, theft, abuse or error on the part of the enrollee.","effective_date":"2018-09-01","last_modified":"2026-10-03T03:24:35.343847+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.2.5","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/1.3.2.5","official_origin":"https://hcopub.dhs.state.mn.us/epm/1_3_2_5.htm","legal_citations":["Minnesota Rules, part 9505.0131","Minnesota Rules, part 9505.2215","Minnesota Statutes, section 256.01, subdivision 2(s)","Minnesota Statutes, section 256.98","Minnesota Statutes, section 256.045, subdivision 10","Minnesota Statutes, section 256.0471","Minnesota Statutes, section 256B.016","Minnesota Statutes, section 270A","United States Code, title 42, section 1396b(d)"],"chunks":[{"chunk_id":"epm:1.3.2.5#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.2.5","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.2 Responsibilities > 1.3.2.5 Overpayments","text":"Overpayments occur when an enrollee receives more Minnesota Health Care Programs (MHCP) benefits than they were entitled to as a result of fraud, theft, abuse or error on the part of the enrollee.\n\nOverpayments are not determined when recovery of the overpayment would be unreasonable or unfair. Examples of when it may be unreasonable or unfair to cite an overpayment include, but are not limited to, when:\n- The overpayment is the result of agency error\n- The enrollee reports a change timely and the agency cannot provide timely notice\n- Eligibility was determined using the enrollee’s estimate of expected income and the enrollee’s actual income was later found to be higher than the original estimate\n- There is suspected fraud or unreported information that has not yet been verified or confirmed\n\nThe overpayment amount:\n- Is the amount the health care program paid for benefits on behalf of the enrollee, either through fee-for-service claims or managed care payments, minus premiums paid for the overpayment period.\n- The amount MHCP paid for benefits is compared to the benefits the enrollee should have received. The overpayment amount may be reduced or eliminated if the enrollee would have been eligible for the same program under a different basis."},{"chunk_id":"epm:1.3.2.5#overpayment-notification","heading":"Overpayment Notification","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.2.5#overpayment-notification","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.2 Responsibilities > 1.3.2.5 Overpayments > Overpayment Notification","text":"## Overpayment Notification\n\nPeople must receive written notice of overpayments using Minnesota Health Care Programs Notice of Overpayment ([DHS-4939](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-4939-ENG)) or Notice of Medical Assistance Overpayment ([DHS-4600](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-4600-ENG)). The notice:\n- explains the reason for the overpayment,\n- shows how the overpayment was computed,\n- requests repayment,\n- advises enrollees that further action may be taken if payment is not made, and\n- advises enrollees of their appeal rights."},{"chunk_id":"epm:1.3.2.5#overpayment-collection","heading":"Overpayment Collection","url":"https://bot-corpus.mn-dhs.online/s/epm/1.3.2.5#overpayment-collection","context":"EPM > 1 Minnesota Health Care Programs > 1.3 Client Rights and Responsibilities > 1.3.2 Responsibilities > 1.3.2.5 Overpayments > Overpayment Collection","text":"## Overpayment Collection\n\nAvailable collection methods vary according to the program, whether the overpayment is determined to be the result of fraud, and whether the person is a current enrollee.\n\n### Voluntary Repayment\n\nVoluntary repayment is available for all MHCPs and for both current and former enrollees. Each county, tribal or state servicing agency sets its own procedures for receiving voluntary repayments.\n\n### Revenue Recapture\n\nRevenue recapture allows the county, tribal or state servicing agency to recover overpayments in MHCPs by intercepting income or property tax refunds and lottery winnings. Counties and DHS collections must submit requests for revenue recapture to the Commissioner of Revenue, who determines if revenue recapture is allowable under the Revenue Recapture Act, Minnesota Statutes 270A.\n- Revenue recapture may be used when the individual is no longer enrolled in the MHCP for which the debt is owed. Revenue recapture may be used for an overpayment established from an agency finding based on enrollee error, an administrative appeal decision based on enrollee error, or a court determination of benefits incorrectly paid.\n- Some health care overpayments may not be recoverable through revenue recapture. Recovery of overpayments for medical care is prohibited if the person’s income was below certain limits at the time the benefits were received.\n\n### Civil Recovery\n\nCivil recovery includes obtaining a judgment and pursuing repayment through methods such as garnishment or property liens. Current enrollees are protected from civil recovery while they are enrolled and for six months after enrollment ends.\n- For MA, these methods are only available after a civil or criminal court judgment with a finding that benefits were incorrectly paid, with or without a finding that fraud occurred.\n- For state funded health care programs, the county agency or DHS collections may use the Judgment by Operation of Law (JOL) procedures outlined in Minnesota Statutes 256.0471.\n\n### Criminal Restitution\n\nAs part of the sentence for a conviction for fraud, the court may order the person to make restitution. The court may:\n- Lower the previously determined overpayment amount. order a monetary restitution for an amount less than the previously determined overpayment amount without reducing the total overpayment. This means that the person must pay a reduced amount as a condition of probation. The county or DHS collections may pursue repayment of the remainder of the overpayment through civil recovery or revenue recapture.\n- Order restitution in addition to the previously determined overpayment amount, such as fines, penalties, and accrued interest. Any added restitution is collected and retained entirely by the court or the agency that brought the fraud charge."}]},{"id":"epm:1.4","number":"1.4","title":"State Residency","parent":"1","breadcrumb":"1 Minnesota Health Care Programs > 1.4 State Residency","summary":"Minnesota Health Care Programs (MHCP) are only available to Minnesota residents.","effective_date":"2018-04-01","last_modified":"2026-10-03T03:24:35.343847+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/1.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/1_4.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.403","Minnesota Statutes, section 256B.056, subdivision 1","Minnesota Statutes, section 256.01, subdivision 18a","Minnesota Statutes, section 256L.09"],"chunks":[{"chunk_id":"epm:1.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.4","context":"EPM > 1 Minnesota Health Care Programs > 1.4 State Residency","text":"Minnesota Health Care Programs (MHCP) are only available to Minnesota residents."},{"chunk_id":"epm:1.4#people-age-21-or-older","heading":"People Age 21 or Older","url":"https://bot-corpus.mn-dhs.online/s/epm/1.4#people-age-21-or-older","context":"EPM > 1 Minnesota Health Care Programs > 1.4 State Residency > People Age 21 or Older","text":"## People Age 21 or Older\n\nPeople age 21 or older are a Minnesota resident if one of the following applies:\n- The person is living in Minnesota AND intends to reside in the state. This includes people without a fixed address.\n- The person is living in Minnesota AND has entered the state with a job commitment or is seeking employment (whether or not currently employed).\n\nIf a person is not capable of indicating intent, the person is a Minnesota resident if they are living in Minnesota. A person is not capable of indicating intent if they meet any of the following:\n- Have an I.Q. of 49 or less\n- Have a mental age of seven or less\n- Is determined legally incompetent by a court\n- Is found incapable of indicating intent by a physician, psychologist, or other person licensed by the state in the field of intellectual disability"},{"chunk_id":"epm:1.4#people-younger-than-age-21","heading":"People Younger Than Age 21","url":"https://bot-corpus.mn-dhs.online/s/epm/1.4#people-younger-than-age-21","context":"EPM > 1 Minnesota Health Care Programs > 1.4 State Residency > People Younger Than Age 21","text":"## People Younger Than Age 21\n\nPeople under age 21 who are emancipated follow the policy for people age 21 or older. Otherwise, people under age 21 are a Minnesota resident if one of the following applies.\n- The person is living in Minnesota, including people without a fixed address\n- The person resides with a parent or caretaker who is a Minnesota resident"},{"chunk_id":"epm:1.4#living-in-minnesota","heading":"Living in Minnesota","url":"https://bot-corpus.mn-dhs.online/s/epm/1.4#living-in-minnesota","context":"EPM > 1 Minnesota Health Care Programs > 1.4 State Residency > Living in Minnesota","text":"## Living in Minnesota\n\nA person is living in Minnesota if they reside in the state. To reside in the state means the person has made Minnesota their home.\n\nIf a person is not physically present in Minnesota, a person is living in Minnesota if they meet a condition for [temporary absence](https://bot-corpus.mn-dhs.online/s/epm/1.4.4).\n\nPeople visiting Minnesota, including for the purpose of obtaining medical care, do not reside in Minnesota and are not residents of the state."},{"chunk_id":"epm:1.4#inconsistent-information-regarding-state-residency","heading":"Inconsistent Information Regarding State Residency","url":"https://bot-corpus.mn-dhs.online/s/epm/1.4#inconsistent-information-regarding-state-residency","context":"EPM > 1 Minnesota Health Care Programs > 1.4 State Residency > Inconsistent Information Regarding State Residency","text":"## Inconsistent Information Regarding State Residency\n\nPeople are not required to provide proof of residency unless the person’s attestation related to residency is inconsistent with other information provided by the person or known to the agency. The person may have to provide proof of residency to resolve the inconsistency.\n\nA person's immigration status cannot be used to establish an inconsistency in state residency. Additional information about state residency can only be requested if information other than immigration status is inconsistent with attested state residency.\n\nExamples of inconsistent information regarding state residency include, but are not limited to:\n- Receipt of a Public Assistance Reporting Information System (PARIS) interstate match\n- Returned mail with an out of state forwarding address\n- Other information or circumstances that may yield information about state residency\n\nAcceptable proof of state residency includes, but is not limited to:\n- Correspondence showing a person receives mail at the address given\n- A copy of a valid Minnesota drivers’ license or ID card. A valid driver’s license is a license that is not expired, suspended, revoked or canceled. The license must contain the person’s current address. If the person moves, they must get a new Minnesota drivers’ license within 30 days. A Minnesota driver’s license is not valid if the person also possesses a driver’s license issued by another state.\n- The most recent federal or state tax forms showing the person’s current address\n- A copy of a Minnesota property tax statement\n- A copy of a rental or lease agreement\n- Documentation that the person came to Minnesota in response to an offer of employment\n- Documentation that the person has looked for work, such as completed job applications or documentation from employers, the local job service office or temporary employment agencies\n- An affidavit from a person engaged in public or private social services, legal services, law enforcement or health services that states he or she knows the person and believes the person resides in Minnesota\n- For preschool, elementary and secondary school-age children, a copy of a student identification card, report card, day care receipt or other documentation of school or day care registration\n- A completed Proof of Residence ([DHS-6035A](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-6035A-ENG)) form"},{"chunk_id":"epm:1.4#people-who-are-a-resident-of-another-state","heading":"People who are a Resident of Another State","url":"https://bot-corpus.mn-dhs.online/s/epm/1.4#people-who-are-a-resident-of-another-state","context":"EPM > 1 Minnesota Health Care Programs > 1.4 State Residency > People who are a Resident of Another State","text":"## People who are a Resident of Another State\n\nPeople cannot be residents of more than one state. Generally, if another state has determined a person to be a resident of their state then they are not a Minnesota resident.\n\nIn cases where two or more states cannot resolve which state is the state of residence, the person is a resident of the state in which they are physically located."},{"chunk_id":"epm:1.4#overlapping-state-coverage","heading":"Overlapping State Coverage","url":"https://bot-corpus.mn-dhs.online/s/epm/1.4#overlapping-state-coverage","context":"EPM > 1 Minnesota Health Care Programs > 1.4 State Residency > Overlapping State Coverage","text":"## Overlapping State Coverage\n\nPeople must not receive Medical Assistance (MA) from more than one state at a time. However, a person who has MA coverage in another state may be eligible for MA coverage in Minnesota when the person:\n- Meets all other eligibility factors for a Minnesota Health Care Program\n- Has requested the other state close coverage, and\n- Cannot reasonably access coverage from the other state"},{"chunk_id":"epm:1.4#residency-rules-for-certain-populations","heading":"Residency Rules for Certain Populations","url":"https://bot-corpus.mn-dhs.online/s/epm/1.4#residency-rules-for-certain-populations","context":"EPM > 1 Minnesota Health Care Programs > 1.4 State Residency > Residency Rules for Certain Populations","text":"## Residency Rules for Certain Populations\n\nThe following groups of people have special rules for determining their state of residency:\n- People, of any age, who receive a State Supplementary Payment (SSP) are residents of the state paying the SSP. SSP is a state paid supplement to federally funded Supplemental Security Income (SSI). Minnesota Supplemental Aid (MSA) is Minnesota’s SSP. A person who receives MSA is a Minnesota resident. A person who receives a SSP from another state is not a Minnesota resident.\n- People who receive [Title IV-E or state-funded adoption assistance or foster care](https://bot-corpus.mn-dhs.online/s/epm/1.4.2)\n- People who reside in an [institution](https://bot-corpus.mn-dhs.online/s/epm/1.4.3)"}]},{"id":"epm:1.4.1","number":"1.4.1","title":"Interstate Residency Agreements","parent":"1.4","breadcrumb":"1 Minnesota Health Care Programs > 1.4 State Residency > 1.4.1 Interstate Residency Agreements","summary":"Minnesota has the following agreements with other states in regards to state residency.","effective_date":"2019-06-01","last_modified":"2026-10-03T03:52:02.277143+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.4.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/1.4.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/1_4_1.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.403","Minnesota Statutes, section 256B.056, subdivision 1","Minnesota Statutes, section 256L.09"],"chunks":[{"chunk_id":"epm:1.4.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.4.1","context":"EPM > 1 Minnesota Health Care Programs > 1.4 State Residency > 1.4.1 Interstate Residency Agreements","text":"Minnesota has the following agreements with other states in regards to state residency."},{"chunk_id":"epm:1.4.1#north-dakota-agreement","heading":"North Dakota Agreement","url":"https://bot-corpus.mn-dhs.online/s/epm/1.4.1#north-dakota-agreement","context":"EPM > 1 Minnesota Health Care Programs > 1.4 State Residency > 1.4.1 Interstate Residency Agreements > North Dakota Agreement","text":"## North Dakota Agreement\n\nMinnesota and North Dakota have an interstate agreement that governs state residence for people who reside in one state and enter a skilled nursing facility in the other state. The agreement applies only to skilled nursing facilities (sometimes referred to as nursing homes). It does not apply to any other type of living arrangement such as assisted living, boarding homes or medical hospitals. It does not apply to home and community-based waiver services.\n\nUnder the agreement, a North Dakota resident who moves to a Minnesota nursing facility from North Dakota is not a Minnesota resident:\n- for 24 months following the date of admission if the person has no community spouse living in North Dakota and was not placed in the facility by North Dakota, or until a Minnesota county, tribal or state servicing agency assumes responsibility for the person’s care, whichever comes first.\n- for at least 24 months following the date of admission and indefinitely as long as the person has a community spouse living in North Dakota, unless a Minnesota county, tribal or state servicing agency assumes responsibility for the person’s care after the 24 months.\n- for at least 24 months following the date of admission if the person was placed in the facility by North Dakota and indefinitely, unless a Minnesota county, tribal or state servicing agency assumes responsibility for the person’s care after the 24 months.\n\nA Minnesota resident who moves to a North Dakota nursing facility from Minnesota is a Minnesota resident:\n- for 24 months following the date of admission if the person has no community spouse living in Minnesota and was not placed in the facility by Minnesota, or until a North Dakota state or county agency assumes responsibility for the person’s care, whichever comes first.\n- for at least 24 months following the date of admission and indefinitely as long as the person has a community spouse living in Minnesota, unless a North Dakota state or county agency assumes responsibility for the person’s care after the 24 months.\n- for at least 24 months following the date of admission if the person was placed in the facility by Minnesota and indefinitely, unless a North Dakota state or county agency assumes responsibility for the person’s care after the 24 months."},{"chunk_id":"epm:1.4.1#interstate-compact-on-mental-health-and-state-operated-services","heading":"Interstate Compact on Mental Health and State Operated Services","url":"https://bot-corpus.mn-dhs.online/s/epm/1.4.1#interstate-compact-on-mental-health-and-state-operated-services","context":"EPM > 1 Minnesota Health Care Programs > 1.4 State Residency > 1.4.1 Interstate Residency Agreements > Interstate Compact on Mental Health and State Operated Services","text":"## Interstate Compact on Mental Health and State Operated Services\n\nThe Interstate Compact on Mental Health (the Compact) is an agreement between most states, including Minnesota, which allows a state to transfer a person directly from a state-operated treatment facility in their state to a state-operated treatment facility in another state. The purpose of the Compact is to enable a family member of a person who meets certain criteria to request that the person receive treatment closer to the family member. People are not transferred under the Compact for the purpose of short-term hospitalization with the intent that they will be returning to the state. Transfer means the person wants to transfer to another state for continued treatment and to remain in the receiving state.\n\nThe Minnesota Department of Human Services (DHS) has a Compact Coordinator who facilitates transfers under this agreement.\n- A person, under this agreement, who is in a Minnesota state-operated treatment facility who is transferred to a state-operated facility in another state, is a resident of the receiving state. The person is no longer a Minnesota resident.\n- A person, under this agreement, who is in a state-operated facility in another state who is transferred to a Minnesota state-operated facility, is a Minnesota resident.\n- Prior to authorizing a transfer under the Compact, the Compact Coordinator obtains agreement from the affected county or tribe to accept financial and social service responsibility for the person."},{"chunk_id":"epm:1.4.1#interstate-compact-on-the-placement-of-children","heading":"Interstate Compact on the Placement of Children","url":"https://bot-corpus.mn-dhs.online/s/epm/1.4.1#interstate-compact-on-the-placement-of-children","context":"EPM > 1 Minnesota Health Care Programs > 1.4 State Residency > 1.4.1 Interstate Residency Agreements > Interstate Compact on the Placement of Children","text":"## Interstate Compact on the Placement of Children\n\nThe Interstate Compact on the Placement of Children (ICPC) is an agreement among all 50 states that governs states' responsibility when sending children across state lines for the purpose of placement in foster care, adoptive homes, group homes and residential treatment centers. See the [MHCP State Residency for Adoption Assistance and Foster Care](https://bot-corpus.mn-dhs.online/s/epm/1.4.2) policy for more information."},{"chunk_id":"epm:1.4.1#interstate-compact-on-adoption-and-medical-assistance","heading":"Interstate Compact on Adoption and Medical Assistance","url":"https://bot-corpus.mn-dhs.online/s/epm/1.4.1#interstate-compact-on-adoption-and-medical-assistance","context":"EPM > 1 Minnesota Health Care Programs > 1.4 State Residency > 1.4.1 Interstate Residency Agreements > Interstate Compact on Adoption and Medical Assistance","text":"## Interstate Compact on Adoption and Medical Assistance\n\nThe Interstate Compact on Adoption and Medical Assistance (ICAMA) is a federal contract between Minnesota and other states designed to prevent and overcome barriers to interstate adoptions and to coordinate services for adopted children with special needs. Under ICAMA children, from another state, who receive Title IV-E adoption assistance are automatically eligible for MA when they move to Minnesota. Children who receive non-Title IV-E adoption assistance through an agreement that includes health care coverage, are automatically eligible for MA when they move to Minnesota. Not all states provide automatic MA for non-Title IV-E adoption assistance children, even if the state is a part of ICAMA. Those states which extend MA coverage to interstate agreements through reciprocity under the Consolidated Omnibus Reconciliation Act of 1985 (COBRA), also known as COBRA-Reciprocity, will provide MA to non-Title IV-E adoption assistance children who move there from another state. See the [COBRA and COBRA-Reciprocity chart](https://aaicama.org/cms/index.php/medical-assistance/state-funded/cobra-cobra-reciprocity) on the Association of Administrators of the Interstate Compact on Adoption and Medical Assistance (AAICAMA) website for a state by state listing. See the [MHCP State Residency for Adoption Assistance and Foster Care](https://bot-corpus.mn-dhs.online/s/epm/1.4.2) policy and [MA Northstar Care Adoption Assistance](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1) subchapter for more information."}]},{"id":"epm:1.4.2","number":"1.4.2","title":"State Residency for Adoption Assistance, Kinship Assistance, and Foster Care","parent":"1.4","breadcrumb":"1 Minnesota Health Care Programs > 1.4 State Residency > 1.4.2 State Residency for Adoption Assistance, Kinship Assistance, and Foster Care","summary":"Children who receive adoption assistance or who are in foster care have special rules for determining their state of residency.","effective_date":"2025-12-05","last_modified":"2026-10-03T03:52:02.820955+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.4.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/1.4.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/1_4_2.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.403","Minnesota Statutes, section 256B.056, subdivision 1","Minnesota Statutes, section 260C.007, subdivision 27","Minnesota Statutes, section 256L.09"],"chunks":[{"chunk_id":"epm:1.4.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.4.2","context":"EPM > 1 Minnesota Health Care Programs > 1.4 State Residency > 1.4.2 State Residency for Adoption Assistance, Kinship Assistance, and Foster Care","text":"Children who receive adoption assistance or who are in foster care have special rules for determining their state of residency."},{"chunk_id":"epm:1.4.2#adoption-assistance","heading":"Adoption Assistance","url":"https://bot-corpus.mn-dhs.online/s/epm/1.4.2#adoption-assistance","context":"EPM > 1 Minnesota Health Care Programs > 1.4 State Residency > 1.4.2 State Residency for Adoption Assistance, Kinship Assistance, and Foster Care > Adoption Assistance","text":"## Adoption Assistance\n\nChildren who live in Minnesota and receive Title IV-E adoption assistance or non-Title IV-E adoption assistance are Minnesota residents. This includes children who receive adoption assistance from another state. Under the [Interstate Compact on Adoption and Medical Assistance (ICAMA)](https://bot-corpus.mn-dhs.online/s/epm/1.4.1), a child who lives in Minnesota and receives non-Title IV-E adoption assistance from another state is automatically eligible for Medical Assistance (MA) in Minnesota, if the adoption assistance agreement from the other state includes health care coverage.\n\nChildren who live in another state and receive non-Title IV-E adoption assistance from Minnesota are residents of the other state if that state has a reciprocity policy under the Consolidated Omnibus Reconciliation Act of 1985 (COBRA), also known as COBRA-Reciprocity. COBRA-Reciprocity, administered through the [Interstate Compact on Adoption and Medical Assistance (ICAMA)](https://bot-corpus.mn-dhs.online/s/epm/1.4.1) provides automatic health care eligibility in a state when an adoption assistance recipient moves there from another state and the adoption assistance agreement includes healthcare. If the state does not have a COBRA-Reciprocity policy, the child remains a Minnesota resident, for the purposes of health care coverage. See the [Medicaid State-Funded (Non-Title IV-E) Adoption Assistance COBRA Reciprocity Chart](https://aaicama.org/wp-content/uploads/2024/02/Medicaid-Reciprocity-Non-Title-IV-E-AA-2024-1.pdf) on the [Association of Administrators of the Interstate Compact on Adoption and Medical Assistance (AAICAMA) website](https://aaicama.org/medicaid/) for a state by state listing."},{"chunk_id":"epm:1.4.2#northstar-kinship-assistance","heading":"Northstar Kinship Assistance","url":"https://bot-corpus.mn-dhs.online/s/epm/1.4.2#northstar-kinship-assistance","context":"EPM > 1 Minnesota Health Care Programs > 1.4 State Residency > 1.4.2 State Residency for Adoption Assistance, Kinship Assistance, and Foster Care > Northstar Kinship Assistance","text":"## Northstar Kinship Assistance\n\nState residency for children who receive [Northstar Kinship Assistance](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2) from Minnesota or Guardianship Assistance from another state is determined according to EPM [1.4 MHCP State Residency](https://bot-corpus.mn-dhs.online/s/epm/1.4)."},{"chunk_id":"epm:1.4.2#foster-care","heading":"Foster Care","url":"https://bot-corpus.mn-dhs.online/s/epm/1.4.2#foster-care","context":"EPM > 1 Minnesota Health Care Programs > 1.4 State Residency > 1.4.2 State Residency for Adoption Assistance, Kinship Assistance, and Foster Care > Foster Care","text":"## Foster Care\n\n[Children in foster care](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3) in Minnesota who are Title IV-E eligible are Minnesota residents. A person who lives in Minnesota and receives these payments is a Minnesota resident; a person who receives these payments who lives in another state is not a Minnesota resident.\n\nChildren in foster care in Minnesota who are not Title IV-E eligible are Minnesota residents if a Minnesota social services agency placed them in foster care, or if another state placed them in foster care in Minnesota with a relative or important friend.\n\nA “relative or important friend” means any of the following:\n- A person related to the child by blood, marriage or adoption\n- The legal parent, guardian or custodian of the child's siblings.\n- An individual who is an important friend of the child or of the child's parent or custodian, including an individual with whom the child has resided or had significant contact or who has a significant relationship to the child or the child's parent or custodian.\n\nChildren placed in foster care in Minnesota by another state who are not Title IV-E eligible are not Minnesota residents if they are placed with a person who does not meet the definition of “relative or important friend,” including placements in facilities or institutions. These children are residents of the state that arranged for the child to be placed in foster care (including the state agency, county agency, or other entity under contract with the state) and therefore are not eligible for any Minnesota Health Care Program."}]},{"id":"epm:1.4.3","number":"1.4.3","title":"State Residency for People in an Institution","parent":"1.4","breadcrumb":"1 Minnesota Health Care Programs > 1.4 State Residency > 1.4.3 State Residency for People in an Institution","summary":"There are specific rules that govern state residency for people who reside in an institution. An institution is an establishment that furnishes food, shelter and some treatment or services to four or more persons unrelated to the proprietor.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:24:35.343847+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.4.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/1.4.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/1_4_3.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.403","Minnesota Statutes, section 256B.056, subdivision 1","Minnesota Statutes, section 256L.09"],"chunks":[{"chunk_id":"epm:1.4.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.4.3","context":"EPM > 1 Minnesota Health Care Programs > 1.4 State Residency > 1.4.3 State Residency for People in an Institution","text":"There are specific rules that govern state residency for people who reside in an institution. An institution is an establishment that furnishes food, shelter and some treatment or services to four or more persons unrelated to the proprietor. It also includes medical institutions, such as a skilled nursing facility, intermediate care facility for persons with developmental disabilities or an inpatient hospital."},{"chunk_id":"epm:1.4.3#residency-rules-for-certain-populations","heading":"Residency Rules for Certain Populations","url":"https://bot-corpus.mn-dhs.online/s/epm/1.4.3#residency-rules-for-certain-populations","context":"EPM > 1 Minnesota Health Care Programs > 1.4 State Residency > 1.4.3 State Residency for People in an Institution > Residency Rules for Certain Populations","text":"## Residency Rules for Certain Populations\n\nThe following people who reside in an institution have special rules for determining state residency:\n- People who reside in a skilled nursing facility (sometimes referred to as a nursing home) under the [North Dakota Agreement](https://bot-corpus.mn-dhs.online/s/epm/1.4.1#north-dakota-agreement)\n- People who reside in a state-operated treatment facility under the [Interstate Compact on Mental Health and State Operated Services](https://bot-corpus.mn-dhs.online/s/epm/1.4.1#interstate-compact-on-mental-health-and-state-operated-services) (SOS)\n- People placed by a state into an out-of-state institution\n\nUnless placed through the Interstate Compact on Mental Health, people who are placed by a state into an out-of-state institution are residents of the state making the placement.\n\nA person who is placed by Minnesota into an institution in another state is a Minnesota resident. A person who is placed by another state into an institution in Minnesota is not a Minnesota resident.\n\n“Placed by a state” means any state agency or entity under contract with the state, including a county agency, which arranges for a person to be placed in an institution located in another state. Providing information to the person or the person’s family does not constitute arranging a placement."},{"chunk_id":"epm:1.4.3#people-age-21-or-older","heading":"People Age 21 or Older","url":"https://bot-corpus.mn-dhs.online/s/epm/1.4.3#people-age-21-or-older","context":"EPM > 1 Minnesota Health Care Programs > 1.4 State Residency > 1.4.3 State Residency for People in an Institution > People Age 21 or Older","text":"## People Age 21 or Older\n\nThe state residency for people age 21 or older who reside in an institution is based on whether the person is capable of indicating intent. A person is incapable of indicating intent if they meet any of the following:\n- Have an I.Q. of 49 or less\n- Have a mental age of seven or less\n- Is determined legally incompetent by a court\n- Is found incapable of indicating intent by a physician, psychologist, or other person licensed by the state in the field of intellectual disability\n\nPeople age 21 or older who reside in an institution are Minnesota residents if:\n- They became incapable of indicating intent before age 21, and any of the following apply:\n  - Their parents reside in separate states, and the parent who submitted an application on behalf of the person is a Minnesota resident. If a legal guardian has been appointed and parental rights are terminated, the state of residence of the legal guardian is used instead of the parent’s state of residence.\n  - The parent or legal guardian at the time of placement was a Minnesota resident. If a legal guardian has been appointed and parental rights are terminated, the state of residence of the legal guardian is used instead of the parent’s state of residence.\n  - The parent or legal guardian who submitted the application on behalf of the person is currently a Minnesota resident and the person resides in an institution in Minnesota. If a legal guardian has been appointed and parental rights are terminated, the state of residence of the legal guardian is used instead of the parent’s state of residence.\n  - The person resides in an institution in Minnesota, has been abandoned by their parents, there is no legal guardian, and the person who submitted the application on behalf of the person is a Minnesota resident.\n- They became incapable of indicating intent on or after age 21 and are physically present in Minnesota\n- They are capable of indicating intent, live in Minnesota and intend to reside in the state"},{"chunk_id":"epm:1.4.3#people-younger-than-age-21","heading":"People Younger Than Age 21","url":"https://bot-corpus.mn-dhs.online/s/epm/1.4.3#people-younger-than-age-21","context":"EPM > 1 Minnesota Health Care Programs > 1.4 State Residency > 1.4.3 State Residency for People in an Institution > People Younger Than Age 21","text":"## People Younger Than Age 21\n\nPeople younger than age 21 who reside in an institution are Minnesota residents if any of the following apply:\n- The parent or legal guardian at the time of placement was a Minnesota resident. If a legal guardian has been appointed and parental rights are terminated, the state of residence of the legal guardian is used instead of the parent’s state of residence.\n- The parent or legal guardian who submitted the application on behalf of the person is currently a Minnesota resident and the person resides in an institution in Minnesota. If a legal guardian has been appointed and parental rights are terminated, the state of residence of the legal guardian is used instead of the parent’s state of residence.\n- The person resides in an institution in Minnesota, has been abandoned by their parents, there is no legal guardian, and the person who submitted the application on behalf of the person is a Minnesota resident."}]},{"id":"epm:1.4.4","number":"1.4.4","title":"Temporary Absence","parent":"1.4","breadcrumb":"1 Minnesota Health Care Programs > 1.4 State Residency > 1.4.4 Temporary Absence","summary":"Temporary absence refers to circumstances where one or more household members are absent from a household they share with others, but the absent members remain part of the household.","effective_date":"2024-09-20","last_modified":"2026-10-03T03:52:02.646875+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.4.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/1.4.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/1_4_4.htm","legal_citations":["Code of Federal Regulations, title 20, section 416.1149","Code of Federal Regulations, title 42, section 435.403","Minnesota Statutes, section 256B.056, subdivision 1","Minnesota Statutes, section 256B.69, subdivision 4","Minnesota Statutes, section 256L.09, subdivision 4"],"chunks":[{"chunk_id":"epm:1.4.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.4.4","context":"EPM > 1 Minnesota Health Care Programs > 1.4 State Residency > 1.4.4 Temporary Absence","text":"Temporary absence refers to circumstances where one or more household members are absent from a household they share with others, but the absent members remain part of the household.\n\nReasons for the temporary absence include but are not limited to:\n- School attendance or training\n- Employment\n- Illness or hospitalization\n- Vacation\n- Job search\n- Military service\n- Working in another state\n- Natural disaster or catastrophe\n- Personal or family emergency\n- Visits with a non-custodial parent or other relatives\n\nWhen temporarily absent for school attendance or training, the student must:\n- maintain a home in Minnesota (or, for children, have a home maintained by a parent or relative caretaker); and\n- return home during vacations and school breaks.\n\nThe following are some of the circumstances that are not considered a temporary absence:\n- An absence of less than one calendar month\n- An absence that is expected to be more than one calendar month and the person does not intend to return to the home, or does not meet a condition for temporary absence\n- An absence due to incarceration for more than one calendar month"},{"chunk_id":"epm:1.4.4#temporary-absences-from-the-state","heading":"Temporary Absences from the State","url":"https://bot-corpus.mn-dhs.online/s/epm/1.4.4#temporary-absences-from-the-state","context":"EPM > 1 Minnesota Health Care Programs > 1.4 State Residency > 1.4.4 Temporary Absence > Temporary Absences from the State","text":"## Temporary Absences from the State\n\nA temporary absence includes when an applicant or enrollee who lives alone or lives with others is absent from Minnesota with the intent to return to the state when the reason for the absence ends. There is no time limit for how long a person may be temporarily absent from the state. A person is no longer considered temporarily absent from the state if they receive Medicaid benefits in another state. An applicant or enrollee’s eligibility for Minnesota Health Care Programs (MHCP) may not be denied or terminated because of the person’s temporary absence from the state.\n\nAn MA-FCA applicant or enrollee who is or expects to be temporarily absent from the state must report the temporary absence to their servicing agency. When a person enrolled in MA-FCA is temporarily absent from Minnesota for more than 30 consecutive days, they must receive their MA benefits on a fee-for-service basis instead of through a managed care plan. Their coverage is provided through the fee for service claims payment system. See EPM [2.2.4.1 Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/2.2.4.1) for further information.\n\nThe date the applicant or enrollee left the state is considered day one in determining whether the temporary absence from Minnesota will last for more than 30 days. The last day of the temporary absence is the date the applicant or enrollee attests he or she is returning to Minnesota, or the date the applicant or enrollee actually returns."}]},{"id":"epm:1.5","number":"1.5","title":"Mandatory Verifications","parent":"1","breadcrumb":"1 Minnesota Health Care Programs > 1.5 Mandatory Verifications","summary":"Each Minnesota Health Care Program (MHCP) has specific verification requirements. Refer to the program sections for detailed information about mandatory verifications.","effective_date":"2022-03-01","last_modified":"2026-10-03T03:24:35.343847+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.5","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/1.5","official_origin":"https://hcopub.dhs.state.mn.us/epm/1_5.htm","legal_citations":["Code of Federal Regulations, title 42, sections 435.940 to 435.956","Code of Federal Regulations, title 45, sections section 155.305 to 155.320","Minnesota Statutes, section 256B.056"],"chunks":[{"chunk_id":"epm:1.5#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.5","context":"EPM > 1 Minnesota Health Care Programs > 1.5 Mandatory Verifications","text":"Each Minnesota Health Care Program (MHCP) has specific verification requirements. Refer to the program sections for detailed information about mandatory verifications.\n- Medical Assistance Mandatory Verifications\n- MinnesotaCare Mandatory Verifications\n- Medicare Savings Programs Mandatory Verifications\n- Minnesota Family Planning Program Mandatory Verifications\n\nThe agency must first attempt to use electronic data sources to verify information provided by the applicant or enrollee. If electronic verification is unsuccessful or unavailable, paper proofs may be required. In some circumstances, self-attestation is acceptable without further verification. Refer to specific eligibility requirements for information on what types of proofs may verify information and when self-attestation is acceptable.\n\nFor certain eligibility factors, verification must occur pre-eligibility, before eligibility is approved. For other eligibility factors, verification can be completed post-eligibility, after eligibility is approved.\n\nIn addition to mandatory verifications, proofs may be required for other eligibility factors when the information provided by the applicant or enrollee is inconsistent with information the county, tribal or state servicing agency has from other sources. See [1.3.2.4 MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4) policy for more information about situations when proofs may be required.\n\nApplicants and enrollees are primarily responsible for providing required paper proofs. However, agencies must assist applicants and enrollees in obtaining proof if the person is unable to provide it. Do not deny or close eligibility for people who are making a good faith effort to obtain the required proofs.\n\nCounty, tribal and state servicing agencies must retain verification documentation in accordance with the [County Human Service Records Retention Schedule](https://www.mnhs.org/preservation/state-archives/government)."}]},{"id":"epm:1.6","number":"1.6","title":"Health Care Delivery","parent":"1","breadcrumb":"1 Minnesota Health Care Programs > 1.6 Health Care Delivery","summary":"Minnesota Health Care Program (MHCP) enrollees must follow guidelines for receiving medically necessary services.","effective_date":"2025-07-25","last_modified":"2026-10-03T03:24:35.343847+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.6","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/1.6","official_origin":"https://hcopub.dhs.state.mn.us/epm/1_6.htm","legal_citations":["Minnesota Statutes, section 256B"],"chunks":[{"chunk_id":"epm:1.6#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.6","context":"EPM > 1 Minnesota Health Care Programs > 1.6 Health Care Delivery","text":"Minnesota Health Care Program (MHCP) enrollees must follow guidelines for receiving medically necessary services."},{"chunk_id":"epm:1.6#managed-care","heading":"Managed Care","url":"https://bot-corpus.mn-dhs.online/s/epm/1.6#managed-care","context":"EPM > 1 Minnesota Health Care Programs > 1.6 Health Care Delivery > Managed Care","text":"## Managed Care\n\nMost MHCP enrollees receive services from a managed care health plan. The health plan coordinates the services provided. The Minnesota Department of Human Services (DHS) pays a fixed rate in advance for each enrollee.\n\nNew enrollees receive information and enrollment forms from the county or tribal servicing agency or MinnesotaCare. People must choose a health plan based on what plans are available in their county of residence.\n\nDetailed information on managed care and managed care exemptions is in the [Prepaid Minnesota Health Care Programs (PMHCP) Manual](http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=id_016959)."},{"chunk_id":"epm:1.6#fee-for-service","heading":"Fee for Service","url":"https://bot-corpus.mn-dhs.online/s/epm/1.6#fee-for-service","context":"EPM > 1 Minnesota Health Care Programs > 1.6 Health Care Delivery > Fee for Service","text":"## Fee for Service\n\nFee-for-service is a method of payment where the medical provider bills MHCP for specific, individual services. Enrollees must use a medical provider enrolled with MHCP, except in special circumstances. A [directory of enrolled providers](http://mhcpproviderdirectory.dhs.state.mn.us/) is available online. See the Medical Assistance and MinnesotaCare Fee-For-Service Member Handbook ([DHS-8646](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-8646-ENG)) for more information.\n\nAdditional resources for enrollees include the Medical Assistance Fee-For-Service Flier ([DHS-8573](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-8573-ENG)) and the MinnesotaCare Fee-For-Service Flier ([DHS-8573c](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-8573c-ENG))"},{"chunk_id":"epm:1.6#covered-services","heading":"Covered Services","url":"https://bot-corpus.mn-dhs.online/s/epm/1.6#covered-services","context":"EPM > 1 Minnesota Health Care Programs > 1.6 Health Care Delivery > Covered Services","text":"## Covered Services\n\nThe MHCP Summary of Coverage and Limits ([DHS-3860](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3860-ENG)) explains covered services and cost-sharing requirements."},{"chunk_id":"epm:1.6#out-of-state-services","heading":"Out of State Services","url":"https://bot-corpus.mn-dhs.online/s/epm/1.6#out-of-state-services","context":"EPM > 1 Minnesota Health Care Programs > 1.6 Health Care Delivery > Out of State Services","text":"## Out of State Services\n\nEnrollees who are temporarily absent from the state may receive MHCP services in a medical emergency. For managed care, enrollees should contact the managed care health plan for these services.\n\nA person who is temporarily living out of the country usually cannot receive MHCP services."},{"chunk_id":"epm:1.6#membership-card","heading":"Membership Card","url":"https://bot-corpus.mn-dhs.online/s/epm/1.6#membership-card","context":"EPM > 1 Minnesota Health Care Programs > 1.6 Health Care Delivery > Membership Card","text":"## Membership Card\n\nEach enrollee has a Person Master Index Number (PMI). The PMI is a unique number that verifies MHCP eligibility when obtaining health care services. MHCP enrollees receive a MHCP member card from the Minnesota Department of Human Services. People enrolled in a managed care plan receive a managed care organization membership card in addition to the MHCP member card."}]},{"id":"epm:1.7","number":"1.7","title":"Help Paying for Medicare Costs","parent":"1","breadcrumb":"1 Minnesota Health Care Programs > 1.7 Help Paying for Medicare Costs","summary":"Medicare is a federal health insurance program for most people age 65 or older, people who are certified disabled, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant). The Centers for Medicare Medicaid Services (CMS) determines who is eligible for Medicare. Medicare eligibility usually begins the month a person turns age 65. People who have ","effective_date":"2023-03-01","last_modified":"2026-10-03T03:41:37.199792+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.7","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/1.7","official_origin":"https://hcopub.dhs.state.mn.us/epm/1_7.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:1.7#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.7","context":"EPM > 1 Minnesota Health Care Programs > 1.7 Help Paying for Medicare Costs","text":"Medicare is a federal health insurance program for most people age 65 or older, people who are certified disabled, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant). The Centers for Medicare Medicaid Services (CMS) determines who is eligible for Medicare. Medicare eligibility usually begins the month a person turns age 65. People who have been certified disabled by the Social Security Administration (SSA) and are receiving Social Security Disability Insurance (SSDI) have a 24 month waiting period before Medicare coverage can start.\n\n[1.7.1 Medicare Buy-In](https://bot-corpus.mn-dhs.online/s/epm/1.7.1)\n\n[1.7.2 Direct Reimbursement of Medicare Premiums](https://bot-corpus.mn-dhs.online/s/epm/1.7.2)"}]},{"id":"epm:1.7.1","number":"1.7.1","title":"Medicare Buy-In","parent":"1.7","breadcrumb":"1 Minnesota Health Care Programs > 1.7 Help Paying for Medicare Costs > 1.7.1 Medicare Buy-In","summary":"The Medicare Buy-In is an automated data exchange process with the Centers for Medicare & Medicaid Services (CMS) and MMIS, that identifies Medicare premiums that will be paid. This data exchange occurs weekly and includes requests to add or remove a person from the state’s Medicare Buy-In enrollment.","effective_date":"2023-03-01","last_modified":"2026-10-03T03:58:39.399612+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.7.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/1.7.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/1_7_1.htm","legal_citations":["United States Code, title 42, section 1395v"],"chunks":[{"chunk_id":"epm:1.7.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.7.1","context":"EPM > 1 Minnesota Health Care Programs > 1.7 Help Paying for Medicare Costs > 1.7.1 Medicare Buy-In","text":"The Medicare Buy-In is an automated data exchange process with the Centers for Medicare & Medicaid Services (CMS) and MMIS, that identifies Medicare premiums that will be paid. This data exchange occurs weekly and includes requests to add or remove a person from the state’s Medicare Buy-In enrollment.\n\nGenerally, a person must be enrolled in Medicare before payments for premiums can begin through the Medicare Buy-In. County, tribal, or state servicing agencies notify people who are eligible for Medicare and for payment of the Medicare premium by sending them the Medicare Buy-In Referral Letter ([DHS-3439](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3439-ENG)). The letter refers them to the Social Security Administration (SSA) to apply for Medicare benefits.\n\nThe Medicare Buy-In does not pay for Medicare Part C or Medicare Part D costs."},{"chunk_id":"epm:1.7.1#buy-in-eligibility-and-payments","heading":"Buy-In Eligibility and Payments","url":"https://bot-corpus.mn-dhs.online/s/epm/1.7.1#buy-in-eligibility-and-payments","context":"EPM > 1 Minnesota Health Care Programs > 1.7 Help Paying for Medicare Costs > 1.7.1 Medicare Buy-In > Buy-In Eligibility and Payments","text":"## Buy-In Eligibility and Payments\n\nThere are two ways people are added to the Medicare Buy-In:\n1. Medicare Savings Programs (MSP) eligibility. Generally, a person must be enrolled in both Medicare Part A and Medicare Part B to be eligible for the Medicare Buy-In through MSPs.    In certain circumstances eligibility for an MSP will begin the Medicare Buy-In. The Medicare Buy-In will pay the Medicare Part A premium even if the person did not previously enroll in Part A and did not pay the premium. See [EPM 4.2.1.7 Types of Medicare Savings Programs](https://bot-corpus.mn-dhs.online/s/epm/4.2.1.7) for more information about each MSP and which premium(s) they pay for.\n2. Categorical eligibility. A person with certain types of categorical eligibility receives payment of the Medicare Part B premium."},{"chunk_id":"epm:1.7.1#categorical-eligibility","heading":"Categorical Eligibility","url":"https://bot-corpus.mn-dhs.online/s/epm/1.7.1#categorical-eligibility","context":"EPM > 1 Minnesota Health Care Programs > 1.7 Help Paying for Medicare Costs > 1.7.1 Medicare Buy-In > Categorical Eligibility","text":"## Categorical Eligibility\n\nCertain MA enrollees are automatically added to the Medicare Buy-In when MA is approved. Categorically eligible persons receive payment of the Medicare Part B premium. These enrollees are entitled to premium free Medicare Part A and are enrolled in one of the following programs:\n- MA and Minnesota Supplemental Aid (MSA)\n- MA status for 1619(a) or 1619(b)\n- MA and Housing Support (HS)\n- Title IV-E Adoption Assistance\n- Title IV-E Foster Care\n- Title IV-E Kinship Assistance"},{"chunk_id":"epm:1.7.1#medicare-begin-date-for-people-turning-age-65","heading":"Medicare Begin Date for People Turning Age 65","url":"https://bot-corpus.mn-dhs.online/s/epm/1.7.1#medicare-begin-date-for-people-turning-age-65","context":"EPM > 1 Minnesota Health Care Programs > 1.7 Help Paying for Medicare Costs > 1.7.1 Medicare Buy-In > Medicare Begin Date for People Turning Age 65","text":"## Medicare Begin Date for People Turning Age 65\n\nThe Medicare Buy-In for MA enrollees who qualify for Medicare because they are turning age 65 may begin the first day of the month of the person's 65th birthday, except when a person turns age 65 on the first day of the month.\n\nSSA deems a person who turns age 65 on the first day of the month eligible for Medicare the first day of the preceding month. A person with a birthday on the first day of the month may be eligible for Medicare Buy-In on the first day of the preceding month."}]},{"id":"epm:1.7.2","number":"1.7.2","title":"Direct Reimbursement of Medicare Premiums","parent":"1.7","breadcrumb":"1 Minnesota Health Care Programs > 1.7 Help Paying for Medicare Costs > 1.7.2 Direct Reimbursement of Medicare Premiums","summary":"Certain Medical Assistance (MA) enrollees are eligible for direct reimbursement of their Medicare Part A and/or Part B premiums. The county or tribal agency reimburses the enrollee for their Medicare premium to ensure that Medicare benefits are not interrupted. See 1.7.1 Medicare Buy-In for more information about the Medicare Buy-In.","effective_date":"2023-06-01","last_modified":"2026-10-03T03:52:03.17308+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.7.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/1.7.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/1_7_2.htm","legal_citations":["Minnesota Statutes, section 256B.057","Minnesota Rules, part 9505.0430"],"chunks":[{"chunk_id":"epm:1.7.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/1.7.2","context":"EPM > 1 Minnesota Health Care Programs > 1.7 Help Paying for Medicare Costs > 1.7.2 Direct Reimbursement of Medicare Premiums","text":"Certain Medical Assistance (MA) enrollees are eligible for direct reimbursement of their Medicare Part A and/or Part B premiums. The county or tribal agency reimburses the enrollee for their Medicare premium to ensure that Medicare benefits are not interrupted. See 1.7.1 Medicare Buy-In for more information about the Medicare Buy-In."},{"chunk_id":"epm:1.7.2#medical-assistance-for-employed-persons-with-disabilities-ma-epd","heading":"Medical Assistance for Employed Persons with Disabilities (MA-EPD)","url":"https://bot-corpus.mn-dhs.online/s/epm/1.7.2#medical-assistance-for-employed-persons-with-disabilities-ma-epd","context":"EPM > 1 Minnesota Health Care Programs > 1.7 Help Paying for Medicare Costs > 1.7.2 Direct Reimbursement of Medicare Premiums > Medical Assistance for Employed Persons with Disabilities (MA-EPD)","text":"## Medical Assistance for Employed Persons with Disabilities (MA-EPD)\n\nMedical Assistance for Employed Persons with Disabilities (MA-EPD) enrollees may be eligible for direct reimbursement of their Part B premiums. Reimbursement is effective the date of MA-EPD eligibility for enrollees who meet both of the following: have income at or below 200% FPG and are not eligible for the Qualified Medicare Beneficiary (QMB) or Service Limited Medicare Beneficiary (SLMB) programs. See [EPM 2.3.5.4.1 MA-EPD Medicare](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.4.1) for more information."},{"chunk_id":"epm:1.7.2#people-residing-in-an-institution-for-mental-diseases-imd","heading":"People Residing in an Institution for Mental Diseases (IMD)","url":"https://bot-corpus.mn-dhs.online/s/epm/1.7.2#people-residing-in-an-institution-for-mental-diseases-imd","context":"EPM > 1 Minnesota Health Care Programs > 1.7 Help Paying for Medicare Costs > 1.7.2 Direct Reimbursement of Medicare Premiums > People Residing in an Institution for Mental Diseases (IMD)","text":"## People Residing in an Institution for Mental Diseases (IMD)\n\nCertain individuals are eligible for direct reimbursement of their Medicare Part A and/or Part B premiums from the agency:\n- MA enrollees who are enrolled in an MSP and lose that coverage due to residing in an Institution for Mental Disease (IMD), or\n- MA applicants who would be eligible for an MSP if they did not reside in an IMD.\n\nSee [EPM 2.5.4.4.1 Program IM Medicare](https://bot-corpus.mn-dhs.online/s/epm/2.5.4.4.1) for more information.\n\nIf an enrollee meets the requirements above, the enrollee must be reimbursed the full Medicare Part A and/or Part B premium amount for any month(s) they are eligible for the reimbursement. There is no time limit for the processing of an agency reimbursement for such premiums.\n\nThe Late Request for Medicare Reimbursement ([DHS-3918](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3918-ENG)) form is used to request reimbursement of the Medicare Part A and/or Part B premium paid to the enrollee from the Department of Human Services if it is submitted 12 months or more after the Medicare Part A and/or Part B premium was paid."}]},{"id":"epm:2","number":"2","title":"Medical Assistance","parent":null,"breadcrumb":"2 Medical Assistance","summary":"Medical Assistance (MA) is Minnesota's name for the federal Medicaid program, which began in the 1960s. County and tribal servicing agencies administer MA. MA provides health care coverage for low income Minnesotans.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:57.24681+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2","context":"EPM > 2 Medical Assistance","text":"Medical Assistance (MA) is Minnesota's name for the federal Medicaid program, which began in the 1960s. County and tribal servicing agencies administer MA. MA provides health care coverage for low income Minnesotans.\n\nThis manual section provides policy information for MA. The first chapter provides policy information that generally applies to all types of MA. The second chapter provides policy information that applies to MA for Families with Children and Adults (MA-FCA). The third chapter covers MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD). The fourth chapter covers payment of long-term care services. The fifth chapter covers MA for certain populations.\n1. [Medical Assistance Overview](https://bot-corpus.mn-dhs.online/s/epm/2.1)\n  1. [MA General Requirements](https://bot-corpus.mn-dhs.online/s/epm/2.1.1)\n  2. [MA Non-Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.1.2)\n  3. [MA Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.1.3)\n  4. [MA Post-Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.1.4)\n2. [Medical Assistance for Families with Children and Adults](https://bot-corpus.mn-dhs.online/s/epm/2.2)\n  1. [MA-FCA General Requirements](https://bot-corpus.mn-dhs.online/s/epm/2.2.1)\n  2. [MA-FCA Non-Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.2.2)\n  3. [MA-FCA Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.2.3)\n  4. [MA-FCA Post-Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.2.4)\n3. [Medical Assistance for People who are Age 65 or Older or People who are Blind or have a Disability](https://bot-corpus.mn-dhs.online/s/epm/2.3)\n  1. [MA-ABD General Requirements](https://bot-corpus.mn-dhs.online/s/epm/2.3.1)\n  2. [MA-ABD Non-Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.2)\n  3. [MA-ABD Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.3)\n  4. [MA-ABD Post-Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.4)\n  5. [MA for Employed Persons with Disabilities (MA-EPD)](https://bot-corpus.mn-dhs.online/s/epm/2.3.5)\n  6. [MA under the TEFRA Option](https://bot-corpus.mn-dhs.online/s/epm/2.3.6)\n  7. [MA 1916(a) and 1916(b)](https://bot-corpus.mn-dhs.online/s/epm/2.3.7)\n4. [Medical Assistance for Long Term Care Services](https://bot-corpus.mn-dhs.online/s/epm/2.4)\n  1. [MA-LTC Eligibility Requirements](https://bot-corpus.mn-dhs.online/s/epm/2.4.1)\n  2. [MA-LTC Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.4.2)\n5. [Medical Assistance for Certain Populations](https://bot-corpus.mn-dhs.online/s/epm/2.5)\n  1. [MA for People with Breast or Cervical Cancer](https://bot-corpus.mn-dhs.online/s/epm/2.5.1)\n  2. [MA Center for Victims of Torture](https://bot-corpus.mn-dhs.online/s/epm/2.5.2)\n  3. [Emergency Medical Assistance](https://bot-corpus.mn-dhs.online/s/epm/2.5.3)\n  4. [Institutions for Mental Diseases](https://bot-corpus.mn-dhs.online/s/epm/2.5.4)\n  5. [Hospitalized Incarcerated People](https://bot-corpus.mn-dhs.online/s/epm/2.5.5)\n  6. [Northstar Care for Children](https://bot-corpus.mn-dhs.online/s/epm/2.5.6)\n    1. [MA Northstar Adoption Assistance](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1)\n    2. [MA Northstar Title IV-E Foster Care and Title IV-E Kinship Assistance](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2)\n    3. [MA Northstar Non-Title IV-E Foster Care and Non-Title IV-E Kinship Assistance](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3)\n  7. [Refugee Medical Assistance](https://bot-corpus.mn-dhs.online/s/epm/2.5.7)"}]},{"id":"epm:2.1","number":"2.1","title":"Overview","parent":"2","breadcrumb":"2 Medical Assistance > 2.1 Overview","summary":"Medical Assistance (MA) eligibility has a variety of non-financial, financial and post-eligibility requirements. Some MA policies apply to all MA applicants and enrollees. For example, residency requirements are the same for all types of MA. Other eligibility requirements are different, depending on the applicant’s basis of eligibility. For example, financial eligibility requirements are different","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:57.24681+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_1.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1","context":"EPM > 2 Medical Assistance > 2.1 Overview","text":"Medical Assistance (MA) eligibility has a variety of non-financial, financial and post-eligibility requirements. Some MA policies apply to all MA applicants and enrollees. For example, residency requirements are the same for all types of MA. Other eligibility requirements are different, depending on the applicant’s basis of eligibility. For example, financial eligibility requirements are different.\n\nThis chapter includes policies that apply to all or most types of MA and links to policies that apply to all Minnesota Health Care Programs (MHCP). Eligibility policy that applies to a specific type of MA is located in the relevant MA chapter.\n\nTopics covered in this chapter are:\n1. [MA General Requirements](https://bot-corpus.mn-dhs.online/s/epm/2.1.1)\n  1. [MA Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.1)\n  2. [MA Responsibilities](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2)\n  3. [MHCP Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1)\n2. [MA Non-Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.1.2)\n  1. [MA Bases of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.1)\n  2. [MA Citizenship and Immigration Status](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2)\n  3. [MA County Residency](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.3)\n  4. [MA Living Arrangement](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.4)\n  5. [MA Social Security Number](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5)\n  6. [MHCP State Residency](https://bot-corpus.mn-dhs.online/s/epm/1.4)\n3. [MA Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.1.3)\n  1. [MA Asset Limit](https://bot-corpus.mn-dhs.online/s/epm/2.1.3.1)\n  2. [MA Income Limit](https://bot-corpus.mn-dhs.online/s/epm/2.1.3.2)\n4. [MA Post-Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.1.4)\n  1. [MA Benefit Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1)\n  2. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n  3. [MA Cooperation](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.2)\n  4. [MA Cost Sharing](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.3)\n  5. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n  6. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n  7. [MA Qualifying Health Care Coverage](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.2)\n  8. [MA Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4)"}]},{"id":"epm:2.1.1","number":"2.1.1","title":"General Requirements","parent":"2.1","breadcrumb":"2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements","summary":"This subchapter provides policy information that generally applies to all types of Medical Assistance (MA) and links to policies that apply to all Minnesota Health Care Programs (MHCP). General requirements that apply to a specific type of MA are located in the relevant MA chapter.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:57.24681+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.1.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_1_1.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.1.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements","text":"This subchapter provides policy information that generally applies to all types of Medical Assistance (MA) and links to policies that apply to all Minnesota Health Care Programs (MHCP). General requirements that apply to a specific type of MA are located in the relevant MA chapter.\n\nTopics covered in this sub-chapter are:\n1. [MA Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.1)\n2. [MA Responsibilities](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2)\n  1. [MA Benefit Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1)\n    1. [MA Estate Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.1)\n    2. [MA Liens](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.2)\n    3. [MHCP Overpayments](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.5)\n    4. [MA Third Party Liability](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3)\n      1. [MA Cost Effective Insurance](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.1)\n      2. [MA Medical Support](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.2)\n      3. [MA Other Third Party Liability](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.3)\n  2. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n  3. [MA Cooperation](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.2)\n  4. [MA Cost Sharing](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.3)\n  5. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n  6. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n  7. [MA Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4)\n3. [MHCP Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1)\n  1. [MHCP Appeals](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.1)\n  2. [MHCP Authorized Representative](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.2)\n  3. [MHCP Civil Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.3)\n  4. [MHCP Data Privacy](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.4)\n  5. [MHCP Notices](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.5)\n  6."}]},{"id":"epm:2.1.1.1","number":"2.1.1.1","title":"Mandatory Verifications","parent":"2.1.1","breadcrumb":"2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.1 Mandatory Verifications","summary":"Mandatory verifications must be verified through an available electronic data source or by paper proof, if electronic data sources are unsuccessful or unavailable. Self-attestation of certain eligibility factors may be accepted if electronic data sources are unsuccessful or unavailable and paper proof does not exist or is not available.","effective_date":null,"last_modified":"2026-10-03T03:51:57.24681+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.1.1.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_1_1_1.htm","legal_citations":["Code of Federal Regulations, title 42, sections 435.940 to 435.956","Minnesota Statutes, section 256B.056"],"chunks":[{"chunk_id":"epm:2.1.1.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.1","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.1 Mandatory Verifications","text":"Mandatory verifications must be verified through an available electronic data source or by paper proof, if electronic data sources are unsuccessful or unavailable. Self-attestation of certain eligibility factors may be accepted if electronic data sources are unsuccessful or unavailable and paper proof does not exist or is not available.\n1. [MA for Families With Children and Adults (MA-FCA) Mandatory Verifications](https://hcopub.dhs.state.mn.us/epm/2_2_1_2ar6.htm)\n2. [MA for People Who Are 65 or Older or People Who Are Blind or Have a Disability (MA-ABD) Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/2.3.1.1)\n3. [MA for Center for Victims of Torture (MA-CVT) Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/2.5.2.1.1)\n4. [Emergency MA (EMA) Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/2.5.3.1.1)\n5. [MA Northstar Adoption Assistance Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.1.1)\n6. [MA Northstar Title IV-E Foster Care and Title IV-E Kinship Assistance Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.1.1)\n7. [MA Breast or Cervical Cancer Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/2.5.1.1.2)"}]},{"id":"epm:2.1.1.2","number":"2.1.1.2","title":"Responsibilities","parent":"2.1.1","breadcrumb":"2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities","summary":"All applicants and enrollees have responsibilities under various laws. This subchapter provides policy that generally applies to all types of Medical Assistance (MA) and links to policies that apply to all Minnesota Health Care Programs (MHCP).","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:57.24681+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.1.1.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_1_1_2.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.1.1.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities","text":"All applicants and enrollees have responsibilities under various laws. This subchapter provides policy that generally applies to all types of Medical Assistance (MA) and links to policies that apply to all Minnesota Health Care Programs (MHCP).\n\nApplicants and enrollees must be informed of their responsibilities. The Notice of Privacy Practices and other information about client rights and responsibilities is part of the online and paper applications, various e-doc forms, eligibility notices, and brochures that include information on client responsibilities. Such information is in plain language and accessible to persons with limited English proficiency (LEP) and persons with disabilities.\n\nTopics covered in this sub-chapter are:\n1. [MA Benefit Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1)\n  1. [MA Estate Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.1)\n  2. [MA Liens](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.2)\n  3. [MA Third Party Liability](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3)\n    1. [MA Cost Effective Insurance](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.1)\n    2. [MA Medical Support](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.2)\n    3. [MA Other Third Party Liability](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.3)\n  4. [MHCP Overpayments](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.5)\n2. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n3. [MA Cooperation](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.2)\n4. [MA Cost Sharing](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.3)\n5. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n6. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n7. [MA Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4)"}]},{"id":"epm:2.1.1.2.1","number":"2.1.1.2.1","title":"Benefit Recovery","parent":"2.1.1.2","breadcrumb":"2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery","summary":"State and federal funds pay for Medical Assistance (MA). The State of Minnesota uses several ways to recover the cost of health care benefits provided to enrollees. This is called benefit recovery.","effective_date":"2018-06-01","last_modified":"2026-10-03T03:51:57.24681+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.1.1.2.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_1_1_2_1.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.1.1.2.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery","text":"State and federal funds pay for Medical Assistance (MA). The State of Minnesota uses several ways to recover the cost of health care benefits provided to enrollees. This is called benefit recovery.\n\nEnrollees may be subject to the following types of benefit recovery depending on their eligibility basis and the type of services they receive:\n1. [MA for People Who Are Age 65 or Older and People Who Are Blind or Disabled (MA-ABD) Annuities](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.8)\n2. [MA Cost-Effective Insurance](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.1)\n3. [MA Estate Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.1)\n4. [MA Liens](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.2)\n5. [MA Medical Support](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.2)\n6. [Minnesota Health Care Programs (MHCP) Overpayments](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.5)\n7. [MA-ABD Pooled Trusts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.5)\n8. [MA Other Third Party Liability](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.3)\n9. [MA-ABD Special Needs Trusts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.4)\n10. [MA-ABD Achieving a Better Life (ABLE) Accounts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.15)"}]},{"id":"epm:2.1.1.2.1.1","number":"2.1.1.2.1.1","title":"Estate Recovery","parent":"2.1.1.2.1","breadcrumb":"2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.1 Estate Recovery","summary":"Medical Assistance (MA) estate recovery is a program that the federal government requires the State of Minnesota to administer to receive MA funds. County agencies, on behalf of the state, assert MA claims against the estates of deceased MA enrollees, or the estates of the enrollees’ spouses, to recover the amount MA paid for certain services described in state and federal law.","effective_date":"2017-08-01","last_modified":"2026-10-03T04:10:20.530463+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.1.1.2.1.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_1_1_2_1_1.htm","legal_citations":["Minnesota Statutes, section 256B.15","United States Code, title 42, section 1396p"],"chunks":[{"chunk_id":"epm:2.1.1.2.1.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.1","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.1 Estate Recovery","text":"Medical Assistance (MA) estate recovery is a program that the federal government requires the State of Minnesota to administer to receive MA funds. County agencies, on behalf of the state, assert MA claims against the estates of deceased MA enrollees, or the estates of the enrollees’ spouses, to recover the amount MA paid for certain services described in state and federal law.\n\nMA estate recovery procedures are found in the [MA estate recovery manual.](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=SRU-Home)"},{"chunk_id":"epm:2.1.1.2.1.1#recoverable-services","heading":"Recoverable Services","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.1#recoverable-services","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.1 Estate Recovery > Recoverable Services","text":"## Recoverable Services\n\nThe following program services are subject to estate recovery:\n- MA\n  - The following MA services received by enrollees 55 years old or older who do not permanently reside in a medical institution:\n    - Nursing facility services (NFS)\n    - Home and community-based services (HCBS)\n    - Hospital and prescription drug services received during the time the enrollee was provided NFS or HCBS\n  - All MA services received by enrollees, regardless of age, who permanently reside in a medical institution\n- General Assistance Medical Care (GAMC)\n- Alternative Care (AC) services received on or after July 1, 2003\n\nGenerally, all these program services fall under the definition of “MA” for estate recovery purposes."},{"chunk_id":"epm:2.1.1.2.1.1#recoverable-assets","heading":"Recoverable Assets","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.1#recoverable-assets","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.1 Estate Recovery > Recoverable Assets","text":"## Recoverable Assets\n\nCounty agencies may recover against the following assets from the estate of an MA enrollee or from the estate of an MA enrollee's surviving spouse:\n- the person's probate estate;\n- all of the person's interests or proceeds of those interests in real property the person owned as a life tenant, or as a joint tenant with a right of survivorship, that were established on or after August 1, 2003, and were owned at the time of the person’s death;\n  - Recovery on a life estate is limited to the value of the person's interest on the date of death as determined by the [Life Estates Mortality Table](https://bot-corpus.mn-dhs.online/s/epm/G).\n- all of the person's interests or proceeds of those interests in securities the person owned in beneficiary form at the time of the person's death, to the extent the interests or proceeds of those interests become part of the probate estate;\n- all of the person's interests in joint accounts, multiple-party accounts, and pay-on-death accounts, brokerage accounts, investment accounts, or the proceeds of those accounts at the time of the person's death to the extent the interests become part of the probate estate; and\n- assets conveyed to a survivor, heir, or assign of the person through survivorship, living trust, or other arrangements."},{"chunk_id":"epm:2.1.1.2.1.1#exceptions-to-estate-recovery","heading":"Exceptions to Estate Recovery","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.1#exceptions-to-estate-recovery","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.1 Estate Recovery > Exceptions to Estate Recovery","text":"## Exceptions to Estate Recovery\n\nRecovery on an estate claim is delayed when one or more of the following people survive an MA enrollee:\n- A spouse\n- A child younger than age 21\n- A child of any age who is blind or totally and permanently disabled according to Supplemental Security Income program criteria\n\nCertain income, resources, and property of [American Indians and Alaska Natives](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=SRU-0204) are exempt from estate recovery. More detailed [limitations](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=SRU-020102) on claims are provided in the [MA Estate Recovery Manual](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=SRU-Home)."}]},{"id":"epm:2.1.1.2.1.2","number":"2.1.1.2.1.2","title":"MA Liens","parent":"2.1.1.2.1","breadcrumb":"2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.2 MA Liens","summary":"The Minnesota Department of Human Services (DHS) files liens against real property interests to recover the amount Medical Assistance (MA) paid for certain services described in state and federal law. A lien is a legal right or interest that a creditor has in another person’s property until the creditor’s claim has been repaid or the lien expires. Real property includes land and buildings on land.","effective_date":"2026-06-23","last_modified":"2026-10-03T04:10:20.347486+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.1.1.2.1.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_1_1_2_1_2.htm","legal_citations":["Minnesota Statutes, section 256B.15","Minnesota Statutes, sections 514.980 to 514.985","United States Code, title 42, section 1396p"],"chunks":[{"chunk_id":"epm:2.1.1.2.1.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.2","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.2 MA Liens","text":"The Minnesota Department of Human Services (DHS) files liens against real property interests to recover the amount Medical Assistance (MA) paid for certain services described in state and federal law. A lien is a legal right or interest that a creditor has in another person’s property until the creditor’s claim has been repaid or the lien expires. Real property includes land and buildings on land.\n\nThe DHS lien process is separate from county-administered [estate recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.1), however, liens help secure county claims against estate assets."},{"chunk_id":"epm:2.1.1.2.1.2#liens-on-real-property","heading":"Liens on Real Property","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.2#liens-on-real-property","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.2 MA Liens > Liens on Real Property","text":"## Liens on Real Property\n\nThere are two types of liens that DHS files to secure repayment of MA:\n- MA liens (also called TEFRA liens)\n- Notices of Potential Claim (NPCs)\n\nRefer to the [MA Estate Recovery Manual](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=SRU-Home) for more information about [MA liens](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=SRU-0301) and [NPCs](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=SRU-0302)."},{"chunk_id":"epm:2.1.1.2.1.2#populations-affected-by-liens","heading":"Populations Affected by Liens","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.2#populations-affected-by-liens","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.2 MA Liens > Populations Affected by Liens","text":"## Populations Affected by Liens\n\n### MA Liens\n\nAn MA lien can be filed against an MA enrollee’s real property interests when the enrollee receives services while residing in a medical institution and is not reasonably expect discharged and returned home, as verified by the enrollee's attending physician, advanced practice registered nurse, or physician assistant.\n\n### NPCs\n\nAn NPC can be filed against an MA enrollee’s real property interests when the enrollee is age 55 or older and receives MA services. An NPC is not an enforceable lien against the real property until after the enrollee dies."},{"chunk_id":"epm:2.1.1.2.1.2#recoverable-services","heading":"Recoverable Services","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.2#recoverable-services","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.2 MA Liens > Recoverable Services","text":"## Recoverable Services\n\nAn MA lien can recover the costs of the following program services:see the MA Estate Recovery Manual for a complete list.\n- MA Long-Term Care (LTC) services\n- All services received by enrollees, regardless of age, during the permanent residence in a medical Institution\n- The following MA services received by enrollees 55 years old or older who do not permanently reside in a medical institution:\n  - Nursing facility services (NFS)\n  - Home and community-based services (HCBS)\n- Brain Injury Waiver (BI)\n- Community Alternative Care (CAC)\n- Community Access for Disability Inclusion (CADI)\n- Developmental Disabilities (DD)\n- Elderly Waiver (EW)\n- Hospital and prescription drug services received during the time the enrollee was provided NFS or HCBS"},{"chunk_id":"epm:2.1.1.2.1.2#nonrecoverable-services","heading":"Nonrecoverable Services","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.2#nonrecoverable-services","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.2 MA Liens > Nonrecoverable Services","text":"## Nonrecoverable Services\n\nThe costs of the following program services cannot be recovered by an MA lien or NPC:\n- MA services not identified in the [Recoverable Services](https://hcopub.dhs.state.mn.us/epm/#Recoverable_Services) section\n- MinnesotaCare\n- Consolidated Chemical Dependency Treatment Fund (CCDTF)"},{"chunk_id":"epm:2.1.1.2.1.2#life-estate-and-joint-tenancy-interests","heading":"Life Estate and Joint Tenancy Interests","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.2#life-estate-and-joint-tenancy-interests","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.2 MA Liens > Life Estate and Joint Tenancy Interests","text":"## Life Estate and Joint Tenancy Interests\n\nIf a person owns a life estate or joint tenancy interest in real property at the time of death, and the interest was established on or after August 1, 2003, that interest remains subject to a lien after death to satisfy repayment of MA. Recovery on a life estate is limited to the value of the person's interest on the date of death as determined by the [Life Estates Mortality Table](https://bot-corpus.mn-dhs.online/s/epm/G)."},{"chunk_id":"epm:2.1.1.2.1.2#other-dhs-recoveries","heading":"Other DHS Recoveries","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.2#other-dhs-recoveries","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.2 MA Liens > Other DHS Recoveries","text":"## Other DHS Recoveries\n\nDHS also recovers MA funds from sources including but not limited to, ABLE accounts, annuities, special needs trusts, pooled trusts, personal injury claims and workers compensation claims."},{"chunk_id":"epm:2.1.1.2.1.2#exceptions-to-liens","heading":"Exceptions to Liens","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.2#exceptions-to-liens","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.2 MA Liens > Exceptions to Liens","text":"## Exceptions to Liens\n\nExceptions to filing or collecting on an [MA Lien](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=SRU-0301) or [NPC](http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=SRU-030602) are provided in the [MA Estate Recovery Manual](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=SRU-Home).\n\n### American Indian and Alaskan Native Exemptions\n\nCertain real property of [American Indians and Alaska Natives](http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=SRU-0309) is exempt from liens, including real property that is:\n- Located on a reservation (any federally recognized Indian Tribe's reservation, Pueblo, or Colony, including former reservations, in Oklahoma, Alaska Native regions established by Alaska Native Claims Settlement Act and Indian allotments, or near a reservation as designated and approved by the Bureau of Indian Affairs of the U.S. Department of the Interior); or\n- For any federally recognized tribe not described in the above bullet point located within the most recent boundaries of a prior federal reservation."}]},{"id":"epm:2.1.1.2.1.3","number":"2.1.1.2.1.3","title":"Third Party Liability","parent":"2.1.1.2.1","breadcrumb":"2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.3 Third Party Liability","summary":"Third parties are people, entities, or programs that are, or may be, liable to pay all or part of the medical costs provided to Medical Assistance (MA) or Children Health Insurance Plan (CHIP) funded MA enrollees.","effective_date":"2023-10-25","last_modified":"2026-10-03T03:51:57.24681+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.1.1.2.1.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_1_1_2_1_3.htm","legal_citations":["Code of Federal Regulations, title 42, sections 433.135 to 433.154","Code of Federal Regulations, title 42, section 435.610","Federal Register, Vol.60, No.131 (July 10, 1995), page 35498","Minnesota Statues, section 256B.042","Minnesota Statutes, section 256B.056","United States Code, title 42, section 1396a","United States Code, title 42, section 1396e","United States Code, title 42, section 1396g-1"],"chunks":[{"chunk_id":"epm:2.1.1.2.1.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.3 Third Party Liability","text":"Third parties are people, entities, or programs that are, or may be, liable to pay all or part of the medical costs provided to Medical Assistance (MA) or Children Health Insurance Plan (CHIP) funded MA enrollees.\n\nA third party may be liable to pay all or part of the medical costs provided to MA or CHIP-funded MA enrollees because these programs are the payer of last resort, with limited exception, such as Indian Health Services. This means enrollees with third party liability (TPL) must have medical costs covered by TPL paid by those sources before MA pays claims.\n\nA third party payer includes, but is not limited to:\n- Other health care coverage, such as group health plans, COBRA continuation of group health plans, individual health plans, Medicare, and military insurance\n- Medical support from absent parents\n- Other sources such as automobile insurance, court judgments or settlements, and workers’ compensation"},{"chunk_id":"epm:2.1.1.2.1.3#other-health-care-coverage","heading":"Other Health Care Coverage","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3#other-health-care-coverage","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.3 Third Party Liability > Other Health Care Coverage","text":"## Other Health Care Coverage\n\nApplicants and enrollees must cooperate with identifying sources of existing health coverage and assign rights to other health care coverage. Those who fail to cooperate with TPL requirements may be denied coverage or have their MA or CHIP-funded MA coverage ended. See the [MA Cooperation](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.2) policy for more information.\n\nPeople must cooperate with TPL requirements by:\n- Providing information to assist the Minnesota Department of Human Services (DHS) or an enrollee’s managed care plan to pursue any third party liable for payment, and applying for other benefits that may help pay for their medical costs. This includes:\n  - Cooperation with completing Medical Service Questionnaires (MSQs) when the person has received a service that potentially indicates a third party may be responsible\n  - Cooperation with completing the Work Injury Report (WIR) when the person has had a work related injury\n  - Cooperation with completing the Accident Injury Report (AIR) when the person has had a motor-vehicle related accident\n  - Giving complete information about third party health, dental, vision and long-term care insurance policies that cover MA enrollees\n- Enrolling or maintaining enrollment in: MA eligibility continues for people who do not enroll in, cooperate with or assign rights to a group health plan if they cannot do so on their own behalf. See [MA Cost Effective Health Insurance](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.1) for more information.\n  - A group health plan that is cost effective\n  - A group health plan when there is no cost for the policyholder to cover all family members enrolled in MA\n- Assigning rights to DHS for medical support and payment for medical care from any third party\n\nEnrollees do not have to cooperate with TPL requirements when they are Safe at Home (SAH) Address Confidentiality program participants and the policyholder is their probable assailant."},{"chunk_id":"epm:2.1.1.2.1.3#medical-support","heading":"Medical Support","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3#medical-support","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.3 Third Party Liability > Medical Support","text":"## Medical Support\n\nMedical support may include cash payments or health insurance coverage that a parent who does not live with their children must provide or are court-ordered to provide to meet the medical needs of their children. Parents and relative caretakers who are referred for medical support must cooperate with the county, tribal or state servicing agency as a condition of their own eligibility, unless they show good cause for non-cooperation. See [MA Medical Support](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.2) for more information."},{"chunk_id":"epm:2.1.1.2.1.3#other-third-party-liability","heading":"Other Third Party Liability","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3#other-third-party-liability","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.3 Third Party Liability > Other Third Party Liability","text":"## Other Third Party Liability\n\nIn some situations, automobile insurance, homeowner insurance, court judgments or settlements, workers’ compensation and other third parties may pay health care costs. See [MA Other Third Party Liability](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.3) for more information."}]},{"id":"epm:2.1.1.2.1.3.1","number":"2.1.1.2.1.3.1","title":"Cost-Effective Health Insurance","parent":"2.1.1.2.1.3","breadcrumb":"2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.3 Third Party Liability > 2.1.1.2.1.3.1 Cost-Effective Health Insurance","summary":"Health insurance other than Medical Assistance (MA) that covers an enrollee is a liable third party. A subset of third party liability (TPL) includes group health plans, individual health plans, TRICARE plans, and certain long-term care (LTC) insurance. When an enrollee is covered by, or could be covered by, health insurance that falls within this subset of TPL, MA will pay the premium, or a porti","effective_date":"2023-03-01","last_modified":"2026-10-03T03:58:39.963443+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.1.1.2.1.3.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_1_1_2_1_3_1.htm","legal_citations":["Code of Federal Regulations, title 42, sections 433.147 and 433.148","Code of Federal Regulations, title 42, section 435.1015","Minnesota Rules, part 9505.0071","Minnesota Rules, part 9505.0430","Minnesota Statutes, section 256B.056, subdivision 8","Minnesota Statutes, section 256B.0625, subdivision 15","United States Code, title 26, section 220","United States Code, title 26, section 223","United States Code, title 26, section 501, paragraph (c), clause (9)","United States Code, title 26, section 5000, paragraph (b)","United States Code, title 26, section 9801, paragraph (f), clause (3)","United States Code, title 42, section 1396d, paragraph (a), clause (29)","United States Code, title 42, section 1396e"],"chunks":[{"chunk_id":"epm:2.1.1.2.1.3.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.1","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.3 Third Party Liability > 2.1.1.2.1.3.1 Cost-Effective Health Insurance","text":"Health insurance other than Medical Assistance (MA) that covers an enrollee is a liable third party. A subset of third party liability (TPL) includes group health plans, individual health plans, TRICARE plans, and certain long-term care (LTC) insurance. When an enrollee is covered by, or could be covered by, health insurance that falls within this subset of TPL, MA will pay the premium, or a portion of the premium, if it is cost effective to have the enrollee covered by the other health insurance.\n\nCost effective means that paying for the other health insurance, and for any MA services the other health insurance does not cover, will cost less than paying for MA services without the other health insurance.\n\nWhen a county or tribal agency determines that a group health plan, individual health plan, TRICARE plan, or LTC insurance is cost effective, it is called cost-effective health insurance (CEHI).\n\nEnrollees who have CEHI for their primary coverage are covered for the same MA services as enrollees without CEHI because MA pays for any MA services the CEHI does not cover."},{"chunk_id":"epm:2.1.1.2.1.3.1#health-insurance-reviewed-for-cost-effectiveness","heading":"Health Insurance Reviewed for Cost Effectiveness","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.1#health-insurance-reviewed-for-cost-effectiveness","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.3 Third Party Liability > 2.1.1.2.1.3.1 Cost-Effective Health Insurance > Health Insurance Reviewed for Cost Effectiveness","text":"## Health Insurance Reviewed for Cost Effectiveness\n\nCounty and tribal agencies review whether a group health plan, individual health plan, TRICARE plan, or LTC insurance available to an enrollee is cost effective. A person must be an MA applicant or enrollee for an agency to review their other health insurance options for CEHI.\n\n### Group Health Plans\n\nA group health plan, including a self-insured plan, is a plan of, or contributed to by, an employer, including a person who is self-employed, or employee organization to provide health care to employees, former employees, the employer, others associated or formerly associated with the employer in a business relationship, or their families. A group health plan is often referred to as employer-sponsored insurance. For purposes of CEHI, the term group health plan also includes continuation coverage of an employer or employee-sponsored group health plan under the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA).\n\nA person may have access to a group health plan through their own employer or a family member’s employer.\n\nAs a condition of eligibility for MA, an enrollee must:\n- Report access to a group health plan at the time of application or any time after when access to a group health plan becomes available\n- Cooperate in determining whether the coverage under a group health plan coverage is cost effective. Enrollees have 10 days to provide information about a group health plan to maintain MA eligibility.\n- Report when coverage under a group health plan ends or changes\n\nIf an enrollee has access to a group health plan through their employer and is notified that one or more group health plans available to the enrollee is cost effective, the enrollee must:\n- Enroll in the cost-effective group health plan at the earliest possible date if they are not currently enrolled\n  - An enrollee loses MA eligibility if they refuse to apply for enrollment in a cost-effective group health plan. The person remains ineligible until the next open enrollment period for the group health plan.\n  - A plan sponsor of a group health plan must allow an employee and their dependents to enroll in the plan during a special enrollment period if all of the following conditions are met:\n    - The employee or their dependents are eligible for the group health plan and are eligible for MA to pay the premium for the group health plan as CEHI\n    - The employee requests such enrollment within 60 days from the date the employee or their dependents were determined eligible for CEHI reimbursement\n- Maintain enrollment in a cost-effective group health plan if they are already enrolled. An enrollee already enrolled in a cost-effective group health plan may choose to enroll in a different group health plan through the same employer if the following is true:\n  - The new group health plan is also cost effective; and\n  - There is no lapse in group health plan coverage.\n  - When there is only one cost-effective group health plan option available to the enrollee and they are enrolled in that option, disenrollment from the plan results in termination of MA eligibility. The person remains ineligible until the next open enrollment period for the group health plan.\n\nAn enrollee with access to a cost-effective group health plan through their own employer loses MA eligibility if they do not cooperate with these requirements, with the exception of a pregnant person eligible for CHIP-funded MA.\n\nAn enrollee who has access to a cost-effective group health plan through a family member’s employer does not lose MA eligibility if they do not enroll in the group health plan. This is because the enrollee cannot enroll in the plan on their own behalf. See EPM section [2.1.1.2.2 MA Cooperation](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.2) for more information.\n\nAn enrollee does not have to cooperate with CEHI requirements when the enrollee is a Safe at Home (SAH) Address Confidentiality program participant and the policyholder, or the potential policyholder, of the other health insurance is the enrollee’s probable assailant.\n\n### Individual Health Plans\n\nAn individual health plan is a health plan other than job-based coverage that a person can purchase on the private insurance market. An enrollee is not required to enroll or maintain enrollment in an individual health plan if it is cost effective. Enrollment is optional.\n\nIndividual health plans available on the MNsure marketplace cannot be reviewed for cost effectiveness.\n\n### TRICARE Plans\n\nTRICARE is the health care program for uniformed U.S. service members. An enrollee with access to a TRICARE plan is not required to enroll or maintain enrollment in the plan if it is cost effective. Enrollment is optional.\n\n### LTC Insurance\n\nAn LTC insurance policy is cost effective for an enrollee who is currently paying a premium for the policy and living in a nursing facility if the policy covers nursing facility costs and their Medicare co-insurance for the current nursing facility stay. An enrollee is not required to enroll or maintain enrollment in this type of LTC insurance. Enrollment is optional."},{"chunk_id":"epm:2.1.1.2.1.3.1#not-reviewed-for-cost-effectiveness-certain-health-care-accounts-arrangements-and-plans","heading":"Not Reviewed for Cost Effectiveness: Certain Health Care Accounts, Arrangements, and Plans","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.1#not-reviewed-for-cost-effectiveness-certain-health-care-accounts-arrangements-and-plans","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.3 Third Party Liability > 2.1.1.2.1.3.1 Cost-Effective Health Insurance > Not Reviewed for Cost Effectiveness: Certain Health Care Accounts, Arrangements, and Plans","text":"## Not Reviewed for Cost Effectiveness: Certain Health Care Accounts, Arrangements, and Plans\n\nThe following types of health insurance are not reviewed or reimbursed CEHI:\n- Medicare\n- Health flexible spending accounts (FSAs)\n- Health savings accounts (HSAs)\n- Archer medical savings accounts (MSAs)\n- Health reimbursement arrangements (HRAs)\n- Voluntary employees’ beneficiary associations (VEBAs)\n- MinnesotaCare\n- Group health, individual health, TRICARE and LTC insurance plans for people who are enrolled in Medicare\n- Individual health plans in which the network providers primarily practice in another state (outside of both Minnesota and Tribal nations that share geography with Minnesota).\n\n### Medicare\n\nWhile Medicare is not reviewed or reimbursed as CEHI, certain enrollees may receive help to pay their Medicare premiums. See EPM section [2.3.5.4.1 MA-EPD Medicare](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.4.1), section [2.5.4.4.1 Program IM Medicare](https://bot-corpus.mn-dhs.online/s/epm/2.5.4.4.1), and [4.2 Medicare Savings Programs](https://bot-corpus.mn-dhs.online/s/epm/4.2) for more information.\n\n### FSAs, HSAs, and MSAs\n\nFSAs, HSAs, or MSAs are not legally responsible by statute, contract, or agreement for payment of a claim for a health care item or service.\n\nThough these accounts receive tax-preferred treatment for payment of qualified medical expenses, account funds are spent at the account holder’s choosing – they are never legally required to spend the funds for any particular purpose, health care related or otherwise. MA can only pay an enrollee’s costs for other insurance coverage strictly limited to health services.\n\nA person with an HSA or MSA must also be covered by a high-deductible health plan (HDHP) for the HSA or MSA to be valid. An HDHP that is a group health plan may be reviewed for cost effectiveness, but the HSA or MSA is not.\n\n### HRAs and VEBAs\n\nWhile HRAs generally are classified as group health plans, only employers can make contributions to HRAs. Because beneficiaries of an HRA do not pay premiums or make contributions, there is no cost to reimburse.\n\nA VEBA is a tax-exempt account that may include health benefit plans, life insurance, disability insurance, accident insurance, vacation, or other employee benefits. Because VEBAs can be complex, technical, and variable, the administrative cost of reviewing them for CEHI makes them not cost effective.\n\n### MinnesotaCare\n\nMinnestaCare premiums are not reviewed or reimbursed as CEHI. A person cannot be eligible for both MA and MinnesotaCare at the same time.\n\n### Plans Available to People Who Are Enrolled in Medicare\n\nAn enrollee who is also enrolled in Medicare cannot have their premiums for a group health plan, individual health plan, TRICARE plan, or LTC insurance reviewed or reimbursed for CEHI because it is not cost effective to do so."},{"chunk_id":"epm:2.1.1.2.1.3.1#medical-support","heading":"Medical Support","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.1#medical-support","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.3 Third Party Liability > 2.1.1.2.1.3.1 Cost-Effective Health Insurance > Medical Support","text":"## Medical Support\n\nCounty and tribal agencies review certain court-ordered medical support for cost effectiveness. Medical support includes health insurance coverage that a noncustodial parent provides, or is court-ordered to provide, to meet the medical needs of their child. See the MA Medical Support policy for more information.\n\n### Medical Support Reviewed for Cost Effectiveness\n\nIf a noncustodial parent has been ordered by a court to carry health insurance for their children, the health insurance is reviewed for cost effectiveness when the parent is enrolled in MA.\n\nIf the noncustodial court-ordered parent is not enrolled in MA, but the noncustodial parent's health insurance covers MA enrollees, the insurance can be reviewed for cost effectiveness only when all of the following criteria are met:\n- The noncustodial parent left a job and has continued dependent coverage available through COBRA.\n- The child support officer determined that the noncustodial parent is no longer financially able to keep the coverage in effect.\n\nWhen the criteria are met and the health insurance is determined to be cost effective, the county or tribal agency reimburses premiums to the former employer or the custodial parent directly. The agency does not reimburse the non-custodial parent for the cost of premiums.\n\n### Medical Support Not Reviewed for Cost Effectiveness\n\nExcept as noted in the previous section, county and tribal agencies do not review a noncustodial parent's health insurance for cost effectiveness when all of the following criteria are met:\n- The noncustodial parent is not enrolled in MA.\n- The noncustodial parent has been ordered by a court to carry the health insurance for their children."},{"chunk_id":"epm:2.1.1.2.1.3.1#methods-for-determining-cost-effectiveness","heading":"Methods for Determining Cost Effectiveness","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.1#methods-for-determining-cost-effectiveness","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.3 Third Party Liability > 2.1.1.2.1.3.1 Cost-Effective Health Insurance > Methods for Determining Cost Effectiveness","text":"## Methods for Determining Cost Effectiveness\n\nThere are only two methods to determine the cost effectiveness of group health plans, individual health plans, and TRICARE plans.\n\n### Standard Calculation\n\nUnder the standard calculation for cost effectiveness, a health plan is cost effective when the monthly insurance premium (or prorated portion of a family premium) plus 1/12th of the annual average cost factor by age, is less than the current MA managed care monthly rate for people of the same age.\n\nThe annual average cost factor is the average paid costs of health insurance, including the deductible, coinsurance, and copayments, plus the cost of MA wraparound benefits and administrative costs in a preceding calendar year, averaged by age group or pregnancy status for individuals with CEHI coverage.\n\nWhen more than one enrollee is considered for CEHI coverage under a single health plan, the prorated premium and average annual costs by age for each individual are added together and compared to the combined MA managed care rate for the individuals.\n\n### 2:1 Ratio Calculation\n\nUnder the 2:1 ratio calculation for cost effectiveness, a health plan is cost effective when the plan’s annual covered medical expenses for enrollees exceed annual premium costs, plus the annual average cost factor, by at least a 2:1 ratio and the enrollees’ medical conditions remain the same."},{"chunk_id":"epm:2.1.1.2.1.3.1#dental-and-vision-insurance-reviewed-for-cost-effectiveness","heading":"Dental and Vision Insurance Reviewed for Cost Effectiveness","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.1#dental-and-vision-insurance-reviewed-for-cost-effectiveness","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.3 Third Party Liability > 2.1.1.2.1.3.1 Cost-Effective Health Insurance > Dental and Vision Insurance Reviewed for Cost Effectiveness","text":"## Dental and Vision Insurance Reviewed for Cost Effectiveness\n\nIf a group health plan, individual health plan, or TRICARE plan is cost effective under the standard calculation, the county or tribal agency can also review whether dental and vision plan options available to an enrollee are cost effective. The agency determines the cost effectiveness of dental and vision plans by factoring the dental and vision plan premiums into the standard calculation.\n\nDental and vision plan options cannot be reviewed for cost effectiveness unless a health plan covering the enrollee is cost effective under the standard calculation. If a health plan is cost effective under the 2:1 ratio calculation, or not cost effective under either calculation, the dental and vision plan options cannot be reviewed for cost effectiveness."},{"chunk_id":"epm:2.1.1.2.1.3.1#premium-payments-for-cehi","heading":"Premium Payments for CEHI","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.1#premium-payments-for-cehi","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.3 Third Party Liability > 2.1.1.2.1.3.1 Cost-Effective Health Insurance > Premium Payments for CEHI","text":"## Premium Payments for CEHI\n\nCounty and tribal agencies reimburse the policyholder, employer, or insurer for CEHI premiums when an enrollee either enrolls or remains enrolled in the CEHI.\n\nPremium payment is limited to one health plan and, if available, one dental plan and vision plan.\n\n### Submitting Proof of Premium Payment\n\nFor a CEHI policyholder to be reimbursed directly by the county or tribal agency, the policyholder must submit proof to the agency showing they paid the CEHI premiums. The policyholder has from the date the CEHI was reported (or from the date the benefit year begins if the CEHI benefit year has not begun yet) to the date the benefit year ends to submit proof of premiums paid during that time span.\n- Reported means information about the insurance was provided to the agency that leads the agency to determine the insurance was cost effective.\n- For the policyholder’s final premium in the CEHI benefit year, the agency provides the policyholder an extra 10 days starting from the beginning of the first month that follows the 12-month span to submit proof of the final premium payment.\n\n### Retroactive Eligibility\n\nA person can receive retroactive MA eligibility for up to three months before the month of MA application. If the person was covered by other health insurance during the retroactive eligibility period, and the health insurance is determined cost effective, the agency reimburses CEHI premiums paid during that period if proof of payment is submitted, even if that period began before the CEHI was reported. See EPM section [1.2.5 MHCP Retroactive Eligibility](https://bot-corpus.mn-dhs.online/s/epm/1.2.5) for more information."},{"chunk_id":"epm:2.1.1.2.1.3.1#managed-care-exclusions","heading":"Managed care exclusions","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.1#managed-care-exclusions","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.3 Third Party Liability > 2.1.1.2.1.3.1 Cost-Effective Health Insurance > Managed care exclusions","text":"## Managed care exclusions\n\nEnrollees with coverage under a cost-effective group or individual health plan are excluded from enrollment in managed care. MA pays fee-for-service for any services that enrollees are entitled to under MA that their CEHI does not cover. However, there can be a one-month overlap of managed care enrollment and reimbursement for CEHI when an enrollee is unable to timely disenroll from MA managed care because of administrative processes.\n\nRefer to the Prepaid Minnesota Health Care Programs Manual for more information."},{"chunk_id":"epm:2.1.1.2.1.3.1#redetermination-of-cost-effectiveness","heading":"Redetermination of Cost Effectiveness","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.1#redetermination-of-cost-effectiveness","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.3 Third Party Liability > 2.1.1.2.1.3.1 Cost-Effective Health Insurance > Redetermination of Cost Effectiveness","text":"## Redetermination of Cost Effectiveness\n\nCounty and tribal agencies must redetermine the cost effectiveness of a CEHI plan for which premiums are being paid when any of the following occurs:\n- The agency conducts an MA renewal\n- There is a change to the health insurance plan that may affect whether it is cost effective, including, but not limited to:\n  - A change in the plan’s premium\n  - An enrollee is added or dropped from the health insurance plan coverage\n  - A person covered under the health insurance plan loses MA eligibility"}]},{"id":"epm:2.1.1.2.1.3.2","number":"2.1.1.2.1.3.2","title":"Medical Support","parent":"2.1.1.2.1.3","breadcrumb":"2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.3 Third Party Liability > 2.1.1.2.1.3.2 Medical Support","summary":"The Medical Assistance (MA) program requires parents or relative caretakers to help provide health care for their children. When both parents live with the child, this requirement is generally met by deeming the parents’ income to the child. When one parent does not live with the child, a referral for medical support may be required.","effective_date":"2024-02-16","last_modified":"2026-10-03T03:51:57.24681+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.1.1.2.1.3.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_1_1_2_1_3_2.htm","legal_citations":["Code of Federal Regulations, title 42, section 433.145","Code of Federal Regulations, title 42, section 433.146","Code of Federal Regulations, title 42, section 433.147","Code of Federal Regulations, title 42, section 433.148","Code of Federal Regulations, title 42, section 435.610","Minnesota Statutes, section 256.741","Minnesota Statutes, section 256B.056, subdivisions 6 and 8"],"chunks":[{"chunk_id":"epm:2.1.1.2.1.3.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.2","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.3 Third Party Liability > 2.1.1.2.1.3.2 Medical Support","text":"The Medical Assistance (MA) program requires parents or relative caretakers to help provide health care for their children. When both parents live with the child, this requirement is generally met by deeming the parents’ income to the child. When one parent does not live with the child, a referral for medical support may be required.\n\nMedical support is health insurance coverage or cash payments that a parent, who is not living with the child, provides or is court-ordered to provide to meet the medical needs of their child. For MA eligibility, the parent or relative caretaker who lives with the child is required to cooperate with medical support referral requirements for children younger than age 19 on MA."},{"chunk_id":"epm:2.1.1.2.1.3.2#assignment-of-rights-and-cooperation","heading":"Assignment of Rights and Cooperation","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.2#assignment-of-rights-and-cooperation","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.3 Third Party Liability > 2.1.1.2.1.3.2 Medical Support > Assignment of Rights and Cooperation","text":"## Assignment of Rights and Cooperation\n\nA parent or relative caretaker assigns the child’s right to medical support by signing a paper or online health care application or renewal form.\n\nCounty, tribal or state servicing agencies are required to mail a medical support referral packet to the parent or relative caretaker. The MA enrolled parent or relative caretaker must return the form within 30 days of the date on the referral packet. Regardless of whether the forms are returned or not, the county, tribal or state servicing agency must initiate a referral to the county or tribal child support agency, also called the IV-D agency.\n\nFor medical support, cooperation may include:\n- Establishing paternity\n- Establishing an order for medical support, or enforcing an existing order\n- Providing information about non-custodial parents\n- Forwarding any medical support payments received directly from the non-custodial parent to the Department of Human Services (DHS)\n\nA pregnant person, or a parent or relative caretaker who is pregnant, is not required to cooperate with medical support for the child she is expecting or for any other child during pregnancy or during the 12 month postpartum period."},{"chunk_id":"epm:2.1.1.2.1.3.2#non-cooperation","heading":"Non-Cooperation","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.2#non-cooperation","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.3 Third Party Liability > 2.1.1.2.1.3.2 Medical Support > Non-Cooperation","text":"## Non-Cooperation\n\nThe county or tribal child support office determines non-cooperation with medical support requirements and notifies the county, tribal or state servicing agency. The parent or relative caretaker’s MA coverage is closed with 10-day notice.\n\nIf MA is closed for non-cooperation, MA coverage cannot be reopened until the parent or relative caretaker cooperates with medical support requirements. If the parent or relative caretaker cooperates, MA may reopen the first day of the month in which cooperation occurs.\n\nThe MA coverage of a child, or of anyone without the legal ability to assign rights, is not impacted by non-cooperation with medical support requirements, such as the non-cooperation of a parent or relative caretaker.\n\n### Good Cause\n\nA parent or relative caretaker may ask to be exempt from cooperating with child support as part of the medical support requirements when they believe cooperating could reasonably result in physical or emotional harm to the parent, relative caretaker, or child, or would otherwise be detrimental to the child. This is called “claiming good cause.” A parent or relative caretaker can claim good cause at any time by completing and submitting the Client Statement of Good Cause on the [Cooperation with Child Support form (DHS-2338)](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-2338-ENG). Parents and relative caretakers who are referred to medical support must be notified in writing of their right to claim good cause. Information about good cause is included in the medical support referral packet sent to parents and relative caretakers who are referred to medical support. A person with an active good cause claim, including someone who is awaiting the good cause committee’s decision, is cooperating with medical support requirements. When a participant of the Safe at Home program (SAH) requests good cause, the good cause committee must review and officially approve the request without requiring additional information. A person may withdraw a claim of good cause at any time in the process.\n\nEach county has a good cause committee that reviews good cause requests. The committee includes representatives from: the Minnesota Family Investment Program (MFIP), Medical Assistance, child support, and Child Care Assistance Program (CCAP). If a person claiming good cause is also a recipient of Tribal Temporary Assistance for Needy Families (Tribal TANF), the county's good cause committee and the Tribal TANF Agency make a joint decision regarding good cause claims, and the Tribal TANF agency’s decision must prevail. Upon request, the good cause committee must assist the person in gathering any evidence requested.\n\nGood cause claims must be redetermined by the good cause committee annually. If a household with an approved good cause claim moves to another county, the review date for the good cause exemption remains one year from the date it was approved by the good cause committee at the original agency.\n\nThe county must share the evidence between agencies upon request from the parent or relative caretaker.\n\nA person whose good cause claim is denied has the right to appeal the decision. See [EPM 1.3.1.1](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.1) for more information about appeals. A person who has submitted a request for appeal of the good cause committee’s decision or who is awaiting the outcome of their appeal is cooperating with medical support requirements. A person whose good cause claim is denied and does not appeal, or does appeal but the appeal is denied, must begin to cooperate with child support to satisfy MA medical support requirements."},{"chunk_id":"epm:2.1.1.2.1.3.2#when-medical-support-referrals-are-made","heading":"When Medical Support Referrals are Made","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.2#when-medical-support-referrals-are-made","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.3 Third Party Liability > 2.1.1.2.1.3.2 Medical Support > When Medical Support Referrals are Made","text":"## When Medical Support Referrals are Made\n\nA medical support referral is made when a child younger than age 19 resides with one parent or a relative caretaker, both the child and the parent or relative caretaker are eligible for MA, and none of the Referral Not Required criteria below applies."},{"chunk_id":"epm:2.1.1.2.1.3.2#referral-not-required","heading":"Referral Not Required","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.2#referral-not-required","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.3 Third Party Liability > 2.1.1.2.1.3.2 Medical Support > Referral Not Required","text":"## Referral Not Required\n\nA medical support referral is not made in any of the following circumstances:\n- One parent in a two-parent household has a temporary absence. Refer to [Section 1.4.4 Minnesota Health Care Programs Temporary Absence](https://bot-corpus.mn-dhs.online/s/epm/1.4.4) for more information.\n- Only a child, and not a parent or relative caretaker, is enrolled in MA.\n- The parent is deceased.\n- The parent or relative caretaker is pregnant or in the 12 month postpartum period.\n- The parent is a minor child under age 18 or is an emancipated minor.\n- The child receives Northstar Adoption Assistance.\n- The child receives Northstar Foster Care or Kinship Assistance.\n- A parent is involuntarily out of the household because he or she is being detained by U.S. Immigration and Customs Enforcement (ICE) or is waiting for immigration authorization from U.S. Citizenship and Immigration Services (USCIS) from outside of the United States."},{"chunk_id":"epm:2.1.1.2.1.3.2#voluntary-referral","heading":"Voluntary Referral","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.2#voluntary-referral","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.3 Third Party Liability > 2.1.1.2.1.3.2 Medical Support > Voluntary Referral","text":"## Voluntary Referral\n\nA parent or relative caretaker may request voluntary medical support or child support referral services from the county or tribal IV-D agency when a referral for MA eligibility purposes is not required. The county or tribal IV-D agencies can assist people in getting the medical or child support referral services."}]},{"id":"epm:2.1.1.2.1.3.3","number":"2.1.1.2.1.3.3","title":"Other Third Party Liability","parent":"2.1.1.2.1.3","breadcrumb":"2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.3 Third Party Liability > 2.1.1.2.1.3.3 Other Third Party Liability","summary":"In some situations, Medical Assistance (MA) enrollees may have access to third party liability other than health care coverage for all or part of their medical expenses related to an illness, accident or injury. The DHS Benefit Recovery Section (BRS) assists in the coordination of Third Party Liability (TPL) benefits and MA.","effective_date":"2023-10-25","last_modified":"2026-10-03T03:52:15.856388+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.1.1.2.1.3.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_1_1_2_1_3_3.htm","legal_citations":["Minnesota Statutes, section 256B.056"],"chunks":[{"chunk_id":"epm:2.1.1.2.1.3.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.3","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.3 Third Party Liability > 2.1.1.2.1.3.3 Other Third Party Liability","text":"In some situations, Medical Assistance (MA) enrollees may have access to third party liability other than health care coverage for all or part of their medical expenses related to an illness, accident or injury. The DHS Benefit Recovery Section (BRS) assists in the coordination of Third Party Liability (TPL) benefits and MA.\n\nExamples of TPL that are not health care coverage include, but are not limited to the following:\n- Workers' Compensation may be liable for the cost of medical care and subsistence related to on-the-job injuries\n- Auto insurance policies may cover medical costs related to auto accidents or injuries involving a motor vehicle\n- Homeowners or business liability policies may cover medical costs related to accidents on the home or business owner's property\n- Tort claims and lawsuits may result in court-ordered awards for recovery of medical expenses caused by another party's negligence or malpractice including but not limited to:\n  - Product liability\n  - Medical malpractice\n  - Pedestrian injuries\n- Health Reimbursement Account (HRA) is considered a Group Health Plan (GHP) as provided for Under the Internal Revenue Code.\n\nActual or potential non-health care coverage TPL payments are not a barrier to MA eligibility; however, the enrollee must cooperate in providing information to determine whether those third parties are liable."},{"chunk_id":"epm:2.1.1.2.1.3.3#accidents-and-injuries","heading":"Accidents and Injuries","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.3#accidents-and-injuries","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.1 Benefit Recovery > 2.1.1.2.1.3 Third Party Liability > 2.1.1.2.1.3.3 Other Third Party Liability > Accidents and Injuries","text":"## Accidents and Injuries\n\nEnrollees must complete additional documentation when possible TPL coverage is identified.\n- A Medical Service Questionnaire (MSQ) ([DHS-2237A](http://edocs.dhs.state.mn.us/lfserver/public/DHS-2237A-ENG)) when there is an accident or injury with an identified treatment code.\n- A Work Injury Report (WIR) wehn there is a work-related accident or injury.\n- An Accident Injury Report (AIR) ([DHS-7336-ENG](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-7336-ENG)) when there is a motor-vehicle related accident or injury.\n\nAdults who fail to cooperate with TPL requirements may have their MA coverage ended. See the [MHCP Cooperation](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.2) policy for more information."}]},{"id":"epm:2.1.1.2.2","number":"2.1.1.2.2","title":"Cooperation","parent":"2.1.1.2","breadcrumb":"2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.2 Cooperation","summary":"Medical Assistance (MA) enrollees must comply with various eligibility requirements. Enrollees who fail to cooperate with requirements may have their MA coverage ended.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:57.24681+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.1.1.2.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_1_1_2_2.htm","legal_citations":["Minnesota Rules, part 9505.0080"],"chunks":[{"chunk_id":"epm:2.1.1.2.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.2","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.2 Cooperation","text":"Medical Assistance (MA) enrollees must comply with various eligibility requirements. Enrollees who fail to cooperate with requirements may have their MA coverage ended.\n\nCooperation is required for the following eligibility requirements:\n1. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n2. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n3. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n4. [MA for Employed Persons with Disabilities (MA-EPD) Premiums and Cost Sharing](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.2)\n5. [Medicaid Eligibility Quality Control (MEQC) and Payment Error Rate Measurement (PERM)](https://hcopub.dhs.state.mn.us/epm/#meqc_perm)\n6. [MA Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.1)\n7. [MA Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4)\n8. [MA Third Party Liability](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3)"},{"chunk_id":"epm:2.1.1.2.2#medicaid-eligibility-quality-control-and-payment-error-rate-measurement-cooperation","heading":"Medicaid Eligibility Quality Control and Payment Error Rate Measurement Cooperation","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.2#medicaid-eligibility-quality-control-and-payment-error-rate-measurement-cooperation","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.2 Cooperation > Medicaid Eligibility Quality Control and Payment Error Rate Measurement Cooperation","text":"## Medicaid Eligibility Quality Control and Payment Error Rate Measurement Cooperation\n\nDHS conducts Medicaid Eligibility Quality Control (MEQC) and Payment Error Rate Measurement (PERM) eligibility reviews for MA. Enrollees are encouraged to cooperate with these eligibility reviews, however, enrollees are not required to cooperate, as a condition of their eligibility for MA; the county, tribal or state servicing agency must:\n- Verification is requested from the enrollee when MEQC or PERM eligibility reviews provide information that is inconsistent with information or documentation on file.\n- Eligibility is redetermined when an MEQC or PERM review results in new information that affects eligibility."}]},{"id":"epm:2.1.1.2.3","number":"2.1.1.2.3","title":"Cost Sharing","parent":"2.1.1.2","breadcrumb":"2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.3 Cost Sharing","summary":"Cost sharing includes those costs a Medical Assistance (MA) enrollee pays towards their health care. MA enrollees do not have deductibles, copays or co-insurance. However, some MA enrollees have premiums, spenddowns, waiver obligations or parental fees.","effective_date":"2025-03-26","last_modified":"2026-10-03T03:51:57.24681+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.1.1.2.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_1_1_2_3.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.225","Minnesota Statutes, section 252.27 (as amended by 2023 MN Laws, chapter 61, article 3, section 1)","Minnesota Statutes, section 256B.14","Minnesota Statutes, section 256B.057","Minnesota Statutes, section 256B.063","Minnesota Statutes, section 256B.0631"],"chunks":[{"chunk_id":"epm:2.1.1.2.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.3","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.3 Cost Sharing","text":"Cost sharing includes those costs a Medical Assistance (MA) enrollee pays towards their health care. MA enrollees do not have deductibles, copays or co-insurance. However, some MA enrollees have premiums, spenddowns, waiver obligations or parental fees."},{"chunk_id":"epm:2.1.1.2.3#premiums","heading":"Premiums","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.3#premiums","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.3 Cost Sharing > Premiums","text":"## Premiums\n\nPremiums are a bill enrollees pay monthly for their health care. MA for Employed Persons with Disabilities (MA-EPD) enrollees have a monthly premium. See EPM section [2.3.5.1.2 MA-EPD Premiums](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.2) policy for more information."},{"chunk_id":"epm:2.1.1.2.3#spenddowns","heading":"Spenddowns","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.3#spenddowns","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.3 Cost Sharing > Spenddowns","text":"## Spenddowns\n\nA spenddown is an approach that allows MA eligibility for certain people whose income exceeds the MA income limit, but who have medical expenses that are equal to the amount of their excess income. Federal rules refer to this population as \"medically needy.\"\n\nMA enrollees can become income eligible for MA by “spending down” their excess income to the appropriate income limit. The excess income is reduced by deducting certain medical expenses.\n\nThere are two types of spenddowns.\n\n### Medical Spenddown\n\nMedical Spenddowns are for enrollees that live in the community. Not all MA bases of eligibility offer MA with a medical spenddown. See EPM section [2.2.3.6 MA-FCA Medical Spenddown](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.6) policy and section [2.3.3.4 MA-ABD Medical Spenddowns](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.4) policy for more information.\n\n### Long-Term Care Spenddown\n\nSome enrollees eligible for the payment of long-term care services may be obligated to contribute toward the cost of services. The amount of income that a person is obligated to contribute to the cost of LTC services is based on basis of eligibility and household composition.\n\nNot all MA bases of eligibility require enrollees contribute toward the cost of long-term care facility services (nursing facility). See EPM section [2.4 MA for Long-Term Care Services](https://bot-corpus.mn-dhs.online/s/epm/2.4) chapter for more information."},{"chunk_id":"epm:2.1.1.2.3#parental-fees","heading":"Parental Fees","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.3#parental-fees","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.3 Cost Sharing > Parental Fees","text":"## Parental Fees\n\nEffective July 1, 2023 parents are no longer assessed a parental fee for children enrolled in MA under the TEFRA option or for children receiving home and community-based services (HCBS) waivers. Parents are still responsible for parental fees assessed for children under the TEFRA option and for children receiving HCBS waivers before June 30, 2023.\n\nEffective 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.\n\nCounty, tribal or state servicing agencies may assess parental fees when a child lives apart from both parents or when a child has a non-custodial parent. .\n\nThe Minnesota Department of Human Services (DHS) collects parental fees. The child’s, county, tribal or state servicing agency must make a referral to the DHS Parental Fee Unit using the County Parental Fee Referral form ([DHS-2982](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-2982-ENG)) to assess a parental fee for children placed in in 24-hour care outside the home. The county, tribal or state servicing agency sends the Important Notice and Parental Fee Worksheet ([DHS-2977](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-2977-ENG)) to parents.\n\n### Parental Fee Amount\n\nDHS uses the birth and adoptive parent's adjusted gross income (AGI) as reported on the previous year's federal tax return to compute parental fees.\n\nParents can estimate the amount of the parental fee using the worksheet and information on DHS-2977.\n\nOnce a parental fee has been assessed, parents will receive a determination order that indicates what the parental fee is for the fiscal year and the amount of monthly payments.\n\nParental fees are reassessed each fiscal year due to annual changes in the FPG or changes in AGI or family size. Parents must tell DHS when there is a change in household size, the child leaves the home, other health insurance coverage starts or stops, or there is change in monthly income in excess of 10%. The parents can send a letter to:\n\nDepartment of Human Services\n\nFinancial Operations Division\n\nPO Box 64171\n\nSt. Paul, MN 55164-0171\n\n### Undue Hardship\n\nParents may send a letter to DHS to request a change to the parental fee when they incur any of the following expenses, not reimbursed by any public or private sector:\n- Payments for medical expenses not covered by MA or health insurance, but that would be allowable as a federal tax deduction under the Internal Revenue Code.\n- Expenditures for adaptations to the parents’ vehicle that are necessary to accommodate the child’s medical needs and are a type that would be allowable as a federal tax deduction under the Internal Revenue Code.\n- Expenditures for physical adaptations to the child’s home that are necessary to accommodate the child’s physical, behavioral, or sensory needs and are a type that would be allowable as a federal tax deduction under the Internal Revenue Code.\n- Unexpected, sudden or unusual expenditures by the parents since the last renewal or within the past 12 months that are not reimbursed by any type of insurance or civil action and which are a type allowable as a casualty loss deduction under the Internal Revenue Code.\n- When a peculiar tax status creates a gross disparity between the amount of income allocated to them and the amount of the cash distributions made to them.\n\n### Non-Cooperation with Parental Fee Requirements\n\nA child’s MA coverage is not closed when a parent does not cooperate with parental fee requirements. Action may be taken against the parent in either of the following circumstances:\n- Refusal to submit the necessary information to DHS in determining a fee can result in a bill for the full reimbursement cost of MA services.\n- Failure to pay the parental fee can result in the account being turned over to a collection agency, garnishment of wages, or taking the parent’s state tax refund"},{"chunk_id":"epm:2.1.1.2.3#waiver-obligations","heading":"Waiver Obligations","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.3#waiver-obligations","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.3 Cost Sharing > Waiver Obligations","text":"## Waiver Obligations\n\nA waiver obligation is the amount a person is obligated to contribute toward the cost of home and community based waiver services. People age 65 and older, receiving Elderly Waiver (EW) services, with income above the Special Income Standard Elderly Waiver (SIS-EW) maintenance needs allowance pay a waiver obligation. The waiver obligation is based on actual income and deductions in a given month. See EPM section [2.4.2.3.2 MA-LTC Home and Community-Based Services Waiver for People Age 65 or Older](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.3.2) subsection for more information."}]},{"id":"epm:2.1.1.2.4","number":"2.1.1.2.4","title":"Referral for Other Benefits","parent":"2.1.1.2","breadcrumb":"2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.4 Referral for Other Benefits","summary":"As of February 2025, Medical Assistance (MA) enrollees are no longer required to apply for, or attempt to obtain, income benefits as a condition of eligibility.","effective_date":"2025-12-12","last_modified":"2026-10-03T03:51:57.24681+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.1.1.2.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_1_1_2_4.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.608"],"chunks":[{"chunk_id":"epm:2.1.1.2.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.4 Referral for Other Benefits","text":"As of February 2025, Medical Assistance (MA) enrollees are no longer required to apply for, or attempt to obtain, income benefits as a condition of eligibility."},{"chunk_id":"epm:2.1.1.2.4#social-security-benefits","heading":"Social Security benefits","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4#social-security-benefits","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.4 Referral for Other Benefits > Social Security benefits","text":"## Social Security benefits\n\nGenerally, MA enrollees do not need to apply for Social Security retirement or other retirement benefits to maintain MA eligibility. Applicants or enrollees seeking MA under the Medical Assistance for People Who Are Blind or Have a Disability basis of eligibility who do not have a disability certification from the Social Security Administration (SSA) must apply for Social Security disability benefits in order to be certified disabled by the SSA. This requirement applies even if the applicant or enrollee has a current disability certification from the State Medical Review Team (SMRT). Enrollees must apply within 30 days of when the county, tribal or state servicing agency notifies them of their potential eligibility, unless they can show good cause for not doing so . Good cause is determined on a case-by-case basis by the tribal, county, or state servicing agency.\n\nMA under the TEFRA Option applicants or enrollees are not required to apply for Social Security disability benefits.\n\n### Retirement Survivors Disability Insurance\n\nSSA administers Retirement, Survivors and Disability Insurance (RSDI) benefits. RSDI provides a monthly income based on payroll contributions made via Social Security taxes.\n\nThe following people, if qualified under a Social Security number having at least 40 work quarters, may be eligible for RSDI:\n- Retired people who meet SSA age requirements\n- People certified disabled by SSA\n- Dependents of a wage earner who is disabled or retired\n- Dependent survivors of a wage earner who has died\n\nPeople who are eligible for RSDI may also be eligible for Supplemental Security Income (SSI) if their RSDI payment is less than the SSI income standard.\n\n### Supplemental Security Income\n\nSSI is a federal supplemental income program operated by SSA and funded by general tax revenues. It provides monthly cash payments to people aged 65 or older and people certified disabled by SSA, who have little or no income, to help them meet basic needs for food, clothing and shelter. MA enrollees who may be eligible for SSI do not need to apply to continue MA eligibility, unless they need and do not have a current disability determination from SSA."},{"chunk_id":"epm:2.1.1.2.4#medicare","heading":"Medicare","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4#medicare","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.4 Referral for Other Benefits > Medicare","text":"## Medicare\n\nEnrollees who are potentially eligible for Medicare must still apply to maintain MA eligibility. MA will not pay for Medicare-covered services for people who are eligible for, but do not enroll in Medicare Part A without a premium. To be eligible for premium-free Part A on the basis of age, MA enrollees must be age 65 or older.\n\nMA enrollees may be eligible for Medicare under a different basis if they meet one of the following:\n- Citizens and qualifying non-citizens age 65 or older who pay a Medicare Part A premium\n- People certified disabled by the SSA receiving RSDI or Railroad Retirement Benefits (RRB) for at least 24 months\n- Widows or widowers and divorced widows and widowers with a certified disability by SSA and who have been receiving RSDI or RRB benefits for at least 24 months\n- People with Amyotrophic Lateral Sclerosis (ALS) (Lou Gehrig’s Disease) are entitled to Part A the first month they are entitled to Social Security or RRB benefits with no waiting period\n- People with End-Stage Renal Disease (ESRD) defined as permanent kidney failure requiring dialysis or a kidney transplant\n\nDHS previously evaluated Medicare premiums for cost-effectiveness, but Medicare premiums are no longer evaluated for cost-effectiveness. People whose premiums were evaluated under the previous policy and determined not cost-effective have good cause for not meeting the requirement to enroll in Medicare if eligible.\n\n### Medicare Part A\n\nMedicare Part A is federal hospitalization insurance. People who are eligible for premium-free Medicare Part A may not refuse to apply or turn down this coverage to gain or continue MinnesotaCare or Advance Premium Tax Credit (APTC) eligibility.\n\n### Medicare Part B\n\nMedicare Part B is medical insurance. There is a monthly premium for Part B. MA enrollees must apply and maintain Medicare Part B coverage, even if they are required to pay a premium. Medicare Savings Programs (MSP), the Medicare Buy-In and MA-EPD can help eligible clients with premiums and other costs. People who are in an Institution for Mental Diseases (IMD) may also receive help paying for premiums and other costs. People have a wide variety of Medicare-approved plans from which to choose.\n\nMA enrollees enrolled in Medicare Part A are not required to enroll in Medicare Part B or enroll in an MSP if they have primary coverage under an employer group health insurance plan through:\n- Their own current employment or their spouse's current employment\n- A parent's current employment where the enrolee is a disabled child (of any age).\n\n### Medicare Part D\n\nMedicare Part D is prescription drug coverage. Enrollment in Medicare Part D is not required as a condition of MA eligibility. However, there are specific rules established for clients eligible for Medicare Part D who fail or refuse to enroll in, or opt out of, that program. MA cannot pay any prescription drug costs for eligible Part D beneficiaries regardless of whether or not they are enrolled in Medicare Part D. However, prescription drug bills that are not covered by Medicare can be used to meet a medical spenddown.\n\nMedicare eligible MA and MSP enrollees qualify for a full Extra Help subsidy automatically and must select a Medicare Part D benchmark plan. Medicare beneficiaries of all ages can get free assistance with selecting a Part D plan by calling the Minnesota Aging Pathways at (800) 333-2433."},{"chunk_id":"epm:2.1.1.2.4#railroad-retirement-benefits","heading":"Railroad Retirement Benefits","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4#railroad-retirement-benefits","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.4 Referral for Other Benefits > Railroad Retirement Benefits","text":"## Railroad Retirement Benefits\n\nThe federal [Railroad Retirement Board](http://www.rrb.gov/) (RRB) administers railroad retirement benefits and Medicare for railroad workers and their families. People who work for a railroad have railroad retirement withheld from their earnings instead of Social Security. If a person has earned enough Social Security credits to receive Social Security benefits as well as railroad retirement benefits, the beneficiary receives the larger of the two.\n\nRetiree benefit amounts are based on the number of years of service. Railroad workers who meet certain service requirements are eligible for:\n- Retiree benefits\n- Disability benefits\n- Dependent benefits for spouses, ex-spouses, and children who meet certain criteria, and\n- Survivor benefits\n\nRRB eligible MA enrollees at full retirement age must apply for benefits. The railroad worker’s family members must also apply for potential benefits if the railroad worker is currently receiving RRB benefits or was receiving or eligible to receive benefits but is now deceased. People turning age 65 who are receiving railroad retirement benefits must apply for Medicare through the RRB."},{"chunk_id":"epm:2.1.1.2.4#financial-needs","heading":"Financial Needs","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4#financial-needs","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.4 Referral for Other Benefits > Financial Needs","text":"## Financial Needs\n\nEnrollees, potentially eligible for the following benefits, must apply to maintain MA eligibility.\n\n[Minnesota Unemployment Insurance](http://www.uimn.org/uimn/applicants/index.jsp) (UI) benefits provide a temporary partial wage replacement to workers who become unemployed through no fault of their own.\n\n[Workers’ Compensation](http://www.dli.mn.gov/WorkComp.asp) provides benefits for people injured or ill from their job.\n\nMA enrollees who are veterans or a spouse of a veteran, using the People Aged 65 or Older, Blind or Disabled basis, living in a long-term care facility, must apply for the federal Veterans’ [Aid and Attendance program](http://www.benefits.va.gov/pension/aid_attendance_housebound.asp) through the U.S. Department of Veterans Affairs (USDVA)."},{"chunk_id":"epm:2.1.1.2.4#exceptions","heading":"Exceptions","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4#exceptions","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.4 Referral for Other Benefits > Exceptions","text":"## Exceptions\n\nEnrollees are not required to reapply for benefits that were previously denied unless there has been a change in circumstances or eligibility requirements of the benefit program."}]},{"id":"epm:2.1.1.2.5","number":"2.1.1.2.5","title":"Periodic Data Matching","parent":"2.1.1.2","breadcrumb":"2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.5 Periodic Data Matching","summary":"Periodic Data Matching (PDM) is a process that uses electronic data sources to identify Medical Assistance for Families with Children and Adults (MA-FCA) enrollees who may no longer meet eligibility criteria for the program.","effective_date":"2019-11-01","last_modified":"2026-10-03T03:51:57.24681+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.5","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.1.1.2.5","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_1_1_2_5.htm","legal_citations":["Minnesota Statutes, section 256B.0561"],"chunks":[{"chunk_id":"epm:2.1.1.2.5#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.5","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.5 Periodic Data Matching","text":"Periodic Data Matching (PDM) is a process that uses electronic data sources to identify Medical Assistance for Families with Children and Adults (MA-FCA) enrollees who may no longer meet eligibility criteria for the program.\n\nEnrollees in MA-FCA are subject to data matching using electronic data sources at least once during an enrollee’s 12-month period of eligibility.\n\nThe electronic data sources used for periodic data matching provide information about an enrollee’s or household member’s income, Medicare Part A enrollment, or death."},{"chunk_id":"epm:2.1.1.2.5#notification-of-discrepant-information","heading":"Notification of Discrepant Information","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.5#notification-of-discrepant-information","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.5 Periodic Data Matching > Notification of Discrepant Information","text":"## Notification of Discrepant Information\n\nDiscrepant information is electronic data that is not consistent with the case information attested to by the enrollee. An enrollee will receive a discrepancy notice only when the information from an electronic data source indicates the enrollee may no longer qualify for the program in which he or she is currently enrolled.\n\nAn enrollee must respond to the discrepancy notice within 30 days from the date on the notice by mail, in person, or by calling the agency. An enrollee may respond to the discrepancy notice by submitting a response form with confirmed or corrected information. An enrollee who confirms the information on the form is correct must not be required to provide paper verification to resolve the discrepancy."},{"chunk_id":"epm:2.1.1.2.5#extension-to-resolve-a-discrepancy","heading":"Extension to Resolve a Discrepancy","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.5#extension-to-resolve-a-discrepancy","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.5 Periodic Data Matching > Extension to Resolve a Discrepancy","text":"## Extension to Resolve a Discrepancy\n\nAn extension of time beyond the 30-day period is available when an enrollee is cooperating with the agency but unable to provide the information needed to resolve a discrepancy before the date of closure. An extension may be granted only upon enrollee request. There is no limit to the number of extensions an enrollee may be granted, if the enrollee is cooperating with the PDM process."},{"chunk_id":"epm:2.1.1.2.5#resolving-a-pdm-discrepancy","heading":"Resolving a PDM discrepancy","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.5#resolving-a-pdm-discrepancy","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.5 Periodic Data Matching > Resolving a PDM discrepancy","text":"## Resolving a PDM discrepancy\n- Income discrepancy\n- An income-related PDM discrepancy is considered resolved when the agency receives an attestation of current household income from the MA enrollee. No verification is required if the enrollee’s attested income is the same as the income listed on the discrepancy notice.\n- Medicare Part A discrepancy\n- A Medicare Part A discrepancy is considered resolved when an enrollee confirms having Medicare Part A or attests that he or she does not have Medicare Part A. If an enrollee disputes having Medicare, the agency must check any other available data sources about Medicare enrollment, and if necessary, refer the enrollee to the Social Security Administration (SSA) to update his or her records. The agency cannot require an enrollee to contact SSA before resolving the discrepancy.\n- Death discrepancy\n- A death discrepancy is considered resolved when the death is either confirmed or denied by the household. If an enrollee denies the death discrepancy, the agency must resolve the discrepancy and refer the enrollee to SSA to correct his or her records. The agency cannot require an enrollee to contact SSA before resolving the discrepancy.\n\nAn enrollee may report changes during the process of resolving their PDM discrepancies. See [MHCP Changes in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1) for more information."},{"chunk_id":"epm:2.1.1.2.5#failure-to-resolve-a-pdm-discrepancy","heading":"Failure to Resolve a PDM Discrepancy","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.5#failure-to-resolve-a-pdm-discrepancy","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.1 General Requirements > 2.1.1.2 Responsibilities > 2.1.1.2.5 Periodic Data Matching > Failure to Resolve a PDM Discrepancy","text":"## Failure to Resolve a PDM Discrepancy\n\nAn MA enrollee must cooperate with the PDM process as a condition of eligibility. Enrollees who fail to resolve a PDM discrepancy or request an extension within 30 days of the notice are no longer eligible for MA. The enrollee is not eligible for MA, MinnesotaCare, advanced premium tax credits (APTC) or cost-sharing reductions (CSR) until the enrollee resolves all outstanding discrepancies. An enrollee with an outstanding discrepancy may be eligible to purchase a qualified health plan without a subsidy if he or she meets the eligibility criteria.\n\nAn MA enrollee whose eligibility ended due to failure to resolve a PDM discrepancy must resolve the outstanding discrepancy to qualify for MA again. Once the person resolves the outstanding discrepancy, the earliest the person can be eligible for MA is the first day of the month in which the person cooperated with the agency to resolve the PDM discrepancy or reapplied."}]},{"id":"epm:2.1.2","number":"2.1.2","title":"Non-Financial Eligibility","parent":"2.1","breadcrumb":"2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility","summary":"This subchapter provides non-financial eligibility policy that generally applies to all types of Medical Assistance (MA) and links to policies that apply to all Minnesota Health Care Programs (MHCP). Non-financial eligibility requirements are not related to a person’s income or assets. Non-financial eligibility policy that applies to a specific type of MA is located in the relevant MA chapter.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:57.24681+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.1.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_1_2.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.1.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility","text":"This subchapter provides non-financial eligibility policy that generally applies to all types of Medical Assistance (MA) and links to policies that apply to all Minnesota Health Care Programs (MHCP). Non-financial eligibility requirements are not related to a person’s income or assets. Non-financial eligibility policy that applies to a specific type of MA is located in the relevant MA chapter.\n\nTopics covered in this sub-chapter are:\n1. [MA Bases of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.1)\n2. [MA Citizenship and Immigration Status](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2)\n  1. [MA Citizenship](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2.1)\n  2. [MA Immigration Status](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2.2)\n3. [MA County Residency](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.3)\n4. [MA Living Arrangement](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.4)\n5. [MHCP State Residency](https://bot-corpus.mn-dhs.online/s/epm/1.4)\n6. [MA Social Security Number](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5)"}]},{"id":"epm:2.1.2.1","number":"2.1.2.1","title":"Bases of Eligibility","parent":"2.1.2","breadcrumb":"2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility > 2.1.2.1 Bases of Eligibility","summary":"Minnesota provides Medical Assistance (MA) to certain groups of people as allowed under law. These groups are referred to as a basis of eligibility. A person’s basis of eligibility determines the non-financial criteria and financial methodology used to determine MA eligibility.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:57.24681+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.1.2.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_1_2_1.htm","legal_citations":["Code of Federal Regulations, title 42, sections 435.2 to 435.350","Code of Federal Regulations, title 42, section 435.404","Code of Federal Regulations, title 42, section 435.907","Code of Federal Regulations, title 42, section 435.911","Minnesota Statutes, section 256B.04","Minnesota Statutes, section 256B.055","Minnesota Statutes, section 256B.08"],"chunks":[{"chunk_id":"epm:2.1.2.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2.1","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility > 2.1.2.1 Bases of Eligibility","text":"Minnesota provides Medical Assistance (MA) to certain groups of people as allowed under law. These groups are referred to as a basis of eligibility. A person’s basis of eligibility determines the non-financial criteria and financial methodology used to determine MA eligibility.\n\nAn applicant or enrollee’s basis of eligibility determines what MA eligibility rules apply. See the specific policies below for definitions of each basis and the begin and end dates for each basis of eligibility.\n1. [MA Families With Children and Adults (MA-FCA) Bases of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1)\n2. [MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) Bases of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.2.1)\n3. [MA Breast or Cervical Cancer (MA-BC) Basis of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.1.2.1)\n4. [MA Center for Victims of Torture (MA-CVT) Basis of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.2.2.1)\n5. [MA Northstar Adoption Assistance Care Bases of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.2.1)\n6. [MA Northstar Title IV-E Foster Care and Title IV-E Kinship Assistance](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.2.1)"},{"chunk_id":"epm:2.1.2.1#multiple-bases-of-eligibility","heading":"Multiple Bases of Eligibility","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2.1#multiple-bases-of-eligibility","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility > 2.1.2.1 Bases of Eligibility > Multiple Bases of Eligibility","text":"## Multiple Bases of Eligibility\n\nPeople may have more than one basis of eligibility. A person’s countable income, asset limits, cost sharing, service delivery options and benefits may differ depending on the eligibility basis used. The county, tribal or state servicing agency must allow a person with multiple bases of eligibility to have eligibility determined under the basis that best meets their needs."},{"chunk_id":"epm:2.1.2.1#change-in-basis-of-eligibility-for-enrollees","heading":"Change in Basis of Eligibility for Enrollees","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2.1#change-in-basis-of-eligibility-for-enrollees","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility > 2.1.2.1 Bases of Eligibility > Change in Basis of Eligibility for Enrollees","text":"## Change in Basis of Eligibility for Enrollees\n\nA change in circumstances may affect an MA enrollee's basis of eligibility. People who lose eligibility under one basis are redetermined under another basis without interruption in their coverage. Additional information may be requested to determine continued eligibility under another basis. Some changes that may affect an enrollee's basis of eligibility include, but are not limited to:\n- Age\n- Household composition\n- Disability Certification\n- Pregnancy"}]},{"id":"epm:2.1.2.2","number":"2.1.2.2","title":"Citizenship and Immigration Status","parent":"2.1.2","breadcrumb":"2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility > 2.1.2.2 Citizenship and Immigration Status","summary":"In order to receive Medical Assistance (MA), applicants must be U.S. citizens, U.S. nationals or certain lawfully present noncitizens. This section covers citizenship and immigration status eligibility and verification policies. The following policies apply to MA.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:57.24681+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.1.2.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_1_2_2.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.1.2.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility > 2.1.2.2 Citizenship and Immigration Status","text":"In order to receive Medical Assistance (MA), applicants must be U.S. citizens, U.S. nationals or certain lawfully present noncitizens. This section covers citizenship and immigration status eligibility and verification policies. The following policies apply to MA.\n1. [MA Citizenship](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2.1)\n2. [MA Immigration Status](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2.2)"}]},{"id":"epm:2.1.2.2.1","number":"2.1.2.2.1","title":"Citizenship","parent":"2.1.2.2","breadcrumb":"2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility > 2.1.2.2 Citizenship and Immigration Status > 2.1.2.2.1 Citizenship","summary":"To receive Medical Assistance (MA), applicants must be U.S. citizens, U.S. nationals or certain lawfully present noncitizens. See the MA Immigration Status policy for more information.","effective_date":"2023-01-01","last_modified":"2026-10-03T03:51:57.24681+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.1.2.2.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_1_2_2_1.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.406","Code of Federal Regulations, title 42, section 435.407","Code of Federal Regulations, title 42, section 435.911","Code of Federal Regulations, title 42, section 435.945","Code of Federal Regulations, title 42, section 435.949","Code of Federal Regulations, title 42, section 435.952","Code of Federal Regulations, title 42, section 435.956","Code of Federal Regulations , title 42. section 435.1008","Code of Federal Regulations, title 42, section 457.320","Code of Federal Regulations, title 42, section 457.380","Patient Protection and Affordable Care Act, Public Law 111-148, section 1413","Patient Protection and Affordable Care Act, Public Law 111-148, section 14141"],"chunks":[{"chunk_id":"epm:2.1.2.2.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2.1","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility > 2.1.2.2 Citizenship and Immigration Status > 2.1.2.2.1 Citizenship","text":"To receive Medical Assistance (MA), applicants must be U.S. citizens, U.S. nationals or certain lawfully present noncitizens. See the [MA Immigration Status](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2.2) policy for more information."},{"chunk_id":"epm:2.1.2.2.1#us-citizen","heading":"U.S. Citizen","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2.1#us-citizen","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility > 2.1.2.2 Citizenship and Immigration Status > 2.1.2.2.1 Citizenship > U.S. Citizen","text":"## U.S. Citizen\n\nA U.S. citizen is someone who is born in the U.S. (including U.S. territories, except for American Samoa) or who was born outside the U.S. and who either:\n- Was naturalized as a U.S. citizen\n- Derived citizenship through the naturalization of their parent(s)\n- Derived citizenship through adoption by U.S. citizen parents, provided certain conditions are met\n- Acquired citizenship at birth because he or she was born to U.S. citizen parent(s)\n- Became a U.S. citizen by operation of law"},{"chunk_id":"epm:2.1.2.2.1#us-national","heading":"U.S. National","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2.1#us-national","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility > 2.1.2.2 Citizenship and Immigration Status > 2.1.2.2.1 Citizenship > U.S. National","text":"## U.S. National\n\nA U.S. national is someone who is a U.S. citizen or owes permanent allegiance to the U.S. With extremely limited exceptions, all noncitizen U.S. nationals are people born in American Samoa or people born abroad with one or more American Samoan parents under certain conditions."},{"chunk_id":"epm:2.1.2.2.1#verification","heading":"Verification","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2.1#verification","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility > 2.1.2.2 Citizenship and Immigration Status > 2.1.2.2.1 Citizenship > Verification","text":"## Verification\n\nCitizenship may be verified electronically at the time of application through a data match with the Federal Data Services Hub( FDSH) or the Social Security Administration (SSA). This is the preferred method of verifying citizenship for applicants and enrollees. The county , tribal, or state agency must attempt and exhaust all trusted electronic sources prior to requiring paper documentation from the enrollee. Only applicants and enrollees whose U.S. citizenship or U.S. national status cannot be verified electronically must provide proofs.\n\nEligibility must be approved for applicants who meet all other eligibility criteria and attest to meeting the citizenship eligibility requirement. A person approved for MA without verification of their citizenship status has a reasonable opportunity to work with the agency to resolve clerical discrepancies preventing electronic verification or to provide proof. The county, tribal , or state servicing agency must help applicants and enrollees obtain required proofs. A notice is sent to the enrollee to indicate they have 90 days, plus 5 days for mailing, from the date of the notice to satisfy the request. The 90 days plus 5 days for mailing cannot be extended for citizenship verification for MA enrollees. Eligibility and coverage must end with a 10-day advance notice if the enrollee fails to provide proof of citizenship by the end of the reasonable opportunity period.\n\nDuring the reasonable opportunity period, the county, tribal or state servicing agency must continue efforts to complete verification of an applicant's citizenship. This includes correcting errant demographic data, re-running electronic sources and checking case records and files for prior instances of successful electronic verification or citizenship documentation received previously. The agency must document efforts to verify an applicant's citizenship during the reasonable opportunity period in the case record. The agency must also help applicants and enrollees obtain required paper proofs .\n\nPeople who were previously enrolled in MA in another state were required to verify citizenship as a condition of eligibility for MA. As such, verification of citizenship obtained from another state's MA program is an acceptable form of verification. Proof of citizenship may be requested from the state where the client was previously enrolled in MA, if it is not available through other sources. A signed release, such as the Minnesota Department of Human Services General Authorization for Release of Information (DHS-2243A) must be obtained from the client to contact another state's MA program agency.\n\nOnce citizenship is verified, county, tribal and state servicing agencies cannot request proof again, unless an agency possesses inconsistent information regarding a person’s citizenship.\n\nA person who reapplies for health care coverage, whose citizenship was not previously verified, must be given a new reasonable opportunity period to provide proof of citizenship."},{"chunk_id":"epm:2.1.2.2.1#paper-proof-of-citizenship","heading":"Paper Proof of Citizenship","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2.1#paper-proof-of-citizenship","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility > 2.1.2.2 Citizenship and Immigration Status > 2.1.2.2.1 Citizenship > Paper Proof of Citizenship","text":"## Paper Proof of Citizenship\n\nApplicants and enrollees who must provide proof when citizenship cannot be electronically verified can submit a copy of one of the following to verify U.S. citizenship:\n- U.S. passport, including a U.S. Passport Card issued by the Department of State, without regard to any expiration date as long as such passport or card was issued without limitation\n- Certificate of Naturalization\n- Certificate of Citizenship\n- Valid Minnesota Enhanced Driver's License or Enhance Identification Card\n- Documentary evidence issued by a federally recognized Native American Tribe which identifies the tribe that issued the document, identifies the individual by name, and confirms the individual's membership, enrollment or affiliation with the tribe. These documents include a tribal enrollment card, a Certificate of Degree of Indian Blood, a tribal census document, or documents on tribal letterhead, issued under the appropriate tribal official.\n\nApplicants and enrollees can also verify citizenship by submitting a copy of one document from each of the following two lists:\n- List 1\n  - U.S. public birth certificate or other birth document\n    - The birth record document may be issued by a state, commonwealth, territory, or local jurisdiction.\n    - For people born in Minnesota, birth records can only be obtained by sending the Minnesota Department of Health ( MDH) the Minnesota Birth Records Application form . For people that were born in another state , birth records can be obtained directly from the state of birth.\n  - U.S. citizen ID card\n  - An electronic data match with a state vital statistics agency can substitute for a List 1 document.\n  - A Certificate of Report of Birth, issued to U.S. citizens born outside of the U.S., or Report of Birth Abroad of a U. S citizen\n  - Certification of birth in the U.S.\n  - Northern Marianas Identification Card issued by the U.S Department of Homeland Security\n  - American Indian card (I-872) from the U.S. Department of Homeland Security\n  - Final U.S. adoption papers that show the child's name and a U.S. place of birth, or if an adoption is not final, a statement from the state approved adoption agency that shows the child's name and the U.S. place of birth\n  - Papers showing U.S. government employment before June 1,1976\n  - U.S. Military Record of Service showing U.S. place of birth\n  - Documentation that a child meets the requirements of section 101 of the Child Citizenship Act of 2000\n  - Medical records showing a U. S. place of birth\n  - Life, health or other insurance company record showing a U. S. place of birth\n  - Official religious record recorded in the U.S. showing that the birth occurred in the U.S.\n  - School records including preschool records, Head Start and daycare showing the child's name and U.S. place of birth\n  - Federal or state census record showing U.S. citizenship or U.S. place of birth\n  - An affidavit can be used in lieu of a List 1 proof, if citizenship cannot be verified electronically and the person does not have any List 1 documents. The affidavit must be signed under penalty of perjury by a person other than the applicant who can attest to the applicant's citizenship. The affidavit must include the applicant's name, date of birth, and place of birth. The affidavit does not need to be notarized.\n- List 2\n- The following are accepted as proof of identity, as long as the document has a photograph or other identifying information sufficient to establish identity, including (but not limited to) name, age, sex, race, height, weight, eye color, or address:\n  - State driver’s license or state ID card\n  - Real ID driver's license or ID card\n  - School ID card\n  - U.S. military ID card or draft record\n  - Military dependent's ID Card\n  - U.S. Coast Guard Merchant Mariner Card\n  - For a child under age 16:\n    - School records including pre-school or daycare records\n    - Clinic, doctor or hospital records\n    - Two other documents containing consistent information that corroborates a person's identity.\n  - Finding of identity from a federal or state government agency\n  - An affidavit can be used in lieu of List 2 proof, if citizenship cannot be verified electronically and the person does not have any List 2 documents.\n\n### Exemptions from the Citizenship Verification Requirement\n\nThe following people are exempt from the U.S. citizenship verification requirement:\n- People enrolled in or entitled to enroll in Medicare. The SSA has already verified citizenship and identity for these people.\n- People who receive or previously received Supplemental Security Income (SSI)\n- People who receive or previously received Retirement, Survivors or Disability Insurance (RSDI) benefits due to disability (also known as SSDI). This does not include people who receive RSDI retirement or survivor’s insurance benefits. They are not exempt from this requirement unless they meet another condition for exemption (such as enrollment in Medicare).\n- Auto newborns and children previously enrolled as auto newborns"}]},{"id":"epm:2.1.2.2.2","number":"2.1.2.2.2","title":"Immigration Status","parent":"2.1.2.2","breadcrumb":"2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility > 2.1.2.2 Citizenship and Immigration Status > 2.1.2.2.2 Immigration Status","summary":"To receive Medical Assistance (MA), applicants must be U.S. citizens, U.S. nationals or certain lawfully present noncitizens. See the MA Citizenship policy for more information.","effective_date":"2026-06-12","last_modified":"2026-10-03T04:10:20.87593+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.1.2.2.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_1_2_2_2.htm","legal_citations":["Additional Ukraine Supplemental Appropriations Act, 2022, Public Law Number 117-128","Afghanistan Supplemental Appropriations Act, 2022, Public Law 117-103","Children’s Health Insurance Program Reauthorization Action of 2009 (CHIPRA), Public Law 111-3, Section 214","Code of Federal Regulations, title 42, section 435.406","Code of Federal Regulations, title 42, section 435.945","Code of Federal Regulations, title 42, section 435.949","Code of Federal Regulations, title 42, section 435.952","Code of Federal Regulations, title 42, section 435.956","Consolidated Appropriations Act, 2021, Public Law 116-260","Minnesota Statutes, section 256B.06, subdivision 4","Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public Law 104-193","United States Code, title 8, section 1611","United States Code, title 8, section 1612","United States Code, title 8, section 1613","United States Code, title 8, section 1641"],"chunks":[{"chunk_id":"epm:2.1.2.2.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2.2","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility > 2.1.2.2 Citizenship and Immigration Status > 2.1.2.2.2 Immigration Status","text":"To receive Medical Assistance (MA), applicants must be U.S. citizens, U.S. nationals or certain lawfully present noncitizens. See the [MA Citizenship](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2.1) policy for more information.\n\nRefer to the [Immigration Status and Minnesota Health Care Programs Eligibility chart](https://hcopub.dhs.state.mn.us/epm/assets/docs/Immigration_Chart.pdf) for a quick reference guide to MA eligibility for applicants and enrollees who are noncitizens."},{"chunk_id":"epm:2.1.2.2.2#ma-eligibility-for-noncitizen-children-under-age-21-and-pregnant-people","heading":"MA Eligibility for Noncitizen Children Under Age 21 and Pregnant People","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2.2#ma-eligibility-for-noncitizen-children-under-age-21-and-pregnant-people","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility > 2.1.2.2 Citizenship and Immigration Status > 2.1.2.2.2 Immigration Status > MA Eligibility for Noncitizen Children Under Age 21 and Pregnant People","text":"## MA Eligibility for Noncitizen Children Under Age 21 and Pregnant People\n\nThe following noncitizens are eligible for MA, regardless of their specific immigration status:\n- Lawfully present noncitizen children younger than age 21\n- Lawfully present pregnant people\n\nSee [Appendix H Lawfully Present Noncitizens](https://bot-corpus.mn-dhs.online/s/epm/H) for more information about lawfully present noncitizens.\n\nNoncitizen children and pregnant people who are not lawfully present or are otherwise ineligible for MA due to immigration status, including Deferred Action for Child Arrival (DACA) grantees, may be eligible for MA under another basis. See [MA for Noncitizens Not Otherwise Eligible for Medical Assistance.](https://hcopub.dhs.state.mn.us/epm/#MA4NC)"},{"chunk_id":"epm:2.1.2.2.2#ma-eligibility-for-noncitizens-age-21-or-older-and-not-pregnant","heading":"MA Eligibility for Noncitizens Age 21 or Older and Not Pregnant","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2.2#ma-eligibility-for-noncitizens-age-21-or-older-and-not-pregnant","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility > 2.1.2.2 Citizenship and Immigration Status > 2.1.2.2.2 Immigration Status > MA Eligibility for Noncitizens Age 21 or Older and Not Pregnant","text":"## MA Eligibility for Noncitizens Age 21 or Older and Not Pregnant\n\nTo be eligible for MA, noncitizens who are age 21 or older and not pregnant must have a qualified immigration status and either satisfy a five-year waiting period or meet an exception.\n\n### Qualified Immigration Statuses Without a Five-Year Waiting Period\n\nNoncitizens with the following qualified immigration statuses are eligible for MA **without** a five-year waiting period:\n- Afghan Humanitarian Parolees, who are defined as Afghan citizens or nationals granted humanitarian parole between July 31, 2021, and September 30, 2023, are eligible for MA until the end of their parole term. Spouses, children, parents and/or guardians of Afghan humanitarian parolees who are paroled after September 30, 2023, are also eligible for MA until the end of their parole term.\n- American Indian noncitizens who are either American Indians born in Canada or members of a federally recognized Indian tribe.\n- Asylees\n- Compact of Free Association (COFA) migrants - Citizens of the Freely Associated States - the Federated States of Micronesia, the Republic of Marshall Islands, and the Republic of Palau\n- Cuban or Haitian Entrants\n- Refugees (also known as Conditional Entrants, prior to April 1, 1980)\n- T nonimmigrants/T-Visa holders\n- Ukrainian Humanitarian Parolees, who are defined as Ukrainian Humanitarian citizens or nationals, or those who last habitually resided in Ukraine, granted humanitarian parole between February 24, 2022, and September 30, 2024, are eligible for MA until the end of their parole term. Spouses, children, parents, and/or legal guardians of Ukrainian humanitarian parolees who are paroled after September 30, 2023, are also eligible for MA until the end of their parole term.\n- Victim of severe trafficking\n- Withholding of Removal\n\n### Qualified Immigration Statuses With a Five-year Waiting Period\n\nNoncitizens with the following qualified immigration statuses are eligible for MA **after** a five-year waiting period **unless**they meet an exception:\n- Lawful Permanent Residents (LPRs or green card holders)\n- Battered noncitizens\n- Individuals paroled for one year or more\n\n### Exceptions to the Five-Year Waiting Period for MA Eligibility\n\nLPRs, battered noncitizens and individuals paroled for one year or more who meet any of the following exceptions are eligible for MA without a five-year waiting period:\n- a U.S. veteran or on active military duty\n- a spouse or child of a U.S. veteran or an individual on active military duty\n- an American Indian born in Canada\n- a member of a federally recognized Indian tribe\n- entered the United States before August 22, 1996, regardless of status at entry, and has continuously resided in the United States\n\nLPRs who meet any of the following exceptions are eligible for MA without a five-year waiting period:\n- An LPR who was previously a refugee (also known as a Conditional Entrant, prior to April 1, 1980)\n- An LPR who was previously an asylee\n- An LPR who was previously granted Withholding of Removal\n- An LPR who was previously a Cuban or Haitian Entrant\n- An LPR who was previously a victim of severe trafficking (including T nonimmigrant/T visa holder)\n- An LPR who was previously an Afghan Humanitarian Parolee\n- An LPR who was previously a Ukrainian Humanitarian Parolee\n- An LPR who gained LPR status as an Iraqi or Afghan Special Immigrant (Special Immigrant Visa holder)\n- An LPR who gained LPR status as an Amerasian Immigrant\n\n### Begin Date of the Five-Year Waiting Period for MA Eligibility\n\nFor battered noncitizens and individuals paroled for one year or more, the five-year waiting period begins on the date they obtain that status.\n\nFor LPRs, the begin date of the five-year waiting period is either:\n- The date they were granted status as a COFA migrant, battered noncitizen or paroled for one year or more, before becoming an LPR; or\n- The date LPR status was granted\n\nThe date a person enters the United States (also called the date of entry) is not always the same date they acquire a qualified immigration status."},{"chunk_id":"epm:2.1.2.2.2#ma-for-noncitizens-not-eligible-for-medical-assistance","heading":"MA for Noncitizens Not Eligible for Medical Assistance","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2.2#ma-for-noncitizens-not-eligible-for-medical-assistance","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility > 2.1.2.2 Citizenship and Immigration Status > 2.1.2.2.2 Immigration Status > MA for Noncitizens Not Eligible for Medical Assistance","text":"## MA for Noncitizens Not Eligible for Medical Assistance\n\nFour programs are available to certain noncitizens who are not eligible for MA because of their immigration status.\n- Children’s Health Insurance Program (CHIP) funded MA may be available for pregnant people who are undocumented or noncitizens not otherwise eligible for MA. Eligibility may continue through the 12 month postpartum period. CHIP-funded MA is not available to people enrolled in other health care coverage. See [2.2.2.1.2 Pregnant person Basis of Eligibility.](https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1.2)\n- People who are receiving services from the Center for Victims of Torture (CVT) may be eligible for state funded MA-CVT See [2.5.2 MA for People Receiving Services at the Center for Victims of Torture](https://bot-corpus.mn-dhs.online/s/epm/2.5.2)\n- People with a medical emergency may be eligible for Emergency Medical Assistance (EMA) See [2.5.3 Emergency Medical Assistance](https://bot-corpus.mn-dhs.online/s/epm/2.5.3)\n- People who meet specific criteria may be eligible for federally funded Refugee Medical Assistance (RMA) See [2.5.7 Refugee Medical Assistance](https://bot-corpus.mn-dhs.online/s/epm/2.5.7)"},{"chunk_id":"epm:2.1.2.2.2#verification","heading":"Verification","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2.2#verification","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility > 2.1.2.2 Citizenship and Immigration Status > 2.1.2.2.2 Immigration Status > Verification","text":"## Verification\n\nImmigration status must be verified electronically:\n- At Application\n- When a change in immigration status is reported by the enrollee after application\n- When a new non-citizen household member is added and requests coverage\n- When corrections are made about a person's immigration status after application\n\nSee [1.3.2.1 MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1) for more information.\n\n### Paper Documentation\n\nThe county, Tribal or state agency must attempt and exhaust all trusted electronic sources, including SAVE, prior to requiring paper documentation from the enrollee.\n\nApplicants and enrollees whose immigration status cannot be verified electronically must be provided an opportunity to submit documents or resolve discrepancies to verify immigration status. Paper documentation submitted to verify immigration status must be validated using electronic sources, such as SAVE.\n\nSee Immigration documentation types at HealthCare.gov for information about immigration documentation.\n\n### Reasonable Opportunity Period\n\nEligibility is approved for applicants who meet all other eligibility criteria and attest to meeting the noncitizen eligibility requirements.\n\nA person approved for MA without electronic verification of their immigration status has a reasonable opportunity to work with the agency to resolve clerical discrepancies preventing electronic verification or to provide proof of status for SAVE validation. A notice is sent to the enrollee to indicate they have 90 days, plus five days for mailing, from the date of the notice to satisfy the request.\n\nThe 95-day reasonable opportunity period can be extended for MA enrollees who demonstrate a good faith effort to get and provide proof of their immigration status. Enrollees who need more time to obtain the needed documents must receive a notice that tells them the new due date. There is no limit to the number of times the reasonable opportunity period can be extended for a MA enrollee to obtain proof of immigration status. Eligibility and coverage for a person whose immigration staatus cannot be verified must end with a 10-day advance notice if the person fails to provide proof or assist in the verification process by the end of the reasonable opportunity period or any extension.\n\nDuring the reasonable opportunity period, the county, tribal or state servicing agency must continue efforts to complete verification of an applicant’s immigration status. This includes correcting errant demographic data, re-running electronic sources and checking case records and files for prior instances of successful electronic verification or immigration status documentation received previously. The agency must document efforts to verify an applicant’s immigration status during the reasonable opportunity period in the case record. The agency must also help applicants and enrollees obtain required paper proofs.\n\nA person who reapplies for health care coverage, whose immigration status was not previously verified, must be given a new reasonable opportunity period to provide proof of immigration status.\n\n### State Residency\n\nVerification of immigration status cannot be used to determine the individual is not a state resident. See [1.4 MHCP State Residency](https://bot-corpus.mn-dhs.online/s/epm/1.4)"}]},{"id":"epm:2.1.2.3","number":"2.1.2.3","title":"County Residency","parent":"2.1.2","breadcrumb":"2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility > 2.1.2.3 County Residency","summary":"Medical Assistance (MA) has rules about county residence. County residency policy determines the:","effective_date":"2024-11-01","last_modified":"2026-10-03T03:51:57.24681+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.1.2.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_1_2_3.htm","legal_citations":["Minnesota Statutes, section 5B, subdivision 1 to 13","Minnesota Statutes, section 256G.02, subdivision 4","Minnesota Statutes, section 256G.02, subdivision 6","Minnesota Statutes, section 256G.07, subdivision 1","Minnesota Statutes, section 256J.75, subdivision 2"],"chunks":[{"chunk_id":"epm:2.1.2.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2.3","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility > 2.1.2.3 County Residency","text":"Medical Assistance (MA) has rules about county residence. County residency policy determines the:\n- County of service\n- County of financial responsibility"},{"chunk_id":"epm:2.1.2.3#county-of-service","heading":"County of Service","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2.3#county-of-service","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility > 2.1.2.3 County Residency > County of Service","text":"## County of Service\n\nCounty of service (also known as Servicing Agency) refers to the county agency that is responsible for ongoing case management after an application has been processed and eligibility has been determined, including, but not limited to:\n- Accepting and acting on changes in circumstances\n- Processing renewals\n- Gathering proofs and documentation\n- Issuing manual notices\n- Recording actions and information in case notes\n- Processing subsequent applications for new household members\n\nThe county of service is determined based on where an enrollee lives.\n\nFor applications submitted through METS, the servicing agency is assigned by METS when eligibility is pending or approved."},{"chunk_id":"epm:2.1.2.3#county-of-financial-responsibility","heading":"County of Financial Responsibility","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2.3#county-of-financial-responsibility","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility > 2.1.2.3 County Residency > County of Financial Responsibility","text":"## County of Financial Responsibility\n\nThe county of financial responsibility is responsible for paying the county share of MA services. The county of financial responsibility is the county where the person lives on the day the county receives a written request for assistance, except in the following circumstances:\n- When an enrollee moves to a different county, the new county becomes the county of financial responsibility after two full calendar months following the month of the move.\n- When an applicant moves to a new county during the application processing period the county in which the client resided at the time the application was submitted is financially responsible, whether or not the county that received the application has acted on the application. The new county becomes the county of financial responsibility after two full calendar months following the month of the move.\n  - Example: John applied for MA in County A on October 4th. On October 20th, he submits all required information to County A and reports that he moved to County B on October 15. County A finishes processing the application and determines John is eligible for MA. County B becomes the county of financial responsibility beginning January 1. November and December are the two full calendar months after the month John moved.\n- When a person lives in an excluded time facility or receives excluded time services, the county of financial responsibility is the county in which the person lived immediately before the excluded time started.\n- When a person leaves an excluded time facility or no longer receives excluded time services, and lives in a county other than the one in which the person lived immediately before the excluded time started, the new county becomes the county of financial responsibility after two full calendar months following the month the excluded time ends."},{"chunk_id":"epm:2.1.2.3#excluded-time","heading":"Excluded Time","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2.3#excluded-time","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility > 2.1.2.3 County Residency > Excluded Time","text":"## Excluded Time\n\nExcluded time facilities and situations include:\n- Hospitals\n- Long-Term Care Facilities (LTCF)\n- Shelters (other than emergency shelters)\n- Halfway houses\n- Foster homes for children receiving Title IV-E and Non-Title IV-E Foster Care\n- Adult foster care\n- Board and lodging facilities\n- Maternity homes\n- Battered women's shelters\n- Correctional facilities\n- Regional treatment centers (RTC)\n- Placement in a facility based on an emergency hold\n- Placements in day training and habilitation programs\n- Assisted living services\n- Placements with an indeterminate commitment, including independent living\n\nA person may receive excluded time services while living at home or in a group living situation. Excluded time services include:\n- Participation in a rehabilitation facility which meets the definition of a long-term sheltered workshop\n- Receiving services from a Semi-Independent Living Services (SILS) Program\n- Receiving integrated community supports or day support services\n- Participation in day training and habilitation programs"},{"chunk_id":"epm:2.1.2.3#safe-at-home","heading":"Safe at Home","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2.3#safe-at-home","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility > 2.1.2.3 County Residency > Safe at Home","text":"## Safe at Home\n\nWhen a person is a Safe at Home (SAH) program participant, they use a PO Box address assigned to them. SAH provides a mail forwarding service. The county of financial responsibility and county of residence are the county in which the person lives. More information about [SAH Address Confidentiality Program](https://www.sos.state.mn.us/safe-at-home/about-safe-at-home/) is available from the Minnesota Secretary of State."}]},{"id":"epm:2.1.2.4","number":"2.1.2.4","title":"Living Arrangement","parent":"2.1.2","breadcrumb":"2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility > 2.1.2.4 Living Arrangement","summary":"Medical Assistance (MA) enrollees live in a variety of community and facility (or institutional) living arrangements. A person’s living arrangement may affect MA eligibility and covered services. This chapter discusses living arrangements.","effective_date":"2025-10-14","last_modified":"2026-10-03T04:10:21.234644+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.1.2.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_1_2_4.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.1010","Minnesota Statutes, section 256B.055, subdivisions 11 to 14"],"chunks":[{"chunk_id":"epm:2.1.2.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2.4","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility > 2.1.2.4 Living Arrangement","text":"Medical Assistance (MA) enrollees live in a variety of community and facility (or institutional) living arrangements. A person’s living arrangement may affect MA eligibility and covered services. This chapter discusses living arrangements."},{"chunk_id":"epm:2.1.2.4#community-living-arrangement","heading":"Community Living Arrangement","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2.4#community-living-arrangement","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility > 2.1.2.4 Living Arrangement > Community Living Arrangement","text":"## Community Living Arrangement\n\nCommunity living arrangements have no impact on MA eligibility. See [Appendix D Community Living Arrangements](https://bot-corpus.mn-dhs.online/s/epm/D) for more information."},{"chunk_id":"epm:2.1.2.4#facility-living-arrangement","heading":"Facility Living Arrangement","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2.4#facility-living-arrangement","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility > 2.1.2.4 Living Arrangement > Facility Living Arrangement","text":"## Facility Living Arrangement\n\nPeople who live in the following settings have a facility living arrangement. People in facility settings may be subject to special eligibility rules related to the living arrangement.\n\n### Institutions for Mental Diseases\n\nAn Institution for Mental Diseases (IMD) is a hospital, nursing facility, or other institution or residential program that has 17 or more beds and is primarily engaged in providing diagnosis, treatment or care of people with mental diseases. An IMD provides treatment for people with mental illness or chemical dependency (CD). See the [Appendix E Institute for Mental Diseases](https://bot-corpus.mn-dhs.online/s/epm/E) for more information.\n\n### Long-Term Care Facilities\n\nPolicies regarding payment of long-term care facility services are different for different types of MA. See the [MA for Long-Term Care Services](https://bot-corpus.mn-dhs.online/s/epm/2.4) chapter for more information.\n\nLong-term care facilities (LTCFs) include:\n- Nursing facilities\n- Intermediate Care Facilities for Persons with Developmental Disabilities (ICF/DDs)\n\n### Correctional Facilities\n\nPeople of any age who apply for or are enrolled in MA, and who are or become incarcerated in a state prison, county detention facility, or city jail are eligible for MA if they meet all MA eligibility factors.However, while an applicant or enrollee is incarcerated, their MA coverage is limited to inpatient hospital services\n\nCorrectional facilities include:\n- City, county, state and federal correctional and detention facilities for adults, including inmates who are:\n  - in a work release program that requires they return to the facility during non-work hours.\n  - sent by the court or penal institution to a chemical dependency residential treatment program while serving a sentence and are required to return to the correctional facility after completing treatment.\n  - sent by the court or penal institution on a furlough while serving a sentence and are required to return to the correctional facility.\n- Juvenile facilities licensed by the Department of Corrections (DOC) that are for holding, evaluation and detention purposes\n\nPeople living in the following settings are not considered incarcerated and are eligible for MA without coverage limitations:\n- People living voluntarily in a correctional setting. This includes, but is not limited to the following:\n  - The person voluntarily enrolled in a program at the correctional facility, and was not placed there through the action of law enforcement authorities\n  - The person is free to leave, but living in the correctional facility for a temporary period pending other arrangements\n- People on home confinement.\n- People in a halfway house, as long as they have freedom of movement. Freedom of movement means:\n  - Residents can work in the community, in jobs that are available to people who are not part of the justice system\n  - Residents can use community resources, such as grocery stores and libraries, at will.\n  - Residents can access health care treatment in the community, to the same extent as people who are not part of the justice system.\n- People residing in a correctional facility may apply for Minnesota Health Care Programs at any time. See the [MHCP Applications for People who are Incarcerated](https://bot-corpus.mn-dhs.online/s/epm/2.5.5.1.1) policy for more information."},{"chunk_id":"epm:2.1.2.4#title-iv-e-certified-facilities","heading":"Title IV-E Certified Facilities","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2.4#title-iv-e-certified-facilities","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility > 2.1.2.4 Living Arrangement > Title IV-E Certified Facilities","text":"## Title IV-E Certified Facilities\n\nThe IV-E program certifies different types of programs for children as Title IV-E eligible facilities. These settings include residential treatment programs, foster homes or group foster homes licensed by DHS and/or Department of Corrections and out-of-state residential treatment programs approved as Title IV-E eligible by their home state.\n\nSee [MA Northstar Care for Children](https://bot-corpus.mn-dhs.online/s/epm/2.5.6) chapter for more information about MA eligibility rules for children who reside in foster care settings."}]},{"id":"epm:2.1.2.5","number":"2.1.2.5","title":"Social Security Number","parent":"2.1.2","breadcrumb":"2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility > 2.1.2.5 Social Security Number","summary":"The Minnesota Department of Human Services (DHS) uses Social Security Numbers (SSNs) to identify applicants and enrollees and to administer Minnesota Health Care Programs (MHCP). DHS matches SSNs against records in electronic data sources to identify and verify household income and size based on the most recent tax return filed by the household tax filer.","effective_date":"2023-03-01","last_modified":"2026-10-03T03:51:57.24681+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.1.2.5","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_1_2_5.htm","legal_citations":["Code of Federal Regulations, title 20, section 422.104","Code of Federal Regulations, title 42, section 435.907","Code of Federal Regulations, title 42, section 435.910","Code of Federal Regulations, title 42, section 435.948","Code of Federal Regulations, title 42, section 435.952","Code of Federal Regulations, title 42, section 435.956","Code of Federal Regulations, title 42, section 457.340"],"chunks":[{"chunk_id":"epm:2.1.2.5#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility > 2.1.2.5 Social Security Number","text":"The Minnesota Department of Human Services (DHS) uses Social Security Numbers (SSNs) to identify applicants and enrollees and to administer Minnesota Health Care Programs (MHCP). DHS matches SSNs against records in electronic data sources to identify and verify household income and size based on the most recent tax return filed by the household tax filer.\n\nEach person requesting Medical Assistance (MA) must provide their SSN as a condition of eligibility unless they meet an exception. People who do not have SSNs and do not meet an exception must apply for an SSN. The following are exceptions:\n- An applicant who refuses to obtain an SSN because of a well-established religious objection\n- A noncitizen who is not eligible to receive an SSN or does not have one and may only be issued one for a valid non-work reason\n- People applying for or receiving Emergency Medical Assistance (EMA), CHIP funded MA for pregnant people or MA for people receiving services from the Center for Victims of Torture (CVT)\n- A child eligible for MA as an auto newborn\n- A child receiving Northstar Title IV-E Adoption Assistance\n- A child receiving Title IV-E or non-Title IV-E adoption assistance under the Interstate Compact on Adoption and Medical Assistance (ICAMA)\n- Refugees applying for or receiving Refugee Medical Assistance (RMA)\n\nAn agency may request but cannot require someone who is not applying for coverage to provide an SSN. If the agency requests the SSN of a non-applicant, the disclosure must:\n- be voluntary,\n- only be used to determine an applicant’s eligibility for a MHCP or for a purpose directly connected to administration of the State Plan, and\n- include clear information on how the SSN will be used and notice to the application filer that it is voluntary."},{"chunk_id":"epm:2.1.2.5#pre--eligibility-verification","heading":"Pre- Eligibility Verification","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5#pre--eligibility-verification","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility > 2.1.2.5 Social Security Number > Pre- Eligibility Verification","text":"## Pre- Eligibility Verification\n\nIf an applicant has an SSN , it must be provided prior to the MA eligibility determination. If an applicant cannot recall their SSN or if an SSN has not been issued for the applicant, and the person does not meet an exception, the county, tribal or state servicing agency must assist the applicant in:\n- completing an application for an SSN, if an SSN has not been issued for the applicant, or\n- contacting the SSA to confirm the applicant’s SSN if one has already been issued\n\nIf an applicant must apply for an SSN, proof that the person applied for an SSN is required prior to the MA eligibility determination. The proof of application is acceptable for the MA eligibility approval until the person receives the SSN. Once the SSN is received the individual must provide it to the agency. The agency must verify the newly issued number electronically."},{"chunk_id":"epm:2.1.2.5#verifying-exceptions-to-having-an-ssn","heading":"Verifying Exceptions to Having an SSN","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5#verifying-exceptions-to-having-an-ssn","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility > 2.1.2.5 Social Security Number > Verifying Exceptions to Having an SSN","text":"## Verifying Exceptions to Having an SSN\n\nCertain exceptions from the requirement to have or apply for an SSN must be verified prior to the MA eligibility determination.\n\nWell-established religious objection\n- A letter or other verification from a church leader that the religion is a recognized sect of division that is conscientiously opposed to applying for an SSN\n- Proof of filing for a waiver with the IRS using form 4029\n\nNoncitizen unable to attain an SSN for a reason other than a valid non-work reason\n- No further proof is needed if the person does not have employment authorization or their status does not permit them to work in the United States\n- A letter from the SSA or other official that the person is not eligible for an SSN except for a valid non-work reason\n\nOther exceptions from the requirement to have or apply for an SSN do not require proof."},{"chunk_id":"epm:2.1.2.5#post-eligibility-verification","heading":"Post Eligibility Verification","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5#post-eligibility-verification","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.2 Non-Financial Eligibility > 2.1.2.5 Social Security Number > Post Eligibility Verification","text":"## Post Eligibility Verification\n\nSSNs must be electronically verified with the Social Security Administration (SSA).\n\nEligibility cannot be delayed for an otherwise eligible applicant pending the electronic verification of an SSN if one is provided at application or when newly obtained by an enrollee. A notice must be sent to the person to inform them that they have 95 days from the date of the notice to provide proof of their SSN or to resolve any clerical discrepancies preventing electronic verification.\n\nThe 95-day period can be extended if the MA enrollee is demonstrating a good faith effort to resolve the discrepancy preventing electronic verification. Enrollees who need more time to resolve the SSN discrepancy must receive a notice that tells them the new due date. There is no limit to the number of times the reasonable opportunity period can be extended for the MA enrollee to resolve the SSN discrepancy. MA eligibility and coverage ends with 10- day advance notice if the enrollee fails to resolve the SSN discrepancy by the end of the reasonable opportunity period or any extension.\n\nDuring the reasonable opportunity period, the county, tribal or state servicing agency must continue efforts to verify an applicant’s SSN. This includes correcting errant demographic data, re-running electronic sources and checking case records and files for prior instances of successful electronic verification. The agency must assist the applicant in resolving discrepancies in the case file that are preventing successful verification. The agency must document efforts to verify an applicant’s SSN during the reasonable opportunity period in the case record.\n\nElectronic verification is ultimately required to verify a person’s SSN.\n\nA person who applies for health care coverage, whose SSN was not previously verified, must be given a new reasonable opportunity period to resolve the SSN discrepancy."}]},{"id":"epm:2.1.3","number":"2.1.3","title":"Financial Eligibility","parent":"2.1","breadcrumb":"2 Medical Assistance > 2.1 Overview > 2.1.3 Financial Eligibility","summary":"This subchapter provides financial eligibility policy for Medical Assistance (MA). This covers eligibility requirements that involve a person’s income or assets. Financial eligibility policy that applies to a specific type of MA is located in the relevant MA chapter.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:57.24681+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.1.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_1_3.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.1.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.3","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.3 Financial Eligibility","text":"This subchapter provides financial eligibility policy for Medical Assistance (MA). This covers eligibility requirements that involve a person’s income or assets. Financial eligibility policy that applies to a specific type of MA is located in the relevant MA chapter.\n\nTopics covered in this sub-chapter are:\n1. [MA Asset Limit](https://bot-corpus.mn-dhs.online/s/epm/2.1.3.1)\n2. [MA Income Limit](https://bot-corpus.mn-dhs.online/s/epm/2.1.3.2)"}]},{"id":"epm:2.1.3.1","number":"2.1.3.1","title":"Asset Limits","parent":"2.1.3","breadcrumb":"2 Medical Assistance > 2.1 Overview > 2.1.3 Financial Eligibility > 2.1.3.1 Asset Limits","summary":"Assets are items of value that people own like bank accounts, stocks and bonds, cars and real estate.","effective_date":"2024-11-15","last_modified":"2026-10-03T03:51:57.24681+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.3.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.1.3.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_1_3_1.htm","legal_citations":["Code of Federal Regulations, title 26, section 1.36B-1","Minnesota Statutes, section 256B.056"],"chunks":[{"chunk_id":"epm:2.1.3.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.3.1","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.3 Financial Eligibility > 2.1.3.1 Asset Limits","text":"Assets are items of value that people own like bank accounts, stocks and bonds, cars and real estate."},{"chunk_id":"epm:2.1.3.1#asset-limit-for-medical-assistance-families-with-children-and-adults-without-a-spenddown","heading":"Asset Limit for Medical Assistance Families with Children and Adults (Without a Spenddown)","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.3.1#asset-limit-for-medical-assistance-families-with-children-and-adults-without-a-spenddown","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.3 Financial Eligibility > 2.1.3.1 Asset Limits > Asset Limit for Medical Assistance Families with Children and Adults (Without a Spenddown)","text":"## Asset Limit for Medical Assistance Families with Children and Adults (Without a Spenddown)\n\nThere is no asset limit for Medical Assistance (MA) for Families with Children and Adults."},{"chunk_id":"epm:2.1.3.1#asset-limit-for-medically-needy-medical-assistance-for-children-and-pregnant-people-with-a-spenddown","heading":"Asset Limit for Medically Needy Medical Assistance for Children and Pregnant People (With a Spenddown)","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.3.1#asset-limit-for-medically-needy-medical-assistance-for-children-and-pregnant-people-with-a-spenddown","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.3 Financial Eligibility > 2.1.3.1 Asset Limits > Asset Limit for Medically Needy Medical Assistance for Children and Pregnant People (With a Spenddown)","text":"## Asset Limit for Medically Needy Medical Assistance for Children and Pregnant People (With a Spenddown)\n\nChildren and pregnant people eligible for MA with a spenddown have no asset limit."},{"chunk_id":"epm:2.1.3.1#asset-limit-for-medically-needy-medical-assistance-parentcaretaker-relatives-with-a-spenddown","heading":"Asset Limit for Medically Needy Medical Assistance Parent/Caretaker Relatives (With a Spenddown)","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.3.1#asset-limit-for-medically-needy-medical-assistance-parentcaretaker-relatives-with-a-spenddown","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.3 Financial Eligibility > 2.1.3.1 Asset Limits > Asset Limit for Medically Needy Medical Assistance Parent/Caretaker Relatives (With a Spenddown)","text":"## Asset Limit for Medically Needy Medical Assistance Parent/Caretaker Relatives (With a Spenddown)\n\nParents and caretaker relatives eligible for MA with a spenddown have the following asset limit:\n- $10,000 asset limit for a household of one\n- $20,000 for a household of two or more\n\nSee the [MA for Families and Children Medical Spenddown](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.6) policy for more information."},{"chunk_id":"epm:2.1.3.1#asset-limit-for-medical-assistance-for-people-who-are-age-65-or-older-and-people-who-are-blind-or-have-a-disability","heading":"Asset Limit for Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.3.1#asset-limit-for-medical-assistance-for-people-who-are-age-65-or-older-and-people-who-are-blind-or-have-a-disability","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.3 Financial Eligibility > 2.1.3.1 Asset Limits > Asset Limit for Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability","text":"## Asset Limit for Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability\n\nThere is an asset limit for MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD), including those with a medical or long-term care spenddown. The asset limits are:\n- $3,000 for a household of one\n- $6,000 for a household of two\n- $200 for each additional household member\n\nSee the [MA-ABD](https://bot-corpus.mn-dhs.online/s/epm/2.3) subchapter for more information."},{"chunk_id":"epm:2.1.3.1#asset-limit-for-children-who-are-blind-or-have-a-disability","heading":"Asset Limit for Children WHo are Blind or Have a Disability","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.3.1#asset-limit-for-children-who-are-blind-or-have-a-disability","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.3 Financial Eligibility > 2.1.3.1 Asset Limits > Asset Limit for Children WHo are Blind or Have a Disability","text":"## Asset Limit for Children WHo are Blind or Have a Disability\n\nThere is no asset limit for Children Who are Blind or Have a Disability."},{"chunk_id":"epm:2.1.3.1#asset-limit-for-medical-assistance-for-employed-persons-with-disabilities","heading":"Asset Limit for Medical Assistance for Employed Persons with Disabilities","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.3.1#asset-limit-for-medical-assistance-for-employed-persons-with-disabilities","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.3 Financial Eligibility > 2.1.3.1 Asset Limits > Asset Limit for Medical Assistance for Employed Persons with Disabilities","text":"## Asset Limit for Medical Assistance for Employed Persons with Disabilities\n\nThere is no asset limit for Medical Assistance for Employed Persons with Disabilities. (MA-EPD)"},{"chunk_id":"epm:2.1.3.1#asset-limit-for-refugee-medical-assistance","heading":"Asset Limit for Refugee Medical Assistance","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.3.1#asset-limit-for-refugee-medical-assistance","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.3 Financial Eligibility > 2.1.3.1 Asset Limits > Asset Limit for Refugee Medical Assistance","text":"## Asset Limit for Refugee Medical Assistance\n\nRefugee MA (RMA) has the following asset limit:\n- $10,000 asset limit for a household of one\n- $20,000 for a household of two or more\n\nSee the [RMA](https://bot-corpus.mn-dhs.online/s/epm/2.5.7) section for more information."}]},{"id":"epm:2.1.3.2","number":"2.1.3.2","title":"Income Limits","parent":"2.1.3","breadcrumb":"2 Medical Assistance > 2.1 Overview > 2.1.3 Financial Eligibility > 2.1.3.2 Income Limits","summary":"Minnesota’s Medical Assistance (MA) program considers income in determining eligibility, benefit set, spenddown and premium amounts. To be eligible for most programs, a person’s income must be less than or equal to the appropriate income limit. Income limits and calculations of countable income vary by program and by a person’s basis of eligibility. Income limits are based on federal poverty guide","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:57.24681+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.3.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.1.3.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_1_3_2.htm","legal_citations":["Minnesota Statutes, section 256B.056"],"chunks":[{"chunk_id":"epm:2.1.3.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.3.2","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.3 Financial Eligibility > 2.1.3.2 Income Limits","text":"Minnesota’s Medical Assistance (MA) program considers income in determining eligibility, benefit set, spenddown and premium amounts. To be eligible for most programs, a person’s income must be less than or equal to the appropriate income limit. Income limits and calculations of countable income vary by program and by a person’s basis of eligibility. Income limits are based on federal poverty guidelines."},{"chunk_id":"epm:2.1.3.2#federal-poverty-guidelines","heading":"Federal Poverty Guidelines","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.3.2#federal-poverty-guidelines","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.3 Financial Eligibility > 2.1.3.2 Income Limits > Federal Poverty Guidelines","text":"## Federal Poverty Guidelines\n\nThe U.S. Department of Health and Human Services (HHS) issues federal poverty guidelines (FPG).\n\nThese guidelines determine income eligibility for MA. A person’s applicable income limit is based on many factors, including, but not limited to:\n- The basis of eligibility for MA\n- The number of people included in the household size\n- Whether the person has a medical or long-term care spenddown for MA"},{"chunk_id":"epm:2.1.3.2#income-limits","heading":"Income Limits","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.3.2#income-limits","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.3 Financial Eligibility > 2.1.3.2 Income Limits > Income Limits","text":"## Income Limits\n\nThe following income limits determine eligibility for MA:\n- Pregnant people: less than or equal to 278% FPG\n- Infants under 2: less than or equal to 283% FPG\n- Children 2 through 18: less than or equal to 275% FPG\n- Children 19 through 20: less than or equal to133% FPG\n- Parent and caretaker relatives: less than or equal to 133% FPG\n- Transition Year MA (TYMA) second six months: less than or equal to 185% FPG\n- Adults without children: less than or equal to 133% FPG\n- Refugee MA: less than or equal to 133% FPG\n- Adults age 65 and older: less than or equal to 100% FPG\n- Adults who are blind: less than or equal to 100% FPG\n- Adults who are disabled: less than or equal to 100% FPG\n- Children who are disabled and enrolled in MA under the TEFRA Option: less than or equal to 100% FPG\n\nSome people have no income limit for MA eligibility. Many of these types of MA have an eligibility requirement that already evaluated income eligibility. See the chapter or policy linked below for more information:\n- [Auto newborns](https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1)\n- [Former foster child younger than age 26](https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1)\n- [MA for Employed Persons with Disabilities (MA-EPD)](https://bot-corpus.mn-dhs.online/s/epm/2.3.5)\n- MA for people receiving Minnesota Supplemental Aid (MA-MSA)\n- [MA for people with 1619 (a) or 1619 (b) status](https://bot-corpus.mn-dhs.online/s/epm/2.3.7)\n- [MA for people with Breast or Cervical Cancer (MA-BC)](https://bot-corpus.mn-dhs.online/s/epm/2.5.1)\n- [MA for people receiving services at the Center for Victims of Torture](https://bot-corpus.mn-dhs.online/s/epm/2.5.2)\n- [MA Northstar Adoption Assistance](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1)\n- [MA Northstar Title IV-E Foster Care and Title IV-E Kinship Assistance](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2)\n\nSee the Minnesota Health Care Programs Income and Asset Guidelines ([DHS-3461A](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-3461A-ENG))for more information."}]},{"id":"epm:2.1.4","number":"2.1.4","title":"Post-Eligibility","parent":"2.1","breadcrumb":"2 Medical Assistance > 2.1 Overview > 2.1.4 Post-Eligibility","summary":"These policies apply to MA enrollees. This subchapter includes policies that apply to all Medical Assistance (MA) programs and links to policies that apply to all Minnesota Health Care Programs (MHCP) programs. Post-eligibility policy that applies to a specific type of MA is located in the relevant MA chapter.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:57.24681+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.1.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_1_4.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.1.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.4","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.4 Post-Eligibility","text":"These policies apply to MA enrollees. This subchapter includes policies that apply to all Medical Assistance (MA) programs and links to policies that apply to all Minnesota Health Care Programs (MHCP) programs. Post-eligibility policy that applies to a specific type of MA is located in the relevant MA chapter.\n\nTopics covered in this sub-chapter are:\n1. [MA Benefit Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1)\n  1. [MA Estate Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.1)\n  2. [MA Liens](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.2)\n  3. [MHCP Overpayments](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.5)\n  4. [MA Third Party Liability](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3)\n    1. [MA Cost-Effective Insurance](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.1)\n    2. [MA Medical Support](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.2)\n    3. [MA Other Third Party Liability](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.3)\n2. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n3. [MA Cooperation](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.2)\n4. [MA Cost Sharing](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.3)\n5. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n6. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n7. [MA Qualifying Health Care Coverage](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.2)\n8. [MA Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4)\n9. [MA Renewals](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.3)"}]},{"id":"epm:2.1.4.1","number":"2.1.4.1","title":"Begin and End Dates","parent":"2.1.4","breadcrumb":"2 Medical Assistance > 2.1 Overview > 2.1.4 Post-Eligibility > 2.1.4.1 Begin and End Dates","summary":"Medical Assistance (MA) eligibility and coverage are separate concepts:","effective_date":"2026-08-19","last_modified":"2026-10-03T03:58:40.139607+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.4.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.1.4.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_1_4_1.htm","legal_citations":["Code of Federal Regulations, title 42, section 431.213","Code of Federal Regulations, title 42, section 435.907","Code of Federal Regulations, title 42, section 435.915","Code of Federal Regulations, title 42, section 435.916","Minnesota Rules, part 9505.0110","Minnesota Rules, part 9505.0015, subpart 5","Minnesota Rules, part 9505.0085","Minnesota Statutes, section 256B.04","Minnesota Statutes, section 256B.08","Minnesota Statute 256B.056, subd.7","Minnesota Statute 256B.061"],"chunks":[{"chunk_id":"epm:2.1.4.1#overview","heading":"Overview","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.4.1#overview","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.4 Post-Eligibility > 2.1.4.1 Begin and End Dates > Overview","text":"## Overview\n\nMedical Assistance (MA) eligibility and coverage are separate concepts:\n- Eligibility refers to when a person meets the MA eligibility rules.\n- Coverage refers to when a person can receive MA benefits.\n\nMA begin and end date policy also applies to [Medicare Savings Programs (MSP)](https://bot-corpus.mn-dhs.online/s/epm/4.2) and the [Minnesota Family Planning Program (MFPP)](https://bot-corpus.mn-dhs.online/s/epm/4.1).\n\nGenerally, MA eligibility and coverage begin and end dates are the same. However, there are situations where eligibility and coverage do not begin or end on the same day. Differences are explained on the policy pages for the types of MA listed below. The eligibility and coverage begin and end dates may not be the same in the following situations:\n- [MA with a medical spenddown for families and children](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.6)\n- [MA with a spenddown for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD)](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.4)\n- [Emergency Medical Assistance (EMA)](https://bot-corpus.mn-dhs.online/s/epm/2.5.3) with a medical spenddown\n- The coverage and eligibility end date exceptions described below\n\nWhen an MA enrollee received coverage for a month they were not eligible for MA, an overpayment may exist. See the [MHCP Overpayment](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.5) policy for more information."},{"chunk_id":"epm:2.1.4.1#eligibility-begin-date","heading":"Eligibility Begin Date","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.4.1#eligibility-begin-date","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.4 Post-Eligibility > 2.1.4.1 Begin and End Dates > Eligibility Begin Date","text":"## Eligibility Begin Date\n\nMA eligibility begins the first day of the month that a person meets the program eligibility rules. It can begin no earlier than the first day of the month of application, if a person does not request retroactive coverage or is not eligible for retroactive coverage. [Retroactive coverage](https://bot-corpus.mn-dhs.online/s/epm/1.2.5) can begin no earlier than the first day of the month, three months before the month of application. People must meet all eligibility requirements in each retroactive month to have coverage in that month, and people may be eligible for some but not all months prior to the month of application.\n\nIf a request for an eligibility determination does not require a new application, the month the request for coverage is received is the application month.\n\nWhen an enrollee is eligible under a new basis, eligibility begins the first day of the month the required supplemental form is submitted. See EPM section [1.3.2.1 MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1) for more information.\n\nGenerally, people who meet all eligibility requirements at any time during a month are eligible for the entire month. The exceptions are:\n- When a person is born, eligibility can begin no earlier than the date the person was born.\n- When a person moves to Minnesota, eligibility can begin no earlier than the date the person became a Minnesota resident.\n- When a person is approved for a spenddown, eligibility begins the date the person meets their spenddown."},{"chunk_id":"epm:2.1.4.1#coverage-begin-date","heading":"Coverage Begin Date","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.4.1#coverage-begin-date","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.4 Post-Eligibility > 2.1.4.1 Begin and End Dates > Coverage Begin Date","text":"## Coverage Begin Date\n\nMA coverage begins the same date MA eligibility begins."},{"chunk_id":"epm:2.1.4.1#eligibility-end-date","heading":"Eligibility End Date","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.4.1#eligibility-end-date","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.4 Post-Eligibility > 2.1.4.1 Begin and End Dates > Eligibility End Date","text":"## Eligibility End Date\n\nWhen an MA enrollee reports a change in circumstances that results in the loss of MA eligibility, the MA eligibility generally ends on the last day of the month in which the change occurred. The exceptions are:\n- When an MA enrollee dies, eligibility ends the date the person died.\n- When the change occurred too late in the month to send a 10-day advance notice, MA eligibility ends the last day of the month following the month in which the change occurred.\n- When an MA enrollee reports a change in circumstance that maintains MA eligibility but results in a beneficial or adverse action, the existing MA eligibility ends the day before the new eligibility begins.\n- Eligibility ends, with a 10 day advance notice, if the enrollee fails to provide the requested supplemental form and any additional information required to complete a redetermination for all possible programs within the required time frame. See EPM section [1.3.2.1 Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1) for more information."},{"chunk_id":"epm:2.1.4.1#coverage-end-date","heading":"Coverage End Date","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.4.1#coverage-end-date","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.4 Post-Eligibility > 2.1.4.1 Begin and End Dates > Coverage End Date","text":"## Coverage End Date\n\nMA coverage ends when an MA enrollee no longer meets the eligibility requirements.\n\n### Coverage End Date due to Ineligibility\n\nWhen an MA enrollee reports a change in circumstance that results in the loss of MA eligibility, MA coverage ends the last day of the month for which advance notice can be given. Generally, 10-day advance notice is needed to end MA coverage. See the MHCP Notices policy for specific situations that require less than 10-day advance notice.\n\n### Coverage End Date due to Change in Basis\n\nWhen an MA enrollee is eligible under a new basis, coverage under the current basis ends the last day of the month, prior to the start of eligibility under the new basis.\n\nWhen an MA enrollee fails to provide the requested supplemental form and any additional information required to complete a redetermination, coverage ends the last day of the month for which advance notice can be given. See EPM section [1.3.2.1 Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1) for more information."}]},{"id":"epm:2.1.4.2","number":"2.1.4.2","title":"Qualifying Health Care Coverage","parent":"2.1.4","breadcrumb":"2 Medical Assistance > 2.1 Overview > 2.1.4 Post-Eligibility > 2.1.4.2 Qualifying Health Care Coverage","summary":"As of January 2014, people must have qualifying health care coverage, qualify for a coverage exemption, or make an individual shared responsibility payment upon filing a federal income tax return. The Individual Health Coverage Mandate is a provision of the Affordable Care Act.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:57.24681+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.4.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.1.4.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_1_4_2.htm","legal_citations":["Code of Federal Regulations, title 26, section 1.5000A","Code of Federal Regulations, title 26, section 1.5000A-2","Code of Federal Regulations, title 26, section 1.5000A–3","Code of Federal Regulations, title 26, section 6055","Code of Federal Regulations, title 45, section 155.605"],"chunks":[{"chunk_id":"epm:2.1.4.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.4.2","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.4 Post-Eligibility > 2.1.4.2 Qualifying Health Care Coverage","text":"As of January 2014, people must have qualifying health care coverage, qualify for a coverage exemption, or make an individual shared responsibility payment upon filing a federal income tax return. The Individual Health Coverage Mandate is a provision of the [Affordable Care Act](http://www.hhs.gov/healthcare/rights/index.html).\n\nMedical Assistance (MA) is qualifying health care coverage and meets the federal individual responsibility requirement. Qualifying health care coverage is also called minimum essential coverage (MEC).\n\nMedical Assistance enrollees receive a [Form 1095-B](http://www.irs.gov/pub/irs-pdf/f1095b.pdf) from the Minnesota Department of Human Services (DHS). Form 1095-B verifies health care coverage and is used to report individual health coverage to taxpayers and the IRS. An individual who maintains continuous health care coverage throughout the year is not liable for the individual shared responsibility payment.\n\nMore information regarding the individual responsibility mandate is located at [MNsure](http://www.mnsure.org/individual-family/mandate/)."},{"chunk_id":"epm:2.1.4.2#ma-with-a-spenddown-hardship-exemption","heading":"MA with a Spenddown – Hardship Exemption","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.4.2#ma-with-a-spenddown-hardship-exemption","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.4 Post-Eligibility > 2.1.4.2 Qualifying Health Care Coverage > MA with a Spenddown – Hardship Exemption","text":"## MA with a Spenddown – Hardship Exemption\n\nMA with a spenddown is not considered qualifying health coverage by the federal government and does not meet the federal individual responsibility requirement. No Form 1095-B is sent to MA with a spenddown enrollees.\n\nPeople enrolled in MA with a spenddown can apply for a hardship exemption from the shared responsibility payment from the Federal Health Insurance Marketplace at HealthCare.gov. The HealthCare.gov website does not specifically list the exemption for MA with a spenddown. The request for an MA with a spenddown exemption must be described on the [Application for Exemption from Shared Responsibility Payment for Individuals who Experience Hardships](https://www.healthcare.gov/exemption-form-instructions/). A Confirmation of Medically Needy Coverage in Minnesota Medical Assistance, available from the Minnesota Department of Human Services, must be included."},{"chunk_id":"epm:2.1.4.2#other-minnesota-health-care-programs","heading":"Other Minnesota Health Care Programs","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.4.2#other-minnesota-health-care-programs","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.4 Post-Eligibility > 2.1.4.2 Qualifying Health Care Coverage > Other Minnesota Health Care Programs","text":"## Other Minnesota Health Care Programs\n\nThe following Minnesota Health Care Programs (MHCP) are not considered qualifying health coverage by the federal government and does not meet the federal individual responsibility requirement. No Form 1095-B is sent to these enrollees.\n- Emergency Medical Assistance (EMA)\n- Medicare Saving Programs (MSP)\n- Minnesota Family Planning Program (MFPP)"}]},{"id":"epm:2.1.4.3","number":"2.1.4.3","title":"Renewals","parent":"2.1.4","breadcrumb":"2 Medical Assistance > 2.1 Overview > 2.1.4 Post-Eligibility > 2.1.4.3 Renewals","summary":"Renewing eligibility means redetermining eligibility. Most MA enrollees have an annual renewal. Some MA enrollees have a six-month renewal. Some MA enrollees are exempt from the renewal requirement.","effective_date":"2025-05-30","last_modified":"2026-10-03T03:51:57.24681+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.4.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.1.4.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_1_4_3.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.916","Minnesota Statutes, section 256B.056, subdivision 7a"],"chunks":[{"chunk_id":"epm:2.1.4.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.4.3","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.4 Post-Eligibility > 2.1.4.3 Renewals","text":"Renewing eligibility means redetermining eligibility. Most MA enrollees have an annual renewal. Some MA enrollees have a six-month renewal. Some MA enrollees are exempt from the renewal requirement.\n\nThe types of MA that have specific renewal policies are:\n- MA for Families with Children and Adults (MA-FCA) Renewals\n- MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) Renewals, including MA for Employed Persons with Disabilities MA-EPD), MA under the TEFRA Option for children with disabilities, 1619 (a), 1619 (b), and Medicare Savings Programs (MSP)\n- Children receiving Title IV-E or non-Title IV-E Foster Care, Kinship Assistance, or Adoption Assistance\n- MA for people with Breast or Cervical Cancer (MA-BC) Renewals\n- MA for people receiving services at the Center for Victims of Torture (MA-CVT) Renewals"},{"chunk_id":"epm:2.1.4.3#exempt-from-renewal","heading":"Exempt from Renewal","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.4.3#exempt-from-renewal","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.4 Post-Eligibility > 2.1.4.3 Renewals > Exempt from Renewal","text":"## Exempt from Renewal\n\nThe types of MA that are exempt from health care renewals, unless specified, are:\n- Auto newborns have eligibility renewed the month following the month of their first birthday\n- People enrolled in Refugee Medical Assistance (RMA)\n- People enrolled in Transitional MA (TMA) or Transition Year MA (TYMA), unless a scheduled renewal is due when TMA or TYMA is ending\n- Pregnant people have eligibility renewed the month following the month the 12 month postpartum ends"},{"chunk_id":"epm:2.1.4.3#timely-renewals","heading":"Timely Renewals","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.4.3#timely-renewals","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.4 Post-Eligibility > 2.1.4.3 Renewals > Timely Renewals","text":"## Timely Renewals\n\nA renewal is timely if one of the following occurs:\n- The renewal form is received during the enrollee’s eligibility period.\n- Any additional information or verifications required to renew are received during the enrollee’s eligibility period.\n\nWhen an enrollee returns a renewal form timely, eligibility must continue until the agency processes the renewal, even if the enrollee’s eligibility period has ended. If additional information is needed for the renewal, the enrollee must be given at least 10 days to provide it.\n\nEligibility must continue until either:\n- The renewal is processed using the additional requested information and the enrollee’s eligibility is redetermined, or\n- The end of the month in which the deadline to submit the additional information has passed without a response, whichever happens later.\n\nIf an enrollee’s eligibility is extended past their eligibility period and the redetermination results in an adverse action, the enrollee must be given at least a 10-day advance notice that includes the action and the reason for the action before their eligibility changes. The enrollee is eligible through the end of the month in which the 10-day advance notice is provided. If 10-day advance notice of adverse action cannot be given in the month the determination occurs, eligibility must be extended an additional month to provide the required 10-day advance notice."},{"chunk_id":"epm:2.1.4.3#reconsideration-period","heading":"Reconsideration Period","url":"https://bot-corpus.mn-dhs.online/s/epm/2.1.4.3#reconsideration-period","context":"EPM > 2 Medical Assistance > 2.1 Overview > 2.1.4 Post-Eligibility > 2.1.4.3 Renewals > Reconsideration Period","text":"## Reconsideration Period\n\nThe reconsideration period is the four-month period after an enrollee’s MA is terminated for failure to complete a renewal. Enrollees in the same household may have different [MA end dates](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.1) and different reconsideration periods. During an enrollee’s reconsideration period, they may return their renewal paperwork instead of reapplying for health care coverage.\n\nA former enrollee’s eligibility must be redetermined when either of the following is true:\n- their renewal form is received on or before the last day of the fourth month after closure for failure to renew, or\n- any additional information or proof that was requested for renewal is received on or before the last day of the fourth month after closure for failure to renew.\n\nA renewal form or requested information for renewal received during an enrollee’s reconsideration period is treated as a new application, and all application policies apply. The date of application is the date that the renewal form or requested information for renewal was received by the agency. See [EPM 1.2, MHCP Applications](https://bot-corpus.mn-dhs.online/s/epm/1.2) and [1.2.5 MHCP Retroactive Eligibility](https://bot-corpus.mn-dhs.online/s/epm/1.2.5) for more information.\n\nA former enrollee determined eligible for MA during the reconsideration period will continue to have the same renewal schedule as other enrollees in their household whose MA eligibility was successfully renewed.\n\nAfter the reconsideration period ends, former enrollees or households whose eligibility was terminated for failure to renew must reapply to request a new eligibility determination."}]},{"id":"epm:2.2","number":"2.2","title":"Medical Assistance for Families with Children and Adults","parent":"2","breadcrumb":"2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults","summary":"Medical Assistance (MA) eligibility is determined using a variety of non-financial, financial and post-eligibility requirements.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:57.24681+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_2.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults","text":"Medical Assistance (MA) eligibility is determined using a variety of non-financial, financial and post-eligibility requirements.\n\nThis subchapter includes policies that apply to MA for Families with Children and Adults (MA-FCA) and links to policies that apply to all MA programs and all Minnesota Health Care Programs (MHCP) programs.\n1. [General Requirements](https://bot-corpus.mn-dhs.online/s/epm/2.2.1)\n  1. [MHCP Applications](https://bot-corpus.mn-dhs.online/s/epm/1.2)\n  2. [MA-FCA Hospital Presumptive Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.2.1.1)\n  3. [MA-FCA Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/2.2.1.2)\n  4. [MA Responsibilities](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2)\n  5. [MHCP Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1)\n  6. [MHCP Retroactive Coverage](https://bot-corpus.mn-dhs.online/s/epm/1.2.5)\n2. [MA-FCA Non-Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.2.2)\n  1. [MA-FCA Bases of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1)\n  2. [MA Citizenship and Immigration Status](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2)\n  3. [MA County Residency](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.3)\n  4. [MA Living Arrangement](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.4)\n  5. [MHCP State Residency](https://bot-corpus.mn-dhs.online/s/epm/1.4)\n  6. [MA Social Security Number](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5)\n3. [MA-FCA Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.2.3)\n  1. [MA-FCA Asset Limits](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.1)\n  2. [MA-FCA Household Composition and Family Size](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.2)\n4. [MA-FCA Sponsor Deeming](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.2.1)\n  1. [MA-FCA Income Limit](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.3)\n  2. [MA-FCA Income Methodology](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.4)\n  3. [MA-FCA Income Verification](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.5)\n  4. [MA-FCA Medical Spenddown](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.6)\n5. [MA-FCA Post-Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.2.4)\n  1. [MA Begin and End Dates](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.1)\n  2. [MA Benefit Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1)\n  3. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n  4. [MA Cooperation](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.2)\n  5. [MA Cost Sharing](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.3)\n  6. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n  7. [MA-FCA Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/2.2.4.1)\n  8. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n  9. [MA Qualifying Health Coverage](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.2)\n  10. [MA Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4)\n  11. [MA-FCA Renewals](https://bot-corpus.mn-dhs.online/s/epm/2.2.4.2)"}]},{"id":"epm:2.2.1","number":"2.2.1","title":"General Requirements","parent":"2.2","breadcrumb":"2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.1 General Requirements","summary":"This subchapter provides general policy information that applies to Medical Assistance for Families with Children and Adults (MA-FCA).","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:57.24681+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.2.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_2_1.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.2.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.1","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.1 General Requirements","text":"This subchapter provides general policy information that applies to Medical Assistance for Families with Children and Adults (MA-FCA).\n\nThis subchapter includes policies that apply to MA-FCA and links to policies that apply to all MA programs and all Minnesota Health Care Programs (MHCP).\n\nTopics covered in this subchapter are:\n1. [MHCP Applications](https://bot-corpus.mn-dhs.online/s/epm/1.2)\n2. [MA-FCA Hospital Presumptive Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.2.1.1)\n  1. [MA-FCA Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/2.2.1.2)\n3. [MA Responsibilities](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2)\n  1. [MA Benefit Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1)\n    1. [MA Estate Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.1)\n    2. [MA Liens](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.2)\n    3. [MHCP Overpayments](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.5)\n    4. [MA Third Party Liability](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3)\n      1. [MA Cost Effective Insurance](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.1)\n      2. [MA Medical Support](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.2)\n      3. [MA Other Third Party Liability](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.3)\n  2. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n  3. [MA Cooperation](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.2)\n  4. [MA Cost Sharing](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.3)\n  5. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n  6. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n  7. [MA Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4)\n4. [MHCP Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1)\n  1. [MHCP Appeals](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.1)\n  2. [MHCP Authorized Representative](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.2)\n  3. [MHCP Civil Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.3)\n  4. [MHCP Data Privacy](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.4)\n  5. [MHCP Notices](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.5)\n5. [MHCP Retroactive Eligibility](https://bot-corpus.mn-dhs.online/s/epm/1.2.5)"}]},{"id":"epm:2.2.1.1","number":"2.2.1.1","title":"Hospital Presumptive Eligibility","parent":"2.2.1","breadcrumb":"2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.1 General Requirements > 2.2.1.1 Hospital Presumptive Eligibility","summary":"The Hospital Presumptive Eligibility (HPE) program allows participating hospitals to determine temporary eligibility for Medical Assistance (MA) for people who meet the basic criteria for Medical Assistance for Families with Children and Adults (MA-FCA). See the Hospital Presumptive Eligibility web site for additional program information.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:57.24681+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.1.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.2.1.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_2_1_1.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.1102","Code of Federal Regulations, title 42, section 435.1103","Code of Federal Regulations, title 42, section 435.1110","Minnesota Statutes, section 256B.057","Social Security Act, section 1902","United States Code, title 42, section 1936a"],"chunks":[{"chunk_id":"epm:2.2.1.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.1.1","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.1 General Requirements > 2.2.1.1 Hospital Presumptive Eligibility","text":"The Hospital Presumptive Eligibility (HPE) program allows participating hospitals to determine temporary eligibility for Medical Assistance (MA) for people who meet the basic criteria for Medical Assistance for Families with Children and Adults (MA-FCA). See the [Hospital Presumptive Eligibility](http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=dhs16_180695) web site for additional program information."},{"chunk_id":"epm:2.2.1.1#individuals-eligible-to-apply-for-hpe","heading":"Individuals eligible to apply for HPE","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.1.1#individuals-eligible-to-apply-for-hpe","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.1 General Requirements > 2.2.1.1 Hospital Presumptive Eligibility > Individuals eligible to apply for HPE","text":"## Individuals eligible to apply for HPE\n\nA person does not need to be a patient at a hospital or hospital clinic to apply for HPE. Qualified hospitals are required to process applications for individuals regardless of whether the applicant is seeking medical treatment."},{"chunk_id":"epm:2.2.1.1#hpe-determination","heading":"HPE Determination","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.1.1#hpe-determination","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.1 General Requirements > 2.2.1.1 Hospital Presumptive Eligibility > HPE Determination","text":"## HPE Determination\n\nHospital staff who have been certified by the Minnesota Department of Human Services (DHS) are responsible for making HPE eligibility determinations. The HPE eligibility determination must be based only on the preliminary information an applicant provides. Hospitals cannot request verifications from an applicant."},{"chunk_id":"epm:2.2.1.1#non-financial-eligibility-for-hpe","heading":"Non-Financial Eligibility for HPE","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.1.1#non-financial-eligibility-for-hpe","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.1 General Requirements > 2.2.1.1 Hospital Presumptive Eligibility > Non-Financial Eligibility for HPE","text":"## Non-Financial Eligibility for HPE\n\nHPE non-financial eligibility rules follow MA-FCA non-financial eligibility rules with the following exceptions:\n- An HPE applicant is not required to provide his or her Social Security number as a condition of eligibility.\n- HPE household composition rules follow non-tax filer household composition rules for MA-FCA, regardless of the applicant’s tax filing status.\n\nAn HPE applicant must be a Minnesota resident to be eligible.\n\nPeople who are incarcerated are not eligible for HPE. See the [MA for Hospitalized Incarcerated People](https://bot-corpus.mn-dhs.online/s/epm/2.5.5) chapter for more information.\n\n### Basis of Eligibility\n\nHPE applicants must have an MA-FCA basis of eligibility under one of the following categories:\n- Infants and children age 0-2\n- Children age 2-18\n- Children age 19-20\n- Parents and relative caretakers\n- Pregnant people\n- Adults without children aged 21-64, without Medicare\n- People under age 26 who were in foster care at age 18 (no income limit)\n\nHPE is not available for people under other MA bases of eligibility.\n\n### Current Minnesota Health Care Programs Eligibility\n\nPeople who currently are enrolled in MA or MinnesotaCare are ineligible for HPE. Hospitals are required to confirm that an applicant does not have current MA or MinnesotaCare coverage before approving HPE eligibility.\n\nEnrollees of the Consolidated Chemical Dependency Treatment Fund or HIV/AIDS Program are eligible for HPE coverage if they are not also enrolled in MA. People enrolled in the Minnesota Family Planning Program (MFPP) are eligible for HPE."},{"chunk_id":"epm:2.2.1.1#financial-eligibility-for-hpe","heading":"Financial Eligibility for HPE","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.1.1#financial-eligibility-for-hpe","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.1 General Requirements > 2.2.1.1 Hospital Presumptive Eligibility > Financial Eligibility for HPE","text":"## Financial Eligibility for HPE\n\nApplicants must meet certain financial requirements for HPE eligibility. The HPE financial eligibility rules are a simplified version of the regular MA-FCA financial eligibility rules. HPE financial eligibility differs in the following ways:\n- HPE income limits are the same as MA-FCA income limits, but hospitals apply the five percent disregard when determining HPE eligibility. Refer to HPE Income and Asset Guidelines ([DHS-3884](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-3884-ENG)) for more information.\n- Sponsor deeming rules do not apply when determining HPE eligibility.\n- HPE financial eligibility rules do not allow deductions from gross income allowed under the modified-adjusted gross income based (MAGI-based) methodology.\n- The income of a child under age 19 who lives with the applicant does not count towards the HPE household income unless the child is expected to earn more than $6,000 in the current year.\n\nSee the [MA-FCA Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.2.3) section for more information."},{"chunk_id":"epm:2.2.1.1#hpe-eligibility-period","heading":"HPE Eligibility Period","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.1.1#hpe-eligibility-period","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.1 General Requirements > 2.2.1.1 Hospital Presumptive Eligibility > HPE Eligibility Period","text":"## HPE Eligibility Period\n\nThe HPE eligibility period begins the date the hospital approves HPE. The HPE period ends:\n- the date ongoing MA eligibility is determined if the HPE enrollee submits an application for MA during the HPE eligibility period.\n- the last day of the month after the month HPE eligibility was approved if the HPE enrollee does not submit an application for MA during the HPE eligibility period."},{"chunk_id":"epm:2.2.1.1#frequency-of-hpe-availability","heading":"Frequency of HPE Availability","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.1.1#frequency-of-hpe-availability","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.1 General Requirements > 2.2.1.1 Hospital Presumptive Eligibility > Frequency of HPE Availability","text":"## Frequency of HPE Availability\n\nPeople are limited to one HPE period every 12 months.\n\nPeople who become pregnant can have one HPE period during each pregnancy."},{"chunk_id":"epm:2.2.1.1#covered-services","heading":"Covered Services","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.1.1#covered-services","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.1 General Requirements > 2.2.1.1 Hospital Presumptive Eligibility > Covered Services","text":"## Covered Services\n\nHPE enrollees are eligible to receive regular MA services during the HPE period."},{"chunk_id":"epm:2.2.1.1#service-delivery","heading":"Service Delivery","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.1.1#service-delivery","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.1 General Requirements > 2.2.1.1 Hospital Presumptive Eligibility > Service Delivery","text":"## Service Delivery\n\nHPE coverage is provided on a fee-for-service basis. HPE enrollees can receive any MA-covered service from a provider that participates in the fee-for-service MA program."},{"chunk_id":"epm:2.2.1.1#ongoing-ma-coverage","heading":"Ongoing MA Coverage","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.1.1#ongoing-ma-coverage","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.1 General Requirements > 2.2.1.1 Hospital Presumptive Eligibility > Ongoing MA Coverage","text":"## Ongoing MA Coverage\n\nAfter a hospital approves a person for HPE, the hospital must help the person file the online or paper application for ongoing coverage. Hospitals may refer people to a certified assister or navigator to help the person complete the online or paper application form. See the [Application Forms](https://bot-corpus.mn-dhs.online/s/epm/1.2.1) policy for more information."},{"chunk_id":"epm:2.2.1.1#appeal-rights","heading":"Appeal Rights","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.1.1#appeal-rights","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.1 General Requirements > 2.2.1.1 Hospital Presumptive Eligibility > Appeal Rights","text":"## Appeal Rights\n\nHPE applicants cannot appeal an HPE eligibility determination."}]},{"id":"epm:2.2.1.2","number":"2.2.1.2","title":"Mandatory Verifications","parent":"2.2.1","breadcrumb":"2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.1 General Requirements > 2.2.1.2 Mandatory Verifications","summary":"Mandatory verifications must be verified through an available electronic data source or by paper proof, if electronic data sources are unsuccessful or unavailable. Self-attestation of certain eligibility factors may be accepted if electronic data sources are unsuccessful or unavailable and paper proof does not exist or is not available. See individual eligibility requirements for acceptable proof ","effective_date":"2026-02-06","last_modified":"2026-10-03T03:51:57.24681+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.1.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.2.1.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_2_1_2.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.945","Code of Federal Regulations, title 42, section 435.952","Minnesota Rules, part 9505.0095"],"chunks":[{"chunk_id":"epm:2.2.1.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.1.2","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.1 General Requirements > 2.2.1.2 Mandatory Verifications","text":"Mandatory verifications must be verified through an available electronic data source or by paper proof, if electronic data sources are unsuccessful or unavailable. Self-attestation of certain eligibility factors may be accepted if electronic data sources are unsuccessful or unavailable and paper proof does not exist or is not available. See individual eligibility requirements for acceptable proof and timelines."},{"chunk_id":"epm:2.2.1.2#pre-eligibility-verification","heading":"Pre Eligibility Verification","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.1.2#pre-eligibility-verification","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.1 General Requirements > 2.2.1.2 Mandatory Verifications > Pre Eligibility Verification","text":"## Pre Eligibility Verification\n\nThe following eligibility factors must be verified prior to the eligibility determination:\n- Exceptions to having a Social Security Number. See [2.1.2.5 MA Social Security Number](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5)\n- All sources of current income, adjustments and income exceptions, based on the modified adjusted gross income (MAGI) methodology. See [2.2.3.5 MA-FCA Income Verification](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.5).\n- Projected Annual Income (PAI), if the person is eligible for Medical Assistance through the safety net provision. See [2.2.3.3 MA-FCA Income Limit](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.3)."},{"chunk_id":"epm:2.2.1.2#post-eligibility-verification","heading":"Post Eligibility Verification","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.1.2#post-eligibility-verification","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.1 General Requirements > 2.2.1.2 Mandatory Verifications > Post Eligibility Verification","text":"## Post Eligibility Verification\n\nThe following factors can be verified after eligibility has been approved. If proof is not provided, eligibility may end.\n- Citizenship or Immigration status: See [2.1.2.2.1 MA Citizenship](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2.1) or [2.1.2.2.2 MA Immigration Status](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2.2)\n- Social Security number (SSN): See [2.1.2.5 MA Social Security Number](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5)"},{"chunk_id":"epm:2.2.1.2#spenddown","heading":"Spenddown","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.1.2#spenddown","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.1 General Requirements > 2.2.1.2 Mandatory Verifications > Spenddown","text":"## Spenddown\n\nFor MA for parents, relative caretakers, pregnant people and children with a spenddown, the following pre-eligibility verifications also apply:\n- Medical expenses to meet a spenddown\n- Assets - when an asset limit applies,\n- \n  - Verification of assets is required at application, renewal, and when a new asset is reported\n  - \n    - At renewal, an excluded asset that was verified does not need to be verified again unless the asset has changed and determination of whether or not the change affects the exclusion is necessary.\n  - Verification of the following assets is not required at application or renewal:\n  - \n    - Homestead if it qualifies for the real property homestead exclusion. The only exception applies to people who are applying for or renewing Medical Assistance for Long term Care eligibility. See [2.4.1.2 MA-LTC Long-Term Care Home Equity Limit](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.2) for more information about the exception.\n    - Vehicles, up to the number of persons in the household of age 16 or older.\n    - Household goods and personal effects\n\nCounty, tribal and state servicing agencies must retain verification documentation in accordance with the County Human Service Records Retention Schedule ([DHS-6928](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-6928-ENG))."},{"chunk_id":"epm:2.2.1.2#self-attestation","heading":"Self-Attestation","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.1.2#self-attestation","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.1 General Requirements > 2.2.1.2 Mandatory Verifications > Self-Attestation","text":"## Self-Attestation\n\nSelf-attestation, either verbal or in writing, of the following eligibility factors may be accepted if electronic data sources are unsuccessful or unavailable and paper proof does not exist or is not available:\n- Income\n- Assets\n- Medical expenses to meet a spenddown\n- Exceptions to having a Social Security number\n\nPaper proof is considered not available if neither the applicant or enrollee, nor the agency can obtain it. The county, tribal and state servicing agency must make efforts to assist the applicant or enrollee in obtaining the requested paper proof, if it exists. This includes obtaining authorization from the applicant or enrollee to contact a third party on their behalf, if appropriate. Decisions to accept an applicant’s or enrollee’s self-attestation must be based on the individual case circumstances.\n\nSelf-attestation cannot be accepted in lieu of electronic verification or paper documentation of an applicant or enrollee’s citizenship, immigration status, or Social Security number."}]},{"id":"epm:2.2.2","number":"2.2.2","title":"Non-Financial Eligibility","parent":"2.2","breadcrumb":"2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.2 Non-Financial Eligibility","summary":"This subchapter includes non-financial eligibility policies. This covers eligibility factors not related to a person’s income or assets.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:57.24681+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.2.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_2_2.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.2.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.2","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.2 Non-Financial Eligibility","text":"This subchapter includes non-financial eligibility policies. This covers eligibility factors not related to a person’s income or assets.\n\nThis subchapter includes policies that apply to MA for Families with Children and Adults (MA-FCA) and links to policies that apply to all MA programs and all Minnesota Health Care Programs (MHCP).\n\nTopics covered in this subchapter are:\n1. [MA-FCA Bases of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1)\n2. [MA Citizenship and Immigration Status](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2)\n  1. [MA Citizenship](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2.1)\n  2. [MA Immigration Status](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2.2)\n3. [MA County Residency](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.3)\n4. [MA Living Arrangement](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.4)\n5. [MHCP State Residency](https://bot-corpus.mn-dhs.online/s/epm/1.4)\n6. [MA Social Security Number](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5)"}]},{"id":"epm:2.2.2.1","number":"2.2.2.1","title":"Bases of Eligibility","parent":"2.2.2","breadcrumb":"2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.2 Non-Financial Eligibility > 2.2.2.1 Bases of Eligibility","summary":"Minnesota provides Medical Assistance (MA) to certain groups of people as allowed under law. These groups are referred to as a basis of eligibility. A person’s basis of eligibility determines the non-financial criteria and financial methodology used to determine MA eligibility.","effective_date":"2026-06-03","last_modified":"2026-10-03T03:51:57.24681+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.2.2.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_2_2_1.htm","legal_citations":["Code of Federal Regulations, title 42, section 431.213","Code of Federal Regulations, title 42, section 435","Code of Federal Regulations, title 42, section 435.916","Minnesota Statutes, section 256B.055, subdivision 6","Minnesota Statutes, section 256B.06, subdivision 4, 5 & 10"],"chunks":[{"chunk_id":"epm:2.2.2.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.2 Non-Financial Eligibility > 2.2.2.1 Bases of Eligibility","text":"Minnesota provides Medical Assistance (MA) to certain groups of people as allowed under law. These groups are referred to as a basis of eligibility. A person’s basis of eligibility determines the non-financial criteria and financial methodology used to determine MA eligibility.\n\nThe following are the bases of eligibility for MA for Families with Children and Adults (MA-FCA):\n- Parent:\n  - Biological, natural, adoptive or step parent\n  - Living with a child younger than age 19\n  - Has primary responsibility for the child’s care\n- Caretaker Relative, including foster parents, legal guardians or others, who are:\n  - A relative of a child younger than age 19, by blood, adoption, or marriage. Including:\n    - Grandparents, siblings\n    - First cousins, nephews, nieces, aunts or uncles and people of preceding generations as denoted by grand, great or great-great\n    - Stepbrother or stepsister\n    - Spouses and former spouses of the people named above\n  - Living with a child younger than age 19\n  - Has primary responsibility for the child’s care\n  - The spouse of a caretaker relative can also use the caretaker relative basis of eligibility\n- Pregnant Person:\n  - A person who is pregnant\n  - A person within the 12 month postpartum period\n- Auto Newborn: child born to a person enrolled in MA\n- Infant: child age 0 through 1:\n  - Children's Health Insurance Program (CHIP) funded MA may be available for infants with income between 275% and 283% FPG who are not enrolled in other health insurance\n  - A CHIP-funded infant who gains other health insurance becomes eligible for MA as a non-CHIP-funded infant\n- Child age 2 through 18\n- Child age 19 and 20\n- Adult age 21 through 64 who: Adults not eligible for this basis may meet the eligibility requirements for [MA for People Who Are Age 65 or Older or People Who Are Blind or Have a Disability](https://bot-corpus.mn-dhs.online/s/epm/2.3).\n  - Is not eligible for or enrolled in Medicare Part A or Medicare Part B\n  - Is not a Supplemental Security Income (SSI) recipient\n  - Is not eligible for MA under 1619 a/b\n  - Is not a former SSI recipient who stopped receiving SSI when they began receiving Retirement, Survivor, Disability (RSDI) benefits from the Social Security Administration (SSA) under a deceased spouse or deceased or retired parent’s earning record\n  - Is not eligible for MA under the parent, caretaker relative, pregnant person or former foster care basis of eligibility\n- Former Foster Care Youth:\n  - Was enrolled in MA or MinnesotaCare another state’s Medicaid program when they aged out of foster care at 18 or older.\n  - Is under age 26\n  - Aged out of foster care in any state, District of Columbia, or United States territory at age 18 or older.\n- A person must have one of the following bases of eligibility for MA-FCA. A person whose basis of eligibility ends must be evaluated for other MA bases of eligibility before MA is closed. Applicants who meet eligibility requirements at any time within a month are eligible for the entire month with the following exceptions: The begin and end dates for the following bases of eligibility are: People may have more than one basis of eligibility. A person’s countable income, asset limit, cost sharing, service delivery options and benefits may differ depending on the eligibility basis used. The county, tribal or state servicing agency must allow a person with multiple bases of eligibility to have eligibility determined under the basis that best meets their needs. A change in circumstances may affect an MA enrollee's basis of eligibility. People who lose eligibility under one basis must be redetermined under another basis without interruption in their coverage. Additional information may be required to determine continued eligibility under another basis. Some changes that may affect an enrollee's basis of eligibility include, but are not limited to: If an enrollee is no longer eligible for MA under their current basis of eligibility, they must be redetermined for all health care programs they are potentially eligible for, without interruption in their coverage. See EPM section [1.3.2.1 Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1) for more information.\n  - A person’s eligibility ends on the date of death\n  - A person’s eligibility begins the date they become a Minnesota resident\n  - A person’s eligibility begins the date they meet their spenddown requirement\n  - Pregnant person:\n    - Begins the first day of the month of conception\n    - Ends the last day of the month following the 12 month postpartum period\n    - Begin and end dates for the pregnant person basis of eligibility are determined using information the applicant or enrollee attests. Verification of pregnancy is not required to establish this basis.\n  - Auto newborn:\n    - Begins the first day of the month of birth\n    - Ends the last day of the month of their first birthday\n  - Infant:\n    - Begins the first day of the month of birth\n    - Ends the last day of the month of their second birthday\n  - Child age 2 through 18:\n    - Begins the first day of the month following their second birthday\n    - Ends the last day of the month of their 19th birthday\n  - Child age 19 and 20:\n    - Begins the first day of the month following their 19th birthday\n    - Ends the last day of the month of their 21st birthday\n  - Parent or caretaker relative:\n    - Begins the first day of the month of the birth or adoption of a child under the age of 19 or the first day of the first full month when a child younger than age of 19 moves into their home.\n    - Ends the last day of the month when:\n      - The only child or youngest child for whom the person is a parent or relative caretaker turns 19\n      - The only child, or all children who live in the home under the age 19, leave the home and the absence is not temporary\n      - The parent or caretaker relative no longer lives with a child younger than age 19\n  - Adults without children:\n    - Begins the first day of the month following their 21st birthday\n    - Ends the last day of the month prior to their 65th birthday\n  - Former Foster Care Youth:\n    - Begins no earlier than the first day of the month after the month that A under a Foster Care basis of eligibility ends\n    - Ends the last day of the month of the youth's 26th birthday\n  - Age\n    - An auto newborn basis of eligibility ends the last day of the month in which the child turns one\n    - A child basis of eligibility ends the last day of the month of the child's 21st birthday\n    - A Former Foster Care Youth basis of eligibility ends the last day of the month of the youth’s 26th birthday\n    - An adult without children basis of eligibility ends the month before the enrollee’s 65th birthday\n  - Disability status\n  - Household Composition\n  - Medicare A or B. An adult without children basis of eligibility ends the month before the enrollee is eligible for or enrolled in Medicare A or B.\n  - Pregnancy. A pregnant basis of eligibility ends on the last day of the month in which the 12 month postpartum period ends.\n- Code of Federal Regulations, title 42, section 457.1\n-"}]},{"id":"epm:2.2.2.1.1","number":"2.2.2.1.1","title":"Auto Newborn Basis of Eligibility","parent":"2.2.2.1","breadcrumb":"2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.2 Non-Financial Eligibility > 2.2.2.1 Bases of Eligibility > 2.2.2.1.1 Auto Newborn Basis of Eligibility","summary":"A child born to a mother who was eligible for Medical Assistance (MA) on the day the child was born, is automatically eligible for MA for one year. This basis is known as “auto newborn.” Auto newborns qualify for MA without regard to financial and non-financial eligibility factors except state residency (i.e., automatic eligibility) through the end of the month of the child’s first birthday.","effective_date":"2019-06-01","last_modified":"2026-10-03T03:51:57.24681+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.2.2.1.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_2_2_1_1.htm","legal_citations":["Centers for Medicare & Medicaid Services (CMS) State Health Officials letter re: CHIPRA (Aug. 31, 2009), at https://www.medicaid.gov/federal-policy-guidance/downloads/sho-08-31-09b.pdf","Code of Federal Regulations, title 42, section 435.117","Minnesota Statutes, section 256B.055, subdivision 10","Minnesota Statutes, section 256B.057, subdivision 1"],"chunks":[{"chunk_id":"epm:2.2.2.1.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1.1","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.2 Non-Financial Eligibility > 2.2.2.1 Bases of Eligibility > 2.2.2.1.1 Auto Newborn Basis of Eligibility","text":"A child born to a mother who was eligible for Medical Assistance (MA) on the day the child was born, is automatically eligible for MA for one year. This basis is known as “auto newborn.” Auto newborns qualify for MA without regard to financial and non-financial eligibility factors except state residency (i.e., automatic eligibility) through the end of the month of the child’s first birthday."},{"chunk_id":"epm:2.2.2.1.1#basis-of-eligibility","heading":"Basis of Eligibility","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1.1#basis-of-eligibility","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.2 Non-Financial Eligibility > 2.2.2.1 Bases of Eligibility > 2.2.2.1.1 Auto Newborn Basis of Eligibility > Basis of Eligibility","text":"## Basis of Eligibility\n\nThe MA auto newborn basis of eligibility requires the child be:\n- Born to a mother who is eligible for and enrolled in MA or Emergency Medical Assistance (EMA) on the date of the child’s birth\n  - Includes children born to people eligible for CHIP-funded MA, EMA, MA for people receiving services from the Center for Victims of Torture (MA-CVT) or any other MA basis.\n  - Includes children whose mothers applied for MA or EMA after the birth and were determined eligible retroactively for the month of the child’s birth.\n  - Includes children whose mother was on MA with a spenddown and met the spenddown in their month of birth.\n  - Continued eligibility as an auto newborn is not dependent on the mother maintaining MA eligibility.\n- A resident of Minnesota\n  - An auto newborn who moves out of the state, but moves back to Minnesota before the last day of the month of their first birthday is eligible again as an auto newborn through the end of the month of their first birthday.\n\nA child born to a mother enrolled in MinnesotaCare does not have an MA basis of eligibility as an auto newborn.\n\n### Verification Requirements\n\nChildren with an auto newborn basis of eligibility are exempt from providing MA-FCA mandatory verifications while they have the auto newborn basis. The child may be required to provide additional verifications when the auto newborn basis ends, depending on the basis or program for which they are being redetermined.\n\n### Citizenship\n\nAll auto newborns and individuals previously eligible as auto newborns are exempt from citizenship verification.\n\n### Social Security Number (SSN)\n\nAn auto newborn is not required to provide a SSN or furnish proof that they have applied for a SSN while eligible under the basis.\n\nWhen the child’s eligibility is redetermined at the end of the auto newborn basis, standard [MA SSN](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5) requirements apply.\n\n### Income\n\nThere is no income test for auto newborns. When eligibility is redetermined for the month following the month of their first birthday, the child is subject to the income limits and guidelines for the basis under which they are being redetermined."},{"chunk_id":"epm:2.2.2.1.1#eligibility-begin-date","heading":"Eligibility Begin Date","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1.1#eligibility-begin-date","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.2 Non-Financial Eligibility > 2.2.2.1 Bases of Eligibility > 2.2.2.1.1 Auto Newborn Basis of Eligibility > Eligibility Begin Date","text":"## Eligibility Begin Date\n\nThe Auto Newborn basis of eligibility begins on the date that the child is born.\n\n### Application\n\nA new application is not required to establish auto newborn eligibility. An auto newborn is entitled to MA under this basis even if the birth is reported at a later time. This includes children who were born in previous certification periods to mothers who were eligible for and enrolled in MA in the month of the child’s birth.\n\n### Change in Circumstances\n\nAuto newborns are not required to live with their mother after leaving the hospital to maintain eligibility.\n- An auto newborn is continuously eligible for the auto newborn MA basis through the last day of the month of their first birthday.\n- Changes in household composition or household income do not impact an auto newborn’s eligibility.\n\nAuto newborns eligible for Title IV-E foster care/kinship assistance and Title IV-E or non-Title IV-E adoption assistance must be redetermined under the Title IV-E foster care/Kinship Assistance or Title IV-E or non-Title IV-E adoption assistance MA basis of eligibility. See [Medical Assistance Northstar Care Title IV-E Foster Care and Kinship Assistance](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.2.1) or [MA Northstar Adoption Assistance](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1).\n\nAuto newborns determined eligible for non-Title IV-E foster care or kinship assistance must continue MA under the auto newborn basis."},{"chunk_id":"epm:2.2.2.1.1#eligibility-end-date","heading":"Eligibility End Date","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1.1#eligibility-end-date","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.2 Non-Financial Eligibility > 2.2.2.1 Bases of Eligibility > 2.2.2.1.1 Auto Newborn Basis of Eligibility > Eligibility End Date","text":"## Eligibility End Date\n\nThe auto newborn period begins the day the child is born and ends the last day of the month of their first birthday. An auto newborn is continuously eligible for the auto newborn basis of eligibility until the end of the month of their first birthday.\n\nEligibility for the auto newborn basis can only be ended before the last day of the month of the child’s first birthday in the following circumstances:\n- Voluntary termination\n- Child starts receiving Title IV-E foster care/kinship assistance or Title IV-E or non-Title IV-E adoption assistance and qualifies for MA under a Northstar basis of eligibility\n- No longer a resident of Minnesota (Including when the child's whereabouts are unknown)\n- Death"},{"chunk_id":"epm:2.2.2.1.1#post-eligibility","heading":"Post-Eligibility","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1.1#post-eligibility","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.2 Non-Financial Eligibility > 2.2.2.1 Bases of Eligibility > 2.2.2.1.1 Auto Newborn Basis of Eligibility > Post-Eligibility","text":"## Post-Eligibility\n\n### Renewal\n\nAn auto newborn is exempt from renewal requirements through the end of the month of their first birthday.\n\n### Cost-Effective Health Insurance\n\nParents/caretakers of auto newborns who have access to a [cost-effective](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.1) group plans through their employer must enroll the newborn if allowable by their plan.\n\n### Third Party Liability (TPL)\n\nParents/caretakers are required to provide information regarding access to or enrollment in other [third party](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3) benefits when reporting the birth of a newborn. An auto newborn’s eligibility is not affected by a parent or relative caretaker’s refusal to provide TPL information."}]},{"id":"epm:2.2.2.1.2","number":"2.2.2.1.2","title":"Pregnant Person Basis of Eligibility","parent":"2.2.2.1","breadcrumb":"2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.2 Non-Financial Eligibility > 2.2.2.1 Bases of Eligibility > 2.2.2.1.2 Pregnant Person Basis of Eligibility","summary":"A person who is pregnant or within the postpartum period may be eligible for Medical Assistance under the pregnant person basis of eligibility.","effective_date":"2026-02-06","last_modified":"2026-10-03T03:51:57.24681+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.2.2.1.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_2_2_1_2.htm","legal_citations":["Centers for Medicare & Medicaid Services (CMS) State Health Officials letter re: Minimum Essential Coverage (Nov. 7, 2014), at https://www.medicaid.gov/federal-policy-guidance/downloads/sho-14-002.pdf","Centers for Medicare & Medicaid Services (CMS) State Health Officials letter re: Medicaid and CHIP Coverage of “Lawfully Residing” Children and Pregnant People (July 1, 2010), at www.cms.gov/smdl/downloads/SHO10006.pdf","Code of Federal Regulations, title 42, section 435.116","Code of Federal Regulations, title 42, section 435.117","Code of Federal Regulations, title 42, section 435.170","Code of Federal Regulations, title 42, section 435.956","Minnesota Statutes, section 256B.055, subdivision 6","Minnesota Statutes, section 256B.057, subdivision 1","Minnesota Statutes, section 256B.06, subdivision 4 & 5"],"chunks":[{"chunk_id":"epm:2.2.2.1.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1.2","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.2 Non-Financial Eligibility > 2.2.2.1 Bases of Eligibility > 2.2.2.1.2 Pregnant Person Basis of Eligibility","text":"A person who is pregnant or within the postpartum period may be eligible for Medical Assistance under the pregnant person basis of eligibility."},{"chunk_id":"epm:2.2.2.1.2#basis-of-eligibility","heading":"Basis of Eligibility","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1.2#basis-of-eligibility","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.2 Non-Financial Eligibility > 2.2.2.1 Bases of Eligibility > 2.2.2.1.2 Pregnant Person Basis of Eligibility > Basis of Eligibility","text":"## Basis of Eligibility\n\nThe pregnant person basis of eligibility requires the person to:\n- Be currently pregnant or recently pregnant with an end date in the past 3 months.\n- Meet all other MA eligibility criteria.\n\nAttestation of pregnancy establishes this basis of eligibility.\n\n### Household Composition\n\nUnborn children are counted in the family size of a pregnant person’s MA household. A pregnant person is counted as two or more, depending on the number of unborn children she is expecting. Eligibility must be redetermined for the entire household upon a report of pregnancy.\n\nThe other parent of an unborn child is not eligible under the Parent basis of eligibility until the month the child is born, unless he is already eligible under the parent basis due to having another child in the household.\n\nA child born to the person eligible for and enrolled in MA in the birth month is automatically eligible for MA as an [auto-newborn](https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1.1) from the date of birth until the last day of the month of their first birthday.\n\n### Income and Spenddown Eligibility\n\nA person eligible for MA under the pregnant person basis must have income at or below 278% FPG.\n\nIf income exceeds 278% FPG, an otherwise eligible MA pregnant person may qualify for MA with a spenddown. See [Medical Assistance for Families with Children and Adults Medical Spenddown](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.6) for more information.\n\nSponsor deeming does not apply when the sponsored noncitizen is pregnant or within the 12 month postpartum period. See [Medical Assistance for Families with Children and Adults Sponsor Deeming](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.2.1) for more information.\n\n### MA for Pregnant Noncitizens Not Otherwise Eligible for Medical Assistance\n\nA person eligible for MA under the pregnant person basis must meet all other MA eligibility criteria, including citizenship and immigration requirements. A pregnant person who is not lawfully present may be eligible for CHIP-Funded MA or [Emergency Medical Assistance](https://bot-corpus.mn-dhs.online/s/epm/2.5.3).\n\nPeople applying for, or enrolled in, CHIP-funded MA for pregnant people or Emergency Medical Assistance are not required to provide a [Social Security number](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5) or to verify their [immigration status](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2.2).\n\n### CHIP-Funded Pregnant Person\n\nChildren’s Health Insurance Program (CHIP) funded MA is available for pregnant people who are undocumented or are noncitizens not otherwise eligible for MA. Like MA for pregnant people, CHIP-funded MA is available from the month of conception through the postpartum period.\n\nA pregnant person may be eligible for CHIP-funded MA if the person:\n- Is undocumented or are a noncitizen ineligible for MA\n- Has income at or below 278% FPG. There is no spenddown eligibility under CHIP-funded MA.\n- Not enrolled in other health care coverage. Access to or the availability of other health insurance, such as insurance through an employer, is not a barrier to CHIP-funded MA. An applicant or enrollee is ineligible for CHIP-funded MA only if enrolled in other health coverage.\n- Meet all other MA eligibility criteria, including state residency\n\n### Emergency Medical Assistance (EMA)\n\nA pregnant person can be eligible for [EMA coverage for labor and delivery costs](https://bot-corpus.mn-dhs.online/s/epm/2.5.3) or other medical emergencies if the person is not lawfully present and is ineligible for CHIP-funded MA, either due to having other health care coverage or due to excess income. EMA is available with a spenddown.\n\nEMA coverage for labor and delivery costs does not include a postpartum period.\n\n### State-Funded MA\n\nA person may be eligible for state-funded MA as a pregnant person if s ineligible for MA or CHIP-funded MA, but is receiving services at the [Center for Victims of Torture](https://bot-corpus.mn-dhs.online/s/epm/2.5.2)."},{"chunk_id":"epm:2.2.2.1.2#eligibility-begin-date","heading":"Eligibility Begin Date","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1.2#eligibility-begin-date","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.2 Non-Financial Eligibility > 2.2.2.1 Bases of Eligibility > 2.2.2.1.2 Pregnant Person Basis of Eligibility > Eligibility Begin Date","text":"## Eligibility Begin Date\n\n### Application\n\nFor an applicant, MA eligibility as a pregnant person begins the first day of the month of conception, but no earlier than three months prior to the month of application. It can begin no earlier than the first day of the month of application if the pregnant person does not want or is not eligible for retroactive coverage.\n\nA person may apply under this basis during or after her pregnancy. An application for a pregnant person must be processed within 15 days.\n\nA pregnant person must be eligible for MA in the month the pregnancy ends to receive the 12 month postpartum period. People determined [retroactively eligible](https://bot-corpus.mn-dhs.online/s/epm/1.2.5) for MA as a pregnant person are entitled to the 12 month postpartum period\n\n### Change in Circumstances\n- Medical Assistance For the person enrolled in MA who reports a pregnancy, eligibility under the pregnant person basis begins the first day of the month of conception.\n- MinnesotaCare For the person enrolled in MinnesotaCare who reports a pregnancy which results in MA eligibility under the pregnant person basis, MA eligibility begins no earlier than three months prior to the month the pregnancy is reported. It can begin no earlier than the first day of the month the pregnancy is reported if the pregnant person does not want or is not eligible for retroactive coverage.\n- Advanced Premium Tax Credits (APTC) If a person enrolled on APTC reports a pregnancy that results in becoming eligible for the MA pregnant person basis of eligibility, the person may choose to move to MA or to continue receiving APTC. Eligibility for MA begins the first day of the month the chang is reported, with up to three months MA eligibility prior to the month the pregnancy is reported."},{"chunk_id":"epm:2.2.2.1.2#eligibility-end-date","heading":"Eligibility End Date","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1.2#eligibility-end-date","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.2 Non-Financial Eligibility > 2.2.2.1 Bases of Eligibility > 2.2.2.1.2 Pregnant Person Basis of Eligibility > Eligibility End Date","text":"## Eligibility End Date\n\nA pregnant person is continuously eligible for the pregnant person basis of eligibility until the end of the postpartum period, regardless of any income or household size changes. The postpartum period:\n- Begins the day the pregnancy ends. Pregnancy ends on the date of a birth, miscarriage, abortion, or stillbirth.\n- Ends the last day of the month 12 month after the pregnancy ends."},{"chunk_id":"epm:2.2.2.1.2#post-eligibility","heading":"Post-Eligibility","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1.2#post-eligibility","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.2 Non-Financial Eligibility > 2.2.2.1 Bases of Eligibility > 2.2.2.1.2 Pregnant Person Basis of Eligibility > Post-Eligibility","text":"## Post-Eligibility\n\n### Renewal\n\nA pregnant person is exempt from renewal requirements through the end of the postpartum period.\n\n### Cost-Effective Health Insurance\n\nPregnant people with access to a [cost-effective group health plan](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.1) through their employer must enroll in that coverage as a condition of MA eligibility, with the exception of CHIP-funded pregnant person.\n\n### Medical Support\n\nA pregnant person, or a parent or relative caretaker who is pregnant, is not required to cooperate with [medical support](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.2) for any child during the pregnancy and postpartum period.\n\n### Change in Basis of Eligibility\n\nA change in circumstances may affect an enrollee’s basis of eligibility.\n\nA person who is pregnant and also eligible for MA using the blind or disabled basis of eligibility may choose to continue receiving MA services under that basis, or may choose to move to the pregnant person basis of eligibility for the duration of the pregnancy. However, if the person is receiving services through a [waiver program](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.3),they must continue to use the disabled basis of eligibility through pregnancy and the postpartum period to retain her waiver services. A pregnant person who meets the disabled basis of eligibility may choose to be excluded from managed care enrollment.\n\nIf a person enrolled in [Medical Assistance for People with Breast or Cervical Cancer (MA-BC)](https://bot-corpus.mn-dhs.online/s/epm/2.5.1) becomes pregnant, and is:\n- Eligible as a pregnant person without a spenddown, the person’s eligibility must be changed to the Pregnant Person basis. At the end of her postpartum period, her eligibility should be redetermined for MA-BC.\n- Eligible as a pregnant person with a spenddown, the person may choose to remain eligible under a MA-BC basis or move to the pregnant person basis. If the person chooses the pregnant person basis, their eligibility for MA-BC must be redetermined at the end of the postpartum period."}]},{"id":"epm:2.2.2.1.3","number":"2.2.2.1.3","title":"Former Foster Care Youth Basis of Eligibility","parent":"2.2.2.1","breadcrumb":"2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.2 Non-Financial Eligibility > 2.2.2.1 Bases of Eligibility > 2.2.2.1.3 Former Foster Care Youth Basis of Eligibility","summary":"A person who left foster care at 18 years of age or older, and who was enrolled in Medical Assistance or another state’s Medicaid program when they left foster care, may be eligible for Medical Assistance under the former foster care youth basis of eligibility (MA-FFY), without regard to income or assets.","effective_date":null,"last_modified":"2026-10-03T03:58:40.321376+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.2.2.1.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_2_2_1_3.htm","legal_citations":["SUPPORT Act (Public Law 115-271)","Centers for Medicare & Medicaid Services (CMS) State Health Official letter re: Coverage of Youth Formerly in Foster Care in Medicaid (Dec. 16, 2022), at https://www.medicaid.gov/federal-policy-guidance/downloads/sho22003.pdf","Code of Federal Regulations, title 42, section 435.150","Minnesota Statutes 256B.055, Subd. 17"],"chunks":[{"chunk_id":"epm:2.2.2.1.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1.3","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.2 Non-Financial Eligibility > 2.2.2.1 Bases of Eligibility > 2.2.2.1.3 Former Foster Care Youth Basis of Eligibility","text":"A person who left foster care at 18 years of age or older, and who was enrolled in Medical Assistance or another state’s Medicaid program when they left foster care, may be eligible for Medical Assistance under the former foster care youth basis of eligibility (MA-FFY), without regard to income or assets."},{"chunk_id":"epm:2.2.2.1.3#basis-of-eligibility","heading":"Basis of Eligibility","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1.3#basis-of-eligibility","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.2 Non-Financial Eligibility > 2.2.2.1 Bases of Eligibility > 2.2.2.1.3 Former Foster Care Youth Basis of Eligibility > Basis of Eligibility","text":"## Basis of Eligibility\n\nTo be eligible for MA-FFY, youth must meet the following criteria:\n- Be under age 26\n- Aged out of foster care in any state, District of Columbia, or United States territory at age 18 or older.\n- Aging out of foster care means youth are no longer in a foster care placement because of their age.\n- In Minnesota, foster care may end at age 18, or youth may qualify for extended foster care up to age 21 if they meet the eligibility criteria for the program.\n  - Youth in extended foster care in Minnesota continue to qualify for [MA under the foster care basis of eligibility (MA-FC)](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3) so are not eligible for MA-FFY. Once extended foster care ends at or before age 21, the youth qualifies for MA-FFY.\n  - A youth who aged out of an extended foster care program in another state, District of Columbia, or U.S. territory before moving to Minnesota qualifies for MA-FFY.\n- Were enrolled in Minnesota MA or another state’s Medicaid program when they aged out of foster care at 18 or older.\n- Meet all MA [non-financial eligibility criteria](https://bot-corpus.mn-dhs.online/s/epm/2.2.2) including Minnesota residency and [post-eligibility cooperation requirements](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.2).\n\n### Financial Eligibility\n\nYouth eligible for MA-FFY are not subject to income or asset requirements.\n\n### Verification\n\nSelf-attestation of foster care and MA or Medicaid history is acceptable, unless the person’s attestation is inconsistent with other information provided by the person or known to the agency. See [EPM 1.3.2.4 Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4).\n\nMA verification policies for [citizenship](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2.1), [immigration](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2.2), and [Social Security number](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5) apply.\n\n### Former Foster Care Youth with a Disability\n\nYouth enrolled in MA-FFY who have been determined disabled by the Social Security Administration (SSA) or State Medical Review Team (SMRT) continue to use the MA-FFY basis of eligibility, even when receiving [home and community-based waiver services](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.3.1). They do not need to use the disabled basis of eligibility.\n\nYouth enrolled in MA-FFY with Medicare must also be determined for [Medicare Savings Programs](https://bot-corpus.mn-dhs.online/s/epm/4.2)."},{"chunk_id":"epm:2.2.2.1.3#eligibility-begin-date","heading":"Eligibility Begin Date","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1.3#eligibility-begin-date","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.2 Non-Financial Eligibility > 2.2.2.1 Bases of Eligibility > 2.2.2.1.3 Former Foster Care Youth Basis of Eligibility > Eligibility Begin Date","text":"## Eligibility Begin Date\n\n### MA-FC to MA-FFY Redetermination\n\nFor a youth who ages out of foster care, MA-FFY eligibility begins the month following the month that eligibility for [MA under the foster care basis of eligibility (MA-FC)](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3) ends, without a break in coverage. Aging out of foster care is a [change in circumstance](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1), and eligibility must be redetermined for MA-FFY. Agencies may only request information needed to redetermine eligibility. The MA eligibility worker must coordinate with the child welfare agency to facilitate this redetermination.\n\n### Application\n\nYouth formerly in foster care must complete an application if they are a new resident of Minnesota or in the event they need to re-enroll in MA due to a break in coverage.\n\nFor a youth who must submit an application, MA-FFY eligibility begins the first day of the month of application, with up to three months of retroactive eligibility if requested and eligible. See [EPM 1.2.5 Retroactive Eligibility](https://bot-corpus.mn-dhs.online/s/epm/1.2.5)."},{"chunk_id":"epm:2.2.2.1.3#eligibility-end-date","heading":"Eligibility End Date","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1.3#eligibility-end-date","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.2 Non-Financial Eligibility > 2.2.2.1 Bases of Eligibility > 2.2.2.1.3 Former Foster Care Youth Basis of Eligibility > Eligibility End Date","text":"## Eligibility End Date\n\nMA-FFY eligibility ends the last day of the month of the youth’s 26th birthday. The enrollee must be notified that eligibility under the FFY basis is ending with at least 10 days advance notice. See [EPM 1.3.1.5 Notices](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.5).\n\nTurning age 26 is a change in circumstance. Eligibility must be redetermined for all other MA bases or Insurance Affordability Programs without interruption in coverage. See [EPM 1.3.2.1 Change in Circumstance](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1) for more information."},{"chunk_id":"epm:2.2.2.1.3#post-eligibility","heading":"Post-Eligibility","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1.3#post-eligibility","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.2 Non-Financial Eligibility > 2.2.2.1 Bases of Eligibility > 2.2.2.1.3 Former Foster Care Youth Basis of Eligibility > Post-Eligibility","text":"## Post-Eligibility\n\n### Renewal\n\nMA-FFY eligibility is renewed annually. MA-FFY eligibility must be automatically renewed as long as the youth is under age 26 in the renewal month. See [EPM 2.2.4.2 Renewals](https://bot-corpus.mn-dhs.online/s/epm/2.2.4.2) for more information.\n\n### Changes in Circumstance\n\n[Changes in circumstance](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)that impact eligibility or delivery of services must be reported and acted on, including but not limited to:\n- Minnesota [state residency](https://bot-corpus.mn-dhs.online/s/epm/1.4) status\n- Address changes\n- Access to and/or enrollment in other health insurance\n- Change in [citizenship or immigration status](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2)\n- Changes in [Third Party Liability](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3)\n\nChanges in circumstances that do not impact MA-FFY eligibility, such as tax filing status or income changes, may impact another household member’s eligibility. When information is needed to determine eligibility for another household member, failure to provide that information does not impact the former foster care youth’s eligibility.\n\n### Third Party Liability (TPL)\n\nFormer foster care youth are subject to [Third Party Liability policy](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3), including Cost-Effective Health Insurance, Medical Support, and Other Third Party Liability.\n\n### Health Care Delivery\n\nAll youth eligible for MA-FFY receive MA health care services through managed care plans unless they meet a reason for an exclusion. See [Prepaid Minnesota Health Care Programs Manual](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=dhs16_145398#excluded) for more information about managed care exclusions. For additional information on health care delivery and cost of services, refer to [EPM 2.2.4.1 MA FCA Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/2.2.4.1)."}]},{"id":"epm:2.2.3","number":"2.2.3","title":"Financial Eligibility","parent":"2.2","breadcrumb":"2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility","summary":"This subchapter provides policy about financial eligibility. This includes eligibility factors that involve a person’s income or assets.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:57.899951+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.2.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_2_3.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.2.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility","text":"This subchapter provides policy about financial eligibility. This includes eligibility factors that involve a person’s income or assets.\n\nThis subchapter includes policies that apply to Medical Assistance for Families with Children and Adults (MA-FCA).\n\nTopics covered in this subchapter are:\n1. [MA-FCA Asset Limits](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.1)\n2. [MA-FCA Household Composition and Family Size](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.2)\n3. [MA-FCA Sponsor Deeming](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.2.1)\n4. [MA-FCA Income Limit](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.3)\n5. [MA-FCA Income Methodology](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.4)\n6. [MA-FCA Income Verification](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.5)\n7. [MA-FCA Medical Spenddown](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.6)"}]},{"id":"epm:2.2.3.1","number":"2.2.3.1","title":"Asset Limits","parent":"2.2.3","breadcrumb":"2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.1 Asset Limits","summary":"Assets are items of value that people own like bank accounts, stocks and bonds, cars and real estate.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:57.899951+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.2.3.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_2_3_1.htm","legal_citations":["Minnesota Statutes, section 256B.056"],"chunks":[{"chunk_id":"epm:2.2.3.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.1","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.1 Asset Limits","text":"Assets are items of value that people own like bank accounts, stocks and bonds, cars and real estate."},{"chunk_id":"epm:2.2.3.1#medical-assistance-for-families-with-children-and-adults-without-a-medical-spenddown","heading":"Medical Assistance for Families with Children and Adults (Without a Medical Spenddown)","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.1#medical-assistance-for-families-with-children-and-adults-without-a-medical-spenddown","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.1 Asset Limits > Medical Assistance for Families with Children and Adults (Without a Medical Spenddown)","text":"## Medical Assistance for Families with Children and Adults (Without a Medical Spenddown)\n\nThere is no asset limit for Medical Assistance (MA) for Families with Children and Adults."},{"chunk_id":"epm:2.2.3.1#medically-needy-medical-assistance-for-children-and-pregnant-people-with-a-medical-spenddown","heading":"Medically Needy Medical Assistance for Children and Pregnant People (With a Medical Spenddown)","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.1#medically-needy-medical-assistance-for-children-and-pregnant-people-with-a-medical-spenddown","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.1 Asset Limits > Medically Needy Medical Assistance for Children and Pregnant People (With a Medical Spenddown)","text":"## Medically Needy Medical Assistance for Children and Pregnant People (With a Medical Spenddown)\n\nChildren and pregnant people eligible for MA with a spenddown have no asset limit."},{"chunk_id":"epm:2.2.3.1#medically-needy-medical-assistance-parentcaretaker-relatives-medical-spenddown","heading":"Medically Needy Medical Assistance Parent/Caretaker Relatives (Medical Spenddown)","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.1#medically-needy-medical-assistance-parentcaretaker-relatives-medical-spenddown","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.1 Asset Limits > Medically Needy Medical Assistance Parent/Caretaker Relatives (Medical Spenddown)","text":"## Medically Needy Medical Assistance Parent/Caretaker Relatives (Medical Spenddown)\n\nParents and caretaker relatives eligible for MA with a spenddown have the following asset limits:\n- $10,000 asset limit for a household of one\n- $20,000 for a household of two or more"}]},{"id":"epm:2.2.3.2","number":"2.2.3.2","title":"Household Composition and Family Size","parent":"2.2.3","breadcrumb":"2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.2 Household Composition and Family Size","summary":"Household composition means the people included in an applicant's or enrollee’s household. Household composition determines the family size. Household composition and family size are factors used to determine financial eligibility.","effective_date":"2018-01-01","last_modified":"2026-10-03T04:10:21.464966+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.2.3.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_2_3_2.htm","legal_citations":["Code of Federal Regulations, title 26, section 1.36B-1","Code of Federal Regulations, title 42, section 435.603"],"chunks":[{"chunk_id":"epm:2.2.3.2#overview","heading":"Overview","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.2#overview","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.2 Household Composition and Family Size > Overview","text":"## Overview\n\nHousehold composition means the people included in an applicant's or enrollee’s household. Household composition determines the family size. Household composition and family size are factors used to determine financial eligibility.\n\nHousehold composition and family size are determined for each person separately. Household composition and family size may be different for each person on an application or in a household."},{"chunk_id":"epm:2.2.3.2#tax-filing-status","heading":"Tax Filing Status","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.2#tax-filing-status","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.2 Household Composition and Family Size > Tax Filing Status","text":"## Tax Filing Status\n\nApplicants and enrollees do not need to file a federal income tax return or be claimed as tax dependents to be eligible for Medical Assistance for Families with Children and Adults (MA-FCA). Additionally, married couples do not need to file a joint federal income tax return to be eligible. Even if legally separated, a married couple is considered married until and unless they are legally divorced.\n\nThe household composition policy for tax filers, tax dependents and non-filers are outlined below. Whose income counts in determining financial eligibility is based on the household composition."},{"chunk_id":"epm:2.2.3.2#household-composition-and-family-size-for-tax-filers-and-joint-tax-filers","heading":"Household Composition and Family Size for Tax Filers and Joint Tax Filers","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.2#household-composition-and-family-size-for-tax-filers-and-joint-tax-filers","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.2 Household Composition and Family Size > Household Composition and Family Size for Tax Filers and Joint Tax Filers","text":"## Household Composition and Family Size for Tax Filers and Joint Tax Filers\n\nThe household composition for a person who expects to file taxes and who does not expect to be claimed as a tax dependent by someone else includes:\n- All of the people expected to be on the taxpayer’s federal income tax return including:\n  - Tax filer\n  - Joint tax filer\n  - Tax dependents\n- The taxpayer’s spouse, if living with the taxpayer and not filing jointly\n\nA person’s household composition may include a deceased person. Deceased people who are expected to be included on the federal income tax return continue to count in the household composition for the remainder of the tax year. A person’s household composition cannot include a deceased person beyond the tax year in which the person died.\n\nThe family size for a person who expects to file taxes and who does not expect to be claimed as a tax dependent by someone else includes:\n- All of the people in the person’s household composition\n- Unborn children of any pregnant person in the household\n\nPeople who expect to file taxes and expect to be claimed as a tax dependent by someone one else follow the policy for people who expect to be claimed as a dependent."},{"chunk_id":"epm:2.2.3.2#household-composition-and-family-size-for-tax-dependents","heading":"Household Composition and Family Size for Tax Dependents","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.2#household-composition-and-family-size-for-tax-dependents","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.2 Household Composition and Family Size > Household Composition and Family Size for Tax Dependents","text":"## Household Composition and Family Size for Tax Dependents\n\nThe household composition for a person who expects to be claimed as a tax dependent is based on the household composition of the tax filer who expects to claim them as a tax dependent, unless the person meets one of the tax dependent exceptions. This is true even if the person also expects to file their own tax return.\n\nThe household composition of a tax dependent includes:\n- The tax dependent\n- Tax filer\n- Joint tax filer\n- All other tax dependents\n- The taxpayer’s spouse, if living with the taxpayer and not filing jointly\n- If the tax dependent is married, the spouse, if they live together\n\nA person’s household composition may include a deceased person. Deceased people who are expected to be included on the federal income tax return continue to count in household composition for the remainder of the tax year. A person’s household composition cannot include a deceased person beyond the tax year in which the person died.\n\nThe family size for a person who expects to be claimed as a tax dependent by someone else is the sum of:\n- All of the people in the person’s household composition\n- Unborn children of any pregnant person in the household\n\n### Tax Dependent Exceptions\n\nThere are different household composition rules for certain tax dependents. Household composition for the people below is determined using the rules for people who do not expect to file taxes and do not expect to be claimed as a tax dependent:\n- People who expect to be claimed as a tax dependent, but are not the spouse or child of the tax-filer\n- Biological, natural, adopted and step children younger than age 19 who live with two parents and expect to be claimed as a tax dependent by one of the parents and whose parents do not expect to file a joint tax return\n- Children younger than age 19 who live with a custodial parent who expect to be claimed as a tax dependent by a non-custodial parent. For purposes of this exception, a court order or binding separation, divorce or custody agreement establishing physical custody determines who is the custodial and non-custodial parent. If there is no such order or agreement or in the event of a shared custody agreement, the custodial parent is the parent with whom the child spends most nights. This does not apply to children who are living with legal guardians, caretaker relatives or on their own who expect to be claimed as a tax dependent by one or more parents.\n\n### Whose Income Counts for Tax Filers and Tax Dependents?\n\nThe household income of a tax filer, joint tax filer or tax dependent consists of the person’s own income and the income of everyone in his or her household composition, unless specifically excluded.\n\n### Exclusions\n\nThe income of a child (regardless of age) who:\n- is included in the household of his or her biological, natural, adopted or step parent, and\n- is not expected to be required to file a tax return for the taxable year that MA-FCA is being determined.\n\nThe income of a tax dependent who:\n- is not the spouse or child of the tax filer or joint tax filer, and\n- is not expected to be required to file a tax return for the taxable year that MA-FCA is being determined.\n\nIn Appendix F Standards and Guidelines, refer to the Tax Filing Income Thresholds for Tax Dependents to determine whether a child or tax dependent may be expected to be required to file a tax return.\n\nIncome that is not taxable (for example, non-taxable social security benefits) is not considered when determining if the child or tax dependent is expected to be required to file a federal tax return. However, if the child or tax dependent is expected to be required to file a federal tax return, all sources of income that comprise the child's or tax dependent's Modified Adjusted Gross Income (MAGI) (including both taxable and non-taxable Social Security benefits) are counted for the household. See the [MA-FCA Income Methodology](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.4) policy for more information."},{"chunk_id":"epm:2.2.3.2#household-composition-and-family-size-for-non-tax-filers-and-non-tax-dependents","heading":"Household Composition and Family Size for Non Tax Filers and Non Tax Dependents","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.2#household-composition-and-family-size-for-non-tax-filers-and-non-tax-dependents","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.2 Household Composition and Family Size > Household Composition and Family Size for Non Tax Filers and Non Tax Dependents","text":"## Household Composition and Family Size for Non Tax Filers and Non Tax Dependents\n\nNon-filers are people who do not expect to file taxes and do not expect to be claimed as a tax dependent. The following people living with the person are included in their household composition:\n- The person\n- The person’s spouse\n- The person’s biological, natural, adopted and step children younger than age 19\n- If the person is under age 19, the following are also included:\n  - Biological, natural, adopted and step parents\n  - Biological, natural, adopted and step siblings, under age 19\n- The family size for a non-filer includes:\n  - All of the people in the person’s household composition\n  - Unborn children of any pregnant person in the household\n\n### Whose Income Counts for Non Tax Filers and Non Tax Dependents?\n\nThe household income of non-filers and non-tax dependents consists of the person’s own income and the income of everyone in his or her household composition, unless specifically excluded.\n\n### Exclusions\n\nThe income of a child (regardless of age) who:\n- is included in the household of his or her biological, natural, adopted or step parent, and\n- is not expected to be required to file a tax return for the taxable year that MA-FCA is being determined.\n\nIn [Appendix F Standards and Guidelines](https://bot-corpus.mn-dhs.online/s/epm/F), refer to the table of Tax Filing Income Thresholds for Children and Tax Dependents to assist in determining whether a child may be expected to be required to file a tax return.\n\nIncome that is not taxable (for example, non-taxable social security benefits) is not considered when determining if the child is expected to be required to file a federal tax return. However, if the child is expected to be required to file a federal tax return, all of the sources of income that comprise the child's Modified Adjusted Gross Income (MAGI) (including both taxable and non-taxable Social Security benefits) are counted. See the [MA-FCA Income Methodology](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.4) policy for more information."}]},{"id":"epm:2.2.3.2.1","number":"2.2.3.2.1","title":"Sponsor Deeming","parent":"2.2.3.2","breadcrumb":"2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.2 Household Composition and Family Size > 2.2.3.2.1 Sponsor Deeming","summary":"Certain noncitizens have a sponsor. For purposes of Medical Assistance for Families with Children and Adults (MA-FCA) eligibility, a sponsor is a U.S. citizen or lawful permanent resident (LPR) who sponsors a noncitizen as a condition of the noncitizen's entry into the United States.","effective_date":"2022-09-01","last_modified":"2026-10-03T03:51:57.899951+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.2.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.2.3.2.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_2_3_2_1.htm","legal_citations":["Minnesota Statutes, section 256B.06","Personal Responsibility and Work Opportunity Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421-423 (1996)","United States Code, title 8, section 1183a"],"chunks":[{"chunk_id":"epm:2.2.3.2.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.2.1","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.2 Household Composition and Family Size > 2.2.3.2.1 Sponsor Deeming","text":"Certain noncitizens have a sponsor. For purposes of Medical Assistance for Families with Children and Adults (MA-FCA) eligibility, a sponsor is a U.S. citizen or lawful permanent resident (LPR) who sponsors a noncitizen as a condition of the noncitizen's entry into the United States.\n\nApplicants, enrollees, and sponsors must cooperate with supplying or obtaining sponsor information if sponsor deeming applies. If the applicant, enrollee, or sponsor fails to cooperate coverage may be closed. The Sponsor Letter ([DHS-3453](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3453-ENG)) reminds sponsors of their legal obligation to provide support and to request verification from the sponsor.\n\nSponsor deeming only applies if the noncitizen was sponsored using [Form I-864, Affidavit of Support](https://www.uscis.gov/i-864). This type of sponsorship only applies to certain family-based immigrants and to employment-based immigrants coming to work for a relative.\n\nTo qualify to be a sponsor, a person must agree and demonstrate to the federal government that they can support the noncitizen to 125% federal poverty guidelines (FPG). To represent the sponsor’s contribution to the noncitizen, 125% FPG for a household of one is added to the sponsored noncitizen’s income to determine MA financial eligibility. If a sponsored noncitizen is eligible for MA after the 125% FPG is added, no verification of sponsor income is needed.\n\nIf a sponsored noncitizen is not eligible for MA due to sponsor deeming and the sponsor is providing less than 125% FPG, they can provide proof and have eligibility redetermined. Once verified, only the income the sponsor or sponsor’s spouse actually contributes to the noncitizen is counted when determining MA financial eligibility."},{"chunk_id":"epm:2.2.3.2.1#exceptions-to-ma-sponsor-deeming","heading":"Exceptions to MA Sponsor Deeming","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.2.1#exceptions-to-ma-sponsor-deeming","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.2 Household Composition and Family Size > 2.2.3.2.1 Sponsor Deeming > Exceptions to MA Sponsor Deeming","text":"## Exceptions to MA Sponsor Deeming\n\nThe sponsorship ends and sponsor deeming no longer applies when any of the following changes occur:\n- The sponsored immigrant becomes a naturalized citizen\n- The sponsor or sponsored immigrant dies\n- The sponsored noncitizen has attained at least 40 work quarters as determined by the Social Security Administration\n\nSponsor deeming does not apply to sponsored noncitizens when the noncitizen:\n- is under age 21\n- is pregnant. This exception ends when the sponsored pregnant person’s 12 month postpartum period ends. Sponsor deeming applies the month following the end of the postpartum period.\n- is sponsored by someone whose income has already been counted in the MAGI-based MA household, such as the applicant’s spouse\n- has sponsorship deferred by U.S. Citizenship and Immigration Services (USCIS) when their immigration status is changed to Battered Noncitizen\n- needs placement in a facility and placement is jeopardized by the sponsor’s failure or inability to provide support, or inability of the client to locate the sponsor"},{"chunk_id":"epm:2.2.3.2.1#exceptions-to-form-i-864-sponsorship","heading":"Exceptions to Form I-864 Sponsorship","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.2.1#exceptions-to-form-i-864-sponsorship","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.2 Household Composition and Family Size > 2.2.3.2.1 Sponsor Deeming > Exceptions to Form I-864 Sponsorship","text":"## Exceptions to Form I-864 Sponsorship\n\nNoncitizens who immigrate with a non-family based petition are not subject to sponsorship and sponsor deeming. These include, but are not limited to the following:\n- Battered noncitizens\n- Cuban Haitian entrants\n- Diversity visa recipients\n- Noncitizen sponsored by a business or organization that is not related to an immigrant\n- People with temporary protected status\n- Refugee and asylees"},{"chunk_id":"epm:2.2.3.2.1#safety-net","heading":"Safety Net","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.2.1#safety-net","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.2 Household Composition and Family Size > 2.2.3.2.1 Sponsor Deeming > Safety Net","text":"## Safety Net\n\nIf deeming a sponsor's income causes an applicant to be ineligible for MA-FCA based on income eligibility, and the applicant's projected annual income is less than 100% FPG according to income standards for MinnesotaCare, the applicant will be eligible for MA. This is because sponsor income is not counted for MinnesotaCare. This is called the Safety Net Provision."}]},{"id":"epm:2.2.3.3","number":"2.2.3.3","title":"Income Limit","parent":"2.2.3","breadcrumb":"2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.3 Income Limit","summary":"To be eligible for Medical Assistance for Families with Children and Adults (MA-FCA) a person’s income must be less than or equal to the applicable income limit. Income limits are based on federal poverty guidelines.","effective_date":"2018-12-01","last_modified":"2026-10-03T03:56:37.805565+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.2.3.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_2_3_3.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.100","Code of Federal Regulations, title 42, section 435.116","Code of Federal Regulations, title 42, section 435.118","Code of Federal Regulations, title 42, section 435.119","Code of Federal Regulations, title 42, section 435.603","Code of Federal Regulations, title 42, section 435.915","Minnesota Statutes, section 256B.056"],"chunks":[{"chunk_id":"epm:2.2.3.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.3","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.3 Income Limit","text":"To be eligible for Medical Assistance for Families with Children and Adults (MA-FCA) a person’s income must be less than or equal to the applicable income limit. Income limits are based on federal poverty guidelines."},{"chunk_id":"epm:2.2.3.3#federal-poverty-guidelines","heading":"Federal Poverty Guidelines","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.3#federal-poverty-guidelines","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.3 Income Limit > Federal Poverty Guidelines","text":"## Federal Poverty Guidelines\n\nThe U.S. Department of Health and Human Services (HHS) issues federal poverty guidelines (FPG) each year. New guidelines are used beginning each July 1.\n\nThese guidelines determine income eligibility for MA-FCA. A person’s applicable income limit is based on many factors, including, but not limited to:\n- The basis of eligibility for Medical Assistance (MA)\n- The number of people included in the family size\n- Whether the person has a medical spenddown for MA"},{"chunk_id":"epm:2.2.3.3#income-limits-for-medical-assistance-for-families-with-children-and-adults","heading":"Income Limits for Medical Assistance for Families with Children and Adults","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.3#income-limits-for-medical-assistance-for-families-with-children-and-adults","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.3 Income Limit > Income Limits for Medical Assistance for Families with Children and Adults","text":"## Income Limits for Medical Assistance for Families with Children and Adults\n\nThe following income limits determine eligibility for MA -FCA:\n- Pregnant people: less than or equal to 278% FPG\n- Infants under 2: less than or equal to 283% FPG\n  - Children's Health Insurance Program (CHIP) funded MA may be available for infants with income between 275% and 283% FPG who are not enrolled in other health insurance\n- Children 2 through 18: less than or equal to 275% FPG\n- Children 19 and 20: less than or equal to133% FPG\n- Parent and caretaker relatives: less than or equal to 133% FPG\n- Adults without children: less than or equal to 133% FPG\n- Transition Year MA (TYMA) second six months: less than or equal to 185% FPG\n\nAuto newborns and former foster children younger than age 26 have no income limit.\n\nSee the Minnesota Health Care Programs Income and Asset Guidelines ([DHS-3461A](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3461A-ENG)) for more information regarding family size and income limits."},{"chunk_id":"epm:2.2.3.3#five-percent-fpg-disregard","heading":"Five Percent FPG Disregard","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.3#five-percent-fpg-disregard","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.3 Income Limit > Five Percent FPG Disregard","text":"## Five Percent FPG Disregard\n\nWhen the person's income is above the income limit, an income disregard equal to 5% FPG is applied. When the person’s income, minus the disregard, is within the income limit, they qualify for MA-FCA. This disregard effectively raises the MA-FCA income limits by 5%."},{"chunk_id":"epm:2.2.3.3#safety-net-provision","heading":"Safety Net Provision","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.3#safety-net-provision","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.3 Income Limit > Safety Net Provision","text":"## Safety Net Provision\n\nIn certain situations, a person’s income may be greater than his or her income standard for MA-FCA and be less than the MinnesotaCare income standard due to differences in how income is calculated for each program. This results in ineligibility for both programs. This may occur when:\n- A lump sum is counted in the month received under the MA-FCA income methodology, but counted as part of annual income using the MinnesotaCare income methodology.\n- Sponsor income is counted in the household income using the MA-FCA income methodology, but not counted in the MinnesotaCare income methodology.\n- A child younger than age of 19 has income greater than the MA-FCA income limit, but has projected annual income (PAI) less than 100% FPG for MinnesotaCare eligibility. This can happen because MA-FCA and MinnesotaCare have different household composition and family size policies.\n- Current income is used in the MA-FCA income methodology, but PAI is used for the MinnesotaCare income methodology.\n\nWhen these situations arise, people are eligible for MA if their PAI is below 100% FPG using the [MinnesotaCare income methodology](https://bot-corpus.mn-dhs.online/s/epm/3.3.3) and [household composition rules](https://bot-corpus.mn-dhs.online/s/epm/3.3.1). People whose PAI is equal to or greater than 100% FPG, but equal to or less than 133% FPG using the MinnesotaCare income methodology and household composition rules are eligible for MinnesotaCare.\n\nA person determined eligible for MA under the safety net provision has PAI for the current calendar year below 100% FPG. When a new year begins, they may have a new PAI amount, and may or may not continue to qualify for MA under the safety net provision.\n\n### Retroactive Eligibility Under the Safety Net Provision\n\nA person may be eligible for retroactive MA under the safety net provision for up to three months prior to the month of application. If a person enrolled in another Insurance Affordability Program is determined eligible for MA under the safety net provision due to a change in circumstances, MA is available under the safety net provision for up to three months prior to the date the change was reported.\n\n### Verification\n\nBecause verification of income is required prior to MA eligibility, PAI is a pre-eligibility verification for people who appear to be eligible under the safety net provision. PAI must be verified through an available electronic data source or by paper proof, if electronic data sources are unsuccessful or unavailable."}]},{"id":"epm:2.2.3.4","number":"2.2.3.4","title":"Income Methodology","parent":"2.2.3","breadcrumb":"2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.4 Income Methodology","summary":"Income eligibility for Medical Assistance for Families with Children and Adults (MA-FCA) is based on current monthly income and adjustments using the Modified Adjusted Gross Income (MAGI) methodology as follows:","effective_date":"2026-08-19","last_modified":"2026-10-03T03:51:57.899951+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.2.3.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_2_3_4.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.603","Code of Federal Regulations, title 45, section 155.305","Minnesota Statutes, section 256B.057","Minnesota Statutes, section 256L.01"],"chunks":[{"chunk_id":"epm:2.2.3.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.4","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.4 Income Methodology","text":"Income eligibility for Medical Assistance for Families with Children and Adults (MA-FCA) is based on current monthly income and adjustments using the Modified Adjusted Gross Income (MAGI) methodology as follows:\n- Household income includes:\n  - The types of income included in Federal taxable income, including losses, minus Federal income tax adjustments\n  - Nontaxable foreign earned income and housing cost of citizens or residents of the United States living abroad\n  - Nontaxable interest income\n  - Nontaxable Social Security and tier one railroad retirement benefits\n- Household income does not include:\n  - Scholarships, awards or fellowship grants used for education purposes and not for living expenses\n  - Certain American Indian/Alaska Native income\n- Lump sum income is counted in the month received, if it is from a type of income that is included in the calculation of modified adjusted gross income (MAGI). If the lump sum is from an income type that is not included in a person's modified adjusted gross income, it is not counted.\n\nRefer to the [MAGI Fact Sheet](https://hcopub.dhs.state.mn.us/epm/assets/docs/MAGI Fact Sheet.pdf) for a quick reference guide on MAGI.\n\nCurrent income is the income a person actually receives in a current or past month, and expects to receive during each month of their 12-month certification period.\n\nCurrent income is reported and counted based on how frequently a person receives it.\n\nA person may receive income weekly, biweekly (every other week), semi-monthly (twice a month), monthly, quarterly, or in other frequencies.\n\nCurrent monthly income is counted in the month received.\n- Income received less frequently than monthly is counted based on the average monthly income.\n- Income that varies month to month including, but is not limited to, seasonal income and corresponding seasonable unemployment compensation, and temporary census income are reported and counted based on the annual amount a person expects to receive during the 12-month certification period."},{"chunk_id":"epm:2.2.3.4#federal-taxable-income","heading":"Federal Taxable Income","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.4#federal-taxable-income","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.4 Income Methodology > Federal Taxable Income","text":"## Federal Taxable Income\n\nFederal taxable income are the different types of income that appear in the Income section of the Internal Revenue Service (IRS) form 1040, IRS form 1040-A and or IRS form 1040-EZ. Only the taxable portions of these types of income are included in the adjusted gross income. The types of losses that would be reported on federal income tax returns can offset income. See the appropriate [IRS](http://www.irs.gov) form instructions for examples of federal taxable income. The general types of taxable income include the following:\n- Wages, salary and tips\n  - Payroll or pre-tax deductions for childcare, health insurance, retirement plans, transportation assistance and other employee benefits are not taxable and are not included in a person's adjusted gross income. These types of deductions must be subtracted from a person's gross wages when they appear on a paystub or wage record.\n  - Waiver payments and personal care services For more information see the IRS website: [Certain Medicaid Waiver Payments May Be Excludable From Income](https://www.irs.gov/individuals/certain-medicaid-waiver-payments-may-be-excludable-from-income)\n    - Medicaid waiver payments received by a person who provides HCBS waiver services (personal care services, habilitation services, and other services) to an HCBS waiver eligible person living with them are not taxable and not included in a person’s adjusted gross income.\n    - Medicaid waiver payments received by a person who provides [HCBS waiver services](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.3) not living with them, are taxable and are included in the person's adjusted gross income.\n    - Wages received for providing personal care to someone without a Medicaid waiver, such as to individuals eligible under state plan Personal Care Assistance or Consumer Support Grant personal care services, may or may not be taxable income. The person receiving payments for providing personal care must attest to whether this type of income is taxable. If the person providing personal care services does not know whether their income is taxable, they should consult with a tax professional.\n- Interest\n- Dividends\n- Taxable refunds, credits or offsets of state and local income taxes\n- Alimony received (spousal maintenance) based on a divorce decree or separation agreement executed before January 1, 2019.\n  - Alimony received based on a divorce decree or separation agreement dated on or after January 1, 2019, is not taxable income to the recipient. It does not need to be reported and is not countable income under the MAGI methodology.\n  - If the divorce decree or separation agreement is modified on or after January 1, 2019, and the modification expressly provides that the alimony tax law changes apply, then the alimony received on or after the date of modification is not considered countable income under the MAGI methodology.\n  - Applicants and enrollees must determine whether the alimony payments they receive are based on a divorce decree or separation agreement executed or modified on or after January 1, 2019, and report accordingly.\n  - Verification of the date of a divorce decree or separation agreement, or a modification to these, is not required.\n- Business income or loss (includes self-employment)\n- Capital gains or losses\n- Other gains or losses\n- Individual retirement account (IRA) distributions\n- Pension and annuity payments\n- Income or loss from rental real estate, royalties, partnerships, S corporations, trusts, etc.\n- Farm income or loss\n- Unemployment compensation\n- Social Security benefits\n- Other income or loss Generally, money a person receives through a fundraising or donation event is considered a personal gift if the money was given directly or indirectly without the expectation of receiving anything in return. Personal gifts are not included in a person's adjusted gross income.\n- Net operating loss, including a carryforward loss"},{"chunk_id":"epm:2.2.3.4#federal-income-tax-adjustments","heading":"Federal Income Tax Adjustments","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.4#federal-income-tax-adjustments","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.4 Income Methodology > Federal Income Tax Adjustments","text":"## Federal Income Tax Adjustments\n\nThe types of adjustments that appear in the Adjusted Gross Income section of the 1040 or 1040-A are subtracted from gross income to calculate the adjusted gross income. Only specific types of adjustments are allowed. See the appropriate [IRS](http://www.irs.gov) form instructions for specific information about the types of adjustments.\n- Educator expenses\n- Certain business expenses of reservists, performing artists and fee-basis government officials\n- Health savings account\n- Moving expenses\n  - Through December 31, 2025, Moving expenses are permitted only for households that include active duty members of the military who move because of a military order and a permanent change in station.\n- Deductible portion of self-employment tax\n- Self-employed Simplified Employee Pension (SEP), Savings Incentive Match Plan for Employees (SIMPLE) and qualified plans\n- Self-employed health insurance\n- Penalty on early withdrawal of savings\n- Alimony paid (spousal support) based on a divorce decree or separation agreement executed before January 1, 2019.\n  - \n    - Alimony paid based on a divorce decree or separation agreement executed on or after January 1, 2019, is not an allowable adjustment to income. It should not be reported as an adjustment to income and is not permitted as an adjustment under the MAGI methodology.\n    - If the divorce decree or separation agreement is modified on or after January 1, 2019, and the modification expressly provides that the alimony tax law changes apply, then the alimony paid on and after the date of modification is not an allowable adjustment under the MAGI methodology.\n    - Applicants and enrollees must determine whether the alimony they pay is based on a divorce decree or separation agreement executed or modified before January 1, 2019, and report accordingly.\n    - Verification of the date of a divorce decree or separation agreement, or a modification to these, is not required.\n- IRA deduction\n- Student loan interest"},{"chunk_id":"epm:2.2.3.4#scholarships-awards-or-fellowship-grants","heading":"Scholarships, Awards or Fellowship Grants","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.4#scholarships-awards-or-fellowship-grants","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.4 Income Methodology > Scholarships, Awards or Fellowship Grants","text":"## Scholarships, Awards or Fellowship Grants\n\nTaxable scholarships, awards or grants used for education purposes and not for living expenses (room and board) are excluded income under the MA-FCA income methodology."},{"chunk_id":"epm:2.2.3.4#american-indian-and-alaska-native-income","heading":"American Indian and Alaska Native Income","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.4#american-indian-and-alaska-native-income","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.4 Income Methodology > American Indian and Alaska Native Income","text":"## American Indian and Alaska Native Income\n\nThe following income is excluded under the MA-FCA income methodology for American Indian and Alaska Native people:\n- Distributions from Alaska Native Corporations and Settlement Trusts\n- Distributions from any property held in trust, subject to federal restrictions, located within the most recent boundaries of a prior federal reservation, or otherwise under the supervision of the Secretary of the Interior\n- Distributions and payments from rents, leases, rights of way, royalties, usage rights or natural resource extraction and harvest from:\n  - rights of ownership or possession in properties held in trust under the supervision of the Secretary of the Interior; or\n  - federally protected rights regarding off-reservation hunting, fishing, gathering or usage of natural resources.\n- Distributions resulting from real property ownership interests related to natural resources and improvements:\n  - located on or near a reservation or within the most recent boundaries of a prior federal reservation, or\n  - resulting from the exercise of federally protected rights relating to such real property ownership interests.\n- Payments resulting from ownership interests in or usage rights to items that have unique religious, spiritual, traditional, or cultural significance or rights that support subsistence or a traditional lifestyle according to applicable Tribal Law or custom\n- Student financial assistance provided under the Bureau of Indian Affairs education programs"},{"chunk_id":"epm:2.2.3.4#lump-sum-income","heading":"Lump Sum Income","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.4#lump-sum-income","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.4 Income Methodology > Lump Sum Income","text":"## Lump Sum Income\n\nUnder MA-FCA, lump sum income is one-time income that is not predictable. Periodic reoccurring income is not lump sum income. Lump sum income is only counted under MA-FCA if it is a type of income that is included in the calculation of modified adjusted gross income (MAGI).\n\nExamples of lump sum income that is part of the MAGI calculation include, but are not limited to:\n- Winnings (lottery, gambling)\n- Alimony Settlements\n- Wage bonuses"}]},{"id":"epm:2.2.3.5","number":"2.2.3.5","title":"Income Verification","parent":"2.2.3","breadcrumb":"2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.5 Income Verification","summary":"All countable income must be verified for Medical Assistance for Families with Children and Adults (MA-FCA).","effective_date":"2024-08-28","last_modified":"2026-10-03T03:51:57.899951+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.5","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.2.3.5","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_2_3_5.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.945","Code of Federal Regulations, title 42, section 435.948","Code of Federal Regulations, title 42, section 435.952","Minnesota Rules, part 9505.0095"],"chunks":[{"chunk_id":"epm:2.2.3.5#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.5","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.5 Income Verification","text":"All countable income must be verified for Medical Assistance for Families with Children and Adults (MA-FCA).\n1. The applicant or enrollee must attest to current monthly household income at application, renewal or when reporting a change.\n2. The county, tribal or DHS servicing agency must attempt to verify attested income, adjustments and exceptions using available electronic data sources.\n3. Income is considered verified if:\n  - The attested income and the electronic data both indicate income is below the applicable MA income limit or\n  - The attested income is at or below the MA income limit and the electronic data indicates income above the MA limit, but they are reasonably compatible.\n4. When the attested information indicates MA-FCA eligibility, but electronic data sources are unavailable, or are reporting information that is not reasonably compatible with attestation, the agency must request paper proof from the person.\n5. The agency must send a notice to the applicant requesting the paper proof and date the proof is due to complete the MA-FCA eligibility determination.    The agency must resolve the discrepancy before granting MA-FCA eligibility. While MA-FCA eligibility is pending, the applicant or enrollee must have an opportunity to resolve errors that prevented successful electronic verification or submit paper proof. The agency must give the applicant at least 10 days to respond to the request, or for a new application until the end of the 45-day application processing period, whichever is later.\n6. The person must provide acceptable proof within 10 days of the request by the agency. MA-FCA eligibility for enrollees cooperating and attempting to obtain verification is not denied or closed, except for when proofs are required to complete a renewal.\n7. The county, tribal or state servicing agency must assist clients in obtaining verification.\n8. An applicant who fails to respond to a request for paper proof is not eligible for MA-FCA. The effective date of the denial is the day after the proof was due.\n\nAn individual who reports having no income is not required to provide verification or an explanation, unless electronic sources or other information the agency has indicate there is inconsistent information. At application, information from electronic data sources that indicate a person has a source of income, such as wages from a job, is inconsistent information when the person has reported no income from that source, and the electronic data indicates income above the MA income limit. Inconsistent information about income at application must be resolved before MA is approved. See [1.3.2.4 MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4) for the full policy."},{"chunk_id":"epm:2.2.3.5#paper-proof-that-clarifies-income-adjustments-and-exceptions","heading":"Paper Proof that Clarifies Income, Adjustments and Exceptions","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.5#paper-proof-that-clarifies-income-adjustments-and-exceptions","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.5 Income Verification > Paper Proof that Clarifies Income, Adjustments and Exceptions","text":"## Paper Proof that Clarifies Income, Adjustments and Exceptions\n\nApplicants may correct or revise their attested information during the application process. A request for information or paper proof submitted by the applicant may provide additional sources of income the applicant forgot to report, or revisions to the amount of income reported from a source. Information received from the applicant while MA-FCA is pending, including income amounts from paper proof that clarify the applicant’s current income, must be used in the initial eligibility determination. This information is considered a correction to the applicant’s attested income.\n\nAn applicant may report a change in circumstances, such as income, while MA-FCA eligibility is pending. When an applicant reports a change that occurred after the date of application, the new information does not impact the initial eligibility determination. The agency must determine eligibility using the original verified information for the month of application and any retroactive months requested. Then, the agency must redetermine eligibility based on the new information received from the applicant, according to standard policies about changes in circumstances."},{"chunk_id":"epm:2.2.3.5#proof-received-after-denial","heading":"Proof Received After Denial","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.5#proof-received-after-denial","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.5 Income Verification > Proof Received After Denial","text":"## Proof Received After Denial\n\nWhen an applicant provides paper proof after the effective date of denial, the submission is considered a new request for coverage. Standard application and begin date policies and procedures apply based on the date the agency received the proof. See [2.1.4.1 MA Begin and End Dates](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.1) for the full policy.\n\nA new application may not be needed if the person is currently eligible for another insurance affordability program (including unassisted qualified health plan) or is a household member on an open case with other eligible people. The agency must verify current income before MA-FCA eligibility can be determined. A new application may be required if there is no one on the case eligible for an insurance affordability program. Reapplications or redeterminations may result in new paper proofs needed."},{"chunk_id":"epm:2.2.3.5#paper-proof","heading":"Paper Proof","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.5#paper-proof","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.5 Income Verification > Paper Proof","text":"## Paper Proof\n\nA wide variety of paper documentation is acceptable proof of financial eligibility. Common proof includes, but is not limited to, the following:\n- Pay stub or earnings statement\n- Employer statement\n- Tax records\n- Copy of check\n- Business financial records\n- Statement from the bank or other financial institution\n- Interest or dividend statement\n- Award letter\n- Proof of alimony\n- Receipt or statement of rent you receive\n- Proof of asset sale (Capital Gain or Loss)\n- Proof or record of other taxable income\n- Proof of lump sum income\n- Other proof"},{"chunk_id":"epm:2.2.3.5#federal-income-tax-adjustments","heading":"Federal Income Tax Adjustments","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.5#federal-income-tax-adjustments","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.5 Income Verification > Federal Income Tax Adjustments","text":"## Federal Income Tax Adjustments\n\nAdjustments to income that appear on line 10 on IRS Form 1040 or on Schedule 1 (Form 1040) are subtracted from gross taxable income to calculate the adjusted gross income. Only these specific types of adjustment are allowable. A copy of the last filed IRS Form 1040 or 1040A is acceptable verification for adjustments.\n\nApplicants and enrollees who expect to have these adjustments for the current tax year can complete the appropriate form or worksheet listed below to determine the adjustment amount. These adjustments are a calculated or limited amount and the listed proof allows applicants to report anticipated adjustment accurately.\n\nA wide variety of paper documentation is acceptable proof of financial eligibility. Common proof includes, but is not limited to, the following:\n\n### Educator expenses\n- Copy of last filed IRS form 1040 with this adjustment listed\n\nAnticipated adjustment for the current tax year\n- Self-attestation of a maximum of $300 for one educators or $600 if both spouses are educators\n\n### Certain business expenses of reservists, performing artists and fee-basis government officials\n- Copy of last filed IRS tax forms with this adjustment listed\n\nAnticipated adjustment for the current tax year\n- Copy of IRS Form 2106 or 2106 EZ\n\n### Health savings account\n- Copy of last filed IRS tax forms with this adjustment listed\n\nAnticipated adjustment for the current tax year\n- Copy of IRS Form 8889\n\n### Moving expenses for members of the armed Forces\n- Copy of last filed IRS tax form with this adjustments listed\n\nAnticipated adjustment for the current tax year\n- Copy of IRS Form 3903\n\n### Adjustment portion of self-employment tax\n- Copy of last filed IRS tax form with this adjustment listed\n\nAnticipated adjustment for the current tax year\n- Copy of IRS Schedule SE\n\n### Self-employed Simplified Employee Pension (SEP), Savings Incentive Match Plan for Employees (SIMPLE) and Qualified Plans\n- Copy of last filed IRS tax form with this adjustment listed\n\nAnticipated adjustment for the current tax year\n- Copy of adjustment worksheets from IRS Publication 560\n\n### Self-employed Health Insurance\n- Copy of last filed IRS tax form with this adjustment listed\n\nAnticipated adjustment for the current tax year\n- Copy of the “Self-Employed Health Insurance Worksheet” ( in the IRS 1040 Instructions)\n\n### Penalty on Early Withdrawal of Savings\n- Copy of last filed IRS tax form with this adjustment listed\n\nAnticipated adjustment for the current tax year\n- Copy of 1099-INT or Form 1099-OID received from the institution, which shows the amount of penalty\n\n### Alimony Paid (spousal support)\n- Copy of last filed IRS tax form with this adjustment listed and the date of the original divorce or deparation agreement listed.\n\nAnticipated adjustment for the current tax year\n- Copy of court order, divorce or separation instrument indicating the date of the agreement and amount of spousal support\n\n### IRA Deduction\n- Copy of last filed IRS tax form with this adjustment listed\n\nAnticipated adjustment for the current tax year\n- Copy of IRA Deduction Worksheet for the IRS 1040 Instructions\n\n### Student Loan Interest\n- Copy of last filed IRS tax form with this adjustment listed\n\nAnticipated adjustment for the current tax year\n- Copy of Student Loan Interest Deduction Worksheet, from the IRS1040 Instructions"},{"chunk_id":"epm:2.2.3.5#other-income-proofs","heading":"Other Income Proofs","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.5#other-income-proofs","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.5 Income Verification > Other Income Proofs","text":"## Other Income Proofs\n\nA wide variety of documentation proof is acceptable proof of financial eligibility. Common proof includes, but is not limited to, the following:\n\nNontaxable foreign earned income and housing cost of citizens or residents of the United States living abroad\n- Tax records\n- Income statement\n\nNontaxable interest income\n- Tax records\n- Bank statement\n\nNontaxable Social Security and tier one railroad retirement benefits\n- Benefit statement\n- Award letter\n- SSA/RRB Form 1099\n\nScholarships, awards or fellowship grants used for education purposes and not for living expenses\n- Proof of scholarship or grant for education purposes\n- Student loan statement\n\nCertain American Indian/Alaska Native income\n- Proof of American Indian or Alaska Native income\n\nLump Sum income\n- Proof of lump sum income\n\nWhen neither the person nor the county, tribal or state servicing are able to obtain outside verification, a reasonable explanation of the discrepancy may be accepted in circumstances where paper proof is not available such as when the source of income has stopped."},{"chunk_id":"epm:2.2.3.5#income-discrepancies","heading":"Income Discrepancies","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.5#income-discrepancies","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.5 Income Verification > Income Discrepancies","text":"## Income Discrepancies\n\nWhen an applicant appears to qualify for MA-FCA based on the applicant’s attested information, and the applicant has not reported any recent changes to income on the application, but an electronic data source indicates the applicant, or a member of the applicant’s household, receives income that was not reported, and that income is above the enrollee's income limit, the agency cannot approve MA-FCA eligibility, because there is discrepant income information. The agency must resolve the discrepancy before granting MA-FCA eligibility. The applicant must provide an explanation for the discrepancy or confirm the unreported source of income. In some cases, the agency may already have information received from the applicant that is sufficient to resolve the discrepancy.    When an applicant has attested to having zero income, or no source of income, and an electronic data source indicates the applicant has income, this is considered a discrepancy if the amount of the income indicated by the data source is above the enrollee’s MA income limit. If the amount of the income provided by the data source is at or below the enrollee’s MA income limit, there is no income discrepancy, since both the applicant’s attested income and the electronic data indicate the person has income at or below the MA limit."}]},{"id":"epm:2.2.3.6","number":"2.2.3.6","title":"Medical Spenddown","parent":"2.2.3","breadcrumb":"2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.6 Medical Spenddown","summary":"A medical spenddown is a cost-sharing approach that allows Medical Assistance (MA) eligibility for people whose income is greater than the applicable limit. Federal law refers to this population as “medically needy.”","effective_date":"2024-06-11","last_modified":"2026-10-03T04:10:21.643359+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.6","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.2.3.6","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_2_3_6.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.811","Code of Federal Regulations, title 42, section 435.831","Code of Federal Regulations, title 42, section 435.832","Code of Federal Regulations, title 42, section 435.840","Minnesota Statutes, section 256B.056, subdivision 3c","Minnesota Statutes, section 256B.056, subdivision 5"],"chunks":[{"chunk_id":"epm:2.2.3.6#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.6","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.6 Medical Spenddown","text":"A medical spenddown is a cost-sharing approach that allows Medical Assistance (MA) eligibility for people whose income is greater than the applicable limit. Federal law refers to this population as “medically needy.”\n\nPeople can become income eligible for MA by “spending down” their excess income to the appropriate income limit. The excess income is reduced by deducting certain health care expenses.\n\nParents, caretaker relatives, pregnant people and children who are not eligible for MA because they are over the income limit and who have medical expenses may be eligible for MA with a medical spenddown. Federal law does not permit stepparents or people using an adults without children basis of eligibility to be eligible for MA with a medical spenddown. If there is no biological or adoptive parent in the home, a stepparent may be eligible for MA with a medical spenddown under the caretaker relative basis of eligibility."},{"chunk_id":"epm:2.2.3.6#retroactive-eligibility-for-ma-for-families-and-children","heading":"Retroactive Eligibility for MA for Families and Children","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.6#retroactive-eligibility-for-ma-for-families-and-children","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.6 Medical Spenddown > Retroactive Eligibility for MA for Families and Children","text":"## Retroactive Eligibility for MA for Families and Children\n\nA person may qualify for MA for Families and Children with a Medical Spenddown up to three months before the month of application."},{"chunk_id":"epm:2.2.3.6#other-insurance-affordability-programs","heading":"Other Insurance Affordability Programs","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.6#other-insurance-affordability-programs","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.6 Medical Spenddown > Other Insurance Affordability Programs","text":"## Other Insurance Affordability Programs\n\nA person may be eligible for MA for Families and Children with a Medical Spenddown in the same month they are or were eligible for or enrolled in MinnesotaCare, Advanced Premium Tax Credits (APTC) or qualified health plan (QHP) without subsidy. Eligibility for or enrollment in MinnesotaCare, APTC, or QHP without subsidy is not a barrier to eligibility for MA for Families and Children with a Medical Spenddown."},{"chunk_id":"epm:2.2.3.6#ma-for-long-term-care-services-for-ma-for-families-and-children-with-a-medical-spenddown","heading":"MA for Long-Term Care Services for MA for Families and Children with a Medical Spenddown","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.6#ma-for-long-term-care-services-for-ma-for-families-and-children-with-a-medical-spenddown","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.6 Medical Spenddown > MA for Long-Term Care Services for MA for Families and Children with a Medical Spenddown","text":"## MA for Long-Term Care Services for MA for Families and Children with a Medical Spenddown\n\nPeople who meet the eligibility criteria for MA for Families and Children with a Medical Spenddown may request MA payment for long-term care services (MA-LTC) in a long-term care facility (LTCF) only. To be eligible for MA-LTC, the person must meet MA-LTC eligibility factors. See EPM [2.4.1 MA-LTC Eligibility Requirements](https://bot-corpus.mn-dhs.online/s/epm/2.4.1) and EPM [2.4.2.4 MA-LTC Long-Term Care Facility Services.](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.4)\n\nPeople who meet the eligibility requirements for MA-LTC may be obligated to contribute income toward the cost of the LTC services they receive. This is called a long-term care (LTC) spenddown. An enrollee in the MA for Families and Children with a Medical Spenddown basis who receives MA-LTC has an LTC spenddown instead of a medical spenddown. See EPM [2.4.2 MA-LTC Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.4.2) and EPM [2.4.2.5 MA-LTC Income Calculations for Long-Term Care Services](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5) policies."},{"chunk_id":"epm:2.2.3.6#medical-spenddown-types-and-health-care-expenses","heading":"Medical Spenddown Types and Health Care Expenses","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.6#medical-spenddown-types-and-health-care-expenses","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.6 Medical Spenddown > Medical Spenddown Types and Health Care Expenses","text":"## Medical Spenddown Types and Health Care Expenses\n\nThe policies for medical spenddown types, medical spenddown adjustments and eligible health care expenses are the same for MA for Families and Children with a Medical Spenddown and MA-ABD with a Medical Spenddown. See the following policies for details:\n- [MA-ABD Spenddown Types](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.4.1)\n- [MA-ABD Health Care Expenses](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.4.2)"},{"chunk_id":"epm:2.2.3.6#eligibility-criteria-for-ma-for-families-and-children-with-a-medical-spenddown","heading":"Eligibility Criteria for MA for Families and Children with a Medical Spenddown","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.6#eligibility-criteria-for-ma-for-families-and-children-with-a-medical-spenddown","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.6 Medical Spenddown > Eligibility Criteria for MA for Families and Children with a Medical Spenddown","text":"## Eligibility Criteria for MA for Families and Children with a Medical Spenddown\n\nPeople may be eligible for MA for Families and Children with a Medical Spenddown if they:\n- meet all other MA eligibility criteria;\n- meet the applicable asset limit;\n- have a parent, caretaker relative, pregnant person or child basis of eligibility;\n- have income that exceeds the applicable MA income standard; and\n- have medical expenses equal to or greater than their spenddown.\n\nPeople with an age 65 or older, blind or disabled basis of eligibility must meet different criteria than those described on this page. See EPM [2.3.3.4.1 MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) Medical Spenddown Types](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.4.1) for more information."},{"chunk_id":"epm:2.2.3.6#non-financial-eligibility-for-ma-for-families-and-children-with-a-medical-spenddown","heading":"Non-Financial Eligibility for MA for Families and Children with a Medical Spenddown","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.6#non-financial-eligibility-for-ma-for-families-and-children-with-a-medical-spenddown","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.6 Medical Spenddown > Non-Financial Eligibility for MA for Families and Children with a Medical Spenddown","text":"## Non-Financial Eligibility for MA for Families and Children with a Medical Spenddown\n\nPeople enrolled in MA for Families and Children with a Medical Spenddown must meet the same responsibilities and post-eligibility requirements as people enrolled in MA (FCA) without a medical spenddown:\n\n### Bases of Eligibility\n\nThis policy applies to medical spenddowns for the following people:\n- Biological, natural or adoptive parent\n- Caretaker relative\n- Pregnant person\n- Child age birth through 20\n\n### Household Composition\n\nHousehold composition and household size affects asset and income limits. People who live together and have the following relationships are considered in the household composition determination for MA for Families and Children with a Medical Spenddown.\n\nThe following people are included in the household size of an adult applicant, age 21 and older:\n- Applicant\n- Spouse\n- Children under age 21, biological, adoptive and step-children\n  - Emancipated minors are not included. An emancipated minor is a person under the age of 18 who is or was married, is on active-duty in the uniformed services, or declared emancipated by a court.\n- Unborn child or children of the applicant or spouse\n\nThe following people are included in the household size of a child applicant, under age 21:\n- Applicant\n- Parents of applicant, including biological, natural, and adoptive parents\n- Biological, adoptive and step-children under age 21\n  - Emancipated minors are not included\n- Spouse\n- Children of the child applicant\n- Unborn child or children of the applicant, spouse or children\n\nThe following people are included in the household size of an emancipated minor:\n- Applicant\n- Spouse\n- Children of the child applicant\n- Unborn child or children of the applicant or spouse"},{"chunk_id":"epm:2.2.3.6#financial-eligibility-for-ma-for-families-and-children-with-a-medical-spenddown","heading":"Financial Eligibility for MA for Families and Children with a Medical Spenddown","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.6#financial-eligibility-for-ma-for-families-and-children-with-a-medical-spenddown","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.6 Medical Spenddown > Financial Eligibility for MA for Families and Children with a Medical Spenddown","text":"## Financial Eligibility for MA for Families and Children with a Medical Spenddown\n\n### Asset Limit\n\nAssets are items of value that people own like bank accounts, stocks and bonds, cars and real estate. See [Appendix A Types of Assets](https://bot-corpus.mn-dhs.online/s/epm/A) for definitions of the different types of assets.\n- Children and pregnant people eligible for MA for Families and Children with a Medical Spenddown have no asset limit.\n- Parents and caretaker relatives eligible for MA for Families and Children with a Medical Spenddown have the following asset limits:\n  - $10,000 asset limit for a household of one\n  - $20,000 for a household of two or more\n\n### Categories of Assets\n\nAssets fall into two categories, excluded and countable.\n- Excluded assets: Certain types and amounts of assets are excluded and do not count against a person’s asset limit. Any assets that are not specifically excluded are countable.\n- Countable assets: Countable assets are evaluated for availability and may count towards the person’s asset limit.\n  - Available assets: count against the asset limit\n  - Unavailable assets: do not count against the asset limit\n\nIncome received in a given month is not an asset in that month. If retained beyond the month of receipt, income becomes an asset.\n\n### Excluded Assets\n\nExcluded assets are not counted against the asset limit when establishing eligibility. Excluded assets for MA for Families and Children with a Medical Spenddown for a parent or caretaker relative include:\n- Adoption Assistance\n- Agent Orange Settlement Fund payments\n- Alaska Native Claims Settlement Act (ANCSA) payments\n- Blood Product Settlement payments\n- Bureau of Indian Affairs (BIA) student financial aid\n- Burial assets\n- Cobell v. Salazar Class Action Settlement (also known as Claims Resolution Act of 2010)\n- Corporation for National and Community Service (CNCS) payments\n- Crime victim payments\n- Disaster assistance, federal declaration\n- Disaster assistance, state declaration\n- Filipino Veterans Equity Compensation (FVEC) payments\n- First $200,000 of household self-employment assets ( net value of assets of a trade of business needed for a client to earn income). This includes self employment assets that are temporarily not being used due to the self-employed person's illness or disability.\n- Foster Care payments\n- Gifts to children with life threatening conditions\n- Homestead property\n- Household goods and personal effects\n- I-35W Bridge Collapse payment\n- Individual Development Accounts (IDA)\n- Interest income from Indian trust land or restricted lands\n- James Zadroga 9/11 Health and Compensation Act of 2010\n- Japanese-American and Aleutian Restitution payments\n- Jensen Settlement Agreement Payment\n- Low Income Home Energy Assistance Program (LIHEAP) payments\n- Minnesota Housing Finance Agency (MHFA) home improvement loan\n- Nazi Persecution payment\n- Personal property\n- Public assistance appeal payments\n- Radiation Exposure Compensation Act payments\n- Real property\n- Relocation Assistance Payments, federal\n- Relocation Assistance Payments, state and local\n- Retirement plans\n- Ricky Ray Hemophilia Relief Act payments\n- Student financial aid\n- Tax refund\n- Term life insurance\n- Trade or business asset\n- Tribal Land Settlements or Judgements\n- Third Party Trusts\n- Vehicles -used for employment or seeking employment, one per household member of legal driving age\n- Veterans’ Benefits for Educational Assistance\n- Veterans’ Children with Certain Birth Defects payments\n- Vietnamese Commando Compensation Act payments\n- Workers’ compensation settlement\n\n### Countable Assets\n\nAssets not specifically excluded are considered countable assets. Countable assets must be evaluated for availability to determine if their value counts toward the person’s asset limit. Countable assets that are available count towards the person’s asset limit, unavailable assets do not.\n- Assets are unavailable if a person is unable to access or use them for self-support and cannot liquidate them. They include:\n  - Legally unavailable assets\n  - [Non-homestead real property](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.2) with a reasonable effort to sell\n- Countable assets are not explicitly excluded from being counted against the asset limit and are available to the person.\n  - Annuities\n  - Continuing Care Retirement Community (CCRC) entrance fee\n  - Cash Surrender Value (CSV)\n  - Certificate of Deposit (CDs)\n  - Home Equity\n  - Interest\n  - Liquid assets\n  - Money market account\n  - Non-homestead real property\n  - Non-term life insurance policy\n  - Promissory notes\n  - Qualified Tuition Program (QTP), also referred to as a Section 529 Plan\n  - Self-employment assets over the maximum excluded net value of $200,000 per household\n  - Trusts\n  - Vehicles - in excess of one per household member of legal driving age\n\n### Reducing Assets\n\nParents and caretake relative who are applying for MA and have excess countable assets in the month of application must reduce those assets to be within their asset limit by the end of the processing period to be eligible.\n\nSome acceptable ways to reduce assets for applicants who have excess assets in the application month include, but are not limited to, paying bills or other obligations such as health care expenses or purchasing assets that do not count toward the asset limit.\n\nApplicants who are requesting MA for Long-Term Care (LTC) services may be subject to a transfer penalty if they reduce assets by giving them away without receiving adequate compensation. See [MA-LTC Uncompensated Transfers](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3) for more information.\n\nApplicants must verify that they have reduced excess countable assets by providing bank statements or other documents that show current asset amounts, but are not required to provide receipts.\n\nEligibility can begin back to the first day of the month of application if the applicant reduces excess assets within the applicable processing period.\n\nApplicants who are requesting retroactive coverage and need to reduce assets have different rules from applicants not requesting retroactive coverage. Applicants requesting retroactive eligibility can only reduce assets by paying medical expenses or retroactively designate burial funds.\n\n### Income\n\nIncome is cash or in-kind benefits available to a person. Income is divided into two major categories, earned and unearned:\n- Earned income is cash or in-kind benefits received in return for work or services, including employment and self-employment.\n- Unearned income is cash or in-kind benefits received without being required to perform any work or service, including spousal maintenance, child support, annuities, pensions, etc.\n\nIncome is either counted or not counted. Income is not counted if it is unavailable or if it is excluded by law. Whether income is counted depends on the type of income. Income is counted in the month it is received. See [Appendix B Types of Income](https://bot-corpus.mn-dhs.online/s/epm/B) for descriptions of each type of income.\n\n### Counted Income\n- AmeriCorps State or National living allowances and other payments\n- AmeriCorps-National Civilian Community Corps (AmeriCorps NCCC) living allowances and other payments\n- Amount over $2,000 interest income from Indian trust land or other restricted Indian lands\n- Amount over $2,000 of cash payments from tax-exempt organizations for a child with a life-threatening condition\n- Annuity payments\n- Blood and blood plasma sales\n- Child support income\n- Clergy housing allowances\n- Commissions\n- Compensation from an employer's vacation donation program, if paid and taxed in the same manner as the employee's usual pay\n- Conservation and Youth Service Corps wages\n- Court-ordered dependent care expense payments\n- Disability payments that are part of the employer’s benefit package\n- Experience Works wages\n- Extended income support payments through the Trade Adjustment Reform Act of 2002 (TAA)\n- Gifts\n- Higher Education Innovative Projects wages\n- Honoraria\n- Hostile fire, imminent danger and combat pay\n- Income from self-employment\n- In-kind income if the person has the option to receive cash instead of in-kind income\n- Interest and dividends received as payments\n- Jury duty pay\n- Lump sum income\n- National and Community Service Models wages\n- Net self-employment income\n- Non-Title IV of HEA and non-BIA grants, scholarships, fellowships and other non-loan financial aid that requires teaching, research, or other work in order to receive the aid for graduate students\n- Non-Title IV of HEA and non-BIA grants, scholarships, fellowships and other non-loan financial aid that does not require work to receive the aid for graduate students, after deducting allowable student expenses\n- Non-Title IV of HEA and non-BIA student loans for graduate students, after deducting allowable student expenses\n- Picket duty pay\n- Public and private pensions\n- Railroad Retirement Board (RRB) benefits\n- Refugee Resettlement Program grants\n- Regular cash gift income or cash gift income that exceeds $30 per three months\n- Retirement, Survivor’s and Disability Insurance (RSDI), except for specific exclusions\n- Royalties\n- Senior Aids Program wages\n- Serve America wages\n- Severance pay\n- Sick pay based on accrued leave time\n- Spousal maintenance income\n- Tips\n- Tribal per capita payments from gaming revenue (casino profits)\n- Trust disbursements\n- Unemployment insurance\n- Vacation pay\n- Value of in-kind gifts from tax-exempt organizations for a child with a life-threatening condition when those gifts are converted to cash\n- Veteran’s Administration benefits\n- Vocational Rehabilitation current living expense payments\n- Voluntary Resettlement Agency Matching Grant Program grants\n- Wages\n- Workers’ Compensation\n- Workforce Investment Act (WIA) earned income of a child under age 18 or 18 years old and expected to graduate by age 19, who is not a student, beyond six months per year\n\n### Excluded Income\n- Agent Orange Settlement Fund payments\n- All income of refugee unaccompanied minors\n- American Indian tribal land settlements and judgment funds that are held in trust by the Secretary of the Interior or distributed per capita pursuant to a plan prepared by the Secretary of the Interior\n- AmeriCorps Vista payments\n- Assets converted to cash\n- Bills paid by a third party\n- Blood Product Settlement payments\n- Bureau of Indian Affairs (BIA) student financial aid for undergraduate and graduate students\n- Child Care and Development Block Grant Act payments\n- Class action settlement agreement in Jensen et al v. Minnesota Department of Human Services, et al.\n- Clinical trial participation payments\n- Cobell Settlement for American Indians\n- Community fundraiser income not under the control of the applicant, enrollee or a responsible relative\n- Consumer Support Grant (CSG) payments\n- Corporation for National and Community Service (CNCS) payments\n- Costs necessary to secure the payments of unearned income, such as attorney's fees and medical fees\n- Court-ordered medical support\n- Coverdell Education Savings Account (ESA) payments used for educational expenses\n- Crime victim payments\n- Disaster assistance\n- Family Support Grant (FSG) payments\n- Federal Relocation Assistance\n- Filipino Veterans Equity Compensation (FVEC) fund payments\n- First $2,000 interest income from Indian trust land or other restricted Indian lands\n- First $2,000 of cash payments from tax-exempt organizations for a child with a life-threatening condition\n- First $10,000 of court-ordered Workers Compensation settlements\n- Foster Care Assistance\n- Gifts of cash for tuition or education\n- Gifts of cash to purchase a prosthetic device not covered by health care or other insurance\n- Housing and Urban Development (HUD) subsidies\n- Inaccessible income such as unpaid court ordered child support\n- Income excluded by the Social Security Administration to determine Supplemental Security Income (SSI) eligibility\n- Income used by the Social Security Administration to determine SSI eligibility\n- Income withheld to repay a prior overpayment of benefits made by the same income source\n- Individual Development Accounts (IDA)\n- In-kind income if the person does not have the option to receive cash\n- Insurance payments not payable or available to the applicant\n- Interest and dividends accrued and combined with counted assets, within the asset limit\n- Irregular cash gift income of less than $30 per three months\n- IV-E and State-Subsidized Adoption Assistance\n- James Zadroga 9/11 Health and Compensation Act of 2010\n- Japanese and Aleutian Restitution payments\n- Loans – principal portion of loan payments\n- Low Income Home Energy Assistance Program (LIHEAP) payments\n- Military salary reductions\n- Mille Lacs Band of Ojibwa Elder Supplement Assistance Program\n- Money received and spent to cover someone else’s expenses\n- Nazi Persecution payments\n- Non-Title IV of HEA and non-BIA grants, scholarships, fellowships and other non-loan financial aid that requires teaching, research, or other work to receive the aid for undergraduate students\n- Non-Title IV of HEA and non-BIA grants, scholarships, fellowships and other non-loan financial aid that does not require work to receive the aid for undergraduate students\n- Non-Title IV of HEA and non-BIA student loans for undergraduate students\n- Payments used to reimburse a custodial parent for health insurance premiums\n- Per capita distributions of all funds held in trust by the Secretary of the Interior to members of an Indian tribe\n- Program participation incentive payments\n- Public Assistance Payments, such as general assistance (GA), Minnesota Supplemental Aid (MSA), Minnesota Family Investment Program (MFIP), Refugee Cash Assistance (RCA), Diversionary Work Program benefits (DWP), Work Benefit Program benefits (WB)\n- Radiation Exposure Compensation Act payments\n- Refunds of security and utility deposits\n- Reimbursements for employment and training, medical expenses and property\n- Relative Custody Assistance\n- Retirement, Survivor’s and Disability Insurance (RSDI) for children under age 18 under the TEFRA option or receiving home and community based waiver services\n- Ricky Ray Hemophilia Relief Act payments\n- Student financial aid expenses for tuition, mandatory fees, course and lab fees, books, supplies and equipment required for course work, child care costs incurred while at school or in transit, transportation to and from school\n- Student financial aid from a Title IV of the Higher Education Act of 1965 program for undergraduate and graduate students\n- SSI\n- Tax credits, rebates and refunds\n- Training expenses under the Trade Adjustment Reform Act of 2002\n- Veterans’ Children with Certain Birth Defects payments\n- Veterans’ Affairs (VA) education assistance\n- Vietnamese Commando Compensation Act payments\n- Vocational Rehabilitation payments, except current living expense payments\n- Wages and other earned income of a child under age 18 or 18 years old and expected to graduate by age 19, who is a full or part-time student and works less than 37.5 hours per week\n- Workforce Investment Act (WIA) earned income of a child under age 18 or 18 years old and expected to graduate by age 19, who is a full or part-time student and works at least 37.5 hours per week\n- WIA earned income of a child under age 18 or 18 years old and expected to graduate by age 19, who is not a student, six months per year\n- WUV payments from the Dutch government to victims of Nazi persecution\n\n### Whose Income and Assets Counts\n\nWhen calculating income and assets for a person, it is often necessary to count another person’s income or assets in that determination. This is called deeming.\n\nIncome of the following people, living with the person, is deemed and counted:\n- Spouse\n- Parents, if the applicant is under age 21 and is not emancipated, including biological, natural and adoptive parents\n\nThe assets of the spouse, who is living with the person applying for MA, are deemed and counted.\n\n### Sponsor Deeming\n\nAdult immigrant non-citizens who have a sponsor must have the income and assets of the sponsor deemed to them for MA for Families and Children with a Medical Spenddown. For MA for Families and Children with a Medical Spenddown, sponsor deeming only occurs for applicants using the parent or caretaker relative basis of eligibility.\n\nThe following income of the sponsor is deemed to the applicant and counted:\n- Gross income\n- Cash assistance received by the sponsor\n- Net self-employment income\n\nThe net assets of the sponsor are deemed to the applicant and counted.\n\n### Sponsor Deeming Exceptions\n\nSponsor deeming does not apply to:\n- Pregnant people\n- Children younger than 21 years old\n- People who need placement in a facility and their placement is jeopardized by the sponsor’s failure or inability to provide support\n- Sponsored non-citizens who have 40 qualifying work quarters\n\nA person meeting both of the following can have a 12-month deferment of sponsor deeming, with a potential 12-month extension:\n1. a battered non-citizen immigration status who is subjected to extreme cruelty and is not living with the batterer; and\n2. there is a substantial connection between the need for health care coverage and the battery. There is substantial connection between the need resulting from the battery of the non-citizen or his or her children and the need for health care coverage if any of the following conditions are met:\n  - To enable them to become self-sufficient following separation from the abuser\n  - To enable escape from the abuser or the community where the abuser lives, or to ensure safety from the abuser\n  - Due to a loss of financial support or loss of a job due to their separation from the abuser\n    - Including job loss due to work absence or reduced job performance because of the abuse or cruelty or related legal proceedings, such as child support or custody disputes\n  - Due to a need to obtain medical attention or mental health counseling or they are disabled because of the battery or cruelty\n  - Because of lost housing or income, or the fear of separation from the abuser jeopardizes the ability to care for their children\n  - To alleviate nutritional risks or need resulting from the abuse or following the separation from the abuser\n  - To provide medical care during an unwanted pregnancy resulting from the abuser’s sexual assault, or the relationship with the abuser. Or to care for any resulting children\n  - To replace medical coverage or health care services they had when living with the abuser\n\n### Income Methodology\n\nNet income is used to determine initial and ongoing eligibility for MA for Families and Children with a Medical Spenddown. Net income is equal to gross counted income minus certain disregards and deductions including:\n- Court ordered child support and arrears payments made to another household\n- Work expense deductions for children age 2-20 including:\n  - First $90 of earned income of a child\n  - First $90 of earned income of each person whose income is deemed to the child\n- Work expense deductions for pregnant people and infants based on household size using the following chart:\n- Earned income disregard of 17% of a person’s gross earned income for four consecutive months\n- Dependent care deduction of dependent care expenses of household members with earned income who need dependent care while at work, in transit to or from work, or not at work but in need of dependent care to maintain employment. Expenses of up to $200 per month for each dependent under age two and $175 each month for each dependent age two and older, are deducted. The dependent care deduction is not available when childcare is provided by a parent, stepparent, sibling under age 19, or when others pay for the cost of childcare.\n\n### Income Limit\n\nPeople eligible for MA for Families and Children with a Medical Spenddown must spend down to the 133% federal poverty guidelines (FPG) standard."},{"chunk_id":"epm:2.2.3.6#post-eligibility-for-ma-for-families-and-children-with-a-medical-spenddown","heading":"Post Eligibility for MA for Families and Children with a Medical Spenddown","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.3.6#post-eligibility-for-ma-for-families-and-children-with-a-medical-spenddown","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.3 Financial Eligibility > 2.2.3.6 Medical Spenddown > Post Eligibility for MA for Families and Children with a Medical Spenddown","text":"## Post Eligibility for MA for Families and Children with a Medical Spenddown\n\nEnrollees in MA for Families and Children FCA with a Medical Spenddown must meet the same responsibilities and post-eligibility requirements as enrollees in MA-FCA without a medical spenddown. See the following for more information:\n1. [MHCP Client Rights and Responsibilities](https://bot-corpus.mn-dhs.online/s/epm/1.3)\n2. [MA-FCA Post-Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.2.4)\n\n### Renewals\n\nEnrollees in MA for Families and Children with a Medical Spenddown must complete an annual renewal and a six-month income renewal."}]},{"id":"epm:2.2.4","number":"2.2.4","title":"Post-Eligibility","parent":"2.2","breadcrumb":"2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.4 Post-Eligibility","summary":"These policies apply to MA enrollees. This subchapter includes policies that apply to Medical Assistance (MA) for Families with Children and Adults (FCA) and links to policies that apply to all MA programs and all Minnesota Health Care Programs (MHCP) programs.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:57.899951+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.2.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_2_4.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.2.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.4","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.4 Post-Eligibility","text":"These policies apply to MA enrollees. This subchapter includes policies that apply to Medical Assistance (MA) for Families with Children and Adults (FCA) and links to policies that apply to all MA programs and all Minnesota Health Care Programs (MHCP) programs.\n\nTopics covered in this sub-chapter are:\n1. [MA Begin and End Dates](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.1)\n2. [MA Benefit Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1)\n3. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n4. [MA Cooperation](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.2)\n5. [MA Cost Sharing](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.3)\n6. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n7. [MA-FCA Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/2.2.4.1)\n8. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n9. [MA Qualifying Health Coverage](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.2)\n10. [MA Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4)\n11. [MA-FCA Renewals](https://bot-corpus.mn-dhs.online/s/epm/2.2.4.2)"}]},{"id":"epm:2.2.4.1","number":"2.2.4.1","title":"Health Care Delivery","parent":"2.2.4","breadcrumb":"2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.4 Post-Eligibility > 2.2.4.1 Health Care Delivery","summary":"Health care services are provided by the Prepaid Medical Assistance Program (PMAP) for Medical Assistance for Families with Children and Adults (MA-FCA) enrollees. PMAP is delivered in Minnesota by managed care organizations and county based purchasing groups.","effective_date":"2024-09-20","last_modified":"2026-10-03T03:51:57.899951+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.4.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.2.4.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_2_4_1.htm","legal_citations":["Minnesota Rules, parts 9500.1450 to 9500.1464","Minnesota Rules, part 9505.0285","Minnesota Statues, section 256B.056, subdivision 1","Minnesota Statutes, section 256B.69"],"chunks":[{"chunk_id":"epm:2.2.4.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.4.1","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.4 Post-Eligibility > 2.2.4.1 Health Care Delivery","text":"Health care services are provided by the Prepaid Medical Assistance Program (PMAP) for Medical Assistance for Families with Children and Adults (MA-FCA) enrollees. PMAP is delivered in Minnesota by managed care organizations and county based purchasing groups.\n\nThe enrollee’s county must educate them about managed care and the need to select a plan.\n- MA-FCA enrollees have 30 days to choose a PMAP plan. After 30 days, a default plan is assigned.\n- Enrollees choose a health plan based on what plans are available in their county of residence.\n- Enrollees may receive services via fee-for-service providers before they are enrolled in a health plan.\n- Enrollees must get services from the health plan's network of providers except in special circumstances.\n- Some enrollees are not allowed to enroll in managed care.\n- Enrollees who are temporarily absent from the state for more than 30 consecutive days are disenrolled from their health plan and receive health care services via fee-for-service for the period of their temporary absence. See [EPM 1.4.4](https://bot-corpus.mn-dhs.online/s/epm/1.4.4) for information about temporary absence.\n\nDetailed information on all of these topics is found in the [Prepaid Minnesota Health Care Programs (PMHCP) Manual.](http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=id_016959)"},{"chunk_id":"epm:2.2.4.1#covered-services","heading":"Covered Services","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.4.1#covered-services","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.4 Post-Eligibility > 2.2.4.1 Health Care Delivery > Covered Services","text":"## Covered Services\n\nThe benefit set for people enrolled in MA-FCA includes a wide range of health care services, from preventive care to hospitalization. Some benefits have limitations on services or level of coverage. This means there may be a limit or maximum dollar amount on specific types of services, like eyeglasses, or on all services in a category, like dental.\n\nServices in a long-term care facility can be covered by MA if the person has a pre-admission screening that indicates the person needs a nursing facility level of care and meets the other requirements to be eligible for [MA for Long-Term Care Services](https://bot-corpus.mn-dhs.online/s/epm/2.4).\n\nThe Minnesota Health Care Programs (MHCP) Summary of Coverage, Cost Sharing and Limits ([DHS-3860](https://www.google.com/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=1&ved=0CCAQFjAA&url=https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3860-ENG&ei=9WZrVPHVC5OnyASpgIKwBw&usg=AFQjCNFK_Yl9QXapcVWWYTJ5mQfMG7MSVw&bvm=bv.79908130,d.aWw)) explains covered services and cost-sharing requirements."}]},{"id":"epm:2.2.4.2","number":"2.2.4.2","title":"Renewals","parent":"2.2.4","breadcrumb":"2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.4 Post-Eligibility > 2.2.4.2 Renewals","summary":"Most Medical Assistance for Families with Children and Adults (MA-FCA) enrollees must have their eligibility renewed annually.","effective_date":"2025-05-30","last_modified":"2026-10-03T04:46:15.419693+00:00","version":3,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.4.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.2.4.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_2_4_2.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.916","Code of Federal Regulations, title 42, section 435.930(b)","Minnesota Statutes, section 256.01","Minnesota Statutes, section 256B.056"],"chunks":[{"chunk_id":"epm:2.2.4.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.4.2","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.4 Post-Eligibility > 2.2.4.2 Renewals","text":"Most Medical Assistance for Families with Children and Adults (MA-FCA) enrollees must have their eligibility renewed annually.\n\nThere are renewal exceptions for people enrolled in MA under the pregnancy basis and children enrolled in MA as auto newborns. See [EPM 2.2.2.1.2 MA-FCA Pregnant Person Basis of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1.2) and [EPM 2.2.2.1.1 MA-FCA Auto Newborn Basis of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1.1) for more information.\n\nEnrollees in MA for Families and Children with a Medical Spenddown must complete an annual renewal and a six-month income review. See [EPM 2.2.3.6, MA-FCA Medical Spenddown](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.6) for more information."},{"chunk_id":"epm:2.2.4.2#renewal-month","heading":"Renewal Month","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.4.2#renewal-month","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.4 Post-Eligibility > 2.2.4.2 Renewals > Renewal Month","text":"## Renewal Month\n\nAn enrollee’s renewal month is the month for which eligibility is redetermined when a renewal is conducted. The renewal month is the first month in the enrollee’s new certification period. The first annual renewal month after application is 12 months from the month of application, and renewals occur annually thereafter as long as the enrollee remains eligible for MA. Eligibility for retroactive MA does not affect when an enrollee’s annual renewal month occurs.\n\nA renewal is conducted individually for each enrollee in a household. If there are multiple enrollees due for renewal within a household, a renewal must not be delayed if all required information is available to determine the enrollee’s eligibility, even if additional information or proof is needed for other enrollees in the household."},{"chunk_id":"epm:2.2.4.2#ex-parte-renewals","heading":"Ex Parte Renewals","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.4.2#ex-parte-renewals","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.4 Post-Eligibility > 2.2.4.2 Renewals > Ex Parte Renewals","text":"## Ex Parte Renewals\n\nWhen it is time for an enrollee’s annual renewal, the agency must attempt to confirm eligibility using information in the case file and from trusted electronic data sources before sending a renewal form and requesting information from the enrollee. This is called an auto or ex parte renewal. When the enrollee’s eligibility cannot be auto renewed, the renewal must be completed using a prepopulated renewal form.\n\nIf eligibility for an MA-FCA enrollee is automatically renewed, the enrollee must receive a notice that includes their renewal outcome, and a summary of the information used to renew their eligibility. If all the information is correct, the enrollee does not need to do anything. If any of the information for the enrollee is inaccurate, the enrollee must report corrections or changes to their county, tribal or state servicing agency.\n\n### Prepopulated Renewal Form\n\nAn MA-FCA enrollee whose eligibility cannot automatically be renewed must receive a prepopulated renewal form listing information the agency has about them. The enrollee must be given until the end of the certification period, but no less than 30 days from the issuance date on the renewal notice, to respond. The enrollee must review the form, make any changes or updates, sign and return the renewal form to their county, tribal or state servicing agency.\n\nThe county, tribal or state servicing agency must accept any renewal form returned by the enrollee in lieu of the prepopulated renewal and must accept renewal information by:\n- mail,\n- fax,\n- telephone,\n- document upload, and\n- in person\n\nWhen all required information has been gathered to redetermine eligibility for an enrollee, a renewal decision must not be delayed for that enrollee while additional information or proof is requested for other enrollees in the household.\n\n### Combined Renewal Results\n\nIn households with more than one enrollee due for a renewal, some enrollees may be automatically renewed while other enrollees will need to complete a renewal form. When this occurs, the household must receive a notice that indicates who was automatically renewed and who is required to return a renewal form. A prepopulated renewal form will be included with the notice."},{"chunk_id":"epm:2.2.4.2#changes-in-circumstances-at-renewal","heading":"Changes in Circumstances at Renewal","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.4.2#changes-in-circumstances-at-renewal","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.4 Post-Eligibility > 2.2.4.2 Renewals > Changes in Circumstances at Renewal","text":"## Changes in Circumstances at Renewal\n\nChanges in circumstances reported on the renewal form or collected in the renewal process may change an enrollee’s eligibility and the eligibility of previously renewed household members. When a renewal is processed, eligibility for all household members is redetermined.\n\nAn enrollee who is no longer eligible under one MA basis of eligibility must be redetermined for all other potential MA bases without interruption in their coverage.\n\nIf the enrollee is ineligible for MA under any basis, eligibility must be redetermined for other programs such as MinnesotaCare, Advanced Premium Tax Credits, or a Qualified Health Plan. Enrollees who lose Medical Assistance eligibility due to changes must receive at least 10-day advance notice. See [EPM 1.3.2.1, MHCP Change in Circumstance](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1) for more information."},{"chunk_id":"epm:2.2.4.2#closure-for-failure-to-renew","heading":"Closure for Failure to Renew","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.4.2#closure-for-failure-to-renew","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.4 Post-Eligibility > 2.2.4.2 Renewals > Closure for Failure to Renew","text":"## Closure for Failure to Renew\n\nMA-FCA eligibility ends for an enrollee who does not complete their renewal or submit required proofs by the last day of the certification period, regardless of whether other enrollees in their household were renewed. The enrollee must receive at least 10-day advance notice of closure for failure to complete a renewal."}]},{"id":"epm:2.2.4.3","number":"2.2.4.3","title":"Transitional Medical Assistance and Transition Year Medical Assistance","parent":"2.2.4","breadcrumb":"2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.4 Post-Eligibility > 2.2.4.3 Transitional Medical Assistance and Transition Year Medical Assistance","summary":"Some Medical Assistance for Families with Children and Adults (MA-FCA) enrollees may extend their MA coverage under Transitional MA (TMA) or Transition Year MA (TYMA) after they are no longer considered MA eligible.","effective_date":"2016-09-01","last_modified":"2026-10-03T03:51:57.899951+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.4.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.2.4.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_2_4_3.htm","legal_citations":["Minnesota Statutes, section 256B.0635, subdivision 1(b)","Minnesota Statutes, section 256B.0635, subdivision 2","Social Security Act, section 1925","Social Security Act, section 1931"],"chunks":[{"chunk_id":"epm:2.2.4.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.4.3","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.4 Post-Eligibility > 2.2.4.3 Transitional Medical Assistance and Transition Year Medical Assistance","text":"Some Medical Assistance for Families with Children and Adults (MA-FCA) enrollees may extend their MA coverage under Transitional MA (TMA) or Transition Year MA (TYMA) after they are no longer considered MA eligible.\n\nTMA may provide up to four months of additional coverage to people who become ineligible for MA-FCA due to increased spousal support (alimony).\n\nTYMA may provide up to 12 months of additional coverage to people who become ineligible for MA-FCA due to increased earned income including income from a parent or relative caretaker who returns to the household. The 12 months consists of two periods of six months each, which have different eligibility and reporting requirements. There are more eligibility and reporting requirements during the second six-month period than during the first six-month period.\n\nNo application is required for TMA/TYMA. People who lose MA due to increased income or spousal support automatically qualify for TMA/TYMA if they meet other requirements."},{"chunk_id":"epm:2.2.4.3#eligibility-requirements","heading":"Eligibility Requirements","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.4.3#eligibility-requirements","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.4 Post-Eligibility > 2.2.4.3 Transitional Medical Assistance and Transition Year Medical Assistance > Eligibility Requirements","text":"## Eligibility Requirements\n\nTo be eligible for either TMA or TYMA, the person must:\n- Be a birth, natural, step or adoptive parent or relative caretaker, a child under age 19, or a pregnant person.\n- Have had MA-FCA coverage in at least three of the six months before the income increase. Re-evaluation of eligibility and reverification for any of the three of the six months before the income increase are not required.\n- Live in a household that includes a child age 18 or younger.\n- Lose eligibility for MA-FCA because of increased spousal support (TMA) or increased earnings (TYMA).\n\nChildren under age 19 and pregnant people are eligible for TMA or TYMA if they were at or below 133% FPG when they were first determined MA eligible, and in three of the six months before the income increase. TMA or TYMA eligibility begins after their income increases above 133% FPG and runs concurrently while they remain eligible under the child or pregnant person MA basis. TMA or TYMA coverage is available for children under age 19 and pregnant people for any remaining TMA or TYMA months after their income increases above the child or pregnant person income standards.\n\nTMA and TYMA are not available for:\n- Enrollees whose MA coverage ends because they did not verify earned income are not eligible for TYMA.\n- Parents or relative caretakers who are convicted of MA fraud for any of the six months before the start of the TMA/TYMA period or for any month of TMA/TYMA.\n\nEnrollees who are determined eligible for TMA/TYMA are exempt from annual renewals for the duration of the TMA/TYMA eligibility.\n\n### Second Six-Month Extension of TYMA\n\nTo continue to receive TYMA beyond the first six months, the household must meet several additional requirements:\n- Receive TYMA for the entire first six-month period.\n- Complete quarterly reports in third, sixth, and ninth month of TYMA eligibility. Enrollees can provide income and childcare information in writing or by phone.\n- Have gross earned income at or below 185% FPG calculated by averaging the family’s gross monthly earnings minus costs for childcare necessary for the employment of the caretaker relative for the immediately preceding 3-month period. Sponsor deeming does not apply to TYMA. See the [MA-FCA Sponsor Deeming](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.2.1) policy for more information.\n- Have a parent or relative caretaker in the household with earned income unless there is good cause for the lack of earnings. Good cause for a lack of earnings during the second six-month extension of TYMA includes, but is not limited to, involuntary loss of employment and illness.\n\n### First Quarterly Report\n\nA TYMA enrollee must receive a Transition Year Medical Assistance First Quarterly Report ([DHS-2975A](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-2975A-ENG)) at the end of the third month of TYMA eligibility. The family must report to the agency the family’s gross monthly earnings and the family’s costs for childcare, which is the cost necessary for the employment of the parent or caretaker relative, in each of the first three months. The report is due on the 21st day of the fourth month of the initial six-month period. Paper proof of childcare costs is not required.\n\nIf the TYMA enrollee returns the form or responds by phone indicating there is no longer a dependent child in the home, the enrollee is no longer eligible for TYMA and is closed with advanced 10-day notice.\n\n### Second and Third Quarterly Reports\n\nTYMA enrollees must also report earnings and childcare costs for each of the previous three months by the 21st day of the seventh and 10th month of the TYMA period. Paper proof of childcare costs is not required.\n\n### Failure to Comply with Reporting Requirements\n\nFailure to report by the 21st day of the reporting month will end the family’s TYMA benefits, unless the person has established good cause for the failure to report on a timely basis. Once the person completes the reporting requirement, TYMA coverage is restored the next month and continues for the remainder of the original 12-month period, if the person’s TYMA eligibility has not otherwise ended.\n\nIf the family does not comply with the reporting requirements, coverage is suspended but eligibility is not closed until the end of the 12-month period."},{"chunk_id":"epm:2.2.4.3#fluctuating-income-and-remaining-tmatyma-months","heading":"Fluctuating Income and Remaining TMA/TYMA Months","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.4.3#fluctuating-income-and-remaining-tmatyma-months","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.4 Post-Eligibility > 2.2.4.3 Transitional Medical Assistance and Transition Year Medical Assistance > Fluctuating Income and Remaining TMA/TYMA Months","text":"## Fluctuating Income and Remaining TMA/TYMA Months\n\nEnrollees with fluctuating income may move between another MA-FCA basis of eligibility and TMA or TYMA. If TMA or TYMA enrollees have an income reduction resulting in income at or under the MA-FCA income limit, they become eligible again under their previous MA-FCA basis. When this happens, TMA or TYMA ends, and any remaining TMA or TYMA months are available if income again increases beyond 133% FPG within the original 12-month period.\n\nIf people enrolled in TMA or TYMA are closed and later reapply for health care, they may be eligible of any remaining months within the original 12-month period.\n\nIf the person has had MA-FCA eligibility for three or more of the past six months, the person again may meet the eligibility criteria for a new period of TMA or TYMA eligibility."},{"chunk_id":"epm:2.2.4.3#new-household-members-for-tma-and-tyma","heading":"New Household Members for TMA and TYMA","url":"https://bot-corpus.mn-dhs.online/s/epm/2.2.4.3#new-household-members-for-tma-and-tyma","context":"EPM > 2 Medical Assistance > 2.2 Medical Assistance for Families with Children and Adults > 2.2.4 Post-Eligibility > 2.2.4.3 Transitional Medical Assistance and Transition Year Medical Assistance > New Household Members for TMA and TYMA","text":"## New Household Members for TMA and TYMA\n\nWhen a new member enters a household in which at least one member of the existing household is receiving TMA or TYMA, and the new member is not eligible for MA under another basis, the new member may be eligible for TMA or TYMA depending on his or her relationship to other household members who are receiving TMA or TYMA.\n\nIf an auto newborn is part of the TMA/TYMA household when the auto newborn period ends, the auto newborn is considered a new household member.\n\n### Relationship to Other Household Members\n\nIf the new household member is the birth, natural, step or adoptive parent, relative caretaker, spouse, child or stepchild of another member of the household who receives TMA or TYMA, then the new member has the same eligibility as the household members receiving TMA or TYMA.\n\nNew members who are added are eligible for TMA or TYMA effective on the first day of the first full month they are in the household. Their TMA/TYMA will continue for the same time period as the spouse or child to whose TMA/TYMA they are added. For TYMA, the new member will be subject to the same quarterly reporting schedule. For new members added during the second six months of TYMA, updated information to determine continued eligibility is required before the person is added."}]},{"id":"epm:2.3","number":"2.3","title":"Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability","parent":"2","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability","summary":"Medical Assistance (MA) eligibility is determined using a variety of non-financial, financial and post-eligibility factors. Some MA policies apply to all MA applicants and enrollees. Other eligibility requirements are different, depending on what type of MA a person may be eligible for.","effective_date":"2020-03-04","last_modified":"2026-10-03T03:51:57.899951+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability","text":"Medical Assistance (MA) eligibility is determined using a variety of non-financial, financial and post-eligibility factors. Some MA policies apply to all MA applicants and enrollees. Other eligibility requirements are different, depending on what type of MA a person may be eligible for.\n\nThis subchapter includes policies that apply to MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) and links to policies that apply to all MA programs and all Minnesota Health Care Programs (MHCP) programs.\n\nFor an overview of requirements and benefits, see the fact sheet [Minnesota Health Care Programs for People Who Have a Disability or Are Age 65 or Older.](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3546A-ENG)\n\nIn-depth information about statewide services is available from mnhelp.info. Specialized assistance for seniors is available from Minnesota Aging Pathways at 800-333-2433 and for people with disabilities from the Disability Hub MN at 866-333-2466.\n1. [MA-ABD General Requirements](https://bot-corpus.mn-dhs.online/s/epm/2.3.1)\n  1. [MHCP Applications](https://bot-corpus.mn-dhs.online/s/epm/1.2)\n  2. [MA-ABD Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/2.3.1.1)\n  3. [MA Responsibilities](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2)\n  4. [MHCP Retroactive Coverage](https://bot-corpus.mn-dhs.online/s/epm/1.2.5)\n  5. [MHCP Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1)\n2. [MA-ABD Non-Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.2)\n  1. [MA-ABD Bases of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.2.1)\n  2. [MA-ABD Certification of Disability](https://bot-corpus.mn-dhs.online/s/epm/2.3.2.2)\n  3. [MA Citizenship and Immigration](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2)\n  4. [MA County Residency](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.3)\n  5. [MA Living Arrangement](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.4)\n  6. [MHCP State Residency](https://bot-corpus.mn-dhs.online/s/epm/1.4)\n  7. [MA Social Security Number](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5)\n3. [MA-ABD Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.3)\n  1. [MA-ABD Household Composition and Family Size](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.1)\n  2. [MA-ABD Assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2)\n    1. [MA-ABD Asset Limits](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2)\n      1. [MA-ABD Asset Deeming](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.2)\n        1. [MA-ABD Sponsor Asset Deeming](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.2.1)\n    2. [MA-ABD Excluded Assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.3)\n    3. [MA-ABD Countable Assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.4)\n    4. [MA-ABD Unknown Assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.5)\n    5. [MA-ABD Excess Assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.6)\n    6. [MA-ABD Asset Evaluation](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7)\n      1. [MA-ABD Liquid Assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.1)\n      2. [MA-ABD Retirement Funds and Plans](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.2)\n      3. [MA-ABD Health Expense Accounts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.3)\n        1. [MA-ABD Flexible Spending Arrangements](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.3.1)\n        2. [MA-ABD Health Savings Accounts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.3.2)\n      4. [MA-ABD Real Property](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4)\n        1. [MA-ABD Homestead Real Property](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.1)\n        2. [MA-ABD Non-Homestead Real Property](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.2)\n        3. [MA-ABD Life Estates and Remainder Interests](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.3)\n        4. [MA-ABD Other Property Interests](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.4)\n      5. [MA-ABD Contract for Deed and Other Property Agreements](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.5)\n      6. [MA-ABD Promissory Notes](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.6)\n      7. [MA-ABD Automobiles and Other Vehicles used for Transportation](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.7)\n      8. [MA-ABD Annuities](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.8)\n      9. [MA-ABD Trusts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9)\n        1. [MA-ABD Identifying the Type of Trust](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.1)\n        2. [MA-ABD Client-Funded Trusts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.2)\n        3. [MA-ABD Medical Assistance Qualifying Trusts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.3)\n        4. [MA-ABD Special Needs Trusts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.4)\n        5. [MA-ABD Pooled Trusts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.5)\n        6. [MA-ABD Third Party Established and Funded Trusts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.6)\n        7. [MA-ABD Supplemental Needs Trusts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.7)\n      10. [MA-ABD Life Insurance Policies](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.10)\n      11. [MA-ABD Burial Contracts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11)\n        1. [MA-ABD Burial Space Exclusion](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.1)\n        2. [MA-ABD Burial Fund Exclusion](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.2)\n      12. [MA-ABD Continuing Care Retirement Community Entrance Fee](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.12)\n      13. [MA-ABD Tribal Payments and Interests](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.13)\n      14. [MA-ABD Household Goods and Personal Effects](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.14)\n  3. [MA-ABD Income](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3)\n    1. [MA-ABD Income Limits](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.1)\n    2. [MA-ABD Income Methodology](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2)\n      1. [MA-ABD Countable Income](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1)\n        1. [MA-ABD Income Deeming](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1.1)\n        2. [MA-ABD Sponsor Income Deeming](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1.2)\n      2. [MA-ABD Disregards and Deductions](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.2)\n      3. [MA-ABD Excluded Income](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.3)\n  4. [MA-ABD Medical Spenddowns](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.4)\n    1. [MA-ABD Spenddown types](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.4.1)\n    2. [MA-ABD Health Care Expenses](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.4.2)\n4. [MA-ABD Post-Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.4)\n  1. [MA Begin and End Dates](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.1)\n  2. [MA Benefit Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1)\n  3. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n  4. [MA Cooperation](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.2)\n  5. [MA Cost Sharing](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.3)\n  6. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n  7. [MA-ABD Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/2.3.4.1)\n  8. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n  9. [MA Qualifying Health Coverage](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.2)\n  10. [MA Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4)\n  11. [MA-ABD Renewals](https://bot-corpus.mn-dhs.online/s/epm/2.3.4.2)"}]},{"id":"epm:2.3.1","number":"2.3.1","title":"General Requirements","parent":"2.3","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.1 General Requirements","summary":"This subchapter provides general policy information that applies to Medical Assistance for People Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD).","effective_date":"2024-05-30","last_modified":"2026-10-03T03:51:57.899951+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_1.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.3.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.1","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.1 General Requirements","text":"This subchapter provides general policy information that applies to Medical Assistance for People Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD).\n\nThis subchapter includes policies that apply to MA-ABD and links to policies that apply to all Medical Assistance (MA) programs and all Minnesota Health Care Programs (MHCP).\n1. [MHCP Applications](https://bot-corpus.mn-dhs.online/s/epm/1.2)\n2. [MA-ABD Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/2.3.1.1)\n3. [MA-ABD Asset Verification Service (AVS)](https://bot-corpus.mn-dhs.online/s/epm/2.3.1.2)\n4. [MA-ABD Authorization to Obtain Financial Information](https://bot-corpus.mn-dhs.online/s/epm/2.3.1.3)\n5. [MA Responsibilities](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2)\n  1. [MA Benefit Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1)\n    1. [MA Estate Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.1)\n    2. [MA Liens](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.2)\n    3. [MA Third Party Liability](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3)\n      1. [MA Cost Effective Insurance](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.1)\n      2. [MA Medical Support](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.2)\n      3. [MA Other Third Party Liability](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.3)\n  2. [MA Cooperation](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.2)\n  3. [MA Cost Sharing](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.3)\n  4. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n  5. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n  6. [MA Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4)\n6. [MHCP Retroactive Eligibility](https://bot-corpus.mn-dhs.online/s/epm/1.2.5)\n7. [MHCP Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1)\n  1. [MHCP Appeals](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.1)\n  2. [MHCP Authorized Representative](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.2)\n  3. [MHCP Civil Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.3)\n  4. [MHCP Data Privacy](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.4)\n  5. [MHCP Notices](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.5)"}]},{"id":"epm:2.3.1.1","number":"2.3.1.1","title":"Mandatory Verifications","parent":"2.3.1","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.1 General Requirements > 2.3.1.1 Mandatory Verifications","summary":"Mandatory verifications must be verified through an available electronic data source or by paper proof, if electronic data sources are unsuccessful or unavailable. Self-attestation of certain eligibility factors may be accepted if electronic data sources are unsuccessful or unavailable and paper proof does not exist or is not available.","effective_date":"2024-10-21","last_modified":"2026-10-03T04:46:27.131138+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.1.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.1.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_1_1.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.407","Code of Federal Regulations, title 42, section 435.541","Code of Federal Regulations, title 42, section 435.920","Code of Federal Regulations, title 42, section 435.945","Code of Federal Regulations, title 42, section 435.948","Code of Federal Regulations, title 42, section 435.949","Code of Federal Regulations, title 42, section 435.952","Code of Federal Regulations, title 42, section 435.956"],"chunks":[{"chunk_id":"epm:2.3.1.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.1.1","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.1 General Requirements > 2.3.1.1 Mandatory Verifications","text":"Mandatory verifications must be verified through an available electronic data source or by paper proof, if electronic data sources are unsuccessful or unavailable. Self-attestation of certain eligibility factors may be accepted if electronic data sources are unsuccessful or unavailable and paper proof does not exist or is not available.\n\nMedical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) has the following mandatory verifications."},{"chunk_id":"epm:2.3.1.1#pre-eligibility-verification","heading":"Pre-Eligibility Verification","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.1.1#pre-eligibility-verification","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.1 General Requirements > 2.3.1.1 Mandatory Verifications > Pre-Eligibility Verification","text":"## Pre-Eligibility Verification\n\nThe following eligibility factors must be verified prior to the eligibility determination:\n- Assets\n  - Verification of assets is required at application, renewal, and when a new asset is reported.\n  - Assets that are counted for a person with an asset limit must be verified even if the asset belongs to a person who is not applying for Medical Assistance (MA) or does not have an asset limit.\n    - At renewal, an excluded asset that was verified does not need to be verified again unless the asset has changed, to determine whether the change affects the exclusion.\n  - Verification of the following assets is not required at application or renewal:\n  - \n    - Homestead if it qualifies for the exclusion. Refer to [Section 2.3.3.2.7.4.1 MA-ABD Homestead Real Property](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.1) for more information.\n    - Vehicle, if only one is reported. Refer to [Section 2.3.3.2.7.7 MA-ABD Automobiles and Other Vehicles Used for Transportation](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.7) for more information.\n    - Household goods and personal effects\n- Certification of Disability through Social Security Administration (SSA) or State Medical Review Team (SMRT) for people claiming a blind or disabled basis of eligibility\n- Income\n  - If a person is receiving Supplemental Security Income (SSI), only the SSI income is verified. Eligibility for SSI is accepted as verification of other income SSA considers in determining eligibility. Note: Veteran's Administration (VA) Aid and Attendance benefits and VA unusual medical expense payments must be verified even if the person is receiving SSI.\n- Medical expenses to meet a spenddown\n\nCounty, tribal and state servicing agencies must retain verification documentation in accordance with the County Human Service Records Retention Schedule ([DHS-6928](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-6928-ENG))."},{"chunk_id":"epm:2.3.1.1#post-eligibility-verification","heading":"Post-Eligibility Verification","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.1.1#post-eligibility-verification","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.1 General Requirements > 2.3.1.1 Mandatory Verifications > Post-Eligibility Verification","text":"## Post-Eligibility Verification\n\nIf the following factors cannot be verified at application, they can be verified after eligibility has been approved so long as the applicant meets all other eligibility requirements. If proof is not provided by the conclusion of the reasonable opportunity period (ROP), eligibility may end.\n- Social Security Number: See [2.1.2.5 MA Social Security Number](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5)\n- Citizenship: See [2.1.2.2.1 MA Citizenship](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2.1)\n- Immigration Status: See [2.1.2.2.2 MA Immigration Status](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2.2)\n\nCounty, tribal and state servicing agencies must retain verification documentation in accordance with the County Human Services Records Retention Schedule (DHS-6928)."},{"chunk_id":"epm:2.3.1.1#verification-received-after-denial","heading":"Verification Received After Denial","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.1.1#verification-received-after-denial","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.1 General Requirements > 2.3.1.1 Mandatory Verifications > Verification Received After Denial","text":"## Verification Received After Denial\n\nWhen an applicant’s MA eligibility is denied and the applicant provides a required verification after the 10-day deadline indicated on the denial notice, the submission is considered a new request to apply that sets a new date of application. See [1.2.3 MHCP Date of Application](https://bot-corpus.mn-dhs.online/s/epm/1.2.3) for more information.\n\nWhen a former enrollee provides a requested verification after the effective date of closure, the submission is considered a new request to apply that sets a new date of application. A new application must be completed to reapply, unless the proof is received within the four-months following closure for failure to complete a renewal. See [2.3.4.2 MA-ABD Renewals](https://hcopub.dhs.state.mn.us/epm/2_3_4_2ar4.htm) for more information.\n\nStandard application and begin date policies and procedures apply based on the date the agency received the proof. See [2.1.4.1 MA Begin and End Dates](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.1) for the more information."},{"chunk_id":"epm:2.3.1.1#self-attestation","heading":"Self-Attestation","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.1.1#self-attestation","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.1 General Requirements > 2.3.1.1 Mandatory Verifications > Self-Attestation","text":"## Self-Attestation\n\nSelf-attestation, either verbal or in writing, of the following eligibility factors may be accepted if electronic data sources are unsuccessful or unavailable and paper proof does not exist or is not available:\n- Income\n- Assets\n- Medical expenses to meet a spenddown\n- Certification of Disability through Social Security Administration (SSA)\n- Exceptions to having a Social Security Number\n\nPaper proof is considered not available if neither the applicant or enrollee, nor the agency can obtain it. The county, tribal and state servicing agency must make efforts to assist the applicant or enrollee in obtaining the requested paper proof, if it exists. This includes obtaining authorization from the applicant or enrollee to contact a third party on their behalf, if appropriate. Decisions to accept an applicant’s or enrollee’s self-attestation must be based on the individual case circumstances.\n\nSelf-attestation cannot be accepted in place of electronic verification or paper documentation of an applicant or enrollee’s citizenship, immigration status, or social security number."}]},{"id":"epm:2.3.1.2","number":"2.3.1.2","title":"Asset Verification Service (AVS)","parent":"2.3.1","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.1 General Requirements > 2.3.1.2 Asset Verification Service (AVS)","summary":"The Asset Verification Service (AVS) must be used to electronically verify financial accounts that might be counted for applicants and enrollees whose MA basis of eligibility is MA-ABD and who have an asset limit. The AVS must also be used to electronically verify the financial accounts of a spouse, sponsor, or sponsor’s spouse whose assets deem to or are considered in the applicant or enrollee’s ","effective_date":"2025-11-26","last_modified":"2026-10-03T03:51:57.899951+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.1.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.1.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_1_2.htm","legal_citations":["United States Code, title 42, section 1396w"],"chunks":[{"chunk_id":"epm:2.3.1.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.1.2","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.1 General Requirements > 2.3.1.2 Asset Verification Service (AVS)","text":"The Asset Verification Service (AVS) must be used to electronically verify financial accounts that might be counted for applicants and enrollees whose MA basis of eligibility is MA-ABD and who have an asset limit. The AVS must also be used to electronically verify the financial accounts of a spouse, sponsor, or sponsor’s spouse whose assets deem to or are considered in the applicant or enrollee’s eligibility determination.\n\nThe servicing agency must use the AVS at application, renewal, and when MHCP enrollee’s basis of eligibility changes to MA-ABD with an asset limit. This includes but is not limited to people who:\n- Request Medical Assistance for payment of long term care services (MA-LTC) with an MA-ABD basis, including people who live in a long-term care facility and people who need home and community-based services (HCBS).\n- Transition between Medical Assistance for Employed Persons with Disabilities (MA-EPD) to MA-ABD with an asset limit.\n- Request coverage under a Medicare Savings Programs (MSP) and who are not current MA-ABD enrollees with an asset limit.\n\nIndividuals 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."},{"chunk_id":"epm:2.3.1.2#avs-requirements","heading":"AVS Requirements","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.1.2#avs-requirements","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.1 General Requirements > 2.3.1.2 Asset Verification Service (AVS) > AVS Requirements","text":"## AVS Requirements\n\nThe county, tribal or state servicing agencies must:\n- Obtain all required information on the Authorization to Obtain Financial Information form (DHS-7823) prior to reqeusting information from the AVS. [See 2.3.1.3 Authorization to Obtain Information](https://bot-corpus.mn-dhs.online/s/epm/2.3.1.3).\n- Check the AVS results a minimum of 10-days after the date the request was submitted and directly prior to approving eligibility.\n- Maintain the AVS Summary Report in the person’s file at the time of making each eligibility determination."},{"chunk_id":"epm:2.3.1.2#social-security-number-ssn","heading":"Social Security Number (SSN)","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.1.2#social-security-number-ssn","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.1 General Requirements > 2.3.1.2 Asset Verification Service (AVS) > Social Security Number (SSN)","text":"## Social Security Number (SSN)\n\nA person’s SSN is required to submit a request through the AVS. With the exceptions noted below, an SSN must be provided as part of the current MHCP request for coverage or on the AVS authorization form (DHS-7823). An SSN known to the agency from a closed case or another non-MHCP program cannot be used to submit a request to the AVS.\n\nAn AVS request cannot be made for an applicant or enrollee who does not have an SSN or who meets an exception for providing an SSN to the agency. If an applicant or enrollee does not have an SSN or meets an exception for providing an SSN to the agency, paper proofs of the applicant or enrollee’s financial accounts are required verification.\n\nThe agency may request but cannot require a non-applicant to provide an SSN. Eligibility cannot be denied or terminated due to a spouse, sponsor, or sponsor’s spouse not providing their SSN to the agency. If a spouse or sponsor whose assets are part of the eligibility determination does not provide their SSN, paper proofs of the spouse or sponsor’s financial accounts are required verification.\n\nSee EPM [2.1.2.5 MA Social Security Number](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5) for more information."},{"chunk_id":"epm:2.3.1.2#exceptions-to-the-10-day-waiting-period","heading":"Exceptions to the 10-day Waiting Period","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.1.2#exceptions-to-the-10-day-waiting-period","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.1 General Requirements > 2.3.1.2 Asset Verification Service (AVS) > Exceptions to the 10-day Waiting Period","text":"## Exceptions to the 10-day Waiting Period\n\nServicing agencies must submit a request through the AVS before approving eligibility , but must not delay the eligibility determination solely due to the 10-day AVS waiting period in the following situations:\n- An enrollee’s eligibility changes from MinnesotaCare or MA for families with children and adults (MA-FCA) to MA-ABD and results in the enrollee having an asset limit.\n- When an enrollee is being determined eligible for MA-ABD in the month after MA-EPD closes for premium non-payment.\n- A person has an immediate medical need at application or renewal, such as but not limited to, the person:\n  - is in a doctor’s office, pharmacy, or hospital in need of services or coverage or has been refused medical services,\n  - is in immediate need of prescription medications, or\n  - has a high-risk pregnancy."}]},{"id":"epm:2.3.1.3","number":"2.3.1.3","title":"Authorization to Obtain Information","parent":"2.3.1","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.1 General Requirements > 2.3.1.3 Authorization to Obtain Information","summary":"A valid Authorization to Obtain Financial Information from the Asset Verification Service (AVS) (DHS-7823) is a condition of eligibility and must be on file for people with an MA-ABD basis of eligibility who are subject to an asset limit. A valid authorization means one that is signed, in effect, and in the electronic or paper case file for the applicant or enrollee and any person whose assets are","effective_date":"2025-04-29","last_modified":"2026-10-03T03:51:57.899951+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.1.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.1.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_1_3.htm","legal_citations":["United States Code, title 42, section 1396w"],"chunks":[{"chunk_id":"epm:2.3.1.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.1.3","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.1 General Requirements > 2.3.1.3 Authorization to Obtain Information","text":"A valid Authorization to Obtain Financial Information from the Asset Verification Service (AVS) ([DHS-7823](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-7823-ENG)) is a condition of eligibility and must be on file for people with an MA-ABD basis of eligibility who are subject to an asset limit. A valid authorization means one that is signed, in effect, and in the electronic or paper case file for the applicant or enrollee and any person whose assets are used to determine the applicant or enrollee’s eligibility.\n\nBefore submitting a request for financial information through the AVS, the county, tribal or state servicing agency must verify a valid authorization is on file.\n\nThe Authorization to Obtain Financial Information form(s) must be maintained in the enrollee's case file, even when it is no longer valid."},{"chunk_id":"epm:2.3.1.3#authorization-requirements","heading":"Authorization Requirements","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.1.3#authorization-requirements","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.1 General Requirements > 2.3.1.3 Authorization to Obtain Information > Authorization Requirements","text":"## Authorization Requirements\n\nThe Authorization to Obtain Financial Information form must be signed by:\n- The person (applicant or enrolee) or their authorized representative\n  - If the person has a legal guardian, the guardian must sign for the person, unless they appoint an authorized representative.\n  - If the person has passed away, the personal representative of the estate must sign for the person.\n- The person’s spouse, sponsor, sponsor’s spouse , or their legal representative, if their assets are used to determine the person’s eligibility. A sponsor is someone who signed an Affidavit of Support (USCIS I-864) as a condition of the person’s, or his or her spouse’s, entry to the country.\n\nA separate authorization is needed for each spouse when both spouses are applying or eligible for MA-ABD and have an asset limit.\n\nEach person may sign the same form or a separate form; however, no other authorization or release form may be used in place of the (DHS-7823) form."},{"chunk_id":"epm:2.3.1.3#duration-of-the-authorization","heading":"Duration of the Authorization","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.1.3#duration-of-the-authorization","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.1 General Requirements > 2.3.1.3 Authorization to Obtain Information > Duration of the Authorization","text":"## Duration of the Authorization\n\nA signed authorization form remains in effect until one of the following occurs:\n- The MA application is withdrawn or denied.\n- The enrollee’s MA is closed. However, an enrollee’s authorization remains in effect if eligibility is reinstated due to agency error or delay in processing.\n- The enrollee’s MA basis of eligibility is no longer MA-ABD with an asset limit.\n- The person or their authorized representative withdraws the authorization in writing.\n- The authorized representative who signed the AVS authorization on behalf of another person is no longer the authorized representative.\n- The person dies, even when it is signed by another person on their behalf."},{"chunk_id":"epm:2.3.1.3#new-authorization-required","heading":"New Authorization Required","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.1.3#new-authorization-required","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.1 General Requirements > 2.3.1.3 Authorization to Obtain Information > New Authorization Required","text":"## New Authorization Required\n\nA new authorization form is required as a condition of eligibility for people who have an MA-ABD basis of eligibility and are subject to an asset limit and before a request can be submitted through the AVS when:\n- A previously completed authorization is no longer in effect for any of the reasons listed under the Duration of the Authorization section above.\n- No record of a valid authorization is in the electronic or paper case file.\n- An enrollee gets married or has a change in eligibility that causes the spouse’s assets to be considered in the eligibility determination when they previously were not considered.\n  - Only the spouse’s signature is required if the enrollee’s authorization form otherwise remains in effect.\n  - The spouse does not need to sign a new form if they already signed the authorization form which remains in effect.\n- The authorization was received and there was not an active MHCP program to make it valid or it was not received with or after an application for a MHCP."}]},{"id":"epm:2.3.2","number":"2.3.2","title":"Non-Financial Eligibility","parent":"2.3","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.2 Non-Financial Eligibility","summary":"This subsection includes non-financial eligibility policies. This covers eligibility factors not related to a person’s income or assets.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:57.899951+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_2.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.3.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.2","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.2 Non-Financial Eligibility","text":"This subsection includes non-financial eligibility policies. This covers eligibility factors not related to a person’s income or assets.\n\nPolicies that apply to Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) and links to policies that apply to all Medical Assistance (MA) programs and all Minnesota Health Care Programs (MHCP) are included in this subchapter:\n1. [MA-ABD Bases of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.2.1) [MA-ABD Certification of Disability](https://bot-corpus.mn-dhs.online/s/epm/2.3.2.2) [MA Citizenship and Immigration Status](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2) [MA County Residency](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.3) [MA Living Arrangement](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.4) [MHCP State Residency](https://bot-corpus.mn-dhs.online/s/epm/1.4) [MA Social Security Number](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5)"}]},{"id":"epm:2.3.2.1","number":"2.3.2.1","title":"Bases of Eligibility","parent":"2.3.2","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.2 Non-Financial Eligibility > 2.3.2.1 Bases of Eligibility","summary":"Minnesota provides Medical Assistance (MA) to certain groups of people as allowed under law. These groups are referred to as a basis of eligibility. A person’s basis of eligibility determines the non-financial criteria and financial methodology used to determine MA eligibility.","effective_date":"2025-07-25","last_modified":"2026-10-03T03:51:57.899951+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.2.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.2.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_2_1.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.121","Code of Federal Regulations, title 42, section 435.201","Code of Federal Regulations, title 42, section 435.230","Code of Federal Regulations, title 42, section 435.330","Code of Federal Regulations, title 42, section 435.520","Code of Federal Regulations, title 42, section 435.522","Code of Federal Regulations, title 42, section 435.530","Code of Federal Regulations, title 42, section 435.540","Code of Federal Regulations, title 42, section 435.541","Code of Federal Regulations, title 42, section 435.911","Code of Federal Regulations, title 42, section 435.916","Minnesota Statutes, section 256B.055","Minnesota Statutes, section 256B.057"],"chunks":[{"chunk_id":"epm:2.3.2.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.2.1","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.2 Non-Financial Eligibility > 2.3.2.1 Bases of Eligibility","text":"Minnesota provides Medical Assistance (MA) to certain groups of people as allowed under law. These groups are referred to as a basis of eligibility. A person’s basis of eligibility determines the non-financial criteria and financial methodology used to determine MA eligibility.\n\nThe bases of eligibility for Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) are:\n- People age 65 or older\n- People certified blind\n- People certified disabled"},{"chunk_id":"epm:2.3.2.1#multiple-bases-of-eligibility","heading":"Multiple Bases of Eligibility","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.2.1#multiple-bases-of-eligibility","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.2 Non-Financial Eligibility > 2.3.2.1 Bases of Eligibility > Multiple Bases of Eligibility","text":"## Multiple Bases of Eligibility\n\nPeople may have more than one basis of eligibility. A person’s countable income, asset limits, cost sharing, service delivery options and benefits may differ depending on the eligibility basis used. The county, tribal or state servicing agency must allow a person with multiple bases of eligibility to have eligibility determined under the basis that best meets their needs."},{"chunk_id":"epm:2.3.2.1#beginning-and-ending-bases-of-eligibility","heading":"Beginning and Ending Bases of Eligibility","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.2.1#beginning-and-ending-bases-of-eligibility","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.2 Non-Financial Eligibility > 2.3.2.1 Bases of Eligibility > Beginning and Ending Bases of Eligibility","text":"## Beginning and Ending Bases of Eligibility\n\nWhen an enrollee’s basis of eligibility ends, they must be evaluated for other MA bases of eligibility and other health care programs before their coverage is closed.\n\n### Begin Dates\n\nThe begin dates for the following bases of eligibility are:\n- Adults age 65 and older:\n  - Begins the first day of the month of their 65th birthday\n- People certified blind or disabled:\n  - Begins the first day of the month of the disability onset date as determined by the Social Security Administration (SSA) or the State Medical Review Team (SMRT)\n\n### End Dates\n\nThe blind or disabled basis ends the last day of the last month a person is certified disabled as determined by SSA or SMRT.\n\nIf a person is receiving MA with a blind or disabled basis with a certification of disability by SMRT and then is found not disabled by SSA, the SSA determination supersedes the SMRT determination and the blind or disabled basis ends, with the following exceptions:\n- If an MA enrollee with a blind or disabled basis with a certification by SMRT then is found not disabled by SSA, the blind or disabled basis of eligibility continues while a person appeals their disability status with the SSA. The blind or disabled basis continues until the person withdraws or discontinues the appeal with SSA, or until an adverse ruling by an administrative law judge. The blind or disabled basis of eligibility ends the last day of the month in which the appeal results in a finding the person no longer meets the disability criteria. See [MA-ABD Certification of Disability](https://bot-corpus.mn-dhs.online/s/epm/2.3.2.2) for more Information.\n- If SSA benefits are denied solely due to earnings above Substantial Gainful Activity (SGA), the blind or disabled basis of eligibility can only be continued with a new disability determination from SMRT. The blind or disabled basis of eligibility may continue while the SMRT determination is completed. See the [MA-ABD Certification of Disability](https://bot-corpus.mn-dhs.online/s/epm/2.3.2.2) policy for more information.\n\nIf an MA enrollee who qualifies under a blind or disabled basis of eligibility via a SMRT certification is found by SMRT to be no longer disabled at their continuing disability review, MA under the blind or disabled basis of eligibility continues while the person appeals their SMRT disability status. The enrollee can continue to use the blind or disabled basis of eligibility until they withdraw or discontinue the appeal with DHS, or until an adverse appeal ruling. If the appeal results in a finding that the person no longer meets the disability criteria, the blind or disabled basis of eligibility ends the last day of the month. See [MHCP Appeals](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.1) and [MA-ABD Certification of Disability](https://bot-corpus.mn-dhs.online/s/epm/2.3.2.2) for more information."},{"chunk_id":"epm:2.3.2.1#change-in-basis-of-eligibility-for-enrollees","heading":"Change in Basis of Eligibility for Enrollees","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.2.1#change-in-basis-of-eligibility-for-enrollees","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.2 Non-Financial Eligibility > 2.3.2.1 Bases of Eligibility > Change in Basis of Eligibility for Enrollees","text":"## Change in Basis of Eligibility for Enrollees\n\nA change in circumstances may affect an MA enrollee's basis of eligibility. People who lose eligibility under one basis must be redetermined under another basis without interruption in their coverage.\n\nSome changes that may affect an enrollee's basis of eligibility include, but are not limited to:\n- A disability certification ending\n- Becoming pregnant. A pregnant person basis of eligibility ends on the last day of the month in which the 12 month postpartum period ends.\n- Becoming a parent or relative caretaker of a minor child\n- Turning age 21 or 65\n\nIf an enrollee is no longer eligible for MA under their current basis of eligibility, they must be redetermined for all health care programs they are potentially eligible for, without interruption in their coverage. See EPM section [1.3.2.1 Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1) for more information.\n\nAdditional information may be requested to determine continued eligibility under a new basis. For example, the Request for Information about Assets Form ([DHS-8623](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-8623-ENG)) is used to collect information about assets when an enrollee no longer qualified for MA without an asset limit and needs to be determined for MA or an MSP with an asset limit."}]},{"id":"epm:2.3.2.2","number":"2.3.2.2","title":"Certification of Disability","parent":"2.3.2","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.2 Non-Financial Eligibility > 2.3.2.2 Certification of Disability","summary":"Disability or blindness must be certified by the Social Security Administration (SSA) or the State Medical Review Team (SMRT). The certification process is also called a disability determination.","effective_date":"2025-07-02","last_modified":"2026-10-03T04:45:30.453351+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.2.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.2.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_2_2.htm","legal_citations":["Code of Federal Regulations, title 20, sections 404.1501 to 404.1599","Code of Federal Regulations, title 20, sections 416.901 to 416.999d","Code of Federal Regulations, title 42, section 435.541","Minnesota Statutes, section 256.01"],"chunks":[{"chunk_id":"epm:2.3.2.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.2.2","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.2 Non-Financial Eligibility > 2.3.2.2 Certification of Disability","text":"Disability or blindness must be certified by the [Social Security Administration](https://www.ssa.gov/disabilityssi/apply.html#&a0=-1) (SSA) or the State Medical Review Team (SMRT). The certification process is also called a disability determination.\n\nPeople receiving the following benefits may or may not be certified disabled by SSA or SMRT.\n- Short-term disability\n- Long-term disability\n- Long-term care insurance\n- Veterans' Administration (VA)\n- Railroad Retirement Board (RRB)\n- Workers' Compensation"},{"chunk_id":"epm:2.3.2.2#medicare","heading":"Medicare","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.2.2#medicare","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.2 Non-Financial Eligibility > 2.3.2.2 Certification of Disability > Medicare","text":"## Medicare\n\nPeople may or may not need a new disability determination if they are eligible for Medicare, and lose their RSDI benefits because they earn more than the Substantial Gainful Activity (SGA) level. Some people are eligible for a Medicare extension during which SSA considers these people to remain disabled. Other people may be former beneficiaries of Social Security benefits who are currently receiving Medicare and are not considered certified disabled by SSA.\n\nAn active certification of disability from SSA cannot be determined solely from the benefit status or the receipt of disability benefits. The status of the certification of disability determines whether a person meets a disabled basis for MA. Former beneficiaries of Social Security disability benefits (SSI or RSDI) who are enrolled in Medicare extension but are no longer considered disabled by SSA must be referred to SMRT for a disability determination.\n\nOnly a SSA or SMRT certification of disability is valid for the purposes listed below."},{"chunk_id":"epm:2.3.2.2#disability-certification-for-ma-eligibility","heading":"Disability Certification for MA Eligibility","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.2.2#disability-certification-for-ma-eligibility","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.2 Non-Financial Eligibility > 2.3.2.2 Certification of Disability > Disability Certification for MA Eligibility","text":"## Disability Certification for MA Eligibility\n\nPeople must be certified disabled and use the disabled or blind basis of eligibility to:\n- Enroll in [MA for Employed Persons with Disabilities](https://bot-corpus.mn-dhs.online/s/epm/2.3.5) (MA-EPD)\n- MA-EPD enrollees who lose their certification of disability with SSA and would like to remain on MA-EPD must be referred to SMRT for a certification of disability. An MA-EPD enrollee who is referred to SMRT remains eligible for MA-EPD during the time SMRT is making its determination.\n- Access MA under the TEFRA (Tax Equity and Fiscal Responsibility Act) option. Children with a disability and household income above the MA income limit need a disability certification and level of care determination to use the TEFRA option. See EPM [2.3.6 MA under the Tefra Option](https://bot-corpus.mn-dhs.online/s/epm/2.3.6) for more details.\n- A SMRT level of care determination is required for all TEFRA referrals, even if the person already is certified by SSA.\n- Receive home and community-based services through the:\n  - [Brain Injury (BI) waiver](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.3)\n  - [Community Alternative Care (CAC) waiver](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.3)\n  - [Community Access for Disability Inclusion (CADI) waiver](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.3)\n  - [Developmentally Disabled (DD) waiver](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.3)\n\nChildren turning 18 need a new disability certification under the adult standards to continue using a blind or disabled basis of eligibility.\n\n### Disability Certification for Other Reasons\n\nSome MA enrollees get a disability certification for managed care reasons including:\n- To be excluded from managed care enrollment\n  - A person with a disability certification from SSA or SMRT can be excluded from managed care enrollment but is not rquired to use a disabled basis of eligibility for Medical Assistance.\n- To enroll in Special Needs Basic Care (SNBC), a specialized managed care plan for people age 18-64 with a certified disability\n\nAdditional reasons for needing a disability certification include:\n- Family Support Grant (FSG) eligibility\n- Aged 65 and older and establishing a pooled trust\n- Establish an asset transfer penalty exception. See EPM [2.4.1.3.3 MA-LTC Transfer Penalty Exceptions and Hardship Waiver](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.3) for more information.\n- Creating certain trusts"},{"chunk_id":"epm:2.3.2.2#state-medical-review-team-certification-of-disability","heading":"State Medical Review Team Certification of Disability","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.2.2#state-medical-review-team-certification-of-disability","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.2 Non-Financial Eligibility > 2.3.2.2 Certification of Disability > State Medical Review Team Certification of Disability","text":"## State Medical Review Team Certification of Disability\n\nSMRT completes disability determinations for people not certified disabled by SSA. SMRT certifies disability using the same disability criteria as the SSA."},{"chunk_id":"epm:2.3.2.2#smrt-referral-process","heading":"SMRT Referral Process","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.2.2#smrt-referral-process","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.2 Non-Financial Eligibility > 2.3.2.2 Certification of Disability > SMRT Referral Process","text":"## SMRT Referral Process\n\nThe county, tribal or state servicing agency completes a SMRT Referral for a Disability Determination. Referrals are submitted through the Integrated Service Delivery System ( ISDS).\n\n### Expedited Case Criteria\n\nSMRT expedites the disability determination process in the following situations where the person is likely to meet disability criteria:\n- The person has a condition that appears on the SSA [Compassionate Allowance Listing](https://secure.ssa.gov/apps10/poms.nsf/lnx/0423022080) (CAL)\n- The person is awaiting discharge from a facility and can be discharged immediately if MA is approved\n- The person has a potentially life-threatening situation and requires immediate treatment or medication\n\n### Continuing Disability Review\n\nPeople certified disabled by SMRT need a continuing disability review every one to seven years. Disability standards are different for children and adults, so at age 18, a child must be evaluated under the adult standards. Newborns certified disabled due to a low birth weight must be reviewed before age one.\n\nDo not deny or close MA or other MHCP eligibility when the SMRT determination is pending if all other MHCP eligibility criteria are met."},{"chunk_id":"epm:2.3.2.2#additional-smrt-referrals","heading":"Additional SMRT Referrals:","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.2.2#additional-smrt-referrals","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.2 Non-Financial Eligibility > 2.3.2.2 Certification of Disability > Additional SMRT Referrals:","text":"## Additional SMRT Referrals:\n\nThe following people need a SMRT referral:\n- People whose Supplemental Security Income (SSI) or Retirement, Survivors, and Disability Insurance (RSDI) application is pending or being appealed.\n- People who are not eligible for SSI or RSDI, because they earn more than the substantial gainful activity (SGA) level.\n- People whose SSI, RSDI, or 1619(a) or 1619(b) benefits are terminated.\n- People who are enrolled in Medicare but not considered certified disabled by SSA.\n- People who are receiving a Medicare extension during which they are still considered certified disabled by SSA should receive a SMRT referral two months before the Medicare extension ends."}]},{"id":"epm:2.3.3","number":"2.3.3","title":"Financial Eligibility","parent":"2.3","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility","summary":"This subchapter provides policy about financial eligibility. This includes eligibility factors that involve a person’s income or assets.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:57.899951+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.3.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility","text":"This subchapter provides policy about financial eligibility. This includes eligibility factors that involve a person’s income or assets.\n\nThis subchapter includes policies that apply to Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD).\n1. [MA-ABD Household Composition and Family Size](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.1)\n2. [MA-ABD Assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2)\n  1. [MA-ABD Asset Limits](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.1)\n    1. [MA-ABD Asset Deeming](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.1)\n      1. [MA-ABD Sponsor Asset Deeming](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.2.1)\n  2. [MA-ABD Excluded Assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.3)\n  3. [MA-ABD Countable Assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.4)\n    1. [MA-ABD Availability of Countable Assets](https://hcopub.dhs.state.mn.us/epm/2_3_3_2_4_1ar1.htm)\n      1. [MA-ABD Shared Ownership](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.4.1.1)\n  4. [MA-ABD Unknown Assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.5)\n  5. [MA-ABD Excess Assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.6)\n  6. [MA-ABD Asset Evaluation](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7)\n    1. [MA-ABD Liquid Assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.1)\n    2. [MA-ABD Retirement Funds and Plans](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.2)\n    3. [MA-ABD Health Expense Accounts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.3)\n      1. [MA-ABD Flexible Spending Arrangements](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.3.1)\n      2. [MA-ABD Health Savings Accounts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.3.2)\n    4. [MA-ABD Real Property](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4)\n      1. [MA-ABD Homestead Real Property](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.1)\n      2. [MA-ABD Non-Homestead Real Property](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.2)\n      3. [MA-ABD Life Estates and Remainder Interests](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.3)\n      4. [MA-ABD Other Property Interests](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.4)\n    5. [MA-ABD Contract for Deed and Other Property Agreements](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.5)\n    6. [MA-ABD Promissory Notes](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.6)\n    7. [MA-ABD Automobiles and Other Vehicles used for Transportation](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.7)\n    8. [MA-ABD Annuities](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.8)\n    9. [MA-ABD Trusts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9)\n      1. [MA-ABD Identifying the Type of Trust](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.1)\n      2. [MA-ABD Client-Funded Trusts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.2)\n      3. [MA-ABD Medical Assistance Qualifying Trusts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.3)\n      4. [MA-ABD Special Needs Trusts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.4)\n      5. [MA-ABD Pooled Trusts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.5)\n      6. [MA-ABD Third Party Established and Funded Trusts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.6)\n      7. [MA-ABD Supplemental Needs Trusts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.7)\n    10. [MA-ABD Life Insurance Policies](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.10)\n    11. [MA-ABD Burial Contracts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11)\n      1. [MA-ABD Burial Space Exclusion](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.1)\n      2. [MA-ABD Burial Fund Exclusion](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.2)\n    12. [MA-ABD Continuing Care Retirement Community Entrance Fee](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.12)\n    13. [MA-ABD Tribal Payments and Interests](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.13)\n    14. [MA-ABD Household Goods and Personal Effects](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.14)\n3. [MA-ABD Income](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3)\n  1. [MA-ABD Income Limits](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.1)\n  2. [MA-ABD Income Methodology](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2)\n    1. [MA-ABD Countable Income](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1)\n      1. [MA-ABD Income Deeming](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1.1)\n      2. [MA-ABD Sponsor Income Deeming](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1.2)\n    2. [MA-ABD Disregards and Deductions](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.2)\n    3. [MA-ABD Excluded Income](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.3)\n4. [MA-ABD Medical Spenddowns](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.4)\n  1. [MA-ABD Spenddown types](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.4.1)\n  2. [MA-ABD Health Care Expenses](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.4.2)"}]},{"id":"epm:2.3.3.1","number":"2.3.3.1","title":"Household Composition and Family Size","parent":"2.3.3","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.1 Household Composition and Family Size","summary":"Household composition means the people included in an applicant's or enrollee’s household. Household composition determines the family size. Household composition and family size are factors used to determine financial eligibility.","effective_date":"2024-02-16","last_modified":"2026-10-03T04:45:30.635634+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_1.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.602","Minnesota Statutes, section 256.01"],"chunks":[{"chunk_id":"epm:2.3.3.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.1","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.1 Household Composition and Family Size","text":"Household composition means the people included in an applicant's or enrollee’s household. Household composition determines the family size. Household composition and family size are factors used to determine financial eligibility.\n\nHousehold composition and family size are determined for each person separately. Household composition and family size may be different for each person on an application or in a household."},{"chunk_id":"epm:2.3.3.1#adults","heading":"Adults","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.1#adults","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.1 Household Composition and Family Size > Adults","text":"## Adults\n\nHousehold composition includes the following people living at least one full calendar month with the adult using the age 65 or older, blind or disabled basis of eligibility:\n- The person\n- The person’s spouse\n- The person’s biological or adoptive children younger than age 21 of the person\n  - A child who is temporarily absent from the parent’s home is included in the parent’s household composition, such as a student away at school for the school year\n  - A child who alternates living with separated or divorced parents is in the household in which he or she spends the most time. A child cannot be a member of more than one household in the same month.\n- The person’s spouse’s biological or adoptive children younger than age 21 (i.e..stepchildren)\n  - The spouse must also be living with the applicant or enrollee, or be temporarily absent to count these children in the person’s household composition\n\nEmancipated minors are not included in an adult’s household composition.\n\nThe family size includes:\n- All of the people in the person’s household composition\n- Unborn children of the person or their spouse included in the household composition"},{"chunk_id":"epm:2.3.3.1#children","heading":"Children","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.1#children","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.1 Household Composition and Family Size > Children","text":"## Children\n\nHousehold composition includes the following people living at least one full calendar month with a child using the aged, blind or disabled basis of eligibility:\n- The child\n- The child's biological, adoptive or stepparents\n- Full, half or stepsiblings younger than age 21, who have a mutual parent living in the home, or who is temporarily absent. Emancipated minors are not included.\n- The child's spouse\n- The child's minor children\n\nThe family size includes:\n- All of the people in the person’s household composition\n- Unborn children of the child or the child’s biological, adoptive or stepparents included in the household composition\n\nEmancipated children follow the adult household composition policy."},{"chunk_id":"epm:2.3.3.1#other-household-composition-policies","heading":"Other Household Composition Policies","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.1#other-household-composition-policies","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.1 Household Composition and Family Size > Other Household Composition Policies","text":"## Other Household Composition Policies\n\nDifferent household composition policies apply for applicants and enrollees using the aged, blind or disabled basis of eligibility in the following situations:\n- [MA-Employed Persons with Disabilities](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.2)\n- [MA under the TEFRA option for children with disabilities](https://bot-corpus.mn-dhs.online/s/epm/2.3.6.3)\n- [MA-LTC Long-Term Care Facility (LTCF) Services](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.4)\n- [MA-LTC Home and Community-Based Services Waivers for People with Disabilities](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.3.1)\n- [MA-LTC Home and Community-Based Services Waiver for People with Age 65 or Older](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.3.2)"}]},{"id":"epm:2.3.3.2","number":"2.3.3.2","title":"Assets","parent":"2.3.3","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets","summary":"Assets are items of value that people own like bank accounts, stocks and bonds, cars, and real estate. The asset provisions contained in this subchapter apply to all people who are using a Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) basis of eligibility unless otherwise specified in this chapter.","effective_date":"2019-06-01","last_modified":"2026-10-03T03:51:57.899951+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.3.3.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets","text":"Assets are items of value that people own like bank accounts, stocks and bonds, cars, and real estate. The asset provisions contained in this subchapter apply to all people who are using a Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) basis of eligibility unless otherwise specified in this chapter."},{"chunk_id":"epm:2.3.3.2#categories-of-assets","heading":"Categories of Assets","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2#categories-of-assets","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > Categories of Assets","text":"## Categories of Assets\n\nAssets fall into two categories, excluded and countable.\n- Excluded assets: Certain types and amounts of assets are excluded and do not count against a person’s asset limit. Any assets that are not specifically excluded are countable.\n- Countable assets: Countable assets are evaluated for availability and may count towards the person’s asset limit.\n  - Available assets: count against the asset limit\n  - Unavailable assets: do not count against the asset limit\n\nThis subchapter provides policy about a person’s assets under one of the bases of eligibility for MA-ABD.\n1. [MA-ABD Household Composition and Family Size](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.1)\n2. [MA-ABD Asset Limits](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.1)\n3. [MA-ABD Asset Deeming](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.2)\n4. [MA-ABD Excluded Assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.3)\n5. [MA-ABD Countable Assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.4)\n6. [MA-ABD Unknown Assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.5)\n7. [MA-ABD Excess Assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.6)\n8. [MA-ABD Asset Evaluation](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7)"}]},{"id":"epm:2.3.3.2.1","number":"2.3.3.2.1","title":"Asset Limits","parent":"2.3.3.2","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.1 Asset Limits","summary":"This section provides information about asset limits for the bases of eligibility for Medical Assistance for People Who Are Age 65 or Older or People Who Are Blind or Have a Disability (MA-ABD). It also discusses which household members’ assets are counted toward the asset limit.","effective_date":"2026-06-03","last_modified":"2026-10-03T05:18:01.666179+00:00","version":3,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_1.htm","legal_citations":["Minnesota Statutes, section 256B.056, subdivision 1a","Minnesota Statutes, section 256B.056, subdivision 3"],"chunks":[{"chunk_id":"epm:2.3.3.2.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.1","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.1 Asset Limits","text":"This section provides information about asset limits for the bases of eligibility for Medical Assistance for People Who Are Age 65 or Older or People Who Are Blind or Have a Disability (MA-ABD). It also discusses which household members’ assets are counted toward the asset limit."},{"chunk_id":"epm:2.3.3.2.1#asset-limit","heading":"Asset Limit","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.1#asset-limit","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.1 Asset Limits > Asset Limit","text":"## Asset Limit\n\nThe asset limit for MA-ABD is based on household size. The asset deeming rules are applied to determine whose assets count.\n\nThe MA-ABD asset limits are as follows:\n\n| Household Size | One | Two | Add this amount for each additional household member |\n| --- | --- | --- | --- |\n| Asset limit | $3,000 | $6,000 | $200 |"},{"chunk_id":"epm:2.3.3.2.1#people-with-no-asset-limit","heading":"People with No Asset Limit","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.1#people-with-no-asset-limit","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.1 Asset Limits > People with No Asset Limit","text":"## People with No Asset Limit\n\nNo asset test applies to the following people for MA-ABD:\n- Children under age 21 through the month of their 21st birthday.\n- Medical Assistance for Employed Persons with Disabilities (MA-EPD) enrollees."}]},{"id":"epm:2.3.3.2.1.1","number":"2.3.3.2.1.1","title":"Reasonable Compatibility Check for Assets","parent":"2.3.3.2.1","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.1 Asset Limits > 2.3.3.2.1.1 Reasonable Compatibility Check for Assets","summary":"At application or when a person returns a renewal form, the agency conducts a reasonable compatibility check to determine asset eligibility for an applicant or enrollee. Reasonable compatibility is checked by comparing the value of total reported countable assets and the value of total verified countable assets to the program asset limit. If these values are both at or below the program asset limi","effective_date":"2024-10-21","last_modified":"2026-10-03T03:51:57.899951+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.1.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.1.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_1_1.htm","legal_citations":["Section 1940 of the Social Security Act","42 Code of Federal Regulations, § 435.916","42 Code of Federal Regulations, § 435.952","Minnesota Statutes, section 256.01, subdivision 18f","Minnesota Rules, part 9505.0095"],"chunks":[{"chunk_id":"epm:2.3.3.2.1.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.1.1","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.1 Asset Limits > 2.3.3.2.1.1 Reasonable Compatibility Check for Assets","text":"At application or when a person returns a renewal form, the agency conducts a reasonable compatibility check to determine asset eligibility for an applicant or enrollee. Reasonable compatibility is checked by comparing the value of total reported countable assets and the value of total verified countable assets to the program asset limit. If these values are both at or below the program asset limit, assets are considered verified, and the person is asset eligible.\n\nWorkers must assist applicants and enrollees who are unable to provide paper proof, including obtaining their authorization to contact a third party on their behalf, if appropriate. Self-attestation is accepted if electronic verification or paper proof do not exist or are unavailable."},{"chunk_id":"epm:2.3.3.2.1.1#reasonable-compatibility-check","heading":"Reasonable Compatibility Check","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.1.1#reasonable-compatibility-check","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.1 Asset Limits > 2.3.3.2.1.1 Reasonable Compatibility Check for Assets > Reasonable Compatibility Check","text":"## Reasonable Compatibility Check\n\nReasonable compatibility is checked by comparing the applicable program asset limit to reported assets and verified assets.\n\n### Reported Assets\n\nThe total value of assets that an applicant or enrollee reports which includes:\n- Assets reported on the application or renewal.\n- At renewal, assets recorded in the case file.\n\n### Verified Assets\n\nThe value of total verified countable assets.\n\nThis includes:\n- Financial accounts, if any, returned by AVS or other reliable electronic sources.\n- Any financial accounts reported on the application or renewal (including at renewal, accounts known to the agency) that do not appear in the AVS results.\n- All other verified assets\n\nWhen an applicant or enrollee sends paper proof with the application or renewal the most recent proof must be used. If AVS returns results for a financial account and the person provides more recent paper proof for the same financial account, the paper proof must be used.\n\nBoth the value of total reported countable assets and the value of total verified countable assets must be at or below the program asset limit for the applicant or enrollee to be asset eligible.\n\nWhen determining eligibility for Medicare Savings Programs (MSP) and Medical Assistance (MA), MSP must be approved or renewed without requiring the person to provide further verification of assets for that program if assets are reasonably compatible for MSP but are not reasonably compatible for MA.\n\n### Example\n\nA person applies for MA for persons who are age 65 or older, which has an asset limit of $3,000. On the application form, bank account #456 is reported with a balance of $850. Two vehicles are reported. One is excluded and the other one is counted. The counted vehicle has a value of $1,000. AVS results show one bank account #456 with a balance of $950.\n\n**Reported assets:** The total value of the reported assets is $1,850 (the checking account of $850 plus the counted vehicle valued at $1,000), which is below the MA program asset limit of $3,000.\n\n**Verified assets:** The total value of the assets returned from AVS is $950 on the same account that was reported. Adding the verified value of $1,000 for the counted vehicle, the total value of verified assets is $1,950, which is below the MA program asset limit of $3,000.\n\nThe value of the total countable assets is reasonably compatible because the reported and verified results are both at or below the MA program asset limit."},{"chunk_id":"epm:2.3.3.2.1.1#not-reasonably-compatible","heading":"Not Reasonably Compatible","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.1.1#not-reasonably-compatible","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.1 Asset Limits > 2.3.3.2.1.1 Reasonable Compatibility Check for Assets > Not Reasonably Compatible","text":"## Not Reasonably Compatible\n\nAssets are not reasonably compatible when one or both of the values in the reasonable compatibility check are over the applicant or enrollee’s program asset limit.\n\nWhen AVS values of financial accounts are used in the reasonable compatibility check and assets are not reasonably compatible, more information must be gathered from the applicant or enrollee about the assets before determining eligibility. Eligibility must not be denied or closed until the applicant or enrollee has had an opportunity to provide verification of the current value of assets or verify that assets have been reduced.\n\nAn applicant or enrollee who does not provide the requested information by the due date is not eligible. Eligibility for the applicant or enrollee must be denied or closed with 10-day advance notice to the enrollee.\n\n### Example\n\nA person applies for MA for persons who have a disability, which has an asset limit of $3000. On the application form, bank account #123 is reported with a balance of $900. Two vehicles were reported. One is excluded and the other one is counted. The counted vehicle has a value of $1,200. AVS results show a checking account #123 with $1,300 and a savings account #789 with a balance of $1,000.\n\n**Reported assets:** The total value of the reported assets is $2,100 (the checking account of $900 plus the counted vehicle valued at $1,200), which is below the MA program asset limit of $3,000.\n\n**Verified assets:** The total value of the assets returned from AVS is $2,300. Adding the verified value of $1,000 for the counted vehicle, the total value of verified assets is $3,300, which is above the MA program asset limit of $3,000.\n\nThe assets are not reasonably compatible because the verified assets value is above the MA asset limit. See [EPM 2.3.3.6 MA-ABD Excess Assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.6) for information on how a person can reduce their assets."}]},{"id":"epm:2.3.3.2.2","number":"2.3.3.2.2","title":"Asset Deeming","parent":"2.3.3.2","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.2 Asset Deeming","summary":"To deem assets is to count one person’s assets in the calculation of another person’s assets. This policy indicates whose assets must be deemed to a person for Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD). This policy also applies to the Medicare Savings Program (MSP). See the MSP chapter for more information.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:58:40.502456+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_2.htm","legal_citations":["Minnesota Statutes, section 256B.056, subdivision 1a","Minnesota Statutes, section 256B.056, subdivision 3"],"chunks":[{"chunk_id":"epm:2.3.3.2.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.2","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.2 Asset Deeming","text":"To deem assets is to count one person’s assets in the calculation of another person’s assets. This policy indicates whose assets must be deemed to a person for Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD). This policy also applies to the Medicare Savings Program (MSP). See the [MSP](https://bot-corpus.mn-dhs.online/s/epm/4.2) chapter for more information.\n\nAsset deeming requirements are not the same as household composition rules. People may be counted in a person’s household size without having their assets deemed to another member of a household.\n\nWhose assets are deemed to a person is determined separately for each person."},{"chunk_id":"epm:2.3.3.2.2#assets-of-a-spouse","heading":"Assets of a Spouse","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.2#assets-of-a-spouse","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.2 Asset Deeming > Assets of a Spouse","text":"## Assets of a Spouse\n\nExcept in the situations noted below, the assets of a spouse are deemed to a person if they live together. If a person is not divorced but is legally separated from their spouse, and continues to live in the same household, the spouse’s assets are deemed.\n\nThe assets of a spouse are not deemed to the person when:\n- The spouses do not live together.\n- The person is applying for or is enrolled in MA for Employed Persons with Disabilities (MA-EPD). This includes the spouse’s share of jointly held assets.\n- The person was enrolled in MA-EPD for 24 consecutive months before the month in which they turned age 65 and there has not been a break in basic MA coverage of more than one calendar month.\n- The enrollee is on the Community Access for Disability Inclusion (CADI), Community Alternatives Care (CAC), Developmental Disabilities (DD) or Brain Injury (BI) waivers."},{"chunk_id":"epm:2.3.3.2.2#assets-of-other-household-members","heading":"Assets of Other Household members","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.2#assets-of-other-household-members","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.2 Asset Deeming > Assets of Other Household members","text":"## Assets of Other Household members\n\nAssets are not deemed from:\n- A child to a parent\n- Sibling to sibling"}]},{"id":"epm:2.3.3.2.2.1","number":"2.3.3.2.2.1","title":"Sponsor Asset Deeming","parent":"2.3.3.2.2","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.2 Asset Deeming > 2.3.3.2.2.1 Sponsor Asset Deeming","summary":"Sponsor deeming rules apply to noncitizens who are sponsored by an individual or individuals and have a signed Affidavit of Support (USCIS I-864), unless an exception is met.","effective_date":"2022-09-01","last_modified":"2026-10-03T03:51:57.899951+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.2.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.2.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_2_1.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.602","Minnesota Statutes, section 256B.06, subdivision 5","Personal Responsibility and Work Opportunity Reconciliation Act of 1996, title IV, Public Law 104–193, section 421 and 422"],"chunks":[{"chunk_id":"epm:2.3.3.2.2.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.2.1","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.2 Asset Deeming > 2.3.3.2.2.1 Sponsor Asset Deeming","text":"Sponsor deeming rules apply to noncitizens who are sponsored by an individual or individuals and have a signed Affidavit of Support (USCIS I-864), unless an exception is met.\n\nAssets of a sponsor and the sponsor’s spouse are deemed to each noncitizen covered by the affidavit regardless of whether the sponsor actually contributes to the noncitizen’s household needs. Assets are deemed even if the sponsor or the sponsor’s spouse are receiving public assistance in Minnesota or another state.\n\nIf the sponsor is a member of the household:\n- The sponsor and the sponsor’s family members are counted in the applicant’s household composition. See [Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) Household Composition](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.1) policy for more information.\n- Applicable asset exclusions are applied to the sponsor’s assets.\n\nIf the sponsor is not a member of the household, the following rules apply:\n- The sponsor or the sponsor’s family members are not counted in the noncitizen’s household composition.\n- The sponsor or the sponsor’s spouse’s assets are not considered unavailable or excluded.\n\nApplicants, enrollees, and sponsors must cooperate with supplying or obtaining sponsor information if sponsor deeming applies. If the applicant, enrollee, or sponsor fails to cooperate coverage may be closed. The Sponsor Letter ([DHS-3453](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3453-ENG)) reminds sponsors of their legal obligation to provide support and to request verification from the sponsor."},{"chunk_id":"epm:2.3.3.2.2.1#exceptions-to-ma-sponsor-deeming","heading":"Exceptions to MA Sponsor Deeming","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.2.1#exceptions-to-ma-sponsor-deeming","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.2 Asset Deeming > 2.3.3.2.2.1 Sponsor Asset Deeming > Exceptions to MA Sponsor Deeming","text":"## Exceptions to MA Sponsor Deeming\n\nThe sponsorship ends and sponsor deeming no longer applies when any of the following changes occur:\n- The sponsored immigrant becomes a naturalized citizen\n- The sponsor or sponsored immigrant dies\n- The sponsored noncitizen has attained at least 40 work quarters as determined by the Social Security Administration\n\nSponsor deeming does not apply to sponsored noncitizens when the noncitizen:\n- is under age 21\n- is pregnant. This exception ends when the sponsored pregnant person’s 12 month postpartum period ends. Sponsor deeming applies the month following the end of the postpartum period.\n- has sponsorship deferred by U.S. Citizenship and Immigration Services (USCIS) when their immigration status is changed to Battered Noncitizen\n- needs placement in a facility and placement is jeopardized by the sponsor’s failure or inability to provide support, or inability of the client to locate the sponsor"},{"chunk_id":"epm:2.3.3.2.2.1#exceptions-to-form-i-864-sponsorship","heading":"Exceptions to Form I-864 Sponsorship","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.2.1#exceptions-to-form-i-864-sponsorship","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.2 Asset Deeming > 2.3.3.2.2.1 Sponsor Asset Deeming > Exceptions to Form I-864 Sponsorship","text":"## Exceptions to Form I-864 Sponsorship\n\nNoncitizens who immigrate with a non-family based petition are not subject to sponsorship and sponsor deeming. These include, but are not limited to the following:\n- Battered noncitizens\n- Cuban Haitian entrants\n- Diversity visa recipients\n- Noncitizen sponsored by a business or organization that is not related to an immigrant\n- People with temporary protected status\n- Refugee and asylees"}]},{"id":"epm:2.3.3.2.3","number":"2.3.3.2.3","title":"Excluded Assets","parent":"2.3.3.2","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.3 Excluded Assets","summary":"An excluded asset is not counted when calculating a person’s total countable assets. An asset can be excluded in whole or in part. Some excluded assets are excluded indefinitely while others are excluded for only a specific period of time. Some excluded assets are excluded only if identifiable from other assets. Income retained after the month of receipt become assets.","effective_date":"2026-06-12","last_modified":"2026-10-03T04:45:30.813613+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_3.htm","legal_citations":["Code of Federal Regulations, title 20, section 416.1248","Minnesota Statutes, section 256.4764, subdivision 7","Minnesota Statutes, section 256B.056, subdivision 1a","Minnesota Statutes, section 256B.056, subdivision 3","Minnesota Statutes, section 256B.056, subdivision 3b","United States Code, title 42, section 1396p(d)"],"chunks":[{"chunk_id":"epm:2.3.3.2.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.3","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.3 Excluded Assets","text":"An excluded asset is not counted when calculating a person’s total countable assets. An asset can be excluded in whole or in part. Some excluded assets are excluded indefinitely while others are excluded for only a specific period of time. Some excluded assets are excluded only if identifiable from other assets. Income retained after the month of receipt become assets."},{"chunk_id":"epm:2.3.3.2.3#identifiable-assets","heading":"Identifiable Assets","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.3#identifiable-assets","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.3 Excluded Assets > Identifiable Assets","text":"## Identifiable Assets\n\nSome assets must be identifiable to be excluded under the bases of eligibility for Medical Assistance for People Who Are Age 65 or Older, or People Who Are Blind or Have a Disability (MA-ABD). Identifiable means that the assets can be distinguished from other assets.\n\nAn asset is identifiable in the following situations:\n- The funds are kept physically apart from other funds, such as a separate bank account.\n- The funds are not kept physically apart from other funds, but can be identified using a complete history of account transactions dating back to the initial date of deposit. The person’s own records should be used, if possible. The person’s allegation regarding the date and amount of a deposit of excluded funds is accepted if it agrees with the evidence on file for receipt of the funds.\n  - When a withdrawal is made from a commingled account, the non-excluded funds are assumed to be withdrawn first, leaving as much of the excluded funds in the account as possible.\n  - The excluded funds remaining in the account can only be added to by deposits of subsequently received excluded funds and excluded interest.\n  - If interest on the excluded funds is excluded, the percent of an interest payment to be excluded is the same as the percent of funds in the account that is excluded at the time the interest is posted. The excluded interest is then added to the excluded funds in the account."},{"chunk_id":"epm:2.3.3.2.3#excluded-assets-if-identifiable","heading":"Excluded Assets if Identifiable","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.3#excluded-assets-if-identifiable","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.3 Excluded Assets > Excluded Assets if Identifiable","text":"## Excluded Assets if Identifiable\n\nThe following assets are excluded if they are identifiable. Exclude the assets indefinitely unless another time period is indicated. Descriptions of each type of assets are located in Appendix A Types of Assets.\n- Achieving a Better Life Experience (ABLE) account\n- Agent Orange Settlement Fund payments\n- Blood Product Settlement payments\n- Corporation for National and Community Service (CNCS) payments. Payments to volunteers, including the following payments authorized under the Domestic Volunteer Services Act, are excluded:\n  - AmeriCorps\n  - Urban Crime Prevention Program\n  - Special Volunteer Programs under Title I\n  - Demonstration Programs under Title II\n  - Senior Corp:\n    - Retired Senior Volunteer Program (RSVP)\n    - Foster Grandparent Program\n    - Senior Companions\n- Food and nutrition program payments. This includes assistance provided by:\n  - Programs established under the Child Nutrition Act, including the Women, Infants, and Children (WIC) Nutrition Program and federally funded school breakfast and milk programs.\n  - National School Lunch program\n  - Supplemental Nutrition Assistance Program (SNAP)\n  - Minnesota Food Assistance Program\n  - Minnesota Grown Supplemental Food Program\n- Individual Development Accounts (IDA)\n- Japanese and Aleutian Restitution payments\n- Jensen Settlement Agreement payments. Payments received by class members are excluded. Funds received under this agreement from countable assets at the time of application and at each renewal are deducted.\n- Low Income Home Energy Assistance Program (LIHEAP) payments\n- Nazi Persecution payments, including payments inherited from the original recipient, and any interest accrued from these funds.\n- Plan to Achieve Self Support (PASS), assets associated with a person's PASS are excluded if they are not already excluded under another provision\n- Radiation Exposure Compensation Trust Fund (RECTF) payments\n- Real estate taxes, homeowner’s insurance and funds set aside for upkeep expenses of the property a person owns. Up to one year’s expenses are excluded. Funds must be kept in a separate account.\n- Relocation Assistance payments, federal\n- Retroactive Retirement, Survivors and Disability Insurance (RSDI) and Supplemental Security Income (SSI) benefits are excluded for the nine calendar months following the month in which the person receives the benefits. Any accrued interest on that account is counted as income in the month received and as an asset in the following months.\n  - People under age 18 who have representative payees and are eligible for past-due SSI payments must have the funds segregated in a dedicated account in order for the exclusion to apply. If a bank requires a deposit of funds in order to open such an account, these funds may remain commingled in the account until the end of the month following the month in which the retroactive benefits are paid.\n  - Supplemental Needs Trusts policy is followed if the lump sum payment is issued under the Sullivan vs Zebley decision, and is used to fund a supplemental needs trust. See [MA-ABD Supplemental Needs Trusts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.7) for more information.\n- Ricky Ray Hemophilia Relief Fund payments\n- Student financial aid\n  - Exclude the following types of student financial aid income:\n    - Student financial aid received under Title IV of the Higher Education Act\n    - Student financial aid received from the Bureau of Indian Affairs (BIA)\n  - Non-Title IV and non-BIA grants, scholarships, fellowships and other non-loan financial aid, if used or set aside to pay educational expenses until the month following the last month the student is enrolled in classes.\n  - Coverdell Educational Savings Accounts (ESA)\n    - Funds in a Coverdell ESA are excluded for the designated beneficiary of the account.\n    - Distributions from a Coverdell ESA are excluded if the funds are used for educational expenses.\n      - Excluded for the designated beneficiary of the account for nine months following the month of receipt of a distribution.\n      - Excluded for anyone who is not a beneficiary who contributes money to the account beginning the month after the month the funds are transferred into the account.\n      - Excluded, due to being a conversion of an asset, for a contributor who is the designated beneficiary beginning with the month after the month the cash is transferred into the account.\n  - Veteran’s Affairs (VA) benefits designated as educational assistance both under graduate and graduate students until the month following the last month the student is enrolled in classes.\n  - Plan to Achieve Self Support (PASS) student financial aid\n  - Training expenses paid by the Trade Adjustment Reform Act of 2002\n  - Qualified Tuition Programs (QTP), also known as a 529 Plan, for the designated beneficiary (the student or future student) who is not the owner of the account and does not have any rights to the funds in the account. The account is counted as an asset for the owner.\n- Supplemental Security Income (SSI) Dedicated Child Account\n- Tribal payments and interests. The following tribal assets are excluded. See [MA-ABD Tribal Payments and Interests](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.13) for other assets owned by American Indians that may not be excluded.\n  - Tribal trust or restricted lands, individual interest\n  - Tribal per capita payments from a tribal trust\n  - Tribal land settlements and judgments\n- Uniform Gift to Minors Act/Uniform Transfers to Minors Act (UGMA/UTMA)\n  - The full value of assets established under the UGMA/UTMA is excluded.\n    - An adult designated to receive, maintain and manage custodial property on behalf of a minor beneficiary is not the owner of UGMA/UTMA assets because he or she cannot legally use any of the funds for his or her support and maintenance.\n  - UGMA/UTMA property is required by statute to be transferred to the beneficiary at the end of the custodianship (usually at the age of 18 or 21 depending on state law). When the beneficiary reaches the age of majority the property becomes available to the beneficiary. It is counted as income in the month of transfer and as an asset in the following month.\n- Veterans’ Children with Certain Birth Defects payments\n- Vietnamese Commando Compensation Act payments"},{"chunk_id":"epm:2.3.3.2.3#excluded-assets-regardless-of-identifiability","heading":"Excluded Assets Regardless of Identifiability","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.3#excluded-assets-regardless-of-identifiability","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.3 Excluded Assets > Excluded Assets Regardless of Identifiability","text":"## Excluded Assets Regardless of Identifiability\n\nThe following assets may be excluded whether or not they are identifiable. These assets are excluded indefinitely unless another time period is indicated.\n- Adoption Assistance payments are excluded in the month of receipt and thereafter.\n- Accrued Interest on assets is excluded if any excess is properly reduced at eligibility redetermination.\n- Alaska Native Claims Settlement Act (ANCSA) payments\n- Appeal Payments are excluded as assets in the month received and for three months after the month of receipt.\n- Clinical trial participation payments excluded by SSI. The first $2,000 a person receives during a calendar year is excluded.\n- Cobell Settlement for American Indians for a period of 12 months beginning with the month of receipt. This exclusion applies to all household members.\n- Consolidated Appropriations Act (CAA) recovery rebate payments.\n- Coronavirus Aid, Relief, and Economic Security (CARES) Act payments.\n- COVID-19 Relief Payments\n- Crime victim payments\n- Disaster assistance, federal payments\n- Disaster assistance, state payments\n- Filipino Veterans Equity Compensation (FVEC) payments\n- Foster Care payments\n- Frontline Worker Payments made under Minnesota’s 2022 Frontline Worker Payments law\n- Gifts to Children with Life Threatening Conditions from 501(c)(3) tax-exempt corporation. These are not considered assets of a parent and apply only to children who are under age 18.\n  - Cash gifts up to $2,000 in any calendar year are excluded. The amount of total cash payments that exceed $2,000 each year are counted as an asset.\n    - Multiple cash gifts in the same calendar year are added together and up to $2,000 of the total is excluded, even if none of the cash gifts exceeds $2,000 individually.\n- Homestead real property\n- Household goods and personal effects\n- I-35W Bridge Collapse payments. The following payments made to survivors of the I-35W bridge collapse are excluded:\n  - Payments from the I-35W Emergency Hardship Relief Fund\n  - Payments from the Catastrophic Survivor Compensation Fund\n- James Zadroga 9/11 Health and Compensation Act of 2010\n- Long-Term Services and Supports workforce incentive payments under the Minnesota Care Force Incentive program\n- Kinship payments\n- Proceeds from the Sale of a Homestead are excluded if a person:\n  - Plans to use the proceeds to buy another homestead, and\n  - Does so within three full calendar months of receiving the funds\n- Reimbursements for replacement of lost, damaged or stolen excluded assets are excluded for the month of receipt and nine months thereafter. The funds are excluded for up to nine more months if the person tries to replace the assets during that time, but cannot do so for good reason.\n- RentHelpMN Assistance\n- Representative Payee Misuse payments. If a person’s SSI, RSDI, or Veterans Benefits for the Elderly is reissued because an individual representative payee misuses benefits, the re-issuance is excluded as an asset for nine months if retained after the month of receipt.\n- State Annuities for Certain Veterans\n- Relocation payments, state and local\n- Tax credits, rebates, and refunds are excluded for 12 months after the month of receipt\n- Teacher stipends under the Minnesota READ Act\n- Term life insurance that does not have a cash surrender value (CSV)"},{"chunk_id":"epm:2.3.3.2.3#potentially-excluded-assets","heading":"Potentially Excluded Assets","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.3#potentially-excluded-assets","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.3 Excluded Assets > Potentially Excluded Assets","text":"## Potentially Excluded Assets\n\nSome assets may be excluded under the following policies. See the corresponding pages for more information:\n1. [MA-ABD Tribal Payments and Interests](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.13)\n2. [MA-ABD Burial Space Exclusion](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.1)\n3. [MA-ABD Burial Fund Exclusion](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.2)\n4. [MA-ABD Retirement Funds & Plans](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.2)\n5. [MA-ABD Trusts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9)\n6. [MA-ABD Automobile and other vehicles used for transportation](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.7)"},{"chunk_id":"epm:2.3.3.2.3#self-support-excluded-assets","heading":"Self-Support Excluded Assets","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.3#self-support-excluded-assets","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.3 Excluded Assets > Self-Support Excluded Assets","text":"## Self-Support Excluded Assets\n\nSelf-Support is the use of certain property to earn wages, to produce goods and services for personal use, or to derive income from property. Self-Employment is one type of self-support.\n\n### Self-Employment Excluded Assets\n\nAll assets of a trade or business, regardless of value, that are in current use and needed for the person to earn income are excluded. Current use includes seasonal use of an asset. The excluded assets can be real or personal property. There is no limit to the amount of assets that can be excluded under this provision. Self-employment liquid assets are excluded if they are identifiable according to the rules in the [Identifiable Assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.3) section.\n\nWhen a person alleges owning trade or business property not already being excluded, it must be determined whether a valid trade or business exists, and if the property is in current use. A person must provide a written statement with the following information:\n- A description of the trade or business\n- A description of the assets of the trade or business\n- The number of years the business has been operating\n- The identity of any co-owners\n- The estimated gross and net earnings of the trade or business for the current tax year, which must be verified using the most recent business tax returns (i.e. Form 1040 and the appropriate schedules) available.\n\nThe tax return can be used to determine the net earnings from self-employment and the validity of the trade or business. The following may be helpful:\n- Schedule C, Profit or Loss from Business or Profession,\n- Schedule SE, Computation of Social Security Self-Employment,\n- Schedule F, Farm Income and Expenses,\n- Form 4562, Depreciation and Amortization, and\n- Form 1065, U.S. Partnership Return of Income.\n\nIf a trade or business has operated for a year or less, consider the following to determine whether a trade or business actually exists:\n- the good faith intention of making a profit or producing income,\n- continuity of operations, repetition of transactions, or regularity of activities\n- regular occupation o holding out to others as being engaged in the selling of goods or services.\n\nSelf-employment assets not currently in use because of reasons beyond the person’s control can be excluded if they expect to resume use of the asset within one year. The person must sign a written statement with the following information:\n- The reason the asset is not in use\n- The date the asset was last used\n- When the asset is expected to be used again\n\nThe exclusion is extended for an additional year if the reason for not using the asset is a disabling condition. The person must sign a written statement with the following information:\n- The nature of the disabling condition\n- When the activity ceased\n- When the property is expected to be used again\n\n### Income Producing Self-Support Assets\n\nUp to $6,000 of the equity value of non-business, non-liquid, income-producing property that produces an annual return of at least six percent of the equity value is excluded:\n- The $6,000 exclusion is limited to the combined equity value of all property meeting the six percent rule.\n- If the person owns more than one piece of income-producing property, each piece must meet the six percent return on the equity value.\n- If the earnings drop below six percent for reasons beyond the person’s control, the property is excluded up to 24 months to allow the property to resume producing a six percent return.\n\n### Non-Income Producing Self-Support Assets\n\nNonbusiness property essential to self-support can be real or personal property. It produces goods or services essential to daily activities if, for example, it is used to:\n- Grow produce or livestock solely for personal consumption in the person’s household; or\n- Perform activities essential to the production of food solely for home consumption.\n\nUp to $6,000 of the equity value for each asset is excluded. Any portion of the property’s equity value in excess of $6,000 is not excluded.\n\nWhile this category of property may encompass a vehicle used solely in a nonbusiness self-support activity (e.g., a garden tractor, or a boat used for subsistence fishing), it does not include any vehicle that qualifies as an automobile. See [MA-ABD Automobiles and Other Vehicles for Transportation](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.7) for more information.\n\nWhen a person alleges owning property that he or she uses to produce goods or services necessary for daily activities, obtain his or her statement giving:\n- A description of the property;\n- How it is used; and\n- An estimate of its current market value and any encumbrances on it\n\n### Personal Property Used by an Employee\n\nNon-liquid personal property used by a person in employment, whether it is required by the employer or not, is excluded. The person must provide a written statement with the following information:\n- The name, address and telephone number of the employer\n- A general description of the personal assets used for work\n- A general description of the person’s job duties\n- Whether the personal assets are currently being used\n\nPersonal property not currently in use because of reasons beyond the person’s control can be excluded if they expect to resume use of the asset within one year. The person must sign a written statement with the following information:\n- The reason the asset is not in use\n- The date the asset was last used\n- When the asset is expected to be used again\n\nThe exclusion is extended for an additional year if the reason for not using the asset is a disabling condition. The person must sign a written statement with the following information:\n- The nature of the disabling condition\n- When the activity ceased\n- When the property is expected to be used again\n\nIf the statement indicates that the person no longer intends to resume using the assets for employment, they become countable assets unless unavailable or excluded under another provision."}]},{"id":"epm:2.3.3.2.4","number":"2.3.3.2.4","title":"Countable Assets","parent":"2.3.3.2","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.4 Countable Assets","summary":"Assets not specifically excluded are considered countable assets.","effective_date":"2024-08-07","last_modified":"2026-10-03T03:51:57.899951+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_4.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.3.3.2.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.4","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.4 Countable Assets","text":"Assets not specifically excluded are considered countable assets."},{"chunk_id":"epm:2.3.3.2.4#availability-of-countable-assets","heading":"Availability of Countable Assets","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.4#availability-of-countable-assets","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.4 Countable Assets > Availability of Countable Assets","text":"## Availability of Countable Assets\n\nCountable assets must be evaluated for availability to determine if their value counts toward the person’s asset limit. Countable assets that are available count towards the person’s asset limit. Countable assets that are unavailable do not count toward the person’s asset limit.\n\nThe value of the portion of an asset the person owns, in whole or in part, is presumed to be available, unless the person proves it is not. A person may prove all or part of an asset is unavailable by verifying a legal or actual barrier to obtaining or disposing of the asset that cannot be reasonably overcome. The person is not required to undertake litigation in order to accomplish the sale of, or gain access to, an asset if there is a documented legal barrier to the sale or use of property."},{"chunk_id":"epm:2.3.3.2.4#shared-ownership-of-countable-assets","heading":"Shared Ownership of Countable Assets","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.4#shared-ownership-of-countable-assets","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.4 Countable Assets > Shared Ownership of Countable Assets","text":"## Shared Ownership of Countable Assets\n\nIf a person shares ownership of a countable asset with one or more people, the person’s ownership interest must be determined to count the proper amount toward the person’s asset limit.\n\nA jointly owned asset is unavailable when all of the following criteria are met:\n- The permission of a joint owner is required to sell or dispose of the asset;\n- The joint owner is not a member of the household or financially responsible relative whose assets are deemed to the person; and\n- The joint owner refuses to allow the sale or disposal of the asset."},{"chunk_id":"epm:2.3.3.2.4#verification","heading":"Verification","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.4#verification","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.4 Countable Assets > Verification","text":"## Verification\n\nVerification of excluded or unavailable assets that have already been verified is not required unless the asset has become available."},{"chunk_id":"epm:2.3.3.2.4#other-asset-availability-rules","heading":"Other Asset Availability Rules","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.4#other-asset-availability-rules","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.4 Countable Assets > Other Asset Availability Rules","text":"## Other Asset Availability Rules\n\nNon-liquid personal property, such as a non-excluded vehicle, is considered available even if it is for sale. The terms of a premarital agreement are not considered when determining the available assets of a married couple.\n\nMinnesota Statutes, section 256B.056, subdivision 1a"}]},{"id":"epm:2.3.3.2.4.1.1","number":"2.3.3.2.4.1.1","title":"Shared Ownership (Archive)","parent":"2.3.3.2.4.1","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.4 Countable Assets > 2.3.3.2.4.1.1 Shared Ownership (Archive)","summary":"A person may be the sole owner of real or personal property or may share ownership with one or more people. Ownership of an asset is determined in order to count the proper amount toward the person’s asset limit.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:57.899951+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.4.1.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.4.1.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_4_1_1.htm","legal_citations":["Minnesota Statutes, section 256b.056, subdivision 1a"],"chunks":[{"chunk_id":"epm:2.3.3.2.4.1.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.4.1.1","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.4 Countable Assets > 2.3.3.2.4.1.1 Shared Ownership (Archive)","text":"A person may be the sole owner of real or personal property or may share ownership with one or more people. Ownership of an asset is determined in order to count the proper amount toward the person’s asset limit.\n\nThis section explains how to count shared interests in personal property. See [Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) Real Property](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4) for information on how to count shared interests in real property."},{"chunk_id":"epm:2.3.3.2.4.1.1#availability-of-shared-ownership-assets","heading":"Availability of Shared Ownership Assets","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.4.1.1#availability-of-shared-ownership-assets","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.4 Countable Assets > 2.3.3.2.4.1.1 Shared Ownership (Archive) > Availability of Shared Ownership Assets","text":"## Availability of Shared Ownership Assets\n\nA jointly owned asset is unavailable when all of the following criteria are met:\n- the permission of a joint owner is required to sell or dispose of the asset;\n- the joint owner is not a member of the household or a financially responsible relative whose assets are deemed to the person; and\n- the joint owner refuses to allow the sale or disposal of the asset.\n\nThese rules do not apply to jointly owned bank accounts."},{"chunk_id":"epm:2.3.3.2.4.1.1#jointly-owned-bank-accounts","heading":"Jointly Owned Bank Accounts","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.4.1.1#jointly-owned-bank-accounts","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.4 Countable Assets > 2.3.3.2.4.1.1 Shared Ownership (Archive) > Jointly Owned Bank Accounts","text":"## Jointly Owned Bank Accounts\n\nA jointly owned bank account may still be available even when another joint owner refuses access if it was titled jointly with the intent of allowing both parties full access. The following factors are used to determine if the jointly owned bank account is available:\n- How the account is titled, and laws governing the type of account\n- What agreements, if any, were signed when the account was opened or the second owner’s name was added to the account\n- Who contributed to the account\n- Who has had access to the account\n- Who has received income and/or 1099 tax forms from the account\n- Who gets the proceeds if the account is closed"},{"chunk_id":"epm:2.3.3.2.4.1.1#other-jointly-owned-assets","heading":"Other Jointly Owned Assets","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.4.1.1#other-jointly-owned-assets","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.4 Countable Assets > 2.3.3.2.4.1.1 Shared Ownership (Archive) > Other Jointly Owned Assets","text":"## Other Jointly Owned Assets\n\nThese general provisions are followed when evaluating joint ownership:\n\n### Uniform Gift to Minors Act/Uniform Transfers to Minors Act\n\nThe full value of assets established under the Uniform Gift to Minors Act/Uniform Transfers to Minors Act (UGMA/UTMA) is excluded.\n\nAn adult designated to receive, maintain and manage custodial property on behalf of a minor beneficiary is not the owner of UGMA/UTMA assets because he or she cannot legally use any of the funds for his or her support and maintenance.\n\n### Payable on Death Beneficiaries\n\nPayable on Death (POD) beneficiaries do not have an ownership interest in an asset.\n\n### Other Assets\n\nFor all other assets, each owner is considered to own an equal share unless the person documents a greater or lesser share of ownership.\n- Accounts\n  - The following rules are applied to bank accounts, including checking accounts, savings accounts, certificates of deposit, savings certificates, and other time deposit accounts which are jointly held:\n    - If the joint owners are people eligible for MA, even if not in the household, ownership of equal shares is presumed.\n    - If the joint owner is a responsible relative, whose assets are deemed available, ownership of equal shares is presumed.\n    - If joint owners do not meet the above two criteria, then the entire balance/value for each adult is counted.\n- Bonds\n  - The value of the jointly owned bond is divided among all named owners listed on the bond."}]},{"id":"epm:2.3.3.2.5","number":"2.3.3.2.5","title":"Unknown Assets","parent":"2.3.3.2","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.5 Unknown Assets","summary":"A person may be unaware of their ownership of an asset. If the person is unaware of their ownership interest in an asset, the value of the asset is not counted towards the asset limit during the period when the person was unaware of their ownership interest.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:57.899951+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.5","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.5","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_5.htm","legal_citations":["Minnesota Statutes, section 256B.056, subdivision 1a"],"chunks":[{"chunk_id":"epm:2.3.3.2.5#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.5","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.5 Unknown Assets","text":"A person may be unaware of their ownership of an asset. If the person is unaware of their ownership interest in an asset, the value of the asset is not counted towards the asset limit during the period when the person was unaware of their ownership interest.\n\nThe value of the previously unknown asset, including any money accumulated on it through the month of discovery, such as interest, is considered income in the month of discovery. In the months after the month of discovery, the previously unknown asset is subject to the usual asset-counting rules.\n\nWhen an unknown asset is discovered, verification of the asset and a signed statement from the person indicating that they were unaware of their ownership of the asset is required."}]},{"id":"epm:2.3.3.2.6","number":"2.3.3.2.6","title":"Excess Assets","parent":"2.3.3.2","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.6 Excess Assets","summary":"A person with one of the bases of eligibility for Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) who is subject to an asset limit and whose countable assets exceed the asset limit may reduce their assets to qualify for eligibility. This section provides information on how a person can reduce their assets.","effective_date":"2026-02-06","last_modified":"2026-10-03T03:51:57.899951+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.6","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.6","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_6.htm","legal_citations":["Minnesota Statutes, section 256B.056, subdivision 3(d)"],"chunks":[{"chunk_id":"epm:2.3.3.2.6#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.6","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.6 Excess Assets","text":"A person with one of the bases of eligibility for Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) who is subject to an asset limit and whose countable assets exceed the asset limit may reduce their assets to qualify for eligibility. This section provides information on how a person can reduce their assets."},{"chunk_id":"epm:2.3.3.2.6#reducing-excess-assets-at-application","heading":"Reducing Excess Assets at Application","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.6#reducing-excess-assets-at-application","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.6 Excess Assets > Reducing Excess Assets at Application","text":"## Reducing Excess Assets at Application\n\nPeople who are applying for MA-ABD who have excess countable assets in the month of application must reduce those assets to be within their asset limit by the end of the processing period to be eligible.\n\nSome acceptable ways to reduce assets for applicants who have excess assets in the application month include, but are not limited to, paying bills or other obligations such as health care expenses or purchasing assets that do not count toward the asset limit.\n\nApplicants who are requesting MA for Long-Term Care (LTC) services may be subject to a transfer penalty if they reduce assets by giving them away without receiving adequate compensation. See [MA-LTC Uncompensated Transfers](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3) for more information.\n\nApplicants must verify that they have reduced excess countable assets by providing bank statements or other documents that show current asset amounts, but are not required to provide receipts.\n\nEligibility can begin back to the first day of the month of application if the applicant reduces excess assets within the applicable processing period."},{"chunk_id":"epm:2.3.3.2.6#reducing-excess-assets-in-retroactive-months","heading":"Reducing Excess Assets in Retroactive Months","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.6#reducing-excess-assets-in-retroactive-months","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.6 Excess Assets > Reducing Excess Assets in Retroactive Months","text":"## Reducing Excess Assets in Retroactive Months\n\nApplicants with excess countable assets in the month of application who want retroactive coverage for any of the three months before the month of the application must reduce those assets to be within their asset limit by the end of the processing period to be eligible.\n\nApplicants with excess assets in a retroactive month may reduce their assets in the following two ways:\n1. Retroactively designate burial funds up to $1,500 if they have not already done so. See [MA-ABD Burial Contracts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11) for more information. Applicants who designate funds for burial are required to verify the designation by a signed and dated statement.\n2. The excess countable assets can be reduced by paying medical bills incurred in the retroactive months by the following people:\n  - The applicant\n  - The applicant’s spouse, regardless of whether the spouse is living in the household\n  - Dependent children under age 18 regardless of whether they live in the household\n  - Children under age 21 who live in the household\n\nTo determine what is an acceptable medical bill for excess asset reduction, apply the same rules used to determine what is an allowable health care expense for medical spenddowns. See [EPM 2.3.3.4.2 MA-ABD Health Care Expenses](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.4.2) for more information.\n\nMA eligibility begins on the date that excess countable assets have been reduced. Medical bills beginning with the next dollar after assets have been reduced are eligible for payment. Therefore, in order to achieve coverage on the earliest possible date, applicants must pay their oldest medical bills first.\n\nPayment of medical bills from the retroactive period must be verified. Verification may include bank statements, receipts, or confirmation from the provider. Medical bills used to reduce assets cannot be applied toward an income spenddown.\n\n### MA Eligibility for Retroactive Months When Excess Assets Have Been Spent\n\nApplicants who no longer have excess assets in the month of application but had excess assets in the retroactive months, and who want retroactive coverage for any of the three months before the month of the application must reduce those assets to be within their asset limit by the end of the processing period. Applicants may be eligible in the retroactive month(s) on the day after their excess countable assets were within the asset limit."},{"chunk_id":"epm:2.3.3.2.6#enrollees-reducing-assets-to-maintain-eligibility","heading":"Enrollees Reducing Assets to Maintain Eligibility","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.6#enrollees-reducing-assets-to-maintain-eligibility","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.6 Excess Assets > Enrollees Reducing Assets to Maintain Eligibility","text":"## Enrollees Reducing Assets to Maintain Eligibility\n\nEnrollees whose assets go over the asset limit are no longer eligible for MA-ABD unless they reduce their excess assets. Enrollees are provided a 10-day advance notice of closing. Eligibility continues if the enrollee reduces their excess assets by the effective date of closing.\n\nSome acceptable ways to reduce assets for enrollees who have excess assets include, but are not limited to, paying bills or other obligations such as health care expenses or purchasing assets that do not count toward the asset limit.\n\nEnrollees who request or receive MA for Long-Term Care (LTC) services may be subject to a transfer penalty if they reduce assets by giving them away without receiving adequate compensation. See [MA-LTC Uncompensated Transfers](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3) for more information.\n\nEnrollees must verify that they have reduced excess countable assets by providing bank statements or other documents that show current asset amounts, but are not required to provide receipts.\n\nAccrued personal needs allowances for people in long-term care facilities (LTCF) and accrued interest that go over the asset limit do not need to be reduced until the time of the next renewal.\n\n### Repayment of Minnesota Health Care Program Benefits\n\nAn enrollee may reduce assets by repaying an outstanding obligation of Minnesota Health Care Program (MHCP) benefits. Obligations to repay MA exist only if an enrollee has a calculated overpayment due to the receipt of health care benefits during a period in which the enrollee was ineligible or has an obligation required by a court as restitution in a fraud action. Agencies should not accept money from an enrollee in any other situation.\n\nThe Minnesota Department of Human Services (DHS) Special Recovery Unit (SRU) may accept payments on an MA claim related to the lien process. When notified by SRU, these payments are credited as an acceptable way to reduce excess assets."}]},{"id":"epm:2.3.3.2.7","number":"2.3.3.2.7","title":"Asset Evaluation","parent":"2.3.3.2","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation","summary":"Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) has specific rules about how the value of a person’s assets affects the person’s eligibility for coverage.","effective_date":"2016-06-01","last_modified":"2026-10-03T04:10:22.022886+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.7","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_7.htm","legal_citations":["Minnesota Statutes, section 256B.056, subdivision 1a","Minnesota Statutes, section 256B.056, subdivision 3"],"chunks":[{"chunk_id":"epm:2.3.3.2.7#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation","text":"Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) has specific rules about how the value of a person’s assets affects the person’s eligibility for coverage.\n\nInformation about how to evaluate different types of assets is discussed in these specific sections:\n1. [MA-ABD Annuities](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.8)\n2. [MA-ABD Automobiles and Other Vehicles Used for Transportation](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.7)\n3. [MA-ABD Burial Contracts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11)\n  1. [MA-ABD Burial Space Exclusion](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.1)\n  2. [MA-ABD Burial Fund Exclusion](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.2)\n4. [MA-ABD Continuing Care Retirement Community Entrance Fee](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.12)\n5. [MA-ABD Health Expense Accounts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.3)\n  1. [MA-ABD Health Flexible Spending Arrangements](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.3.1)\n  2. [MA-ABD Health Savings Accounts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.3.2)\n6. [MA-ABD Household Goods and Personal Effects](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.14)\n7. [MA-ABD Life Insurance Policies](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.10)\n8. [MA-ABD Liquid Assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.1)\n9. [MA-ABD Promissory Notes](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.6)\n10. [MA-ABD Real Property](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4)\n  1. [MA-ABD Homestead Real Property](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.1)\n  2. [MA-ABD Non-Homestead Real Property](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.2)\n  3. [MA-ABD Life Estates and Remainder Interests](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.3)\n  4. [MA-ABD Life Estate Mortality Table](https://bot-corpus.mn-dhs.online/s/epm/G)\n  5. [MA-ABD Other Property Interests](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.4)\n11. [MA-ABD Contract for Deed and Other Property Agreements](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.5)\n12. [MA-ABD Retirement Funds & Plans](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.2)\n13. [MA-ABD Tribal Payments and Interests](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.13)\n14. [MA-ABD Trusts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9)\n  1. [MA-ABD Identifying the Type of Trust](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.1)\n  2. [MA-ABD Client Funded Trusts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.2)\n  3. [MA-ABD Medical Assistance Qualifying Trusts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.3)\n  4. [MA-ABD Special Needs Trusts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.4)\n  5. [MA-ABD Pooled Trusts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.5)\n  6. [MA-ABD Third Party Established and Funded Trusts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.6)\n  7. [MA-ABD Supplemental Needs Trusts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.7)"}]},{"id":"epm:2.3.3.2.7.1","number":"2.3.3.2.7.1","title":"Liquid Assets","parent":"2.3.3.2.7","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.1 Liquid Assets","summary":"Liquid assets include cash or any other types of assets that can be converted to cash within 20 workdays. Workdays are any days other than Saturdays, Sundays, and federal holidays. This section discusses the types of liquid assets and clarifies whether they count towards the person’s asset limit.","effective_date":"2024-04-17","last_modified":"2026-10-03T03:51:57.899951+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.7.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_7_1.htm","legal_citations":["Minnesota Statutes, section 256B.056, subdivision 1a"],"chunks":[{"chunk_id":"epm:2.3.3.2.7.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.1","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.1 Liquid Assets","text":"Liquid assets include cash or any other types of assets that can be converted to cash within 20 workdays. Workdays are any days other than Saturdays, Sundays, and federal holidays. This section discusses the types of liquid assets and clarifies whether they count towards the person’s asset limit."},{"chunk_id":"epm:2.3.3.2.7.1#evaluation-of-liquid-assets","heading":"Evaluation of Liquid Assets","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.1#evaluation-of-liquid-assets","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.1 Liquid Assets > Evaluation of Liquid Assets","text":"## Evaluation of Liquid Assets\n\nThe total cash value of a liquid asset is counted towards the person’s asset limit unless the proof provided indicates that the asset is any of the following:\n- An Excluded Asset\n- An Unavailable Asset\n- A Jointly Owned Asset, for which the full value is not counted to each owner.\n\nIncome received in a given month is not an asset in that month. If retained beyond the month of receipt, income becomes a liquid asset."},{"chunk_id":"epm:2.3.3.2.7.1#assumption-of-liquidity","heading":"Assumption of Liquidity","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.1#assumption-of-liquidity","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.1 Liquid Assets > Assumption of Liquidity","text":"## Assumption of Liquidity\n\nAbsent evidence to the contrary, assume the following types of resources are liquid:\n- Bonds\n- Certificates of Deposit (CDs)\n- Checking accounts\n- Foreign Currency\n- Guardianship accounts. The total value of the guardianship account the person owns or the person or someone acting on behalf of the person has a legal right to use for the person’s support and maintenance is counted.\n- Money market account\n- Mortgages (Applicant or enrollee is the lender)\n- Mutual fund shares\n- Promissory notes (Applicant or enrollee is the lender)\n- Savings accounts\n- Social Welfare fund\n- Stocks. An applicant or enrollee may use stock listings to define the value of stocks.\n- Time deposits\n- Treasury Bills\n- U. S. Savings Bonds. An applicant or enrollee may use the Comprehensive Savings Bond Value table on the U.S. Bureau of Public Debt website or consult a bank to define the value of a savings bond.\n- Virtual currency that has a value in real currency or acts as a substitute for real currency."},{"chunk_id":"epm:2.3.3.2.7.1#assumption-of-non-liquidity","heading":"Assumption of Non-Liquidity","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.1#assumption-of-non-liquidity","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.1 Liquid Assets > Assumption of Non-Liquidity","text":"## Assumption of Non-Liquidity\n\nAbsent evidence to the contrary, the following types of assets are assumed not to be liquid:\n- Automobiles, trucks, tractors and other vehicles\n- Buildings, land and other real property rights\n- Household goods and personal effects\n- Machinery and livestock\n- Non-cash business property"},{"chunk_id":"epm:2.3.3.2.7.1#jointly-owned-liquid-assets","heading":"Jointly Owned Liquid Assets","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.1#jointly-owned-liquid-assets","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.1 Liquid Assets > Jointly Owned Liquid Assets","text":"## Jointly Owned Liquid Assets\n\nWhen more than one person is listed on the account as the account owner, or listed as an authorized signer, the account is considered jointly owned.\n\n### Ownership Assumption\n\nWhen an applicant or enrollee jointly owns an account with someone who is not eligible or applying for MA, we assume that all the funds in the account belong to the applicant or enrollee.\n\n### Account holders include one or more applicants or enrollees\n\nIf there is more than one applicant or enrollee, assume all of the funds in the account belong to the applicant(s) or enrollee(s), in equal shares.\n\n### Account holders include one or more deemors who are not MA applicants or enrollees\n\nWhen none of the account holders is an applicant or enrollee, assume all of the funds in the account belong to the deemor(s), in equal shares, if there is more than one deemor."},{"chunk_id":"epm:2.3.3.2.7.1#assumption-dispute","heading":"Assumption Dispute","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.1#assumption-dispute","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.1 Liquid Assets > Assumption Dispute","text":"## Assumption Dispute\n\nThe applicant, enrollee or deemor has the right to dispute the ownership assumption. The assumption dispute must occur at every determination or redetermination to overcome the ownership assumption.\n\nTo dispute the ownership assumption the person must provide a completed [DHS-8511](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-8511-ENG), or a separate written statement that provides the information requested on the form , including:\n- A corroborating statement from all other account holders, and;\n- Account records showing deposits, withdrawals, and interest in the months where ownership is contested\n\n### Dispute Outcome\n\nIf the agency determines the applicant, enrollee, or deemor:\n- does not own any of the funds, they must provide proof they have removed themselves as owner of the account.\n- owns only a portion of the funds in the account, the person must provide proof:\n  - they are removed themselves as an owner of the account and their proportionate share of the funds, if any, to have the account removed from current and retro countable income, or\n  - of removal of funds owned by the other account holder(s), and the other account owners removed themselves as an owner of the account. The remaining balance of the account is applied to the current and retro countable income.\n\nWhen the person does not provide proof they removed themselves, or other account holders from the account, the ownership assumption is not overcome and all of the funds are applied to the person’s countable income.\n\n### Effects on LTC Eligibility\n\nThe person must provide proof they removed their proportionate share of the funds prior to removing their name from the account to avoid a LTC transfer penalty."},{"chunk_id":"epm:2.3.3.2.7.1#other-jointly-owned-assets","heading":"Other Jointly Owned Assets","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.1#other-jointly-owned-assets","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.1 Liquid Assets > Other Jointly Owned Assets","text":"## Other Jointly Owned Assets\n\nThese general provisions are followed when evaluating other joint ownerships:\n\n### Uniform Gift to Minors Act/Uniform Transfers to Minors Act\n\nThe full value of assets established under the Uniform Gift to Minors Act/Uniform Transfers to Minors Act (UGMA/UTMA) is excluded.\n\nAn adult designated to receive, maintain and manage custodial property on behalf of a minor beneficiary is not the owner of UGMA/UTMA assets because he or she cannot legally use any of the funds for his or her support and maintenance.\n\n### Payable on Death Beneficiaries\n\nPayable on Death (POD) beneficiaries do not have an ownership interest in an asset."}]},{"id":"epm:2.3.3.2.7.2","number":"2.3.3.2.7.2","title":"Retirement Funds and Retirement Plans","parent":"2.3.3.2.7","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.2 Retirement Funds and Retirement Plans","summary":"Retirement funds are assets held by a person for use during retirement. A retirement plan is an arrangement to provide people with income during retirement. Employers, insurance companies, the government or other institutions such as employer associations or trade unions may set up retirement plans.","effective_date":"2026-06-03","last_modified":"2026-10-03T03:51:57.899951+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.7.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_7_2.htm","legal_citations":["Minnesota Statutes, section 256B.056, subdivision 1a"],"chunks":[{"chunk_id":"epm:2.3.3.2.7.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.2","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.2 Retirement Funds and Retirement Plans","text":"Retirement funds are assets held by a person for use during retirement. A retirement plan is an arrangement to provide people with income during retirement. Employers, insurance companies, the government or other institutions such as employer associations or trade unions may set up retirement plans.\n\nThe available value of retirement funds and retirement plans count toward the Medical Assistance for People who are Age 65 or Older and People who are Blind or have a Disability (MA-ABD) asset limit unless an exception applies.\n\nExceptions:\n- Individual Retirement Accounts held in the form of an annuity (or an annuity account in the accumulation phase) must be evaluated as an annuity. See MA-ABD Annuities for more information.\n- A retirement plan of a spouse that is owned by a spouse not enrolled in MA is not counted for a spouse enrolled in MA-ABD.\n- A retirement plan that cannot be accessed until a person terminates employment.\n- A retirement plan that has been converted to an income stream that pays periodic payments that does not allow for other withdrawals in addition to the income stream. Periodic payments received from a retirement plan are counted as income in the month received and as an asset in the months after the month of receipt."},{"chunk_id":"epm:2.3.3.2.7.2#evaluation-of-retirement-plans","heading":"Evaluation of Retirement Plans","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.2#evaluation-of-retirement-plans","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.2 Retirement Funds and Retirement Plans > Evaluation of Retirement Plans","text":"## Evaluation of Retirement Plans\n\nEach specific retirement plan establishes the circumstances under which retirement funds are available. Some retirement plans allow for disbursements of retirement funds due to disability or other circumstances. Others allow for disbursements of any portion or an account balance that represents assets a person rolled into the plan from another employer-sponsored retirement plan . The value of a retirement plan is the amount of funds that a person can currently withdraw. If there is a penalty for early withdrawal, the plan's value is the amount of funds available after the penalty deduction. However, any taxes due as a result of the withdrawal are not deducted when determining the plan's value.\n\nA delay in payment of retirement plan funds for reasons beyond the individual’s control, such as processing time, does not mean that the funds are unavailable. The retirement plan funds are available because the individual can legally withdraw the funds. The distributed funds that are retained will be an asset in the months after the month of receipt."},{"chunk_id":"epm:2.3.3.2.7.2#types-of-retirement-plans","heading":"Types of Retirement Plans","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.2#types-of-retirement-plans","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.2 Retirement Funds and Retirement Plans > Types of Retirement Plans","text":"## Types of Retirement Plans\n- An individual retirement arrangement is an umbrella term used to describe a personal retirement savings plan that provides the owner tax advantages for setting aside money for retirement. Individual retirement arrangements can be in the form of a trust, an account, or an annuity. Individually-purchased individual retirement arrangements are generally purchased by a person from an insurance company, bank or financial planner. Common individually-purchased individual retirement arrangements include: These retirement plans fall under one of the following three categories: defined-benefit plans, defined-contribution plans and employer-sponsored retirement arrangements. When an IRA is held in the form of a trust, account or annuity, the IRA is the plan that meets the federal government guidelines to receive certain tax advantages and the trust, account or annuity is the vehicle used to fund the IRA (retirement plan). IRAs held in the form of a trust or account must be evaluated as a retirement plan using the policy in this section. IRAs held in the form of an annuity (or an annuity account for an annuity in the accumulation phase), must be evaluated as an annuity using the policies in [Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) Annuities](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.8). Funds that a person intends to use for retirement, but that are not placed in a retirement plan are treated differently. Retirement funds not in a retirement plan are evaluated as [liquid assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.1). For example, funds held in a bank account a person intends to use for retirement, are treated as a liquid asset, not as a retirement plan. \n  - Traditional IRAs\n  - Roth IRAs\n  - Spousal IRAs\n  - Defined-Benefit Plans. This is a retirement plan (also referred to as a pension plan) that promises a specified monthly benefit at retirement. The plan may state the promised benefit as an exact dollar amount. More commonly, however, the plan sponsor calculates a benefit through a plan formula that considers certain factors such as salary and years of service. There are three types of defined benefit plans: traditional plans, cash balance plans and defined-benefit Keogh plans\n    - Traditional plans. A type of defined-benefit retirement plan offered by both private and public employers. These types of retirement plans are often referred to as a pension. Examples of traditional defined benefit plans include:\n      - Federal Employee Retirement System (FERS)\n      - Military pension (Air Force, Marine Corps, Navy, and Coast Guard)\n      - Minnesota State Retirement System (MSRS)\n      - Minnesota Teachers Retirement Association (TRA)\n      - Public Employees Retirement Association (PERA)\n      - Railroad Retirement\n      - Traditional plans offered by public and private employers\n    - Cash balance plan. A defined-benefit plan that defines the benefit in terms that are more characteristic of a defined contribution plan. Employers bear the financial risk of cash balance plans and are required to maintain sufficient funds to pay future benefits. The unique feature of a cash balance plan is that the employee’s account shows benefits as a lump sum - the “cash balance” of the account - rather than as periodic payments the employee will receive during retirement.\n    - Defined-benefit Keogh plan. A tax deferred pension plan available to self-employed individuals or unincorporated businesses for retirement purposes. A Keogh plan can be set up as either a defined-benefit or defined contribution plan, although most plans are defined contribution plans.\n  - Defined contribution plans. A defined contribution plan is a retirement plan that does not promise a specific amount of benefits at retirement. In these plans, the employee or the employer (or both) contribute to the employee’s individual account under the plan. These contributions generally are invested on the employee’s behalf. The employee will ultimately receive the balance in the account, which is based on contributions, plus or minus investment gains or losses. The value of the account will fluctuate due to the changes in the value of the investments purchased with the contributions added to the employee's individual account. Distributions start at retirement age, but participants can also take distributions if they change jobs or in certain emergencies. Participants can choose to take distributions as a lump sum, annual installments or as an annuity. The following are examples of defined contribution plans:\n    - 401(k) plans\n    - Roth 401(k) plans\n    - 403(b) plans\n    - 457 plans\n    - Thrift Savings Plans (TSPs)\n    - Employee Stock Ownership Plans (ESOPs)\n    - Profit sharing plans\n    - Defined-contribution Keogh plans\n  - Employer-Sponsored IRAs. An employer-sponsored IRA is an individual retirement arrangement that an employer establishes for an employee. The following are examples of employer-based IRAs:\n    - Simplified Employee Pension (SEP) IRAs (available to employees and self-employed individuals)\n    - Savings Incentive Match Plans for Employees (SIMPLE) IRAs (available to employees and self-employed individuals)\n    - Deemed IRAs\n    - Payroll Deduction IRAs"}]},{"id":"epm:2.3.3.2.7.3","number":"2.3.3.2.7.3","title":"Health Expense Accounts","parent":"2.3.3.2.7","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.3 Health Expense Accounts","summary":"Various programs give people tax advantages to offset health care costs:","effective_date":"2016-06-01","last_modified":"2026-10-03T04:10:22.204618+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.7.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_7_3.htm","legal_citations":["Minnesota Statutes, section 256B.056, subdivision 1a"],"chunks":[{"chunk_id":"epm:2.3.3.2.7.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.3","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.3 Health Expense Accounts","text":"Various programs give people tax advantages to offset health care costs:\n- [Health Flexible Spending Arrangements](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.3.1) (FSAs)\n- Health Reimbursement Arrangements (HRAs)\n  - These arrangements are unavailable.\n- [Health Savings Accounts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.3.2) (HSAs)\n\nSee [Appendix A Types of Assets](https://bot-corpus.mn-dhs.online/s/epm/A) for definitions of these health expense accounts."}]},{"id":"epm:2.3.3.2.7.3.1","number":"2.3.3.2.7.3.1","title":"Health Flexible Spending Arrangements","parent":"2.3.3.2.7.3","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.3 Health Expense Accounts > 2.3.3.2.7.3.1 Health Flexible Spending Arrangements","summary":"Health flexible spending arrangements (FSA), also known as flexible spending accounts, are an employer-established benefit plan used to reimburse employees for qualified medical expenses. An employee’s voluntary salary reduction agreement with the employer usually funds health FSAs. The employer may also contribute to the health FSA.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:57.899951+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.3.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.7.3.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_7_3_1.htm","legal_citations":["Minnesota Statutes, section 256B.056, subdivision 1a"],"chunks":[{"chunk_id":"epm:2.3.3.2.7.3.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.3.1","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.3 Health Expense Accounts > 2.3.3.2.7.3.1 Health Flexible Spending Arrangements","text":"Health flexible spending arrangements (FSA), also known as flexible spending accounts, are an employer-established benefit plan used to reimburse employees for qualified medical expenses. An employee’s voluntary salary reduction agreement with the employer usually funds health FSAs. The employer may also contribute to the health FSA."},{"chunk_id":"epm:2.3.3.2.7.3.1#availability-of-health-fsas","heading":"Availability of Health FSAs","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.3.1#availability-of-health-fsas","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.3 Health Expense Accounts > 2.3.3.2.7.3.1 Health Flexible Spending Arrangements > Availability of Health FSAs","text":"## Availability of Health FSAs\n\nHealth FSAs are not counted as an asset because FSA funds are restricted to pay for qualified medical expenses. Employers ensure that health FSA funds are only used for qualified medical expenses."},{"chunk_id":"epm:2.3.3.2.7.3.1#identifying-health-fsas","heading":"Identifying Health FSAs","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.3.1#identifying-health-fsas","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.3 Health Expense Accounts > 2.3.3.2.7.3.1 Health Flexible Spending Arrangements > Identifying Health FSAs","text":"## Identifying Health FSAs\n\nGeneral criteria for health FSAs include the following:\n- People must have an employer. Self-employed people are not eligible for FSAs.\n- To pay for medical expenses, employers issue debit cards, credit cards, and stored value cards to a person for use with participating medical providers.\n- Employers may also reimburse individuals who file a claim for reimbursement or submit an Explanation of Benefits (EOB) showing the funds the employee owes to the medical provider.\n- Employees may use FSA funds for qualified medical expenses for themself, or their spouse and dependents.\n- Employers do not deduct federal income taxes from the FSA contributions.\n- Employees do not have to report FSA reimbursements on income tax returns.\n\n### Contributions to FSAs\n\nContributions to a health FSA plan may vary. Each health FSA plan sets a maximum amount or maximum percentage of compensation that can be contributed to the FSA.\n\nPeople do not pay federal income tax or employment taxes on the portion of their salary that they contribute or the amounts their employer contributes to the health FSA.\n\n### Distributions from FSAs\n\nHealth FSA distributions paid directly to the person are not income. Health FSA plans reimburse people for qualified medical expenses by issuing debit, credit, or stored value cards to pay for the expenses. They may also reimburse the person directly through a check or direct deposit."}]},{"id":"epm:2.3.3.2.7.3.2","number":"2.3.3.2.7.3.2","title":"Health Savings Accounts","parent":"2.3.3.2.7.3","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.3 Health Expense Accounts > 2.3.3.2.7.3.2 Health Savings Accounts","summary":"A Health Savings Account (HSA) is a tax-exempt trust or custodial account used to pay for the qualified medical expenses of the account beneficiary, spouse, or dependents. HSAs are set up with qualified trustees, which can be banks, insurance companies or any entity already approved by the IRS to be a trustee of individual retirement arrangements.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:57.899951+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.3.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.7.3.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_7_3_2.htm","legal_citations":["Minnesota Statutes, section 256B.056, subdivision 1a"],"chunks":[{"chunk_id":"epm:2.3.3.2.7.3.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.3.2","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.3 Health Expense Accounts > 2.3.3.2.7.3.2 Health Savings Accounts","text":"A Health Savings Account (HSA) is a tax-exempt trust or custodial account used to pay for the qualified medical expenses of the account beneficiary, spouse, or dependents. HSAs are set up with qualified trustees, which can be banks, insurance companies or any entity already approved by the IRS to be a trustee of individual retirement arrangements."},{"chunk_id":"epm:2.3.3.2.7.3.2#availability-of-health-savings-accounts","heading":"Availability of Health Savings Accounts","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.3.2#availability-of-health-savings-accounts","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.3 Health Expense Accounts > 2.3.3.2.7.3.2 Health Savings Accounts > Availability of Health Savings Accounts","text":"## Availability of Health Savings Accounts\n\nGenerally, HSAs are considered available because people may use the funds to pay for expenses unrelated to their medical needs. However, some HSAs are considered excluded assets.\n\n### Exception to counting HSAs as an available asset\n\nWhen access to the HSA funds is restricted, the HSA is considered an excluded asset. The trustee of an HSA may restrict access to the account to pay only for qualified medical expenses. The account terms must be verified to determine if the account is legally restricted from uses other than qualified medical expenses."},{"chunk_id":"epm:2.3.3.2.7.3.2#determining-the-value-of-an-available-health-savings-accounts","heading":"Determining the Value of an Available Health Savings Accounts","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.3.2#determining-the-value-of-an-available-health-savings-accounts","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.3 Health Expense Accounts > 2.3.3.2.7.3.2 Health Savings Accounts > Determining the Value of an Available Health Savings Accounts","text":"## Determining the Value of an Available Health Savings Accounts\n\nThe value of an HSA is the balance in the account available for withdrawal. In rare cases, there may be a penalty for early withdrawal from an HSA. If a penalty exists, the amount of the early withdrawal penalty prior to determining the resource value is deducted. Tax penalties are not deducted prior to determining the resource value of an HSA."},{"chunk_id":"epm:2.3.3.2.7.3.2#identifying-hsas","heading":"Identifying HSAs","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.3.2#identifying-hsas","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.3 Health Expense Accounts > 2.3.3.2.7.3.2 Health Savings Accounts > Identifying HSAs","text":"## Identifying HSAs\n\nGeneral criteria for identifying HSAs include the following:\n- HSAs require people to have coverage under a high deductible health plan (HDHP). Besides an HDHP plan, people could have separate coverage for dental or vision care, or coverage:\n  - Specifically designed for a certain disease\n  - For hospitalization at a fixed amount per day\n  - For liabilities incurred under workers’ compensation laws, tort liabilities, or liabilities related to ownership or use of property\n- A person cannot have an HSA and enroll in Medicare.\n- Contributions remain in the HSA from year to year until depleted.\n- HSA distributions may be tax free if used to pay for qualified medical expenses.\n- HSAs are portable. Portable means that if a person changes jobs or leaves the workforce, he or she has the option to keep the HSA.\n\n### Contributions to HSAs\n\nContributions to an HSA must be in cash. Contributions of stock or property are not allowed.\n- Who may contribute to an HSA:\n  - An eligible person, employer, or both can contribute to an HSA in the same year\n  - Self-employed (or unemployed) people, their family members, or any other person may contribute to an HSA\n- Limits on the amount of contribution to an HSA depends on the:\n  - Type of HDHP coverage\n  - Person’s age the date of HSA eligibility\n  - Date the person ceases to be eligible for the HSA\n\nThe amounts also vary per year. For example in 2016, for self-only plans the contribution limit was $3,350. For more information on the contribution limits to HSAs, refer to the IRS website.\n\n### Distributions from an HSA\n\nDistributions from an HSA are not income. An HSA distribution is a conversion of an asset. HSA trustees report distributions on the Form 1099-SA (Distributions from an HSA).\n\n### Balance in an HSA\n\nUnused amounts that remain at the end of the year in an HSA are generally carried over to the next year."}]},{"id":"epm:2.3.3.2.7.4","number":"2.3.3.2.7.4","title":"Real Property","parent":"2.3.3.2.7","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.4 Real Property","summary":"Real property includes land and all buildings or immovable objects attached permanently to the land. Real property is an asset and is counted toward a person’s asset limit if available and not excluded. Availability depends upon the type of real property and the person’s ownership interest in it. See the following types of real property for more information.","effective_date":"2016-09-01","last_modified":"2026-10-03T04:10:22.540798+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.7.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_7_4.htm","legal_citations":["Minnesota Rules, part 9505.0015","Minnesota Statutes, section 256B.056, subdivision 1a"],"chunks":[{"chunk_id":"epm:2.3.3.2.7.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.4 Real Property","text":"Real property includes land and all buildings or immovable objects attached permanently to the land. Real property is an asset and is counted toward a person’s asset limit if available and not excluded. Availability depends upon the type of real property and the person’s ownership interest in it. See the following types of real property for more information.\n1. [Homestead Real Property](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.1)\n2. [Non-Homestead Real Property](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.2)\n3. [Life Estates and Remainder Interest](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.3)\n4. [Life Estates Mortality Table](https://bot-corpus.mn-dhs.online/s/epm/G)\n5. [Other Property Interests](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.4)\n\nThis section explains the ways in which a person can own real property."},{"chunk_id":"epm:2.3.3.2.7.4#sole-ownership-in-real-property","heading":"Sole Ownership in Real Property","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4#sole-ownership-in-real-property","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.4 Real Property > Sole Ownership in Real Property","text":"## Sole Ownership in Real Property\n\nSole ownership of real property means that only one person may sell, transfer, or otherwise dispose of the property. Sole ownership may be limited by conditions imposed by other interests."},{"chunk_id":"epm:2.3.3.2.7.4#shared-ownership-in-real-property","heading":"Shared Ownership in Real Property","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4#shared-ownership-in-real-property","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.4 Real Property > Shared Ownership in Real Property","text":"## Shared Ownership in Real Property\n\nShared ownership of real property means that two or more people own the property at the same time. Shared ownership may be limited by conditions imposed by other interests. There are three types of shared ownership:\n\n### Tenancy-in-common\n\nTenancy-in-common is a form of property ownership in which:\n- Owners may not have the same interests in the property. This means that while two or more people each have an interest in the entire property, these interests are not necessarily equal; e.g., two joint tenants do not necessarily each own half of the property.\n- Owners may sell, transfer or otherwise dispose of their share of the property without the permission of the other owner(s).\n- Owners do not have survivorship rights. This means that when one tenant-in-common dies, the other tenant(s)-in-common does not automatically gain rights to the deceased owner’s interest in the property.\n\n### Joint tenancy\n\nJoint tenancy is a form of property ownership in which:\n- Owners have the same interest in the property. Each owner owns all of the property and may possess all of the property.\n- Owners generally may not sell, transfer or otherwise dispose of their share of the property without the permission of all other owners.\n- Owners have survivorship rights. If one-joint owner dies, that owner’s interest in the property passes to the other joint owner(s).\n\nThe value of a person’s joint tenancy interest in real property is determined by dividing the equity value by the number of owners.\n\n### Tenancy by the entirety\n\nTenancy by the entirety is a form of property ownership in which:\n- Owners are a married couple. Each spouse owns the entire property.\n- A spouse cannot sell, transfer, or otherwise dispose of the property without the consent of the other spouse.\n- Owners have survivorship rights. If one spouse dies, the other spouse becomes the sole owner of the property.\n\nThis type of real property ownership does not exist in Minnesota, but may apply to property held in another state. This form of ownership protects the property owner from debts contracted outside the marriage. Creditors of the debtor spouse may not collect against the property unless the debtor spouse becomes the sole owner."},{"chunk_id":"epm:2.3.3.2.7.4#ownership-of-homestead-property-in-minnesota","heading":"Ownership of Homestead Property in Minnesota","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4#ownership-of-homestead-property-in-minnesota","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.4 Real Property > Ownership of Homestead Property in Minnesota","text":"## Ownership of Homestead Property in Minnesota\n\nIn Minnesota, a spouse cannot sell, transfer, or otherwise dispose of homestead property without the consent of the other spouse. This is true regardless of whether the spouses own the homestead as tenants-in-common, as joint tenants, or if the homestead is held solely in the name of only one spouse."},{"chunk_id":"epm:2.3.3.2.7.4#limits-on-ownership","heading":"Limits on Ownership","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4#limits-on-ownership","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.4 Real Property > Limits on Ownership","text":"## Limits on Ownership\n\nFee simple ownership means absolute and unqualified title to real property. The owners can sell, transfer, possess, use, or otherwise dispose of their interest in the property during their lifetime without limit or condition. Upon his or her death, property held in fee simple can pass to the owner’s heirs. Fee simple ownership may exist with respect to property owned jointly or solely.\n\nLess than fee simple ownership means the real property owners may have limits on their rights to sell, transfer, possess, use or otherwise dispose of their property. Two types of less than fee simple ownership are:\n- Life estate. An interest in real property with the right of use or enjoyment limited to the owner’s life or the life of some other person. A life estate is a form of legal ownership and usually created through a deed or will or by operation of law.\n- Remainder interest. A life estate instrument often gives property to one person for life (life estate owner) and to one or more others (remaindermen) upon the death of the life estate owner. A remainderman has an ownership interest in the physical property but without the right to possess and use the property until termination of the life estate."},{"chunk_id":"epm:2.3.3.2.7.4#verification-of-real-property-ownership-interests","heading":"Verification of Real Property Ownership Interests","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4#verification-of-real-property-ownership-interests","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.4 Real Property > Verification of Real Property Ownership Interests","text":"## Verification of Real Property Ownership Interests\n\nIt is assumed, absent evidence to the contrary, that each owner of shared property owns only his or her fractional interest in the property. Documents that people may use to verify ownership interests include, but are not limited to:\n- Deeds\n- Assessment notices\n- Current tax bills\n- Current mortgage statements\n- Report of title searches\n- Wills, court records or documents which show rights of an heir to property after death of a former owner"}]},{"id":"epm:2.3.3.2.7.4.1","number":"2.3.3.2.7.4.1","title":"Homestead Real Property","parent":"2.3.3.2.7.4","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.4 Real Property > 2.3.3.2.7.4.1 Homestead Real Property","summary":"A homestead is any property in which a person or a person’s spouse has an ownership interest and which serves as the person’s principal place of residence. It includes the surrounding land and buildings on that land, provided the land is not separated by any property owned by others. Easements and public rights of way (e.g. utility lines, roads, etc.) do not separate other land from the home plot.","effective_date":"2026-06-03","last_modified":"2026-10-03T03:51:57.899951+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.7.4.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_7_4_1.htm","legal_citations":["Minnesota Statutes, section 256B.056, subdivision 1a","Minnesota Statutes, section 256B.056, subdivision 2"],"chunks":[{"chunk_id":"epm:2.3.3.2.7.4.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.1","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.4 Real Property > 2.3.3.2.7.4.1 Homestead Real Property","text":"A homestead is any property in which a person or a person’s spouse has an ownership interest and which serves as the person’s principal place of residence. It includes the surrounding land and buildings on that land, provided the land is not separated by any property owned by others. Easements and public rights of way (e.g. utility lines, roads, etc.) do not separate other land from the home plot. It may be fixed or mobile and located on land or water.\n\nThis section provides policy detail regarding homestead real property."},{"chunk_id":"epm:2.3.3.2.7.4.1#homestead-real-property-exclusion","heading":"Homestead Real Property Exclusion","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.1#homestead-real-property-exclusion","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.4 Real Property > 2.3.3.2.7.4.1 Homestead Real Property > Homestead Real Property Exclusion","text":"## Homestead Real Property Exclusion\n\nThe homestead includes a home owned and occupied by a person, a person’s spouse, or a person’s disabled or dependent child, regardless of its value. The following factors must both be met for a person to have the homestead excluded:\n- The person has an ownership interest in the homestead.\n- The person, or dependent relative, resides in the homestead and considers it his or her principal home.\n\nThe home continues to be excluded if the person is not currently residing in the home, but as long as they intend to return to it. An excluded homestead does not need to be verified."},{"chunk_id":"epm:2.3.3.2.7.4.1#homestead-real-property-exclusion-for-long-term-care","heading":"Homestead Real Property Exclusion for Long-Term Care","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.1#homestead-real-property-exclusion-for-long-term-care","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.4 Real Property > 2.3.3.2.7.4.1 Homestead Real Property > Homestead Real Property Exclusion for Long-Term Care","text":"## Homestead Real Property Exclusion for Long-Term Care\n\nFor people who reside in a [Long-Term Care Facility](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.4) (LTCF), the homestead is excluded as follows:\n- The first six full calendar months the person resides in the LTCF if the person is expected to remain in the LTCF indefinitely. The homestead of a person who has already resided in the LTCF for more than six full calendar months is not excluded; the property is evaluated as non-homestead real property\n- As long as the person intends to return home and can reasonably be expected to return home. To meet these criteria, all of the following must occur:\n  - The person must attest, either verbally or in writing to a continued intent to return home.\n  - If the person's attestation of intent contradicts the information about the anticipated length of stay on the Physician's Certification Statement ([DHS-1503](http://edocs.dhs.state.mn.us/lfserver/Legacy/DHS-1503-ENG)), then the person's attending physician, advanced practice registered nurse, or physician assistant must provide a statement that indicates the person can reasonably be expected to return home: and\n  - MA or other sources will cover the cost of care if the person will require services upon returning home. Eligibility for MA or coverage of the services through Medicare or other private health insurance is acceptable verification.\n- The homestead is excluded for as long as it is the residence of one or more of the following relatives of the LTCF resident:\n  - Spouse\n  - Child under age 21\n  - Child of any age with a certified disability\n  - Sibling\n    - This exclusion is applied if the sibling lived in the home for at least one year immediately before the date of the person’s admission to the LTCF and the sibling has an equity interest in the home.\n  - Child or grandchild of any age\n    - This exclusion is applied if the child or grandchild meets both of the following:\n      - Lived in the home for at least two years immediately before the date of the person’s admission to the LTCF\n      - The child or grandchild provided verifiable care that allowed the person to remain at home rather than enter an LTCF. A physician's statement that verifies the care provided by the child or grandchild allowed the person to remain at home is required.\n\nIf the property does not meet any of the criteria, the home is reviewed as [MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) Non-Homestead Real Property](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.2)."}]},{"id":"epm:2.3.3.2.7.4.2","number":"2.3.3.2.7.4.2","title":"Non-Homestead Real Property","parent":"2.3.3.2.7.4","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.4 Real Property > 2.3.3.2.7.4.2 Non-Homestead Real Property","summary":"Non-homestead real property is land with or without buildings or immovable objects attached permanently to the land that are not the person’s principal place of residence. Non-homestead real property is generally counted as an asset; however, it is not counted during the time a person makes a reasonable effort to sell the property.","effective_date":"2019-04-01","last_modified":"2026-10-03T03:51:58.594961+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.7.4.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_7_4_2.htm","legal_citations":["Minnesota Statutes, section 256B.056, subdivision 1a","Minnesota Statutes, section 273.125, subdivision 8"],"chunks":[{"chunk_id":"epm:2.3.3.2.7.4.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.2","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.4 Real Property > 2.3.3.2.7.4.2 Non-Homestead Real Property","text":"Non-homestead real property is land with or without buildings or immovable objects attached permanently to the land that are not the person’s principal place of residence. Non-homestead real property is generally counted as an asset; however, it is not counted during the time a person makes a reasonable effort to sell the property."},{"chunk_id":"epm:2.3.3.2.7.4.2#evaluating-manufactured-homes-as-non-homestead-real-property","heading":"Evaluating Manufactured Homes as Non-Homestead Real Property","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.2#evaluating-manufactured-homes-as-non-homestead-real-property","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.4 Real Property > 2.3.3.2.7.4.2 Non-Homestead Real Property > Evaluating Manufactured Homes as Non-Homestead Real Property","text":"## Evaluating Manufactured Homes as Non-Homestead Real Property\n\nA manufactured home, including a mobile home that is not the person's principal place of residence is evaluated as non-homestead real property only if each of the following criteria is met:\n- The owner of the manufactured home holds title to the land on which it is situated;\n- The manufactured home is affixed to the land by a permanent foundation, is affixed to the land like other real property in the community, or is installed according to the building codes and standards; and\n- The manufactured home is connected to public utilities, has a well and septic tank system, or is serviced by water and sewer facilities comparable to other real property in the community.\n\nIf a non-homestead manufactured home does not meet these criteria, then it is evaluated as personal property. See [Household Goods, Personal Effects, and Other Personal Property](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.14)."},{"chunk_id":"epm:2.3.3.2.7.4.2#evaluating-the-equity-value-of-non-homestead-real-property","heading":"Evaluating the Equity Value of Non-Homestead Real Property","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.2#evaluating-the-equity-value-of-non-homestead-real-property","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.4 Real Property > 2.3.3.2.7.4.2 Non-Homestead Real Property > Evaluating the Equity Value of Non-Homestead Real Property","text":"## Evaluating the Equity Value of Non-Homestead Real Property\n\nEquity value of non-homestead real property is determined by subtracting encumbrances from the estimated market value (EMV) found on a property tax statement. An encumbrance is any legal debt, such as a mortgage, lien, loan, purchase contract, or security interest. It must be supported with evidence of:\n- The original amount owed\n- The outstanding principal balance\n- The schedule and amount of payments due on the principal balance\n\nEquity value of non-homestead real property is counted toward the asset limit, unless:\n- The property is determined to be unavailable, due to a legal or actual barrier to obtaining or disposing of the property.\n- The person is making a reasonable effort to sell the property."},{"chunk_id":"epm:2.3.3.2.7.4.2#what-is-a-reasonable-effort-to-sell","heading":"What is a reasonable effort to sell?","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.2#what-is-a-reasonable-effort-to-sell","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.4 Real Property > 2.3.3.2.7.4.2 Non-Homestead Real Property > What is a reasonable effort to sell?","text":"## What is a reasonable effort to sell?\n\nA reasonable effort to sell has three criteria:\n1. Attempting to sell the property, which means:\n  - Listing the property with a real estate broker, or\n  - Advertising the property for sale using one or more public forms of advertisement available to residents of the geographic area where the property is located.\n2. Listing an appropriate price for the property. The asking price should be the EMV on the tax statement, except when the accuracy of the EMV is disputed.\n3. The owner must not reject any reasonable offer to buy the property.\n\nThe asking price can be the fair market value (FMV) determined by a licensed real estate appraiser if a person disputes the accuracy of the EMV. Neither a letter from a real estate agent with a recommended market price nor comparable listings from the immediate neighborhood are acceptable. A person who disputes the EMV but cannot afford an appraisal can request a new EMV determination from the county in which the property is located.\n\nReasonable efforts to sell the property must continue until the property is sold; otherwise, the property becomes a countable asset at the point reasonable efforts are no longer made."},{"chunk_id":"epm:2.3.3.2.7.4.2#what-is-a-reasonable-offer","heading":"What is a reasonable offer?","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.2#what-is-a-reasonable-offer","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.4 Real Property > 2.3.3.2.7.4.2 Non-Homestead Real Property > What is a reasonable offer?","text":"## What is a reasonable offer?\n\nAn owner must attempt to get offers for the EMV or the verified FMV if the owner disputes the EMV.\n- No minimum length of time is required for an owner to try to get offers close to the EMV (or FMV). The reasonable length of time is based on the local market, or the time period designated in a real estate contract.\n- The property must be offered for sale on the open market before the owner may accept an offer lower than the EMV (or FMV).\n- An offer for less than two-thirds of the EMV (or FMV) is not considered reasonable."}]},{"id":"epm:2.3.3.2.7.4.3","number":"2.3.3.2.7.4.3","title":"Life Estates and Remainder Interests","parent":"2.3.3.2.7.4","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.4 Real Property > 2.3.3.2.7.4.3 Life Estates and Remainder Interests","summary":"A life estate is an ownership interest in real property. The right of ownership exists for the lifetime of the person holding it, the lives of one or more other designated persons, or one or more other specified conditions within the lifetime of the life estate owner. A life estate document specifies when the life estate terminates.","effective_date":"2022-09-01","last_modified":"2026-10-03T04:10:22.721735+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.7.4.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_7_4_3.htm","legal_citations":["Minnesota Statutes, section 256B.056, subdivision 1a","Minnesota Statutes, section 256B.056, subdivision 4a"],"chunks":[{"chunk_id":"epm:2.3.3.2.7.4.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.3","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.4 Real Property > 2.3.3.2.7.4.3 Life Estates and Remainder Interests","text":"A life estate is an ownership interest in real property. The right of ownership exists for the lifetime of the person holding it, the lives of one or more other designated persons, or one or more other specified conditions within the lifetime of the life estate owner. A life estate document specifies when the life estate terminates.\n\nThe owner(s) of a life estate may be called a “life tenant” or “tenant for life.” Generally, a life estate entitles the life tenant to occupy, possess or otherwise use the property as long as he or she lives.\n\nWhen the owner of property gives it to one party in the form of a life estate, and designates a second person to inherit it upon the death of the life estate owner, the second person has a remainder interest in the property and is referred to as a remainderman.\n\nA life estate is generally created:\n- When a person with property rights in real property transfers a remainder interest in the property to another and retains a life estate in the property\n- When a person purchases a life estate interest in someone else’s property\n- By operation of probate law"},{"chunk_id":"epm:2.3.3.2.7.4.3#rights-and-responsibilities-of-the-life-estate-owner","heading":"Rights and Responsibilities of the Life Estate Owner","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.3#rights-and-responsibilities-of-the-life-estate-owner","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.4 Real Property > 2.3.3.2.7.4.3 Life Estates and Remainder Interests > Rights and Responsibilities of the Life Estate Owner","text":"## Rights and Responsibilities of the Life Estate Owner\n\nThe life estate owner:\n- Has the right to occupy, possess, or otherwise use the property until the life estate is terminated\n- Has the right to sell the life estate interest if not prohibited in the legal instrument establishing the life estate interest\n- Is entitled to all income and profits of the life estate interest, such as rent on the property\n- Cannot sell the property or the remainder interest\n- Is responsible for paying the mortgage, taxes, and insurance on the property\n- Is responsible for the upkeep and the repair of the property"},{"chunk_id":"epm:2.3.3.2.7.4.3#rights-of-the-remainderman","heading":"Rights of the Remainderman","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.3#rights-of-the-remainderman","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.4 Real Property > 2.3.3.2.7.4.3 Life Estates and Remainder Interests > Rights of the Remainderman","text":"## Rights of the Remainderman\n\nThe remainderman has ownership interest in the property subject to the life estate interest. The remainderman does not have the right to occupy, possess or otherwise use the property until the life estate is terminated.\n\nThe remainderman can:\n- Sell his or her interest in the property even before the life estate interest terminates, if allowed by the legal instrument establishing the life estate interest. In such cases, the life estate owner retains the life estate interest until the life estate terminates.\n- Sell the entire property with the permission of the life estate owner"},{"chunk_id":"epm:2.3.3.2.7.4.3#life-estate-evaluation","heading":"Life Estate Evaluation","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.3#life-estate-evaluation","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.4 Real Property > 2.3.3.2.7.4.3 Life Estates and Remainder Interests > Life Estate Evaluation","text":"## Life Estate Evaluation\n\nLife estate interests are treated as real property.\n- Homestead life estates: If the life estate is the person's principal place of residence, it is homestead property and is excluded.\n- Non-homestead life estates: If the life estate is not the person's principal place of residence, it is non-homestead property.\n  - If a non-homestead life estate is owned by the applicant or enrollee, it is not counted toward the person's asset limit. The applicant or enrollee is entitled to any income derived from the life estate. DHS places liens on non-homestead life estates owned by certain enrollees. See [MA Estate Recovery Manual](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=SRU-Home) for more information.\n  - For MA-LTC, if a non-homestead life estate is owned by the community spouse, the life estate is included in the couple's asset evaluation.\n\n### Determining the value of a life estate interest\n\nThe value of a life estate interest is the property’s equity value on the date the life estate interest is created, terminated, or sold, multiplied by the person’s mortality figure, as determined by the [Life Estate Mortality Table](https://bot-corpus.mn-dhs.online/s/epm/G).\n\nThe value of the property may be determined by a licensed real estate appraiser if the accuracy of the EMV is disputed.\n\nThe value of a life estate on the date the life estate was created is based on the equity value of the property on the date the life estate was established.\n\nThe value of a life estate on the date the life estate was terminated is based on the equity value of the property on the termination date. The termination date is the date of death of the life estate owner or, if termination is due to a specific condition in the deed or contract, then the date the condition occurred.\n\nThe value of the life estate at the time the property is sold is based on the sale price of the property. Expenses related to the sale of the property that are the responsibility of the life estate owner are deducted from the value of the life estate interest.\n\nThe proceeds from the sale of a life estate interest are counted as an asset in the month following the month of the sale, if retained:\n- When the property is sold\n- When the remainderman or someone else purchases the life estate interest"},{"chunk_id":"epm:2.3.3.2.7.4.3#multiple-owners","heading":"Multiple Owners","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.3#multiple-owners","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.4 Real Property > 2.3.3.2.7.4.3 Life Estates and Remainder Interests > Multiple Owners","text":"## Multiple Owners\n\nIf there are two or more life estate owners, each owner's life estate interest is that owner's share of the equity value multiplied by their mortality figure. Absent evidence to the contrary, each owner is presumed to have an equal equity interest in the property.\n\nExample: Frank (age 85) and Norma have life estate interests in non-homestead property. Frank is applying for MA. The total equity value of the property is $100,000. Frank has a mortality figure of .35359 and presumed equity value of $50,000 because there are two life estate owners. Therefore, Frank's life estate interest is valued at $17,679.50 (.35359 x $50,000)"},{"chunk_id":"epm:2.3.3.2.7.4.3#evaluation-of-a-remainder-interest","heading":"Evaluation of a Remainder Interest","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.3#evaluation-of-a-remainder-interest","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.4 Real Property > 2.3.3.2.7.4.3 Life Estates and Remainder Interests > Evaluation of a Remainder Interest","text":"## Evaluation of a Remainder Interest\n\nRemainder interests are treated as real property and are a countable asset.\n\n### Determining the value of a remainder interest in real property\n\nThe value of a remainder interest in real property is the property’s equity value, multiplied by the remainderman mortality figure that corresponds to the life estate owner’s age, as determined by the [Life Estates Mortality Table](https://bot-corpus.mn-dhs.online/s/epm/G)."},{"chunk_id":"epm:2.3.3.2.7.4.3#when-the-remainder-interest-is-available-to-the-life-estate-owner","heading":"When the Remainder Interest is Available to the Life Estate Owner","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.3#when-the-remainder-interest-is-available-to-the-life-estate-owner","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.4 Real Property > 2.3.3.2.7.4.3 Life Estates and Remainder Interests > When the Remainder Interest is Available to the Life Estate Owner","text":"## When the Remainder Interest is Available to the Life Estate Owner\n\nIf a person owns both the life estate interest and the remainder interest, the life estate and remainder interests merge into full ownership of the property. The property is evaluated as a non-life estate real property and the equity value of the property is a countable asset."}]},{"id":"epm:2.3.3.2.7.4.4","number":"2.3.3.2.7.4.4","title":"Other Real Property Interests","parent":"2.3.3.2.7.4","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.4 Real Property > 2.3.3.2.7.4.4 Other Real Property Interests","summary":"This section provides policies that apply to other real property interests. Unless otherwise specified, these interests generally are treated as real property, and equity value is evaluated as a non-homestead property.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:58.594961+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.7.4.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_7_4_4.htm","legal_citations":["Minnesota Statutes, section 256B.056, subdivision 1a"],"chunks":[{"chunk_id":"epm:2.3.3.2.7.4.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.4","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.4 Real Property > 2.3.3.2.7.4.4 Other Real Property Interests","text":"This section provides policies that apply to other real property interests. Unless otherwise specified, these interests generally are treated as real property, and equity value is evaluated as a non-homestead property."},{"chunk_id":"epm:2.3.3.2.7.4.4#cooperative-living-arrangement","heading":"Cooperative Living Arrangement","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.4#cooperative-living-arrangement","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.4 Real Property > 2.3.3.2.7.4.4 Other Real Property Interests > Cooperative Living Arrangement","text":"## Cooperative Living Arrangement\n\nIn a cooperative living arrangement, people buy shares or a membership in a cooperative housing corporation and share a common residential structure. The corporation owns or leases all real estate, and the members share a fee to cover the operating expenses. As part of the membership in the cooperative, the person has an exclusive right to live in a specific unit as long as he or she adheres to the cooperative’s rules and regulations.\n\n### Evaluation of Cooperative Living Arrangements\n\nIf the cooperative is the primary residence of a person, it is considered homestead property and is excluded.\n\nIf a person leaves the home and does not expect to return, the cooperative would no longer qualify for the homestead exclusion and would be evaluated as non-homestead real property."},{"chunk_id":"epm:2.3.3.2.7.4.4#easements","heading":"Easements","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.4#easements","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.4 Real Property > 2.3.3.2.7.4.4 Other Real Property Interests > Easements","text":"## Easements\n\nAn easement gives one person the right to use the land of another person for a specific purpose."},{"chunk_id":"epm:2.3.3.2.7.4.4#leaseholds","heading":"Leaseholds","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.4#leaseholds","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.4 Real Property > 2.3.3.2.7.4.4 Other Real Property Interests > Leaseholds","text":"## Leaseholds\n\nA leasehold gives one person control over certain property of another person for a specified period. In some states, a “lease for life” can create a life estate."},{"chunk_id":"epm:2.3.3.2.7.4.4#mineral-rights","heading":"Mineral Rights","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.4#mineral-rights","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.4 Real Property > 2.3.3.2.7.4.4 Other Real Property Interests > Mineral Rights","text":"## Mineral Rights\n\nMineral rights represent ownership interest in natural resources such as coal, oil, or natural gas, which normally are extracted from the ground.\n\n### Evaluation of Mineral Rights\n\nIf a person owns both surface rights and mineral rights on the same property, mineral rights are not considered separate resources. The fair market value (FMV) of the land can be assumed to include the value of the mineral rights.\n- If surface rights on the same property are excluded (for example, as the home), so are the oil and mineral rights.\n\nIf a person does not own the land to which the mineral rights pertain, the FMV is estimated from a knowledgeable source, such as:\n- The Bureau of Land Management\n- The United States Geological Survey\n- Any mining company that holds leases"},{"chunk_id":"epm:2.3.3.2.7.4.4#timber-rights","heading":"Timber Rights","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.4#timber-rights","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.4 Real Property > 2.3.3.2.7.4.4 Other Real Property Interests > Timber Rights","text":"## Timber Rights\n\nTimber rights permit one person to cut and remove freestanding trees from the property of another person."},{"chunk_id":"epm:2.3.3.2.7.4.4#water-rights","heading":"Water Rights","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.4#water-rights","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.4 Real Property > 2.3.3.2.7.4.4 Other Real Property Interests > Water Rights","text":"## Water Rights\n\nWater rights usually confer upon the owner of riverfront or shorefront property the right to access and use the adjacent water."}]},{"id":"epm:2.3.3.2.7.5","number":"2.3.3.2.7.5","title":"Contract for Deed and Other Property Agreements","parent":"2.3.3.2.7","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.5 Contract for Deed and Other Property Agreements","summary":"This section provides policy provisions for contracts for deed and other property agreements. The analysis for contracts for deed is used to evaluate all property agreements.","effective_date":"2020-12-01","last_modified":"2026-10-03T03:51:58.594961+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.5","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.7.5","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_7_5.htm","legal_citations":["Minnesota Statutes, section 256B.056, subdivision 1a"],"chunks":[{"chunk_id":"epm:2.3.3.2.7.5#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.5","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.5 Contract for Deed and Other Property Agreements","text":"This section provides policy provisions for contracts for deed and other property agreements. The analysis for contracts for deed is used to evaluate all property agreements."},{"chunk_id":"epm:2.3.3.2.7.5#contract-for-deed","heading":"Contract for Deed","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.5#contract-for-deed","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.5 Contract for Deed and Other Property Agreements > Contract for Deed","text":"## Contract for Deed\n\nA contract for deed is a conditional sales contract for the purchase of real property. It is similar to a mortgage; however:\n- Generally, a private party or business, rather than a lending institution, owns the contract for deed.\n- The seller of real property via a contract for deed or other property arrangement can often sell the contract to another person(s) or entity."},{"chunk_id":"epm:2.3.3.2.7.5#property-agreement","heading":"Property Agreement","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.5#property-agreement","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.5 Contract for Deed and Other Property Agreements > Property Agreement","text":"## Property Agreement\n\nA property agreement is a pledge or security of particular property for the payment of a debt or the performance of some other obligation within a specified period. Property agreements on real estate generally are referred to as mortgages but also may be called real estate or land contracts, contracts for deed, deeds of trust, etc."},{"chunk_id":"epm:2.3.3.2.7.5#contract-creditor-seller","heading":"Contract Creditor (Seller)","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.5#contract-creditor-seller","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.5 Contract for Deed and Other Property Agreements > Contract Creditor (Seller)","text":"## Contract Creditor (Seller)\n\nContracts for deed and other property agreements, such as deeds-of-trust, land contracts and mortgages held by the seller, are considered a liquid asset to the seller (creditor). The property itself is not an asset for the seller because the contract seller cannot legally convert it to cash while it is encumbered by the contract for deed. If payments received by the seller consist of both principal and interest, only the interest portion is income. The principal portion of the payments received is treated as a conversion of an asset, so is not income.\n\n### Determining Availability of a Contract for Deed or Other Property Agreement – Seller\n\nA contract for deed or other property agreement is unavailable if:\n- There is a legal bar prohibiting the sale of the contract for deed or other property agreement.\n- The person is making reasonable efforts to sell the contract for deed.\n\n### Asset Value of the Agreement – Seller\n\nFor a seller, the value of a contract for deed or property agreement is its outstanding principal balance less any encumbrances, unless the person furnishes evidence that it has a lower cash value.\n- An amortization schedule can be used to determine the outstanding principal balance and the interest income if the terms of the agreement are known."},{"chunk_id":"epm:2.3.3.2.7.5#contract-debtor-buyer","heading":"Contract Debtor (Buyer)","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.5#contract-debtor-buyer","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.5 Contract for Deed and Other Property Agreements > Contract Debtor (Buyer)","text":"## Contract Debtor (Buyer)\n\nA person who is the buyer of property by a contract for deed or other property agreement has an equitable interest in the real property and usually has the right to occupy the property. The buyer generally will not receive title to the property until payments are complete under the contract.\n\n### Asset Value of the Agreement – Buyer\n\nFor a buyer, the contract for deed or other property agreement is an encumbrance against the real property, not an asset.\n- A person’s equity interest in a home subject to a contract for deed is excluded as a homestead.\n- A person’s equity interest in real property subject to a contract for deed that is not a home is considered an available asset unless the property is determined to be an unavailable asset or the person is making reasonable efforts to sell the property.\n- Reverse mortgages allow owners to convert some of the equity in their homes to cash. Because the payments received from a reverse mortgage are actually a loan against the equity of the borrower’s home, such payments are treated as an encumbrance, not as a counted available asset."},{"chunk_id":"epm:2.3.3.2.7.5#purchase-of-interest-in-a-contract-for-deed","heading":"Purchase of Interest in a Contract for Deed","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.5#purchase-of-interest-in-a-contract-for-deed","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.5 Contract for Deed and Other Property Agreements > Purchase of Interest in a Contract for Deed","text":"## Purchase of Interest in a Contract for Deed\n\nA person who purchases the seller’s interest in a contract for deed or other property agreement acquires the seller’s right to receive payments pursuant to the contract for deed. This is considered a conversion of assets for the seller and the interest of the payments is income for the buyer."},{"chunk_id":"epm:2.3.3.2.7.5#reasonable-effort-to-sell-contract-for-deed-or-other-property-agreement","heading":"Reasonable Effort to Sell Contract for Deed or Other Property Agreement","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.5#reasonable-effort-to-sell-contract-for-deed-or-other-property-agreement","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.5 Contract for Deed and Other Property Agreements > Reasonable Effort to Sell Contract for Deed or Other Property Agreement","text":"## Reasonable Effort to Sell Contract for Deed or Other Property Agreement\n\nA contract for deed or other property agreement is considered unavailable due to reasonable effort to sell if a person can verify all of the following criteria:\n1. Attempting to sell the property agreement, which means:\n  - The person must offer the agreement for sale, a minimum of two times, to two separate businesses or individuals that routinely engage in the purchase of interest in property agreement, and\n  - Advertise the agreement for sale using one or more public forms of advertisement available to residents of the geographic area where the property is located.\n2. List the agreement for the appropriate price. The value of the agreement is the principal balance, less any encumbrances, unless proof of lesser value is provided..\n3. The owner must not reject any reasonable offer to buy the property agreement.\n\nReasonable efforts to sell the property agreement must continue until the property agreement is sold in order to continue the exclusion."},{"chunk_id":"epm:2.3.3.2.7.5#what-is-a-reasonable-offer","heading":"What is a reasonable offer?","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.5#what-is-a-reasonable-offer","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.5 Contract for Deed and Other Property Agreements > What is a reasonable offer?","text":"## What is a reasonable offer?\n\nA contract creditor (seller) must attempt to get offers for the principal balance of the contract, less encumbrances, or the verified lesser value of the contract if the seller disputes the value.\n- No minimum length of time is required for an owner to try to get offers. The reasonable length of time is based on the local market, or time period designated in a real estate contract.\n- The property agreement must be offered for sale on the open market before the owner may accept an offer lower than the principal balance of the agreement, less any encumbrances.\n- An offer for less than two-thirds of the principal balance of the agreement, less encumbrances, is not considered reasonable."}]},{"id":"epm:2.3.3.2.7.6","number":"2.3.3.2.7.6","title":"Promissory Notes","parent":"2.3.3.2.7","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.6 Promissory Notes","summary":"A promissory note is a written, unconditional agreement whereby one party promises to pay a specified sum of money at a specified time (or on demand) to another party. It may be given in return for goods, money loaned, or services rendered.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:58.594961+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.6","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.7.6","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_7_6.htm","legal_citations":["Minnesota Statutes, section 256B.056, subdivision 1a"],"chunks":[{"chunk_id":"epm:2.3.3.2.7.6#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.6","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.6 Promissory Notes","text":"A promissory note is a written, unconditional agreement whereby one party promises to pay a specified sum of money at a specified time (or on demand) to another party. It may be given in return for goods, money loaned, or services rendered.\n\nThis section provides policies that apply to promissory notes. The evaluation of promissory notes depends upon whether the person is a seller (creditor) or a buyer (debtor) under the agreement."},{"chunk_id":"epm:2.3.3.2.7.6#creditor-seller","heading":"Creditor (Seller)","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.6#creditor-seller","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.6 Promissory Notes > Creditor (Seller)","text":"## Creditor (Seller)\n\nFor the owner of the agreement (the seller), a promissory note is a liquid asset. The property itself is not an asset because the seller cannot legally convert it to cash while it is encumbered by the agreement. If payments received by the seller consist of both principal and interest, only the interest portion is income. The principal portion is the conversion of an asset so is not income."},{"chunk_id":"epm:2.3.3.2.7.6#debtor-buyer","heading":"Debtor (Buyer)","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.6#debtor-buyer","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.6 Promissory Notes > Debtor (Buyer)","text":"## Debtor (Buyer)\n\nFor the buyer of the property (debtor), the promissory note is an encumbrance against the real property, not an asset. However, the property purchased may be a countable asset in the month following the month of the transaction."},{"chunk_id":"epm:2.3.3.2.7.6#purchase-of-interest-in-a-promissory-note","heading":"Purchase of Interest in a Promissory Note","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.6#purchase-of-interest-in-a-promissory-note","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.6 Promissory Notes > Purchase of Interest in a Promissory Note","text":"## Purchase of Interest in a Promissory Note\n\nThe purchase of an interest in a promissory note occurs when a third party person buys the right to receive payments under the promissory note from another person or entity.\n\nThe purchaser of an interest in a promissory note takes the place of the seller and becomes the creditor (owner) of the promissory note. This is considered a conversion of assets for the seller and the interest of the payments is income for the new creditor."},{"chunk_id":"epm:2.3.3.2.7.6#evaluation-of-a-promissory-note","heading":"Evaluation of a Promissory Note","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.6#evaluation-of-a-promissory-note","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.6 Promissory Notes > Evaluation of a Promissory Note","text":"## Evaluation of a Promissory Note\n\nThe value of promissory note is an available asset unless the person provides evidence of a legal bar to the sale of the promissory note.\n\nThe value of the promissory note is assumed to be its outstanding principal balance in the month for which the determination is made, unless the person provides an estimate from a knowledgeable source (bank or commercial credit institution, etc.) demonstrating the market value of the promissory note is less than its outstanding principal balance. An amortization schedule can be used to determine the outstanding principal balance and the interest income if the terms of the agreement are known."}]},{"id":"epm:2.3.3.2.7.7","number":"2.3.3.2.7.7","title":"Automobiles and Other Vehicles Used for Transportation","parent":"2.3.3.2.7","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.7 Automobiles and Other Vehicles Used for Transportation","summary":"An “automobile” means any registered or unregistered vehicle used for transportation. Vehicles used for transportation include but are not limited to cars, trucks, motorcycles, boats, snowmobiles, animal-drawn vehicles, and even animals.","effective_date":"2024-09-10","last_modified":"2026-10-03T03:51:58.594961+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.7","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.7.7","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_7_7.htm","legal_citations":["Minnesota Statutes, section 256B.056, subdivision 1a"],"chunks":[{"chunk_id":"epm:2.3.3.2.7.7#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.7","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.7 Automobiles and Other Vehicles Used for Transportation","text":"An “automobile” means any registered or unregistered vehicle used for transportation. Vehicles used for transportation include but are not limited to cars, trucks, motorcycles, boats, snowmobiles, animal-drawn vehicles, and even animals.\n- A temporarily broken down vehicle normally used for transportation meets the definition of an automobile.\n\nThe following vehicles do not meet the definition of an automobile:\n- A vehicle that has been junked\n- A vehicle used only as a recreational vehicle, such as a boat used on weekends for pleasure\n\nThe equity value of a vehicle that does not meet the definition of an automobile is a countable asset. In addition, the [personal effects](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.14) exclusion does not apply to such vehicles.\n\nA leased vehicle is not an asset because it is not owned by the person and has no equity value to the person."},{"chunk_id":"epm:2.3.3.2.7.7#verification-of-an-automobile","heading":"Verification of an Automobile","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.7#verification-of-an-automobile","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.7 Automobiles and Other Vehicles Used for Transportation > Verification of an Automobile","text":"## Verification of an Automobile\n\nVerification of an automobile is not required if the household only reports one vehicle. If the household reports more than one vehicle, verification of the equity value of all vehicles is determined by using the trade-in value published in JD Power or Kelley Blue Book. If the trade-in value results in excess assets the equity value must be verified."},{"chunk_id":"epm:2.3.3.2.7.7#automobile-exclusion","heading":"Automobile Exclusion","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.7#automobile-exclusion","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.7 Automobiles and Other Vehicles Used for Transportation > Automobile Exclusion","text":"## Automobile Exclusion\n\nThe automobile exclusion allows the equity value of one automobile per household, regardless of value, to be completely excluded if the person or a member of the person’s household uses the automobile for transportation.\n\nIt is assumed someone in the household uses the automobile for transportation, absent evidence to the contrary."},{"chunk_id":"epm:2.3.3.2.7.7#application-of-the-exclusion","heading":"Application of the Exclusion","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.7#application-of-the-exclusion","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.7 Automobiles and Other Vehicles Used for Transportation > Application of the Exclusion","text":"## Application of the Exclusion\n\nWhen a person owns more than one automobile, the exclusion is applied as follows:\n- In the manner most advantageous to the recipient\n- To the automobile with the greatest equity value if the person owns more than one automobile for transportation of the person or a member of the person’s household.\n\nThe equity value of any automobile, other than the one wholly excluded, is a countable asset when:\n- the person is the owner; and\n- it cannot be excluded under another provision.\n\nThe value of the following is excluded:\n- An automobile used as the person’s principal place of residence, if a homestead is not already excluded\n- An automobile used for self-support or a Plan to Achieve Self Support (PASS) plan"},{"chunk_id":"epm:2.3.3.2.7.7#equity-value-of-an-automobile","heading":"Equity Value of an Automobile","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.7#equity-value-of-an-automobile","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.7 Automobiles and Other Vehicles Used for Transportation > Equity Value of an Automobile","text":"## Equity Value of an Automobile\n\nThe equity value of an automobile is the price it can sell for on the open market to a private party, in the particular geographic area involved, minus any encumbrances.\n\nJD Power or Kelley Blue Book can be used to verify the average trade-in value. If the value of a non-excluded vehicle puts the person over the program asset limit, the person may be contacted to see if there are encumbrances.\n\nIf the value cannot be obtained via JD Power or Kelley Blue Book, or the person disputes the value, the person must submit a written statement from a local automobile dealer to verify the current trade-in value."}]},{"id":"epm:2.3.3.2.7.8","number":"2.3.3.2.7.8","title":"Annuities","parent":"2.3.3.2.7","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.8 Annuities","summary":"An annuity is a purchase contract where the purchasing party generally pays a lump sum of money or periodic payments to an entity issuing the annuity (a bank or insurance company) in return for an expectation of future regular payments in certain amounts. These payments may continue for a fixed period of time or for as long as the person or another designated beneficiary lives, creating an ongoing","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:58.594961+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.8","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.7.8","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_7_8.htm","legal_citations":["Minnesota Statutes, section 256B.056, subdivision 1a","United States Code, title 42, section 1396p(e)"],"chunks":[{"chunk_id":"epm:2.3.3.2.7.8#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.8","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.8 Annuities","text":"An annuity is a purchase contract where the purchasing party generally pays a lump sum of money or periodic payments to an entity issuing the annuity (a bank or insurance company) in return for an expectation of future regular payments in certain amounts. These payments may continue for a fixed period of time or for as long as the person or another designated beneficiary lives, creating an ongoing income stream. The annuity may or may not include a remainder clause under which, if the annuitant dies, the contracting entity converts whatever is remaining in the annuity into a lump sum or periodic payments that are paid to a designated beneficiary. Once the annuity has been converted to an income stream, it is no longer an asset."},{"chunk_id":"epm:2.3.3.2.7.8#classification-of-annuities","heading":"Classification of Annuities","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.8#classification-of-annuities","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.8 Annuities > Classification of Annuities","text":"## Classification of Annuities\n\nAnnuities can be classified in a number of ways, including:\n1. The time at which annuity payments begin\n  - Immediate annuity\n  - Deferred annuity\n2. The nature of the periodic payments\n  - Fixed annuity\n  - Variable annuity\n3. The period over which annuity payments will be made\n  - Term certain annuity\n  - Life annuity\n4. The type of annuity issuer\n  - Commercial annuity\n  - Private annuity"},{"chunk_id":"epm:2.3.3.2.7.8#free-look-period","heading":"Free Look Period","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.8#free-look-period","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.8 Annuities > Free Look Period","text":"## Free Look Period\n\nThe purchaser of an annuity typically has the right to cancel an annuity contract within ten days following the date of receiving a copy of the annuity contract. Some annuity contracts allow a free look period longer than ten days.\n\nThis cancellation period is often referred to as the “free look period.” The free look period should be indicated in the annuity contract. The purchaser cannot waive the right to cancel an annuity contract. The purchaser of the annuity always has this right, even if he or she agrees to give up this right or the right is not stated on the annuity documents.\n\nThe purchaser is entitled to a refund of the annuity's entire purchase value when the annuity is cancelled within a free look period.\n- The refund the annuity purchaser is entitled to receive when a variable annuity is cancelled within a free look period is based upon several factors. As a result, the refund could be more or less than the annuity's purchase value."},{"chunk_id":"epm:2.3.3.2.7.8#cash-value","heading":"Cash Value","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.8#cash-value","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.8 Annuities > Cash Value","text":"## Cash Value\n\nThe cash value, also known as the cash surrender value (CSV), of an annuity is the amount the person can withdraw from the annuity.\n\nIt is most common for an annuity to have cash value during the accumulation phase. Typically, at annuitization there is no longer a cash value to count because the funds are no longer available as a lump sum.\n\nIf a person withdraws from the annuity, it is considered a conversion of assets and the policy for the asset in which the cash value was converted is followed.\n\nThe cash value of an annuity is:\n1. The total of all deposits made to the annuity plus any earnings on the deposits not previously paid out\n2. Minus any earlier withdrawals and any surrender costs charged for the withdrawal\n  - There may be tax penalties for early withdrawal. Income tax withheld or tax penalties for early withdraw are not allowable deductions from cash value."},{"chunk_id":"epm:2.3.3.2.7.8#commuted-cash-value","heading":"Commuted Cash Value","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.8#commuted-cash-value","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.8 Annuities > Commuted Cash Value","text":"## Commuted Cash Value\n\nA commuted cash value allows the owner to cash in the contract even after annuitization. This allows the owner to cash in the policy for the present value of all future payments. Commuted cash value can be a provision in the contract."},{"chunk_id":"epm:2.3.3.2.7.8#required-minimum-distributions","heading":"Required Minimum Distributions","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.8#required-minimum-distributions","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.8 Annuities > Required Minimum Distributions","text":"## Required Minimum Distributions\n\nRequired minimum distributions from an annuity during the accumulation phase are considered a conversion of assets, not income. The required minimum distributions are age specific. At a certain age, usually 59½ or 70½, the owner of the annuity has to make a withdrawal of cash."},{"chunk_id":"epm:2.3.3.2.7.8#counting-annuities-as-assets","heading":"Counting Annuities as Assets","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.8#counting-annuities-as-assets","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.8 Annuities > Counting Annuities as Assets","text":"## Counting Annuities as Assets\n\nAnnuities where the person is the annuity owner is counted toward the asset limit as follows:\n- Accumulation phase\n  - The cash value of the annuity, if the person is able to withdraw it from the annuity\n  - The value of an annuity in a free look period\n- Annuitization phase\n  - Any available cash value of the annuity\n  - The value of an annuity in a free look period\n  - The commuted cash value"},{"chunk_id":"epm:2.3.3.2.7.8#annuity-verification","heading":"Annuity Verification","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.8#annuity-verification","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.8 Annuities > Annuity Verification","text":"## Annuity Verification\n\nThe person must provide verification of the annuity’s market value if the annuity is countable."}]},{"id":"epm:2.3.3.2.7.9","number":"2.3.3.2.7.9","title":"Trusts","parent":"2.3.3.2.7","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts","summary":"A trust is any arrangement in which a grantor transfers property to a trustee or trustees with the intention that it be held, managed, or administered by the trustee(s) for the benefit of certain designated beneficiaries. A trustee holds a fiduciary responsibility to hold or manage the trust’s corpus and income for the benefit of the beneficiaries.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:58.594961+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.7.9","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_7_9.htm","legal_citations":["Minnesota Statutes, section 256B.056, subdivision 3b","Minnesota Statutes, section 501C.1205, subdivision 1","United States Code, title 42, section 1396p(d)"],"chunks":[{"chunk_id":"epm:2.3.3.2.7.9#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts","text":"A trust is any arrangement in which a grantor transfers property to a trustee or trustees with the intention that it be held, managed, or administered by the trustee(s) for the benefit of certain designated beneficiaries. A trustee holds a fiduciary responsibility to hold or manage the trust’s corpus and income for the benefit of the beneficiaries.\n\nThe term “trust” also includes any legal instrument, device or arrangement which may not be called a trust or qualify as a trust under state law, but which is similar to a trust."},{"chunk_id":"epm:2.3.3.2.7.9#parties-to-a-trust","heading":"Parties to a Trust","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9#parties-to-a-trust","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > Parties to a Trust","text":"## Parties to a Trust\n\n### Beneficiary\n\nA beneficiary is any person(s) designated in the trust instrument as benefiting in some way from the trust. The beneficiary can be the grantor theirself, another person(s), or a combination of any of these parties. A beneficiary does not hold legal title to trust property but does have an equitable ownership interest in it. As equitable owner, the beneficiary has certain rights that will be enforced by a court because the trust exists for their benefit. The beneficiary receives the benefits of the trust while the trustee holds the title and duties.\n\n### Grantor\n\nA grantor, also called a settlor or trustor, is the person who provides the trust principal (or corpus). Therefore, a person may be a grantor even if an agent or other person, legally empowered to act on their behalf (e.g., a legal guardian, representative payee, person acting under a power of attorney, or conservator), establishes the trust with funds or property that belong to the grantor.\n\n### Trustee\n\nA trustee is any person(s) or entity (such as an insurance company or bank) that manages a trust or similar device and has fiduciary responsibilities. The trustee holds legal title to property for the use and benefit of the beneficiary. In most instances, the trustee has no legal right to revoke the trust or use the property for their own benefit."},{"chunk_id":"epm:2.3.3.2.7.9#trust-availability","heading":"Trust Availability","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9#trust-availability","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > Trust Availability","text":"## Trust Availability\n\nThe availability of trust assets is a critical factor in determining a person’s eligibility. Only trust assets that are determined to be available to the person are considered when determining the person’s eligibility.\n\n### Excluded Trusts\n\nSome types of trusts are excluded in whole by federal and state law. These types of trusts include:\n- Special Needs Trusts\n- Pooled Trusts"},{"chunk_id":"epm:2.3.3.2.7.9#income-to-the-trust-versus-income-to-the-person","heading":"Income to the Trust versus Income to the Person","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9#income-to-the-trust-versus-income-to-the-person","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > Income to the Trust versus Income to the Person","text":"## Income to the Trust versus Income to the Person\n\nWhen evaluating a trust it is necessary to distinguish what is considered income to the trust and what is considered income to the person. The terms of the trust will dictate what is considered income to the trust versus income to the person.\n\n### Income to the Trust\n- Income earned by the trust assets that is retained by the trust\n- Income that has been legally assigned to the trust and is directly deposited into the trust\n\n### Income to the Person\n- Income earned by the trust that is distributed to the person, or for the benefit of the person\n- Income received by the person that the person later deposits into a trust\n- Income that is directly deposited into a trust that has not been legally assigned to the trust."},{"chunk_id":"epm:2.3.3.2.7.9#trust-provisions-linked-to-public-assistance","heading":"Trust Provisions Linked to Public Assistance","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9#trust-provisions-linked-to-public-assistance","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > Trust Provisions Linked to Public Assistance","text":"## Trust Provisions Linked to Public Assistance\n\nProvisions in a trust established on or after July 1, 1992, that provide for suspension, termination, limitation or diversion of the trust corpus or income if the beneficiary applies or receives public assistance or benefits under public health care programs are unenforceable.\n\nThis requirement does not apply to Special Needs, supplemental needs and Pooled Trusts."}]},{"id":"epm:2.3.3.2.7.9.1","number":"2.3.3.2.7.9.1","title":"Identifying the Type of Trust","parent":"2.3.3.2.7.9","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.1 Identifying the Type of Trust","summary":"The type of trust involved is a critical factor in determining whether the trust assets are available, unavailable, or meet one of the exclusions. Always consider the following factors when determining what type of trust is involved:","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:58.594961+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.7.9.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_7_9_1.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.3.3.2.7.9.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.1","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.1 Identifying the Type of Trust","text":"The type of trust involved is a critical factor in determining whether the trust assets are available, unavailable, or meet one of the exclusions. Always consider the following factors when determining what type of trust is involved:\n- When the trust was established\n- Who established the trust\n- Whose income or resources were used to fund the trust\n- Who is the beneficiary of the trust\n- Whether the trustee has any discretion"},{"chunk_id":"epm:2.3.3.2.7.9.1#trust-characteristics","heading":"Trust Characteristics","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.1#trust-characteristics","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.1 Identifying the Type of Trust > Trust Characteristics","text":"## Trust Characteristics\n\nSee the specific page for information for how these types of trusts are treated. The following information provides general characteristics to help identify what type of trust is involved.\n\n### Client-Funded Trust\n\nA [Client-Funded Trust](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.2) has the following characteristics:\n- It was established on or after August 11, 1993\n- The trust was not established by will\n- Funded with the income and/or assets of the Medical Assistance (MA) person and/or the person’s spouse\n\n### Medical Assistance Qualifying Trust\n\nA [Medical Assistance Qualifying Trust](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.3) (MQT) has the following characteristics:\n- It was established before August 11, 1993.\n- It is funded with the income and/or assets of the MA person and/or the person’s spouse.\n\n### Special Needs Trust\n\nA [Special Needs Trust](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.4) has the following characteristics:\n- It was established on or after August 11, 1993.\n- The trust was established solely for the benefit of a person with a disability who met Social Security Administration (SSA) disability criteria when the trust was established.\n- The person with a disability was under age 65 when the trust was established.\n- It is funded in whole or in part with the income or assets of the person with a disability.\n- It was not established by will.\n- Minnesota Department of Human Services (DHS) is named as the remainder beneficiary.\n\n### Pooled Trust\n\nA [Pooled Trust](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.5) has the following characteristics:\n- It was established on or after August 11, 1993.\n- The trust is managed by a non-profit organization.\n- The sub-accounts in the trust are established solely for the person with a disability according to SSA disability criteria.\n- The sub-account is funded in whole or in part with the income or assets of the person with a disability.\n- It was not established by will.\n- DHS is named as the remainder beneficiary.\n\n### Third Party Established and Funded Trusts\n\nA [third party established and funded trust](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.6) has the following characteristics:\n- It is funded by a third party grantor during the third party’s life or upon the third party grantor’s death.\n- The trust does not meet all of the guidelines for a Supplemental Needs Trusts.\n\n### Supplemental Needs Trust\n\nA [Supplemental Needs Trust](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.7) has the following characteristics:\n- A third party grantor funds the trust during the third party’s life or upon the third party grantor’s death.\n- The lifetime beneficiary was a person with a disability at the time the trust was established\n- The purpose of the trust is to supplement government benefits the beneficiary receives but not supplant (replace) government benefits.\n\n### Zebley Trust\n\nA Zebley Trust has the following characteristics:\n- It was established on or after 1990.\n- It is funded with payment made to the person by SSA pursuant to the United States Supreme Court Decision, Sullivan v. Zebley, 493 U.S. 521 (1990)."}]},{"id":"epm:2.3.3.2.7.9.2","number":"2.3.3.2.7.9.2","title":"Client-Funded Trusts","parent":"2.3.3.2.7.9","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.2 Client-Funded Trusts","summary":"Client-funded trusts are trusts funded with the income and assets of the person and/or the person’s spouse. A client-funded trust must be evaluated for people with an asset limit to determine whether the trust is available to contribute toward the person’s health care needs.","effective_date":"2022-09-01","last_modified":"2026-10-03T03:51:58.594961+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.7.9.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_7_9_2.htm","legal_citations":["Minnesota Statutes, section 256B.056, subdivision 3b","United States Code, title 42, section 1396p(d)"],"chunks":[{"chunk_id":"epm:2.3.3.2.7.9.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.2","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.2 Client-Funded Trusts","text":"Client-funded trusts are trusts funded with the income and assets of the person and/or the person’s spouse. A client-funded trust must be evaluated for people with an asset limit to determine whether the trust is available to contribute toward the person’s health care needs."},{"chunk_id":"epm:2.3.3.2.7.9.2#trust-characteristics","heading":"Trust Characteristics","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.2#trust-characteristics","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.2 Client-Funded Trusts > Trust Characteristics","text":"## Trust Characteristics\n\nA client-funded trust must meet all of the following criteria:\n- Not established by will;\n- Funded with the assets or income of the person or the person’s spouse;\n- Established by one or more of the following; and:\n  - The person\n  - The person’s spouse\n  - A person, including a court or administrative body, with legal authority to act in place of or on behalf of the person or the person’s spouse\n  - A person including any court or administrative body, acting at the direction or upon the request of the person or the person’s spouse\n- Established on or after August 11, 1993."},{"chunk_id":"epm:2.3.3.2.7.9.2#trust-funding","heading":"Trust Funding","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.2#trust-funding","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.2 Client-Funded Trusts > Trust Funding","text":"## Trust Funding\n\nWho funds the trust determines how the assets held in the trust are analyzed for purposes of determining eligibility for Medical Assistance (MA).\n\n### Funded by the Person and/or Person’s Spouse\n\nThe assets in the trust are analyzed using the availability concepts applicable to [revocable](https://hcopub.dhs.state.mn.us/epm/#revocable_cft) and [irrevocable](https://hcopub.dhs.state.mn.us/epm/#irrevocable_cft) client-funded trusts.\n\n### Funded by the Person and Any Other Person\n\nThe portion of the trust funded with assets of the person or the person’s spouse are analyzed using the availability concepts applicable to [revocable](https://hcopub.dhs.state.mn.us/epm/#revocable_cft) and [irrevocable](https://hcopub.dhs.state.mn.us/epm/#irrevocable_cft) client-funded trusts.\n\nThe portion of the trust funded with assets of any other person is not analyzed using the availability concepts applicable to [revocable](https://hcopub.dhs.state.mn.us/epm/#revocable_cft) and [irrevocable](https://hcopub.dhs.state.mn.us/epm/#irrevocable_cft) client-funded trusts. The portion of the trust funded with assets of any other person is analyzed under the availability concepts applicable to [third party established and funded trusts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.6)."},{"chunk_id":"epm:2.3.3.2.7.9.2#trust-availability","heading":"Trust Availability","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.2#trust-availability","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.2 Client-Funded Trusts > Trust Availability","text":"## Trust Availability\n\nThe availability concepts applicable to client-funded trusts apply regardless of any of the following:\n- The purpose for which the trust was established\n- Whether the trustees have or exercise any discretion\n- Any restrictions on when or if a distribution may be made from the trust\n- Any restrictions on the use of the distributions from the trust.\n\nHow a specific trust is evaluated for eligibility purposes depends on the characteristics of the trust."},{"chunk_id":"epm:2.3.3.2.7.9.2#revocable-client-funded-trusts","heading":"Revocable Client-Funded Trusts","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.2#revocable-client-funded-trusts","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.2 Client-Funded Trusts > Revocable Client-Funded Trusts","text":"## Revocable Client-Funded Trusts\n\nA revocable client-funded trust is any trust that:\n- Can be revoked by the grantor\n- Provides that the trust can only be modified or terminated by a court\n- Is called irrevocable but contains language that allows it to terminate if some action is taken by the grantor\n\n### Trust Principal (or Assets)\n\nThe entire value of the trust principal is an available asset.\n\n### Disbursements\n\nAny payments from a revocable client-funded trust to or from the benefit of the person or the person's spouse is income to the individual in the month received.\n\nAny payment from the trust to a third party not for the benefit of the person or the person's spouse is a transfer of assets. See [2.4.1.3 MA-LTC Uncompensated Transfers](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3)."},{"chunk_id":"epm:2.3.3.2.7.9.2#irrevocable-client-funded-trusts","heading":"Irrevocable Client-Funded Trusts","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.2#irrevocable-client-funded-trusts","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.2 Client-Funded Trusts > Irrevocable Client-Funded Trusts","text":"## Irrevocable Client-Funded Trusts\n\nAn irrevocable trust is a trust that cannot be revoked by the grantor in any way.\n\n### Availability of Trust Assets\n\nIf there are any circumstances under which payment from the assets could be made to or for the benefit of the person or their spouse, the portion of the trust assets from which payment could be made is available and counted in the asset evaluation.\n\nTrust assets are available to the extent the terms of the trust provided that the trustee can do any of the following:\n- can or must make disbursements, including loans or gifts, to the person or spouse;\n- has complete power, authority, or discretion over whether to make disbursements to the person or spouse;\n- can make disbursements to the person or spouse only if a specific even occurs, even if the event has not yet occurred or even if the event is unlikely to occur; or\n- can make disbursements to benefit the person or spouse even if the trustee cannot make payments directly to these individuals.\n\nFor example:\n- the trustee could purchase an asset for the person or spouse to use; or\n- the trust owns property that the person or spouse resides on, and the trustee could pay for expenses for upkeep of the property.\n\n### Availability of Trust Income\n\nIf there are any circumstances under which payment from trust income could be made to or for the benefit of the person or the person's spouse, the income (including accumulated income that may have been reinvested in the trust) is available.\n\nDepending on the specific terms in the trust, income earned by the trust assets may be available while trust assets are unavailable.\n\n### Unavailable Trusts\n\nIf there are NO circumstances under which payment from a client-funded irrevocable trust (or a portion of that trust) could be made to or for the benefit of the person or the person's spouse, the trust (or portion thereof) is unavailable and not counted.\n\nAn unavailable trust must be evaluated to determine if an uncompensated transfer occurred during the 60-month lookback period or during enrollment in MA-LTC when the trust was established or when the person or the person's souse made additions to the trust. See [2.4.1.3.4 MA-LTC Other Asset Transfer Considerations](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.4)\n\n### Disbursements\n\nAny payment from available trust assets or income directly to or for the benefit of the person or the person's spouse is income to that individual in the month received. Any payment from available trust asset or income that does not benefit the person or their spouse must be evaluated to determine if an uncompensated transfer occurred for MA-LTC."},{"chunk_id":"epm:2.3.3.2.7.9.2#client-funded-trusts-for-people-with-a-disability","heading":"Client-Funded Trusts for People with a Disability","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.2#client-funded-trusts-for-people-with-a-disability","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.2 Client-Funded Trusts > Client-Funded Trusts for People with a Disability","text":"## Client-Funded Trusts for People with a Disability\n\nThe availability concepts do not apply to trusts that meet the statutory requirements for Special Needs or Pooled Trusts. See the specific sections to evaluate the availability of assets held in a [Special Needs Trust](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.4) or [Pooled Trust](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.5)."}]},{"id":"epm:2.3.3.2.7.9.3","number":"2.3.3.2.7.9.3","title":"Medical Assistance Qualifying Trust","parent":"2.3.3.2.7.9","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.3 Medical Assistance Qualifying Trust","summary":"Client-funded trusts established prior to August 11, 1993, the effective date in the Omnibus Reconciliation Act of 1993, continue to be analyzed by the law in place prior to that time.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:58.594961+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.7.9.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_7_9_3.htm","legal_citations":["Minnesota Statutes, section 256B.056, subdivision 3b"],"chunks":[{"chunk_id":"epm:2.3.3.2.7.9.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.3","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.3 Medical Assistance Qualifying Trust","text":"Client-funded trusts established prior to August 11, 1993, the effective date in the Omnibus Reconciliation Act of 1993, continue to be analyzed by the law in place prior to that time."},{"chunk_id":"epm:2.3.3.2.7.9.3#trust-characteristics","heading":"Trust Characteristics","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.3#trust-characteristics","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.3 Medical Assistance Qualifying Trust > Trust Characteristics","text":"## Trust Characteristics\n\nA Medical Assistance (MA) Qualifying Trust must meet all of the following criteria:\n- It is not established by will.\n- The trust is funded with the assets or income of the person or the person’s spouse.\n- It is established by one or more of the following:\n  - The person\n  - The person’s spouse\n  - A person, including a court or administrative body, with legal authority to act in place of or on behalf of the person or the person’s spouse\n  - A person, including any court or administrative body, acting at the direction or upon the request of the person or the person’s spouse\n- It was established before August 11, 1993."},{"chunk_id":"epm:2.3.3.2.7.9.3#trust-availability","heading":"Trust Availability","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.3#trust-availability","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.3 Medical Assistance Qualifying Trust > Trust Availability","text":"## Trust Availability\n\n### Trust Corpus\n\nThe maximum amount that a trustee is permitted to disburse to the person under the terms of the trust agreement is considered an available asset.\n\n### Distributions\n\nPayments from the trust income or trust corpus made to or for the benefit of the person is income to the person."}]},{"id":"epm:2.3.3.2.7.9.4","number":"2.3.3.2.7.9.4","title":"Special Needs Trusts","parent":"2.3.3.2.7.9","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.4 Special Needs Trusts","summary":"A special needs trust is a trust established for the sole benefit of a person under age 65 who is certified disabled. The principal or corpus of a trust that meets all the requirements of a special needs trust is excluded.","effective_date":"2019-11-01","last_modified":"2026-10-03T03:51:58.594961+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.7.9.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_7_9_4.htm","legal_citations":["Minnesota Statutes, section 256B.056, subdivision 1a","Minnesota Statutes, section 256B.056, subdivision 3b","Minnesota Statutes, section 501C.1205, subdivisions 3 and 4","United States Code, title 42, section 1396p(d)"],"chunks":[{"chunk_id":"epm:2.3.3.2.7.9.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.4","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.4 Special Needs Trusts","text":"A special needs trust is a trust established for the sole benefit of a person under age 65 who is certified disabled. The principal or corpus of a trust that meets all the requirements of a special needs trust is excluded."},{"chunk_id":"epm:2.3.3.2.7.9.4#trust-requirements","heading":"Trust Requirements","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.4#trust-requirements","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.4 Special Needs Trusts > Trust Requirements","text":"## Trust Requirements\n\nA trust must satisfy all of the following legal requirements in order to be excluded as a special needs trust.\n\n### Date Established\n\nIt is established on or after August 11, 1993.\n\n### Beneficiary Age Limit for Establishing a Special Needs Trust\n\nIt is established before the beneficiary reaches age 65. A special needs trust established before the beneficiary reaches age 65 remains excluded after the beneficiary reaches age 65.\n\n### Established By\n\nA special needs trust established before December 13, 2016, must be established through the actions of the beneficiary's parents, grandparents, legal guardian, or a court.\n\nA special needs trusts established on or after December 13, 2016, may also be established by the actions of the beneficiary on their own behalf. A special needs trust established before December 13, 2016, cannot be established by the beneficiary.\n\n### Funded By\n\nIt is funded with the income or assets of the beneficiary. A special needs trust may also contain assets of other people.\n\n### Disability Standard\n\nThe beneficiary must meet the disability criteria of the Supplemental Security Income (SSI) program at the time the trust is established. A person with a disability established by the Social Security Administration (SSA) or State Medical Review Team (SMRT) meets this qualification.\n\nThe trust does not meet the criteria for the exclusion if the beneficiary’s disability began after the trust was established.\n\nIf SSA or SMRT did not determine the beneficiary’s disability at the time the trust was established, SMRT must determine whether the beneficiary was disabled according to SSI disability criteria at the time the trust was established.\n\n### Sole Benefit Requirement\n\nThe trust must be established for and used for the sole benefit of the disabled beneficiary and must provide that all disbursements are for the sole benefit of the beneficiary, with the following exceptions:\n- The trust may allow reasonable compensation for a trustee or trustees to manage the trust.\n- The trust may also allow reasonable costs associated with investment, legal, or other services rendered on behalf of the beneficiary with regard to the trust.\n\nA trust is not excluded as a special needs trust if it includes a provision that allows for either of the following:\n- Benefits to other people or entities during the beneficiary's lifetime, or\n- Termination of the trust prior to the beneficiary's death with payment of the corpus to another person or entity, other than repaying the State\n\n### DHS Remainder Beneficiary\n\nThe trust must provide that, upon the death of the beneficiary or earlier termination of the trust, the Minnesota Department of Human Services (DHS), or \"the State” receives all amounts remaining in the trust, up to an amount equal to the total amount of Medical Assistance (MA) paid on behalf of the beneficiary.\n\n### Allowable Administrative Expenses\n\nThe trust may pay the following types of administrative expenses from the trust before the repayment of DHS as the remainder beneficiary:\n- Taxes due from the trust to the State, other states, or federal government because of the death of the beneficiary\n- Reasonable expenses for the administration of the trust estate, such as an accounting of the trust to a court, completion and filing of documents, or other required actions associated with termination and wrapping up of the trust. For these administrative expenses, the trust must provide that:\n  - The DHS Special Recovery Unit (SRU) must receive advance notice and must approve any payment of administrative expenses before such expenses are paid, and\n  - The administrative expenses must be reasonable\n\n### Prohibited Expenses and Payments\n\nA trust that provides for payment of any of the following expenses prior to repayment of DHS is not excluded as a special needs trust:\n- Taxes due from the estate of the beneficiary other than those arising from inclusion of the trust in the estate;\n- Inheritance taxes due for residual beneficiaries;\n- Payment of debts owed to third parties;\n- Funeral expenses; or\n- Payments to residual beneficiaries."},{"chunk_id":"epm:2.3.3.2.7.9.4#evaluation-of-trust-principal-and-additions-to-the-trust","heading":"Evaluation of Trust Principal and Additions to the Trust","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.4#evaluation-of-trust-principal-and-additions-to-the-trust","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.4 Special Needs Trusts > Evaluation of Trust Principal and Additions to the Trust","text":"## Evaluation of Trust Principal and Additions to the Trust\n\n### Trust Principal\n\nThe trust principal, including any income generated by the trust that is retained by the trust, is considered excluded as long as the trust is established and any additions occur before the beneficiary reaches age 65.\n\n### Additions to the Trust Before Age 65\n\nAdditions to the trust principal made directly to the trust before the beneficiary reaches age 65 are excluded.\n\nIncome not irrevocably assigned to the trust is not considered to be made directly to the trust and therefore is counted as income to the beneficiary. A court order irrevocably assigning income to the trust is required to show an irrevocable assignment. If an assignment is revocable, the payment is income to the beneficiary because the beneficiary is legally entitled and eligible to receive it, unless another income exclusion applies. Note that certain payments to a beneficiary are not assignable by law. Send a HealthQuest if you have questions about assignability of income to a trust.\n\n### Additions to the Trust At or After Age 65\n\nAdditions to the trust after the beneficiary reaches age 65 are not excluded. The value of any non-excluded assets added to the trust after the beneficiary reaches age 65 is considered available to the beneficiary.\n\nHowever, if the beneficiary’s right to receive payments from an annuity, support payments, or Survivor Benefit Plan (SBP) payments was irrevocably assigned to the trust before the beneficiary reached age 65, the payments are excluded and do not disqualify the trust as a special needs trust.\n\nInterest, dividends, or other earnings of the trust after the beneficiary reaches age 65 remain excluded.\n\n### Evaluations of the Trust Disbursements\n\nDisbursements of cash from the trust made directly to the beneficiary or to a person acting on the beneficiary's behalf are counted as unearned income in the month received.\n\nDisbursements to a third party that result in the beneficiary receiving non-cash items, are not counted. Disbursements that do not count as income may include, but are not limited to those made for educational expenses, therapy, transportation, professional fees, medical services not covered by Medicaid, phone bills, recreation, and entertainment.\n\nDisbursements must be for the sole benefit of the beneficiary.\n\nConsider disbursements to be for the sole benefit of the beneficiary if the trustee makes payments of any sort from the principal or income of the trust to another person or entity such that the beneficiary derives the primary benefit from the payment.\n\nPurchased goods that require registration or titling, such as a vehicle or real property, must generally be registered or titled in the name of the beneficiary, the trustee, or the trust."},{"chunk_id":"epm:2.3.3.2.7.9.4#special-needs-trust-verifications","heading":"Special Needs Trust Verifications","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.4#special-needs-trust-verifications","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.4 Special Needs Trusts > Special Needs Trust Verifications","text":"## Special Needs Trust Verifications\n\nVerification of a Special Needs Trust is required. A copy of the trust instrument and most recent trust accounting along with a completed Special Needs/Pooled Trust Referral Form ([DHS-4759](http://edocs.dhs.state.mn.us/lfserver/Legacy/DHS-4759-ENG)) must be sent to the DHS Special Recovery Unit (SRU).\n\n### Annual Reporting by Trustees\n\nThe trustee of a Special Needs Trust with a beneficiary who is an MA applicant or enrollee is required by state law to submit an annual trust accounting directly to the SRU. The person is not required to provide this information as part of the renewal process.\n\nIf the person or the person’s authorized representative or trustee provides this information to the county, the information must be forwarded to the SRU."}]},{"id":"epm:2.3.3.2.7.9.5","number":"2.3.3.2.7.9.5","title":"Pooled Trusts","parent":"2.3.3.2.7.9","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.5 Pooled Trusts","summary":"A pooled trust is a type of irrevocable trust established and managed by a non-profit association that “pools” the assets of multiple individuals from separate sub-accounts for investment and management purposes. A pooled trust agreement consists of an overarching “master trust” established by a non-profit association and a “joinder agreement” that contains provisions specific to the sub-account b","effective_date":"2023-06-01","last_modified":"2026-10-03T03:51:58.594961+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.5","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.7.9.5","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_7_9_5.htm","legal_citations":["Minnesota Statutes, section 256B.056, subdivision 1a","Minnesota Statutes, section 256B.056, subdivision 3b","Minnesota Statutes, section 501C.1205, subdivisions 3 and 4","United States Code, title 42, section 1396p(d)"],"chunks":[{"chunk_id":"epm:2.3.3.2.7.9.5#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.5","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.5 Pooled Trusts","text":"A pooled trust is a type of irrevocable trust established and managed by a non-profit association that “pools” the assets of multiple individuals from separate sub-accounts for investment and management purposes. A pooled trust agreement consists of an overarching “master trust” established by a non-profit association and a “joinder agreement” that contains provisions specific to the sub-account beneficiary. A pooled trust is established for the sole benefit of a beneficiary who is certified disabled. The principal or corpus of a trust that meets all the requirements of a pooled trust is excluded."},{"chunk_id":"epm:2.3.3.2.7.9.5#trust-requirements","heading":"Trust Requirements","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.5#trust-requirements","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.5 Pooled Trusts > Trust Requirements","text":"## Trust Requirements\n\nA trust must satisfy all of the following legal requirements in order to be excluded as a pooled trust.\n\n### Date Established\n\nIt is established on or after August 11, 1993.\n\n### Beneficiary Age Limit\n\nThere is no age limit for a person to establish a pooled trust; however, a transfer of funds into a pooled trust for a person who is age 65 or older must be evaluated under the transfer policy. See [Medical Assistance for Long-Term Care Services (MA-LTC) Other Asset Transfer Considerations](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.4)[.](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.4)\n\n### Trust Management\n\nA non-profit association establishes and manages a pooled trust. A separate account, known as a sub-account, is maintained for each beneficiary of the trust, but for purposes of investment and management of the trust, the funds are pooled.\n\n### Established By\n\nA pooled trust must be established through the actions of the beneficiary, beneficiary’s parents or grandparents, legal guardian or a court.\n\n### Funded By\n\nA pooled trust is funded with the income or assets of the beneficiary. A pooled trust may also contain assets of other people.\n\n### Disability Standard\n\nThe beneficiary must meet the disability criteria of the Supplemental Security Income (SSI) program at the time the trust is established. A person with a disability established by the Social Security Administration (SSA) or State Medical Review Team (SMRT) meets this qualification.\n\nThe trust does not meet the criteria for the exclusion if the beneficiary’s disability began after the trust was established.\n\nIf SSA or SMRT did not determine the beneficiary’s disability at the time the trust was established, SMRT must determine whether the beneficiary was disabled according to SSI disability criteria at the time the trust was established.\n\n### Sole Benefit Requirement\n\nThe trust sub-account must be established and used for the sole benefit of the disabled beneficiary. Disbursements must also be used for the beneficiary’s sole benefit and may not be used on items that are otherwise covered by public assistance benefits, with the following exceptions:\n- The trust may allow reasonable compensation for a trustee or trustees to manage the trust.\n- The trust may also allow reasonable costs associated with investment, legal, or other services rendered on behalf of the beneficiary with regard to the trust.\n\nA trust is not excluded as a pooled trust if it includes a provision that allows for either of the following:\n- Benefits to other people or entities during the beneficiary's lifetime, or\n- Termination of the trust prior to the beneficiary's death and payment of the trust corpus to another person or entity, other than repaying the State.\n\n### DHS Remainder Beneficiary\n\nThe trust must provide that, upon the death of the beneficiary or earlier termination of the trust, to the extent that amounts remaining in the beneficiary's sub-account are not retained by the trust, the Minnesota Department of Human Services (DHS) or \"the State” receives such remaining amounts, up to an amount equal to the total amount of Medical Assistance (MA) paid on behalf of the beneficiary. A remainder amount of up to ten percent of the value of the beneficiary's sub-account at the time of death may be retained by the trust.\n\n### Allowable Administrative Expenses\n\nThe trust may pay the following types of administrative expenses from the trust before repayment of DHS as the remainder beneficiary:\n- Taxes due from the trust to the State, other states, or federal government because of the death of the beneficiary\n- Reasonable expenses for the administration of the trust estate, such as an accounting of the trust to a court, completion and filing of documents, or other required actions associated with termination and wrapping up of the trust. For these administrative expenses, the trust must provide that:\n  - The DHS Special Recovery Unit (SRU) must receive advance notice and must approve any payment of administrative expenses before such expenses are paid, and\n  - The administrative expenses must be reasonable.\n\n### Prohibited Expenses and Payments\n\nA trust that provides for payment of any of the following expenses before repayment of DHS is not excluded as a pooled trust:\n- Taxes due from the estate of the beneficiary other than those arising from inclusion of the trust in the estate;\n- Inheritance taxes due for residual beneficiaries;\n- Payment of debts owed to third parties;\n- Funeral expenses; or\n- Payments to residual beneficiaries, other than the trustee."},{"chunk_id":"epm:2.3.3.2.7.9.5#evaluation-of-trust-principal-and-additions-to-the-trust","heading":"Evaluation of Trust Principal and Additions to the Trust","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.5#evaluation-of-trust-principal-and-additions-to-the-trust","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.5 Pooled Trusts > Evaluation of Trust Principal and Additions to the Trust","text":"## Evaluation of Trust Principal and Additions to the Trust\n\n### Trust Principal\n\nThe trust principal, including any income generated by the trust that is retained by the trust, is considered excluded.\n\n### Additions to the Trust\n\nAdditions to the trust principal made directly to the trust are excluded; however, an addition or transfer of funds to a pooled trust for a person who has reached age 65 must be evaluated under the transfer policy. See [MA-LTC Other Asset Transfer Considerations](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.4).\n\nIncome not irrevocably assigned to the trust is not considered to be made directly to the trust and is therefore counted as income to the beneficiary. A court order irrevocably assigning income to the trust is required to show an irrevocable assignment. If an assignment is revocable, the payment is income to the beneficiary because the beneficiary is legally entitled and eligible to receive it, unless another income exclusion applies. Note that certain payments to a beneficiary are not assignable by law. Send a HealthQuest if you have questions about assignability of income to a trust.\n\n### Evaluation of Trust Disbursements\n\nFunds from a beneficiary’s sub-account must be disbursed for the sole benefit of the beneficiary, and may not be used on items that are otherwise covered by public assistance benefits.\n\nDisbursements of cash from the trust made directly to the beneficiary or to a person acting on the beneficiary’s behalf are counted as unearned income in the month received.\n\nDisbursements made by the trustee to a third party that result in the beneficiary receiving non-cash items, are not counted. Disbursements that do not count as income may include, but are not limited to those made for educational expenses, therapy, transportation, professional fees, medical services not covered by MA, phone bills, recreation, and entertainment.\n\nConsider disbursements to be for the sole benefit of the beneficiary if the trustee makes payments of any sort from the principal or income of the trust to another person or entity such that the beneficiary derives the primary benefit from the payment.\n\nPurchased goods that require registration or titling, such as a vehicle or real property, must generally be registered or titled in the name of the beneficiary, the trustee, or the trust."},{"chunk_id":"epm:2.3.3.2.7.9.5#pooled-trust-verifications","heading":"Pooled Trust Verifications","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.5#pooled-trust-verifications","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.5 Pooled Trusts > Pooled Trust Verifications","text":"## Pooled Trust Verifications\n\nFor a person of any age who transfers funds to a pooled trust sub-account, a copy of the master trust, joinder agreement and any accompanying documentation are required verifications. These documents should be sent along with a completed Special Needs/Pooled Trust Referral Form [(DHS-4759)](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-4759-ENG) to the DHS Special Recovery Unit (SRU) at [dhs.srutrusts@state.mn.us](mailto:dhs.srutrusts@state.mn.us?subject=Pooled%20Trust%20(DHS-4759)&body=Please%20see%20the%20attached%20Pooled%20Trust%20Referral%20Form%20(DHS-4759)%2C%20along%20with%20a%20copy%20of%20the%20master%20trust%20and%20joinder%20agreement.).\n\n### Annual Reporting by Trustees\n\nThe trustee of a pooled trust with a beneficiary who is an MA applicant or enrollee is required by state law to submit an annual trust accounting directly to SRU. The beneficiary is not required to provide this information as part of the renewal process.\n\nIf the person or person’s authorized representative or trustee provides this information to the county, that information should be forwarded to SRU."}]},{"id":"epm:2.3.3.2.7.9.6","number":"2.3.3.2.7.9.6","title":"Third Party Established and Funded Trusts","parent":"2.3.3.2.7.9","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.6 Third Party Established and Funded Trusts","summary":"A trust can be established and funded by a person (third party grantor) other than the person applying for Medical Assistance (MA) for the benefit of the person applying for MA during the grantor’s lifetime or under the grantor’s will.","effective_date":"2017-12-01","last_modified":"2026-10-03T03:51:58.594961+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.6","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.7.9.6","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_7_9_6.htm","legal_citations":["Minnesota statutes, section 256B.056, subdivision 1a"],"chunks":[{"chunk_id":"epm:2.3.3.2.7.9.6#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.6","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.6 Third Party Established and Funded Trusts","text":"A trust can be established and funded by a person (third party grantor) other than the person applying for Medical Assistance (MA) for the benefit of the person applying for MA during the grantor’s lifetime or under the grantor’s will.\n\nA trust established under a third party grantor’s will is called a testamentary trust. A testamentary trust is established at the time of the grantor’s death, rather than at the time the will was created. However, if the beneficiary is entitled to any part of the corpus or income under the terms of the trust, it may not be available until the grantor’s estate is settled.\n\nA trust funded by a third party during his or her lifetime is called an inter vivos or living trust.\n\nTrusts funded by a third party that meet the requirements of a Supplemental Needs Trust are evaluated under the policy for Supplemental Needs Trust, not under Third Party Trust policy."},{"chunk_id":"epm:2.3.3.2.7.9.6#trust-availability","heading":"Trust Availability","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.6#trust-availability","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.6 Third Party Established and Funded Trusts > Trust Availability","text":"## Trust Availability\n\nThe availability concepts applicable to Third Party Funded and Established Trusts depend on the type of Third Party Trust involved:\n- Discretionary Trust\n- Discretionary Trust with Support Standards\n- Support Trust\n\nThe terms of the trust establish which type of trust is involved."},{"chunk_id":"epm:2.3.3.2.7.9.6#discretionary-trust","heading":"Discretionary Trust","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.6#discretionary-trust","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.6 Third Party Established and Funded Trusts > Discretionary Trust","text":"## Discretionary Trust\n\nA discretionary trust is a trust with provisions that grant the trustee absolute discretion regarding whether distributions from the trust will be made. A discretionary trust gives the trustee complete discretion to distribute all, some, or nothing from the trust.\n\n### Trust Corpus\n\nIf the trust provides that neither the trustee nor the court can invade the corpus to make disbursements to the beneficiary, the trust corpus is treated as unavailable to the beneficiary even when:\n- the trust can be revoked by someone other than the beneficiary or the beneficiary’s spouse; or\n- the trust provides a regular specified payment from the corpus to the beneficiary.\n  - When the applicant or enrollee is a beneficiary of a testamentary trust, the maximum distribution available to the beneficiary from the trust (including provisions permitting invasion of the corpus for the beneficiary’s support and maintenance) does not mean the maximum distribution available is actually made available to the beneficiary.\n\nThe trust corpus is considered to be unavailable if the beneficiary’s access is restricted. The trust is restricted if the beneficiary cannot compel the trustee to make disbursements to the beneficiary. If the trust provisions provide that neither the trustee nor the court can invade the corpus to make disbursements to the beneficiary, the trust corpus is treated as unavailable to the beneficiary.\n\n### Distributions\n\nAny payments made directly from the trust to the beneficiary are considered income to the beneficiary."},{"chunk_id":"epm:2.3.3.2.7.9.6#discretionary-trust-with-support-standards","heading":"Discretionary Trust with Support Standards","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.6#discretionary-trust-with-support-standards","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.6 Third Party Established and Funded Trusts > Discretionary Trust with Support Standards","text":"## Discretionary Trust with Support Standards\n\nA discretionary trust with support standards is a trust that includes trust provisions granting the trustee absolute discretion, but also includes standards of support for the beneficiary which limits the trustee’s discretion. A discretionary trust with support standards directs the trustee to distribute trust income or principal as necessary for the support and maintenance of the beneficiary.\n\n### Trust Corpus\n\nThe entire trust corpus is counted as available when the trust contains provisions permitting disbursements from the corpus for the beneficiary’s health or medical care.\n\n### Distributions\n\nAny payments made directly from the trust to the beneficiary are considered income to the beneficiary."},{"chunk_id":"epm:2.3.3.2.7.9.6#support-trust","heading":"Support Trust","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.6#support-trust","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.6 Third Party Established and Funded Trusts > Support Trust","text":"## Support Trust\n\nA support trust is a trust with provisions that direct the trustee to restrict the use of the trust for the beneficiary’s basic support needs such as food, clothing, medical care and education.\n\n### Trust Corpus\n\nThe entire corpus of a support trust is counted as an available asset.\n\n### Distributions\n\nAny payments made directly from the trust to the beneficiary are income to the beneficiary."}]},{"id":"epm:2.3.3.2.7.9.7","number":"2.3.3.2.7.9.7","title":"Supplemental Needs Trusts","parent":"2.3.3.2.7.9","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.7 Supplemental Needs Trusts","summary":"A supplemental needs trust is a trust established and funded by a third party to provide for the supplemental needs of a person living with a disability while allowing the person to remain eligible for Medical Assistance (MA).","effective_date":"2025-02-27","last_modified":"2026-10-03T03:51:58.594961+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.7","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.7.9.7","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_7_9_7.htm","legal_citations":["Minnesota Statutes, section 501C.1205, subdivision 2"],"chunks":[{"chunk_id":"epm:2.3.3.2.7.9.7#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.7","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.7 Supplemental Needs Trusts","text":"A supplemental needs trust is a trust established and funded by a third party to provide for the supplemental needs of a person living with a disability while allowing the person to remain eligible for Medical Assistance (MA)."},{"chunk_id":"epm:2.3.3.2.7.9.7#trust-requirements","heading":"Trust Requirements","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.7#trust-requirements","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.7 Supplemental Needs Trusts > Trust Requirements","text":"## Trust Requirements\n\nA trust must satisfy all of the following requirements in order to be evaluated as a supplemental needs trust. If a trust does not meet all of the requirements, the trust must be evaluated as a third party established and funded trust.\n\n### Purpose\n\nThe purpose of a supplemental needs trust is to provide for the reasonable living expenses and other basic needs of a person with a disability when benefits from publicly funded benefit programs are not sufficient to provide adequately for those needs. A supplemental needs trust may allow or require distributions only in ways and for purposes that supplement or complement the benefits available under MA.\n\nA supplemental needs trust must contain provisions that prohibit disbursements that would have the effect of replacing, reducing, or substituting for publicly funded benefits otherwise available to the beneficiary or rendering the beneficiary ineligible for publicly funded benefits.\n\n### Established By\n\nThe trust must be established by someone other than the beneficiary or the beneficiary’s spouse.\n\n### Funded By\n\nThe trust must be funded with the income or assets of someone other than the beneficiary, the beneficiary’s spouse, or anyone obligated to pay any sum for damages or any other purpose to or for the benefit of the trust beneficiary under the terms of a settlement agreement or judgment.\n- An exception to this requirement is when a supplemental needs trust is established with lump sum proceeds of payments made by the Social Security Administration (SSA) pursuant to the United States Supreme Court decision in Sullivan v. Zebley, 493 U.S. 521 (1990).\n\n### Disability Standard\n\nFor supplemental needs trusts established before July 1, 1993, the beneficiary must meet the disability criteria of the Supplemental Security Income (SSI) program before the trust is established. A person with a disability established by SSA or the State Medical Review Team (SMRT) meets this qualification.\n\nA disability may also be established by the written opinion of a licensed professional who is qualified to diagnose the illness or condition, confirmed by the written opinion of a second licensed professional who is qualified to diagnose the illness or condition. The licensed professional must determine the beneficiary has a mental illness or condition, which to a reasonable degree of medical certainty is expected to:\n- Last for a continuous period of 12 months or more; and\n- Substantially impair the person’s ability to provide for their care or custody.\n\n### Trustee\n\nThe beneficiary cannot be the trustee.\n\n### Distributions upon the Beneficiary’s Death\n\nA supplemental needs trust may provide for other beneficiaries upon the death of the beneficiary.\n\nA supplemental needs trust is not required to include a provision to reimburse the Minnesota Department of Human Services (DHS) for all MA benefits paid on behalf of the beneficiary at the beneficiary’s death."},{"chunk_id":"epm:2.3.3.2.7.9.7#evaluation-of-trust-assets","heading":"Evaluation of Trust Assets","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.7#evaluation-of-trust-assets","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.7 Supplemental Needs Trusts > Evaluation of Trust Assets","text":"## Evaluation of Trust Assets\n\n### Trust Corpus\n\nTrust assets, including any income generated by the trust assets that is retained by the trust, are unavailable assets.\n\n### Distributions\n\nDisbursements from the trust made directly to the beneficiary or to someone acting on the beneficiary’s behalf, such as a guardian or legal representative are counted as unearned income in the month received.\n\nPayments made by the trustee for the benefit of the beneficiary, but not made directly to the beneficiary, are not counted."},{"chunk_id":"epm:2.3.3.2.7.9.7#limitation-on-unavailability","heading":"Limitation on Unavailability","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.7#limitation-on-unavailability","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.9 Trusts > 2.3.3.2.7.9.7 Supplemental Needs Trusts > Limitation on Unavailability","text":"## Limitation on Unavailability\n\nA supplemental needs trust, established on or after July 1, 1993, is unenforceable when all of the following conditions are met:\n- The beneficiary is age 65 or older\n- The beneficiary resides in a state institution or nursing facility for six months or longer; and\n- There is no reasonable expectation that the beneficiary will be discharged from the institution or facility.\n\nHousing Support (HS) is not considered a state institution or facility for purposes of this exemption.\n\nIf the supplemental needs trust is unenforceable under this paragraph, it must be evaluated as a third party established and funded trust. See [EPM section 2.3.3.2.7.9.6](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.6)."}]},{"id":"epm:2.3.3.2.7.10","number":"2.3.3.2.7.10","title":"Life Insurance","parent":"2.3.3.2.7","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.10 Life Insurance","summary":"The cash surrender value (CSV) of life insurance policies owned by a person is an asset that counts towards the MA ABD asset limit when the total face value (FV) of all policies owned by the person that insures the same person, is more than $1,500. A limited life insurance exclusion applies to the CSV of a life insurance policy when the face value of all policies owned by a person that insures the","effective_date":"2019-08-07","last_modified":"2026-10-03T04:10:22.906968+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.10","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.7.10","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_7_10.htm","legal_citations":["United States Code, title 42, section 1382b","Code of Federal Regulations, title 20, section 416.1230","Minnesota Statutes, section 256B.056, subdivision 1a"],"chunks":[{"chunk_id":"epm:2.3.3.2.7.10#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.10","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.10 Life Insurance","text":"The cash surrender value (CSV) of life insurance policies owned by a person is an asset that counts towards the MA ABD asset limit when the total face value (FV) of all policies owned by the person that insures the same person, is more than $1,500. A limited life insurance exclusion applies to the CSV of a life insurance policy when the face value of all policies owned by a person that insures the same person is $1,500 or less.\n\nA life insurance policy is a contract that can sometimes be turned into cash. The basic concept of the contract is that the policy owner pays the premiums during the insured's lifetime and, when the insured dies, the life insurance company will make one or more payments to the designated beneficiary or beneficiaries. The policy owner may not be the person who is insured. However, life insurance companies have created many varieties of their products, which may require additional research and documentation. For additional detailed information and definitions of types of life insurance and life insurance provisions, see [Appendix I - Life Insurance Concepts.](https://bot-corpus.mn-dhs.online/s/epm/I)\n\nBurial insurance and term life insurance do not have a cash surrender value. These insurance products do not count toward the MA-ABD asset limit.\n\nAnnuities are a type of life insurance product that may provide income to the policy owner while they are still living. Annuities are evaluated differently than life insurance. See Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) [Annuities](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.8) for how the annuity is evaluated as an asset."},{"chunk_id":"epm:2.3.3.2.7.10#policy-for-evaluating-life-insurance","heading":"Policy For Evaluating Life Insurance","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.10#policy-for-evaluating-life-insurance","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.10 Life Insurance > Policy For Evaluating Life Insurance","text":"## Policy For Evaluating Life Insurance\n\n### Life Insurance as an asset\n\nThe asset value of a life insurance policy is its cash surrender value (CSV), not its face value (FV).\n\nDividend accumulations and interest attached to the life insurance policy are separate assets and are evaluated separately.\n\n### Limited life insurance exclusion of cash surrender value\n\nThe limited life insurance exclusion of CSV applies when the FV of all polices owned by one person that insure one person is $1,500 or less. This exclusion is applied per person.\n- The cash surrender value of life insurance policies owned by one person that insure only one person, if the cumulative face value of all policies held for the benefit of that one person amount to $1,500 or less, is excluded as an asset. If the cumulative FV of all policies held on that one person amount to over $1,500, then the CSV of the policies is counted as an asset (subject to possible exclusion under the burial fund exclusion- see [MA-ABD Burial Fund Exclusion](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.2)).\n- Interest and dividend additions are not included when determining whether the total face value of all polices is over $1,500 a life insurance policy is a countable or excluded asset.\n\nEXAMPLE\n\nMaria is 67 years old and owns three life insurance policies on theirself with the following values:\n- $400 FV with $700 CSV,\n- $500 FV with $1000 CSV, and\n- $200 FV with $400 CSV\n\nThe total FV of their policies is $1,100 ($400 + $500 + $200 = $1,100). Even though the total CSV of the three policies is $2,100 ($700 + $1,000 + $400 = $2,100), the CSV of the life insurance policies are entirely excluded because the life insurance polices are for the same insured person and the total FV is less than $1,500.\n\nEXAMPLE\n\nMaria, from the previous example, also owns three additional life insurance polices on three other insured people. In this case, if the total FV of the policies owned on each of the other people is less than $1,500, the CSV of those policies are also excluded.\n\nEXAMPLE\n\nMaria is 67 years old and owns three life insurance policies on theirself with the following values:\n- $600 FV with $900 CSV,\n- $900 FV with $1,200 CSV and,\n- $400 FV with $600 CSV\n\nThe total FV of their policies is $1,900 ($600 + $900 + $400 = $1,900). The total CSV of the three policies is $2,700 ($900 + $1,200 + $600 = $2,700). Since the total FV of the policies is over $1,500, the CSV of the life insurance policies are counted as an asset with a value of $2,700.\n\n### Interaction with the burial fund exclusion\n\nThe $1,500 burial fund exclusion is reduced by the FV of:\n- any life insurance policy where the CSV is excluded; and,\n- any burial insurance policy for the burial expenses of the person.\n\nThe $1,500 burial exclusion is also reduced by the FV of a life insurance policy for which a funeral provider has been made the irrevocable beneficiary, if the life insurance policy owner has irrevocably waived their right to, and cannot obtain, any CSV the life insurance policy may generate.\n\nFor burial fund exclusion policy, see [MA-ABD Burial Fund Exclusion](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.2).\n\n### Dividend additions and dividend accumulations\n\nDividends are payments from annual surplus earnings that life insurance companies may offer their policy owners. Dividends are not included when determining the face value of a life insurance policy. When dividends accrue in an account controlled by the insurance company for the policy owner, these are called dividend accumulations. When dividends are used to purchase more insurance for the policy owner these are called dividend additions.\n\nDividend accumulations\n- Dividend accumulations under the life insurance provision are counted, even if you exclude the CSV of a life insurance policy that pays the accumulations.\n- Unless the accumulations are excluded under another provision (for example, because they have been designated under the burial fund exclusion), the accumulations are counted as an asset, even if you exclude the CSV of the life insurance policy itself because the policy's FV is $1,500 or less.\n\nDividend additions\n- If the CSV of a life insurance policy is a countable asset, the CSV of dividend additions is included when determining the person's countable assets.\n- If the CSV of a life insurance policy is an excluded asset, the CSV of the dividend additions is not included when determining the person's countable assets.\n\n### Income treatment of dividends\n\nDividends count as income if the CSV of the life insurance policy is excluded.\n\nDividends are excluded as income if the CSV of the life insurance policy is counted as an asset. If the CSV of a life insurance policy is designated under the burial fund exclusion, dividends are also excluded."},{"chunk_id":"epm:2.3.3.2.7.10#accelerated-life-insurance-payments","heading":"Accelerated Life Insurance Payments","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.10#accelerated-life-insurance-payments","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.10 Life Insurance > Accelerated Life Insurance Payments","text":"## Accelerated Life Insurance Payments\n\nReceipt of an accelerated life insurance payment may reduce the FV and CSV. A policy owner may take out a loan against the life insurance policy which also may reduce the CSV."}]},{"id":"epm:2.3.3.2.7.10.1","number":"2.3.3.2.7.10.1","title":"Life Insurance Funded Burial Contracts","parent":"2.3.3.2.7.10","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.10 Life Insurance > 2.3.3.2.7.10.1 Life Insurance Funded Burial Contracts","summary":"A life insurance funded burial (LIFB) contract involves a person purchasing a life insurance policy on his or her own life and then assigning, revocably or irrevocably, either the proceeds or ownership, or both, of the policy to a third party, generally a funeral provider. The purpose of the assignment is to fund a burial contract. Life insurance funded burial contracts are not burial insurance.","effective_date":"2021-10-01","last_modified":"2026-10-03T03:51:58.594961+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.10.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.7.10.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_7_10_1.htm","legal_citations":["United States Code, title 42, section 1382b","Code of Federal Regulations, title 20, section 416.1230","Minnesota Statutes, section 256B.056, subdivision 1a","Minnesota Statutes, section 72A.325"],"chunks":[{"chunk_id":"epm:2.3.3.2.7.10.1#life-insurance-funded-burial-arrangements","heading":"Life Insurance Funded Burial Arrangements","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.10.1#life-insurance-funded-burial-arrangements","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.10 Life Insurance > 2.3.3.2.7.10.1 Life Insurance Funded Burial Contracts > Life Insurance Funded Burial Arrangements","text":"## Life Insurance Funded Burial Arrangements\n\nA life insurance funded burial (LIFB) contract involves a person purchasing a life insurance policy on his or her own life and then assigning, revocably or irrevocably, either the proceeds or ownership, or both, of the policy to a third party, generally a funeral provider. The purpose of the assignment is to fund a burial contract. Life insurance funded burial contracts are not burial insurance.\n\nA life insurance policy purchased by an MA applicant or enrollee to fund a burial contract for someone other than the MA applicant or enrollee, such as a spouse, is treated as a life insurance policy, not a life insurance funded burial. See [2.3.3.2.7.10 MA-ABD Life Insurance](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.10)\n\nIf an annuity policy is being used to fund a burial contract, it is called an annuity-funded burial (AFB) and follows LIFB policies. Otherwise, see Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability [(MA-ABD) Annuities](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.8) for how the annuity is evaluated as an asset.\n\n### Proceeds\n\nProceeds of a life insurance policy are the face value of the policy plus any additions payable at maturity or death. This does not include dividends, cash surrender value (CSV) or interest.\n\n### Dividend Accumulations\n\nDividend accumulations of a life insurance policy as part of the value of the policy or the burial contract are not excluded assets. Dividend accumulations are separate assets and must be evaluated separately.\n\nIf ownership of the life insurance policy has been irrevocably assigned, then absent evidence to the contrary, the dividend accumulations are also assigned.\n\n### Contingent Beneficiary\n\nA person’s estate must be named as contingent beneficiary when irrevocably assigning ownership of a life insurance policy to fund a burial arrangement. If a person’s estate is not named as the contingent beneficiary, the policy is treated as a life insurance policy, not a life insurance funded burial or annuity funded burial."},{"chunk_id":"epm:2.3.3.2.7.10.1#effect-of-revocable-assignment-of-ownership","heading":"Effect of Revocable Assignment of Ownership","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.10.1#effect-of-revocable-assignment-of-ownership","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.10 Life Insurance > 2.3.3.2.7.10.1 Life Insurance Funded Burial Contracts > Effect of Revocable Assignment of Ownership","text":"## Effect of Revocable Assignment of Ownership\n\n### Burial Spaces\n\nThe [burial space exclusion](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.10) does not apply. This is because the funeral provider has not received any payment and no purchase of burial spaces has been made. The provider has no obligation to provide any spaces until the person dies and therefore no spaces are being held for the person.\n\n### Burial Funds\n\nThe life insurance funded burial arrangement is evaluated under the [life insurance policy.](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.1) The burial funds exclusion may apply.\n\n### Example\n\nEmma has a burial contract funded by the revocable assignment of ownership of a life insurance policy. She doesn't have any other burial assets. The face value (FV) of both the burial contract and the life insurance policy is $3,000 and the CSV of the life insurance policy is currently $1,700. The total asset value of Emma’s burial contract is equal to the CSV of $1,700.\n\nThe burial space exclusion does not apply to Emma’s contract. However, Emma can exclude $1,500 of the CSV under the burial fund exclusion. The remaining $200 of the CSV is considered a countable asset."},{"chunk_id":"epm:2.3.3.2.7.10.1#effect-of-irrevocable-assignment-of-ownership","heading":"Effect of Irrevocable Assignment of Ownership","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.10.1#effect-of-irrevocable-assignment-of-ownership","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.10 Life Insurance > 2.3.3.2.7.10.1 Life Insurance Funded Burial Contracts > Effect of Irrevocable Assignment of Ownership","text":"## Effect of Irrevocable Assignment of Ownership\n\n### Burial Spaces\n\nThe burial space exclusion may apply, depending on the nature of the contract (See [MA-ABD Burial Space Exclusion](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.1)). Any portion of the contract that represents the purchase of a burial space has no effect on the burial fund exclusion.\n\n### Burial Funds\n\nThe life insurance policy and the burial contract are not assets because the person no longer owns them. The FV of the burial fund portion of the contract (if any) offsets the $1,500 burial fund exclusion.\n\n### Example\n\nBill has made provision for his burial by irrevocably assigning ownership of a life insurance policy on his life to a funeral home to fund a burial contract. The FV of the life insurance policy is $3,000.\n\nThe burial contract identifies the purchase of $1,300 of burial spaces and $1,700 of burial funds. The $1,700 burial funds portion of the contract is not an asset because he no longer owns them, but, since the assignment of policy ownership is irrevocable, the $1,700 burial funds portion reduces the $1,500 burial fund exclusion.;Bill may not designate any additional assets under the burial fund exclusion (the $1,700 reduced the $1,500). The $1,300 burial space purchase is not an asset either, and will not reduce the amount of the burial fund exclusion."},{"chunk_id":"epm:2.3.3.2.7.10.1#effect-of-revocable-assignment-of-proceeds","heading":"Effect of Revocable Assignment of Proceeds","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.10.1#effect-of-revocable-assignment-of-proceeds","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.10 Life Insurance > 2.3.3.2.7.10.1 Life Insurance Funded Burial Contracts > Effect of Revocable Assignment of Proceeds","text":"## Effect of Revocable Assignment of Proceeds\n\n### Burial Spaces\n\nThe burial space exclusion does not apply to the CSV of the life insurance policy. This is because the funeral provider has not received any payment and no purchase of burial spaces has been made. The provider has no obligation to provide any spaces until the person dies and, therefore, no spaces are being held for the person.\n\n### Burial Funds\n\nThe life insurance funded burial arrangement is evaluated as a [life insurance policy.](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.10) The asset value of the burial contract is the amount of the CSV of the life insurance policy.\n\n### Treatment of CSV\n\nIf the FV of all life insurance policies on the person's life is $1,500 or less, the CSV is excluded under the life insurance exclusion.\n\nIf the face value of all policies exceeds $1,500, the CSV of the policy is applied according to the burial fund exclusion, if applicable (See MA-ABD Burial Fund Exclusion).\n\n### Examples\n\nLydia has a burial contract funded by the revocable assignment of the proceeds of an insurance policy on her life, with a face value of $1,300. The CSV of the policy is $1,000. If this is the only life insurance policy she owns on her life, then the CSV of the life insurance policy would be excluded under the life insurance exclusion and the burial fund and burial space exclusions would not apply, because the FV is $1,500 or less.\n\nThe life insurance policy's FV of $1,300 reduces the maximum $1,500 burial fund exclusion by that same amount. So, Lydia may designate an additional $200 under the burial fund exclusion.\n\nIf Lydia has another life insurance policy on her life and the total FV of the two policies exceeds $1,500 (and, therefore, the life insurance exclusion does not apply), then $1,500 of the CSV may be excluded under the burial fund exclusion. No burial space exclusion applies."},{"chunk_id":"epm:2.3.3.2.7.10.1#effect-of-irrevocable-assignments-of-proceeds","heading":"Effect of Irrevocable Assignments of Proceeds","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.10.1#effect-of-irrevocable-assignments-of-proceeds","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.10 Life Insurance > 2.3.3.2.7.10.1 Life Insurance Funded Burial Contracts > Effect of Irrevocable Assignments of Proceeds","text":"## Effect of Irrevocable Assignments of Proceeds\n\nWhen there is an irrevocable assignment of proceeds or an irrevocable designation of a beneficiary, but the insured has not irrevocably assigned ownership, the CSV is a countable asset if the person has access to the CSV. Each policy may be different and must be reviewed to determine the terms of the contract. If the policy indicates that the person does not have access to the CSV, then the CSV is not a countable asset because it is unavailable.\n\n### Burial Spaces\n\nThe burial space exclusion may apply, depending on the nature of the contract (See [MA-ABD Burial Space Exclusion](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.1)). Any portion of the contract that represents the purchase of a burial space may be excluded and has no effect on the burial fund exclusion.\n\n### Burial Funds\n\nIf the CSV of the life insurance policy and the burial contract are unavailable, because the person cannot access them, then the FV of the burial funds portion of the contract (if any) offsets the $1,500 burial fund exclusion. This is because the contract represents an irrevocable arrangement available to meet the person’s burial."},{"chunk_id":"epm:2.3.3.2.7.10.1#life-insurance-policy-placed-in-a-trust","heading":"Life Insurance Policy Placed In A Trust","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.10.1#life-insurance-policy-placed-in-a-trust","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.10 Life Insurance > 2.3.3.2.7.10.1 Life Insurance Funded Burial Contracts > Life Insurance Policy Placed In A Trust","text":"## Life Insurance Policy Placed In A Trust\n\nA life insurance company may provide a person with the option of irrevocably transferring ownership of a revocable life insurance policy that funds a burial contract to a trust established by the company. If a policy is placed in trust, the asset value of the policy (its CSV) is evaluated as follows:\n\n### Treatment of Policy's CSV\n\nThe CSV is not an asset when a person does not own or have the legal right to direct the use of trust assets to meet his or her support and maintenance.\n\n### Treatment of Dividends\n\nIf the policy's CSV is not an asset, then, any dividends paid on the policy are also not an asset.\n\n### Person Retains Right to Change Funeral Firm\n\nUnder an irrevocable trust arrangement, the life insurance policy's CSV is not an asset even if the person retains the right to change the funeral firm that will provide the burial goods and services.\n\n### Burial Fund Exclusion Offset\n\nA revocably assigned life insurance policy placed in an irrevocable life insurance trust is treated the same as a life insurance policy for which the ownership has been irrevocably assigned to fund a burial contract. This means that the value of the burial funds portion of the contract (if any) reduces the $1,500 burial fund exclusion. This is because the burial funds portion of the contract represents an irrevocable arrangement that is available to meet the person's burial expenses."}]},{"id":"epm:2.3.3.2.7.11","number":"2.3.3.2.7.11","title":"Burial Contracts","parent":"2.3.3.2.7","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.11 Burial Contracts","summary":"This subchapter provides links to policy about a person's financial eligibility regarding evaluation of their burial assets.","effective_date":"2019-08-07","last_modified":"2026-10-03T03:51:58.594961+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.7.11","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_7_11.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.3.3.2.7.11#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.11 Burial Contracts","text":"This subchapter provides links to policy about a person's financial eligibility regarding evaluation of their burial assets.\n\nThis subchapter includes policies that apply to Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD).\n\n[MA-ABD Burial Space Exclusion](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.1)\n\n[MA-ABD Burial Fund Exclusion](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.2)\n\n[MA-ABD Prepaid Burial Arrangements](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.3)"}]},{"id":"epm:2.3.3.2.7.11.1","number":"2.3.3.2.7.11.1","title":"Burial Space Exclusion","parent":"2.3.3.2.7.11","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.11 Burial Contracts > 2.3.3.2.7.11.1 Burial Space Exclusion","summary":"A burial space or agreement which represents the purchase of a burial space held for the burial of the person, his or her spouse, or any other member of his or her immediate family is an excluded asset, regardless of value.","effective_date":"2019-08-07","last_modified":"2026-10-03T03:51:58.594961+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.7.11.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_7_11_1.htm","legal_citations":["United States Code, title 42, section 1382b","Code of Federal Regulations, title 20, section 416.1231","Minnesota Statutes, section 256B.056, subdivision 1a","Minnesota Statutes, section 256B.056, subdivision 3d"],"chunks":[{"chunk_id":"epm:2.3.3.2.7.11.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.1","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.11 Burial Contracts > 2.3.3.2.7.11.1 Burial Space Exclusion","text":"A burial space or agreement which represents the purchase of a burial space held for the burial of the person, his or her spouse, or any other member of his or her immediate family is an excluded asset, regardless of value."},{"chunk_id":"epm:2.3.3.2.7.11.1#burial-space","heading":"Burial Space","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.1#burial-space","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.11 Burial Contracts > 2.3.3.2.7.11.1 Burial Space Exclusion > Burial Space","text":"## Burial Space\n\nA burial space is a(n):\n- Burial Plot;\n- gravesite;\n- crypt;\n- mausoleum;\n- casket;\n- urn;\n- niche; or\n- other repository customarily and traditionally used for the deceased's bodily remains.\n\nA burial space also includes necessary and reasonable improvements or additions to such spaces, including but not limited to:\n- vaults;\n- headstones, markers, or plaques;\n- burial containers (e.g. for caskets); and\n- arrangements for the opening and closing of the gravesite.\n\nFor example, a contract for care and maintenance of the gravesite, sometimes referred to as endowment or perpetual care, can be excluded as a burial space."},{"chunk_id":"epm:2.3.3.2.7.11.1#no-effect-on-burial-fund-exclusion","heading":"No Effect on Burial Fund Exclusion","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.1#no-effect-on-burial-fund-exclusion","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.11 Burial Contracts > 2.3.3.2.7.11.1 Burial Space Exclusion > No Effect on Burial Fund Exclusion","text":"## No Effect on Burial Fund Exclusion\n\nThe burial space exclusion is in addition to, and has no effect on, the burial fund exclusion (see [MA-ABD Burial Fund Exclusion](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.2))."},{"chunk_id":"epm:2.3.3.2.7.11.1#multiple-burial-spaces","heading":"Multiple Burial Spaces","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.1#multiple-burial-spaces","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.11 Burial Contracts > 2.3.3.2.7.11.1 Burial Space Exclusion > Multiple Burial Spaces","text":"## Multiple Burial Spaces\n\nFor items that serve the same purpose, only one item is excluded per person. For example, a cemetery lot and a casket for the same person is excluded, but not a casket and an urn for the same person. If a person has multiple burial space items for the same purpose, the person may choose the one to which the exclusion will apply."},{"chunk_id":"epm:2.3.3.2.7.11.1#spaces-owned-by-a-persons-spouse-or-sponsor","heading":"Spaces Owned by a Person's Spouse or Sponsor","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.1#spaces-owned-by-a-persons-spouse-or-sponsor","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.11 Burial Contracts > 2.3.3.2.7.11.1 Burial Space Exclusion > Spaces Owned by a Person's Spouse or Sponsor","text":"## Spaces Owned by a Person's Spouse or Sponsor\n\nBurial spaces owned by a spouse whose assets deem to a person for the burial of an eligible person, his/her spouse and/or any member of the eligible person's immediate family (including the spouse or sponsor) are excluded."},{"chunk_id":"epm:2.3.3.2.7.11.1#agreement-which-represents-the-purchase-of-a-burial-space","heading":"Agreement Which Represents the Purchase of a Burial Space","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.1#agreement-which-represents-the-purchase-of-a-burial-space","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.11 Burial Contracts > 2.3.3.2.7.11.1 Burial Space Exclusion > Agreement Which Represents the Purchase of a Burial Space","text":"## Agreement Which Represents the Purchase of a Burial Space\n\nAn agreement which represents the purchase of a burial space is a contract with a provider for a burial space held for the eligible person or a member of their immediate family."},{"chunk_id":"epm:2.3.3.2.7.11.1#persons-immediate-family","heading":"Person's Immediate Family","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.1#persons-immediate-family","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.11 Burial Contracts > 2.3.3.2.7.11.1 Burial Space Exclusion > Person's Immediate Family","text":"## Person's Immediate Family\n\nThe person's immediate family includes the person's:\n- parents, including adoptive parents;\n- minor or adult children, including adoptive and stepchildren;\n- siblings (brothers and sisters), including adoptive and stepsiblings;\n- spouses of the above relatives.\n\nIf the relative's relationship to the person is by marriage only, the marriage must be in effect in order for the burial space exclusion to continue to apply. For example, a burial space held for a sister-in-law is no longer excluded if she and the person's brother divorce."},{"chunk_id":"epm:2.3.3.2.7.11.1#held-for","heading":"Held For","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.1#held-for","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.11 Burial Contracts > 2.3.3.2.7.11.1 Burial Space Exclusion > Held For","text":"## Held For\n\nA burial space is \"held for\" a person when they have:\n- title to and/or possesses a burial space intended for the person's use (for example, has title to a burial plot or owns a burial urn stored in the basement for his or her own use); or\n- a contract with a funeral service company for the specified burial spaces for the person's burial (i.e., an agreement which represents the person's current right to use the items at the amount shown).\n\nUntil the purchase price is paid in full, burial spaces are not \"held for\" a person under an installment sales contract or similar device if:\n- the person does not currently own the space;\n- the person does not currently have the right to use the space; and\n- the seller is not currently obligated to provide the space.\n\nUntil all payments are made on the contract, the amounts paid may be excluded under the $1,500 burial funds exclusion. See [MA-ABD Burial Fund Exclusion](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.2) for more information."},{"chunk_id":"epm:2.3.3.2.7.11.1#agreements-which-represent-the-purchase-of-a-burial-space","heading":"Agreements Which Represent the Purchase of a Burial Space","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.1#agreements-which-represent-the-purchase-of-a-burial-space","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.11 Burial Contracts > 2.3.3.2.7.11.1 Burial Space Exclusion > Agreements Which Represent the Purchase of a Burial Space","text":"## Agreements Which Represent the Purchase of a Burial Space\n\nIf the contract shows the purchase of a burial space at the specified price, the space is held for the person, and the contract is irrevocable, it is not an asset. If the contract is revocable, or the space is not held for the person, it is an asset that is not excluded under the burial space exclusion but could be excluded under the burial funds exclusion."}]},{"id":"epm:2.3.3.2.7.11.2","number":"2.3.3.2.7.11.2","title":"Burial Fund Exclusion","parent":"2.3.3.2.7.11","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.11 Burial Contracts > 2.3.3.2.7.11.2 Burial Fund Exclusion","summary":"Up to $1,500 of liquid assets set aside for a person's burial expenses is excluded. The $1,500 burial fund exclusion is reduced when a person owns certain other assets.","effective_date":"2020-06-01","last_modified":"2026-10-03T03:57:10.906392+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.7.11.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_7_11_2.htm","legal_citations":["United States Code, Title 42, section 1382b","Code of Federal Regulations, Title 20, section 416.1231","Minnesota Statues, section 256B.056, subdivision 1a","Minnesota Statues, section 256B.056, subdivision 3d"],"chunks":[{"chunk_id":"epm:2.3.3.2.7.11.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.2","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.11 Burial Contracts > 2.3.3.2.7.11.2 Burial Fund Exclusion","text":"Up to $1,500 of liquid assets set aside for a person's burial expenses is excluded. The $1,500 burial fund exclusion is reduced when a person owns certain other assets."},{"chunk_id":"epm:2.3.3.2.7.11.2#burial-funds","heading":"Burial Funds","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.2#burial-funds","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.11 Burial Contracts > 2.3.3.2.7.11.2 Burial Fund Exclusion > Burial Funds","text":"## Burial Funds\n\nBurial funds may be:\n- revocable burial contracts;\n- revocable burial trusts;\n- other revocable burial arrangements (including the value of certain installment sales contracts for burial spaces);\n- cash;\n- financial accounts (e.g., savings or checking accounts); or\n- other financial instruments with a definite cash value (e.g. stocks, bonds, certificate of deposit, etc.)\n- cash surrender value of a non-excluded life insurance policy\n\nThese funds must be clearly designated for the person or the person's spouse's burial, cremation or other burial-related expenses. Property other than that listed in this definition is not considered burial funds and cannot be excluded under the burial funds provision. For example, a car, real property, and livestock, are not burial funds."},{"chunk_id":"epm:2.3.3.2.7.11.2#expenses-for-burial-fund-exclusion-purposes","heading":"Expenses for Burial Fund Exclusion Purposes","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.2#expenses-for-burial-fund-exclusion-purposes","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.11 Burial Contracts > 2.3.3.2.7.11.2 Burial Fund Exclusion > Expenses for Burial Fund Exclusion Purposes","text":"## Expenses for Burial Fund Exclusion Purposes\n\nExpenses included for burial fund exclusion purposes are generally those related to preparing a body for burial and any services prior to burial. They may include, for example: transportation of the body, embalming, cremation, flowers, clothing, and services of the funeral director and staff. Expenses may also be associated with cultural customs, other than burial, when a person dies such as scattering of ashes.\n\nUsually, expenses for items used for interment of the deceased's remains are not included for burial fund exclusion purposes. Such items may be subject to the burial space exclusion (See MA-ABD Burial Space Exclusion). However, items that do not qualify for the burial space exclusion, for example, a space being purchased by installment contract, may be excluded under the burial fund exclusion."},{"chunk_id":"epm:2.3.3.2.7.11.2#originally-designated-amount","heading":"Originally Designated Amount","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.2#originally-designated-amount","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.11 Burial Contracts > 2.3.3.2.7.11.2 Burial Fund Exclusion > Originally Designated Amount","text":"## Originally Designated Amount\n\nThe originally designated amount of a burial fund is the amount set aside for burial, including excluded and non-excluded funds, but exclusive of interest and appreciation, at the time of the most recent designation. Any amount can be designated for burial, but excluded only up to a certain amount.\n\n### Increases in Value of Burial Funds\n\nAny appreciation in the value of excluded burial funds is an excluded (and excluded income) as long as the appreciation is left to accumulate in the fund, even if the total burial fund exclusion exceeds $1,500 due to appreciation in value.\n\n### Increases in Maximum Exclusion of Burial Funds\n\nOnce the amount of designated burial funds equals $1,500, the only additions to that amount that can be excluded under the burial fund exclusion are appreciation, interest, and growth in the excluded burial fund or the excluded portion of the CSV of a life insurance policy set aside for burial.\n\nUntil $1,500 (or the remaining amount available to be excluded) in burial funds has been designated, additional amounts can be excluded under the burial fund exclusion if the person designates them for burial expenses. Interest on excluded burial funds is not included in determining if the $1,500 maximum has been reached.\n\nA person's designated burial fund remains in effect until:\n- MA eligibility terminates; or\n- the person uses the funds for another purpose\n\nA person may designate additional funds, up to $1,500, as their burial fund when assets originally designated as the burial fund are no longer excluded under the burial fund exclusion."},{"chunk_id":"epm:2.3.3.2.7.11.2#amount-of-funds-that-can-be-excluded","heading":"Amount of Funds That Can Be Excluded","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.2#amount-of-funds-that-can-be-excluded","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.11 Burial Contracts > 2.3.3.2.7.11.2 Burial Fund Exclusion > Amount of Funds That Can Be Excluded","text":"## Amount of Funds That Can Be Excluded\n\nUp to $1,500 of liquid assets set aside for a person's burial expenses is excluded. The $1,500 burial fund exclusion is reduced when a person owns certain other assets.\n\n### Maximum Exclusion\n\nThe maximum amount that can be excluded is $1,500 set aside for:\n- the burial expenses of the person;\n- the burial expenses of the person's spouse. The spouse does not have to be eligible for MA and,\n- the burial expenses of the persons dependent children who are MHCP enrollees and live with the person or the person's spouse\n\nThis exclusion is separate from, and in addition to, the burial space exclusion. However, the $1,500 burial fund exclusion may also include the value of funds paid on installment contracts for burial spaces that do not qualify for the burial space exclusion because they have not yet been paid for in full.\n\n### Other Assets and the Maximum Exclusion\n\nThese burial service arrangements apply to the maximum $1,500 exclusion to the extent that they do not represent excluded burial spaces:\n- the face value (FV) of any life insurance policy on the person (or spouse, if applicable), if such policy is excluded under the life insurance exclusion (See [MA-ABD Life Insurance](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.10)); and\n- any amount held in an irrevocable trust, burial contract, or other irrevocable arrangement for the person ( or the person's spouse) burial expenses unless it is excluded under the burial space exclusion.\n- the face value of burial insurance\n\n### Subsequent Purchase of Excluded Life Insurance or Irrevocable Burial Contract\n\nA subsequent purchase of an excluded life insurance policy or an irrevocable burial contract reduces the amount of the available burial fund exclusion as described above. The reduction is effective the month after the month in which the life insurance or the irrevocable burial contract was purchased. This may also change which funds are excluded.\n\nExample:\n\nJacob has the following burial assets:\n\n| $1,000 | designated savings account |\n| --- | --- |\n| $200 | irrevocable burial contract |\n| $1,500 | maximum exclusion |\n| -200 | irrevocable burial contract |\n| $1,300 | available exclusion |\n| -1,000 | designated savings account |\n| $300 | still available for exclusion |\n\nThe designated $1,000 savings account is excluded under the burial fund exclusion. Two years later, Jacob wants to add to his designated burial savings account which now has a balance of $1,150 due to accumulated interest. He can increase the excluded funds in the account by up to $300 which would bring the total designated burial funds up to $1,300 (1,500-200) plus interest.\n\nThe amount of interest which accumulated in the account was not counted."},{"chunk_id":"epm:2.3.3.2.7.11.2#modifications-are-permitted","heading":"Modifications are Permitted","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.2#modifications-are-permitted","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.11 Burial Contracts > 2.3.3.2.7.11.2 Burial Fund Exclusion > Modifications are Permitted","text":"## Modifications are Permitted\n\n### Change of Form\n\nTransferring excluded burial funds from one form to another (for example, from a certificate of deposit to a burial contract) is allowed.\n\n### Loans Against Burial Funds\n\nA loan against the cash surrender value (CSV) of a life insurance policy that has been excluded under the burial fund exclusion is allowed if the loan is for the purchase of another burial fund.\n\nUse of a burial fund as collateral for a loan is not allowed because the loan creates an encumbrance on the funds. Since the funds are not available for the individual's burial as long as they are encumbered, the funds cannot be considered set aside for the individual's burial. This is true even if the loan is used for burial purposes."},{"chunk_id":"epm:2.3.3.2.7.11.2#burial-funds-must-be-kept-separate","heading":"Burial Funds Must Be Kept Separate","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.2#burial-funds-must-be-kept-separate","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.11 Burial Contracts > 2.3.3.2.7.11.2 Burial Fund Exclusion > Burial Funds Must Be Kept Separate","text":"## Burial Funds Must Be Kept Separate\n\nBurial funds may be commingled with other burial expense-related assets. but must be kept separate from non-burial related assets to be excluded. Burial-related assets are burial funds (excluded and non-excluded) and burial spaces (including agreements representing the purchase of a burial space). If burial funds are commingled with non-burial related assets, the exclusion does not apply.\n\n### Examples\n\nA single burial contract for $2,500 of burial services and $2,000 in burial spaces does not have to be separated into 2 contracts since the whole amount is burial-related, even though only $1,500 of the contract as a burial fund is excluded.\n\nA bank account containing $1,200, $500 of which is designated for burial and $700 of which is other funds the individual uses for living expenses, is not allowable and the $500 may not be excluded as a burial fund."},{"chunk_id":"epm:2.3.3.2.7.11.2#re-designation","heading":"Re-designation","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.2#re-designation","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.11 Burial Contracts > 2.3.3.2.7.11.2 Burial Fund Exclusion > Re-designation","text":"## Re-designation\n\nThe burial fund exclusion may change when a person obtains additional assets for burial expenses of the amount or nature of the existing assets designated as the burial fund occur. A re-designation is a change or correction of a previous burial fund designation made necessary by a change in the amount of burial funds originally designated (not including accumulated interest or appreciation). This may be caused by addition of funds (other than interest) or use of funds. The burial fund exclusion is not lost and reapplied, but merely corrected."},{"chunk_id":"epm:2.3.3.2.7.11.2#deeming-considerations","heading":"Deeming Considerations","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.2#deeming-considerations","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.11 Burial Contracts > 2.3.3.2.7.11.2 Burial Fund Exclusion > Deeming Considerations","text":"## Deeming Considerations\n\nThe burial fund exclusion also applies to assets owned by the person's spouse that are designated as set aside for the burial expenses of the person or their spouse or eligible dependent children."}]},{"id":"epm:2.3.3.2.7.11.3","number":"2.3.3.2.7.11.3","title":"Prepaid Burial Arrangements","parent":"2.3.3.2.7.11","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.11 Burial Contracts > 2.3.3.2.7.11.3 Prepaid Burial Arrangements","summary":"A prepaid (or pre-need) burial contract is an agreement, whereby the buyer pays in advance for burial services and/or burial spaces that the seller agrees to furnish upon the death of the buyer or other designated individual.","effective_date":"2022-01-01","last_modified":"2026-10-03T03:57:11.122534+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.7.11.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_7_11_3.htm","legal_citations":["United States Code, title 42, section 1382b","Code of Federal Regulations, title 20, section 416.1231","Minnesota Statutes, section 256B.056, subdivision 1a","Minnesota Statutes, section 256B.056, subdivision 3d"],"chunks":[{"chunk_id":"epm:2.3.3.2.7.11.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.3","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.11 Burial Contracts > 2.3.3.2.7.11.3 Prepaid Burial Arrangements","text":"A prepaid (or pre-need) burial contract is an agreement, whereby the buyer pays in advance for burial services and/or burial spaces that the seller agrees to furnish upon the death of the buyer or other designated individual.\n\nPre-need Burial Arrangements funded by a life insurance policy should be evaluated under the [Life Insurance Funded Burial Contracts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.10.1) policy."},{"chunk_id":"epm:2.3.3.2.7.11.3#contract-is-a-countable-asset","heading":"Contract is a Countable Asset","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.3#contract-is-a-countable-asset","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.11 Burial Contracts > 2.3.3.2.7.11.3 Prepaid Burial Arrangements > Contract is a Countable Asset","text":"## Contract is a Countable Asset\n\nIf a burial contract is revocable it is a countable asset. However:\n- any portion of the contract that clearly represents the purchase of burial spaces may be excluded, regardless of value; and\n- some or all of any remaining value of the contract may be excluded under the [burial fund exclusion.](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.2)"},{"chunk_id":"epm:2.3.3.2.7.11.3#contract-is-not-a-countable-asset","heading":"Contract is Not a Countable Asset","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.3#contract-is-not-a-countable-asset","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.11 Burial Contracts > 2.3.3.2.7.11.3 Prepaid Burial Arrangements > Contract is Not a Countable Asset","text":"## Contract is Not a Countable Asset\n\nUp to $2,000 of a burial contract can be irrevocable for one person or $3,000 for a couple. This amount is not counted because it is unavailable to the person. The portion of a burial contract that cannot be revoked is not a countable asset. However:\n- any portion of the contract that clearly represents the purchase of burial spaces is excluded, regardless of value; and\n- any portion of the contract that represents burial funds reduces the $1,500 burial fund exclusion for an individual."},{"chunk_id":"epm:2.3.3.2.7.11.3#contract-revocability","heading":"Contract Revocability","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.3#contract-revocability","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.11 Burial Contracts > 2.3.3.2.7.11.3 Prepaid Burial Arrangements > Contract Revocability","text":"## Contract Revocability\n\nIrrevocable burial agreements set up in another state are considered irrevocable up to the full amount allowed under that state's laws. A state's laws determine whether a contract is revocable. Some burial contracts may be partly revocable. For example, if the total value of an otherwise irrevocable contract exceeds the limit set for irrevocability by State law, the excess is revocable.\n\nEXAMPLE\n\nA contract for $2,850 in unspecified burial goods or services:\n\n| $2,850 | - | total value of contract |\n| --- | --- | --- |\n| $2,000 | - | maximum irrevocable under State law |\n| $1,500 |  | Applied to the burial fund exclusion |\n| $500 |  | not excluded, but unavailable due to irrevocability of contract |\n| $850 | - | available, counted asset |\n\nFor people who are married, any division of burial contract funds is acceptable. For example, one spouse may have a $2,500 burial contract, the other spouse a $500 burial contract.\n\nInterest earned on the irrevocable burial contract is neither income nor assets, as long as it is left to accumulate."},{"chunk_id":"epm:2.3.3.2.7.11.3#evaluating-contracts","heading":"Evaluating Contracts","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11.3#evaluating-contracts","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.11 Burial Contracts > 2.3.3.2.7.11.3 Prepaid Burial Arrangements > Evaluating Contracts","text":"## Evaluating Contracts\n\n### Conditions for Liquidation\n\nA prepaid burial contract, even when not technically irrevocable, may have conditions attached to its liquidation or revocation. If either of the following conditions exists, the contract is not an asset.\n- Significant hardship may result from the conditions required for revoking a contract. Significant hardship means an unrealistic demand; for example, having to move out of state.\n- State law or contractual terms may require mutual consent of buyer and seller in order to sell or revoke a contract. If the seller will not consent, or will consent only under conditions that would pose a significant hardship to the buyer, this must be documented.\n\n### Value of Contract as an asset\n\nIf a burial contract is an asset, the value is the amount payable to the owner upon revocation, or cash surrender value.\n\n### Single-Purpose Burial Space Contracts\n\nGeneral\n\nThe burial space exclusion applies to any single-purpose burial space contract if:\n- the contract lists all of the burial spaces and either includes a value for each space or the total value of all the spaces combined; and\n- the seller's obligation to provide those items is not contingent on further payment (as in certain installment contracts); for example, the items are actually being held for the individual's future use.\n\nException: The burial fund exclusion applies (subject to the $1,500 maximum or as reducing that maximum) to:\n- the unidentified portion of a single source burial space contract that does not identify some or all of the spaces, or does not include either a value for each burial space or the total value of all the spaces combined; and\n- the amount paid on an installment contract for burial spaces if the contract does not entitle the person to the spaces until the full purchase price has been paid.\n\nUntil the burial space contract has been paid in full, all payments are considered to be funds set aside for burial. Amounts paid in excess of the maximum available burial fund exclusion are countable assets. On the first of the month following the month in which full payment has been made, these items can become subject to the unlimited burial space exclusion because at the point of full payment the contract becomes an agreement representing the purchase of a burial space.\n\n### Single- Purpose Contracts for Burial Expenses\n\nA single-purpose contract for burial expenses includes only services that are applicable to burial expenses and that are subject to, or reduce the amount of, the burial fund exclusion.\n\n### Contracts for Both Burial Spaces and Burial Expenses\n\n### Irrevocability Designation\n\nIf a combined contract designates which portion is irrevocable and which is not, that designation is controlling. That is, if the contract designates only the burial space purchase as irrevocable, the portion dealing with burial funds is revocable and is subject to the burial fund exclusion.\n\nIf it cannot be determined which amounts represent the purchase of burial spaces and which represent burial funds, and which parts of the contract, if any, are irrevocable, the person has not distinguished spaces versus services. In those cases, the entire contract is considered as an asset in the form of burial funds. The person may ask the funeral provider to amend the contract to distinguish burial services from burial space items.\n\n### Maximum on Irrevocable Amount\n\nIf the contract does not designate which part is irrevocable and the contract value exceeds $2,000 ($3,000 for a couple), we apply the maximum to burial spaces first.\n- If space purchases exceed the maximum excluded contract value of $2,000, the excess is revocable but subject to the burial space exclusion.\n- If space purchases are less than the maximum excluded contract value of $2,000, the balance is considered burial services.\n\nIrrevocable burial funds reduce the amount available for excluding other burial funds.\n\n### Installment Contracts\n\nThe amount paid for any spaces and services in a combined contract being purchased in installments are considered burial funds if the contract:\n- does not entitle the individual to the spaces and services listed until the full purchase amount has been paid; or\n- relieves the seller of the obligation to provide the spaces and services listed at the price listed until the contract is paid in full.\n\nOnce the contract has been paid in full, the space and fund exclusions are applied as appropriate.\n\n### Value of a Revocable Contract\n\nThe amount refundable upon revocation of the contract should be stated in the contract. If it is not, additional documentation may be required."}]},{"id":"epm:2.3.3.2.7.12","number":"2.3.3.2.7.12","title":"Continuing Care Retirement Community Entrance Fee","parent":"2.3.3.2.7","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.12 Continuing Care Retirement Community Entrance Fee","summary":"A continuing care retirement community (CCRC) entrance fee provides housing, services and nursing care, usually all in one location. This enables people to remain in a familiar setting as they grow older. Types of services provided by a CCRC include but are not limited to:","effective_date":"2016-09-01","last_modified":"2026-10-03T03:51:58.594961+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.12","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.7.12","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_7_12.htm","legal_citations":["Minnesota Statutes, section 256B.056, subdivision 3e","United States Code, title 42, section 1396p(g)"],"chunks":[{"chunk_id":"epm:2.3.3.2.7.12#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.12","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.12 Continuing Care Retirement Community Entrance Fee","text":"A continuing care retirement community (CCRC) entrance fee provides housing, services and nursing care, usually all in one location. This enables people to remain in a familiar setting as they grow older. Types of services provided by a CCRC include but are not limited to:\n- Board\n- Lodging\n- Nursing services\n- Medical services\n- Home health care\n- Other health-related services\n\nA CCRC must be registered with the county recorder in the county where it is located. The CCRC must meet the following criteria to be registered:\n- Have a written contract with a person to provide services for the life of the person or a period in excess of one year. Services and lodging provided by a CCRC do not need to be provided at the same location\n- Requires an entrance fee of $100 or more\n- Requires the person to pay regular periodic charges for the care provided\n\nThe following are not considered to be a CCRC:\n- A facility operating solely as a nursing facility\n- A facility that delivers housing without services\n- A program or organization that provides services but not housing\n- Services received by a person that a relative (either blood or marriage) provides"},{"chunk_id":"epm:2.3.3.2.7.12#asset-value-of-the-ccrc-entrance-fee","heading":"Asset Value of the CCRC Entrance Fee","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.12#asset-value-of-the-ccrc-entrance-fee","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.12 Continuing Care Retirement Community Entrance Fee > Asset Value of the CCRC Entrance Fee","text":"## Asset Value of the CCRC Entrance Fee\n\nThe available portion of an entrance fee paid to a CCRC counts toward the person’s asset total at application or renewal."},{"chunk_id":"epm:2.3.3.2.7.12#availability-of-a-ccrc-entrance-fee","heading":"Availability of a CCRC Entrance Fee","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.12#availability-of-a-ccrc-entrance-fee","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.12 Continuing Care Retirement Community Entrance Fee > Availability of a CCRC Entrance Fee","text":"## Availability of a CCRC Entrance Fee\n\nThe availability of the CCRC entrance fee is determined by reviewing the contract specifications signed by the person.\n\nIn order to be available to the person, the entrance fee paid to a CCRC must meet all of the following conditions:\n- All or a portion of the entrance fee can be refunded or used to pay for needed services if the person does not have other sufficient resources to pay for those services. Needed services may include, but are not limited to:\n  - Medical care, both inpatient and outpatient\n  - Home health care\n  - Skilled nursing care\n- The entire fee amount or the remaining portion of the fee can be refunded if the person:\n  - Dies\n  - Ends the contract and leaves the CCRC\n- The entrance fee does not purchase ownership interest in the CCRC."},{"chunk_id":"epm:2.3.3.2.7.12#verification-requirements","heading":"Verification Requirements","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.12#verification-requirements","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.12 Continuing Care Retirement Community Entrance Fee > Verification Requirements","text":"## Verification Requirements\n\nThe amount of the entrance fee available to the person must be verified at application and at renewal if not previously verified or if the contract was changed. The contract between a person and the CCRC may allow for a change in the availability of an entrance fee."}]},{"id":"epm:2.3.3.2.7.13","number":"2.3.3.2.7.13","title":"Tribal Payments and Interests","parent":"2.3.3.2.7","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.13 Tribal Payments and Interests","summary":"Many federal statutes provide an asset exclusion for certain interests held by and payments made to members of tribes and groups. Some statutes address interests and payments to specific tribes while others address certain types of interests and payments. This section explains how to count these interests and payments.","effective_date":"2026-02-06","last_modified":"2026-10-03T03:51:58.594961+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.13","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.7.13","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_7_13.htm","legal_citations":["United States Code, title 25, section 1407","United States Code, title 25, section 1408"],"chunks":[{"chunk_id":"epm:2.3.3.2.7.13#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.13","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.13 Tribal Payments and Interests","text":"Many federal statutes provide an asset exclusion for certain interests held by and payments made to members of tribes and groups. Some statutes address interests and payments to specific tribes while others address certain types of interests and payments. This section explains how to count these interests and payments."},{"chunk_id":"epm:2.3.3.2.7.13#individual-interests-in-trust-or-restricted-lands","heading":"Individual Interests in Trust or Restricted Lands","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.13#individual-interests-in-trust-or-restricted-lands","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.13 Tribal Payments and Interests > Individual Interests in Trust or Restricted Lands","text":"## Individual Interests in Trust or Restricted Lands\n\nThe interests of individual tribal members in trust or restricted lands are excluded (P.L. 103-66 § 13736; 25 USC § 1408).\n\nIn 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)."},{"chunk_id":"epm:2.3.3.2.7.13#per-capita-distributions-of-funds-held-in-trust","heading":"Per Capita Distributions of Funds Held in Trust","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.13#per-capita-distributions-of-funds-held-in-trust","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.13 Tribal Payments and Interests > Per Capita Distributions of Funds Held in Trust","text":"## Per Capita Distributions of Funds Held in Trust\n\nPer capita distributions of all funds held in trust by the Secretary of the Interior to members of an Indian tribe are excluded (P.L. 98-64).\n\nAny local tribal funds that a tribe distributes to individual tribal members on a per capita basis, but which have not been held in trust by the Secretary of the Interior, are not excluded under this provision."},{"chunk_id":"epm:2.3.3.2.7.13#tribal-land-settlements-or-judgments","heading":"Tribal Land Settlements or Judgments","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.13#tribal-land-settlements-or-judgments","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.13 Tribal Payments and Interests > Tribal Land Settlements or Judgments","text":"## Tribal Land Settlements or Judgments\n\nAmerican Indian tribal land settlements and judgment funds that are held in trust by the Secretary of the Interior or distributed per capita pursuant to a plan prepared by the Secretary of the Interior (P.L. 93-134; P.L. 97-458) are excluded."},{"chunk_id":"epm:2.3.3.2.7.13#tribal-general-welfare","heading":"Tribal General Welfare","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.13#tribal-general-welfare","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.13 Tribal Payments and Interests > Tribal General Welfare","text":"## Tribal General Welfare\n\nPayments made under Tribal General Welfare programs may be excluded as income or assets for MA-ABD only if the program meets the definition of “Assistance Based on Need” (ABON). To meet the definition of ABON, the assistance must be:\n- provided under a program which uses income as a factor of eligibility; and\n- funded wholly by a State (including the District of Columbia, Indian tribes and the Northern Mariana Islands), a political subdivision of a State, or a combination of such jurisdictions\n\nThe Minnesota Department of Human Services (DHS) evaluated Tribal General Welfare payments programs and determined whether certain types of income are excluded for MA-ABD. See[MA-ABD Excluded Income](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.3) for a list of public assistance payments, including Tribal General Welfare payments, that DHS has determined are excluded from income."},{"chunk_id":"epm:2.3.3.2.7.13#certain-assets-owned-by-american-indians","heading":"Certain Assets owned by American Indians","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.13#certain-assets-owned-by-american-indians","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.13 Tribal Payments and Interests > Certain Assets owned by American Indians","text":"## Certain Assets owned by American Indians\n\nExcluded assets for American Indians, in addition to items excluded under the general provisions, include:\n- Real property that is located on Indian land, or land held in trust, subject to restriction or supervision by the Secretary of the Interior. Indian land includes:\n  - A federally recognized reservation, pueblo or colony\n  - Former reservations located in Oklahoma\n  - Alaska Native regions established by the Alaska Native Claims Settlement Act\n  - Indian allotments on or near a reservation as designated by the Bureau of Indian Affairs of the Department of the Interior\n  - Property located within the most recent boundaries of a prior federal reservation\n- Ownership interests in rents, leases, royalties, or usage rights related to natural resources (extraction of natural resources, harvesting timber, plants, animals, fish and shellfish)\n- Ownership interests in or usage rights to items that have unique religious, spiritual, traditional, or cultural significance or rights that support subsistence or a traditional lifestyle according to tribal law or custom."},{"chunk_id":"epm:2.3.3.2.7.13#alaska-native-claims-settlement-act-ancsa-payments","heading":"Alaska Native Claims Settlement Act (ANCSA) Payments","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.13#alaska-native-claims-settlement-act-ancsa-payments","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.13 Tribal Payments and Interests > Alaska Native Claims Settlement Act (ANCSA) Payments","text":"## Alaska Native Claims Settlement Act (ANCSA) Payments\n\nThe following items received from a native corporation pursuant to Alaska Native Claims Settlement Act (ANCSA) (P.L. 100-241) are excluded:\n- Cash received from a native corporation (including cash dividends on stock received from a native corporation) to the extent it does not exceed $2,000 per person per year\n- Stock (including stock issued or distributed by a native corporation as a dividend or distribution on stock)\n- A partnership interest\n- Land or an interest in land (including land received from a native corporation as a dividend or distribution on stock)\n- An interest in a settlement trust\n- 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))."},{"chunk_id":"epm:2.3.3.2.7.13#cobell-settlement-for-american-indians","heading":"Cobell Settlement for American Indians","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.13#cobell-settlement-for-american-indians","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.13 Tribal Payments and Interests > Cobell Settlement for American Indians","text":"## Cobell Settlement for American Indians\n\nCobell Settlement payments made to American Indians are excluded income in the month received and as an asset for one year from the date of receipt. Payments are excluded regardless of whether they are issued as lump sums or periodic payments.\n\nThis exclusion applies for 12 months beginning with the month of receipt and applies to all members of the household.\n\nThe verbal or written statement of a person regarding the date and amount of the excluded settlement payment are accepted."},{"chunk_id":"epm:2.3.3.2.7.13#tribal-gaming-revenues","heading":"Tribal Gaming Revenues","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.13#tribal-gaming-revenues","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.13 Tribal Payments and Interests > Tribal Gaming Revenues","text":"## Tribal Gaming Revenues\n\nPer capita distributions of gaming revenues (casino profits) count as unearned income in the month received and as an asset in the following months."},{"chunk_id":"epm:2.3.3.2.7.13#canadian-first-nations-settlements-or-judgments","heading":"Canadian First Nations Settlements or Judgments","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.13#canadian-first-nations-settlements-or-judgments","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.13 Tribal Payments and Interests > Canadian First Nations Settlements or Judgments","text":"## Canadian First Nations Settlements or Judgments\n\nCanadian First Nations Settlement or Judgment payments count as unearned income in the month received and as an asset if retained after the month of receipt."}]},{"id":"epm:2.3.3.2.7.14","number":"2.3.3.2.7.14","title":"Household Goods and Personal Effects, and Other Personal Property","parent":"2.3.3.2.7","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.14 Household Goods and Personal Effects, and Other Personal Property","summary":"This section discusses how personal property is evaluated. Household goods and personal effects are types of personal property.","effective_date":"2024-01-19","last_modified":"2026-10-03T03:51:58.594961+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.14","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.7.14","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_7_14.htm","legal_citations":["Minnesota Statutes, section 256B.056, subdivision 1a","Minnesota Statutes, section 273.125, subdivision 8"],"chunks":[{"chunk_id":"epm:2.3.3.2.7.14#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.14","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.14 Household Goods and Personal Effects, and Other Personal Property","text":"This section discusses how personal property is evaluated. Household goods and personal effects are types of personal property."},{"chunk_id":"epm:2.3.3.2.7.14#household-goods","heading":"Household Goods","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.14#household-goods","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.14 Household Goods and Personal Effects, and Other Personal Property > Household Goods","text":"## Household Goods\n\nHousehold goods are items of personal property found in or near a home that a person uses on a regular basis or items needed by the household for maintenance, use, and occupancy of the premises as a home. Examples include furniture, clothing, appliances, children’s toys, tools and other equipment used in the home.\n\nHousehold goods are an excluded asset and do not need to be verified. Household goods do not include personal property that a person acquires or holds because of its monetary value or as an investment. See [Evaluating Items Acquired or Held Because of Their Monetary Value or as Investments](https://hcopub.dhs.state.mn.us/epm/#Evaluating_Items) below for more information."},{"chunk_id":"epm:2.3.3.2.7.14#personal-effects","heading":"Personal Effects","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.14#personal-effects","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.14 Household Goods and Personal Effects, and Other Personal Property > Personal Effects","text":"## Personal Effects\n\nPersonal effects are items of personal property ordinarily worn or carried by the person, and articles otherwise having an intimate relation to the person. Personal effects include, but are not limited to, personal jewelry including wedding and engagement rings, personal care items, pets, and educational or recreational items such as books or musical instruments.\n\nPersonal effects include:\n- Items of cultural or religious significance to a person, such as ceremonial attire\n- Items required because of a person's physical or mental impairment, such as prosthetic devices or wheelchairs\n\nPersonal effects do not include personal property that a person acquires or holds because of its monetary value or as an investment.\n\nPersonal effects are an excluded asset and do not need to be verified."},{"chunk_id":"epm:2.3.3.2.7.14#other-types-of-personal-property","heading":"Other Types of Personal Property","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.14#other-types-of-personal-property","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.14 Household Goods and Personal Effects, and Other Personal Property > Other Types of Personal Property","text":"## Other Types of Personal Property\n\n### Evaluating Manufactured Homes as Personal Property\n\nA manufactured home (including a mobile home) that is not the person's principal place of residence is evaluated as personal property if any of the following criteria are met:\n- The person does not own the land on which the manufactured home is situated. For example, the person is a lessee of the land under the terms of a lease, or the manufactured home is located in a manufactured home park; or\n- The manufactured home is not affixed to the land by a permanent foundation, is not affixed to the land like the other real property in the community, or is not installed according to the building codes and standards; or\n- The manufactured home is not connected to public utilities, does not have a well and septic tank system, or is not serviced by water and sewer facilities comparable to other manufactured homes in the community.\n\nThe estimated market value of a non-homestead manufactured home that is personal property, based on the above criteria, is counted as an available asset. If the manufactured home is personal property, the reasonable effort to sell policy does not apply.\n\nIf none of the above criteria are met, then the manufactured home is considered real property. See [Non-Homestead Real Property.](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.2)"},{"chunk_id":"epm:2.3.3.2.7.14#evaluating-items-acquired-or-held-because-of-their-monetary-value-or-as-investments","heading":"Evaluating Items Acquired or Held Because of Their Monetary Value or as Investments","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.14#evaluating-items-acquired-or-held-because-of-their-monetary-value-or-as-investments","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.14 Household Goods and Personal Effects, and Other Personal Property > Evaluating Items Acquired or Held Because of Their Monetary Value or as Investments","text":"## Evaluating Items Acquired or Held Because of Their Monetary Value or as Investments\n\nPersonal property that a person acquires or holds because of its monetary value or as an investment is a countable asset and not considered to be household goods or personal effects. Other personal property items include, but are not limited to, gems, jewelry and collectibles acquired or held because of its monetary value or as an investment.\n\nThe equity value of any item acquired or held because of its monetary value is counted.\n\nA recent sales slip, an appraisal of the item, or insurance coverage can be used to verify the current market value of an item acquired or held because of its value or as an investment. If this information is not available, an estimate from a knowledgeable source, such as a local merchant, can be used to verify the current market value.\n- Insurance appraisals and amounts of insurance coverage often reflect replacement value (the amount it would cost to purchase a similar item new) rather than current market value. Replacement value may not be used in lieu of current market value."},{"chunk_id":"epm:2.3.3.2.7.14#shared-ownership-of-personal-property","heading":"Shared Ownership of Personal Property","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.14#shared-ownership-of-personal-property","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.14 Household Goods and Personal Effects, and Other Personal Property > Shared Ownership of Personal Property","text":"## Shared Ownership of Personal Property\n\nRefer to [EPM 2.3.3.2.4 Countable Assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.4) for shared ownership of household goods, personal effects and other personal property that is not excluded."}]},{"id":"epm:2.3.3.2.7.15","number":"2.3.3.2.7.15","title":"Achieving a Better Life Experience (ABLE) Accounts","parent":"2.3.3.2.7","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.15 Achieving a Better Life Experience (ABLE) Accounts","summary":"Achieving a Better Life Experience (ABLE) Act allows people with disabilities to save and invest money into special ABLE accounts without affecting their program eligibility. ABLE accounts are tax-free savings accounts for people with disabilities that can be used for certain qualified disability expenses (QDEs).","effective_date":"2018-06-01","last_modified":"2026-10-03T03:51:58.594961+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.15","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.7.15","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_7_15.htm","legal_citations":["Minnesota Statutes, section 256Q","Achieving a Better Life Experience Act of 2014, \n Public Law 113-295"],"chunks":[{"chunk_id":"epm:2.3.3.2.7.15#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.15","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.15 Achieving a Better Life Experience (ABLE) Accounts","text":"Achieving a Better Life Experience (ABLE) Act allows people with disabilities to save and invest money into special ABLE accounts without affecting their program eligibility. ABLE accounts are tax-free savings accounts for people with disabilities that can be used for certain qualified disability expenses (QDEs).\n\nAn eligible Minnesotan can set up an ABLE account in Minnesota or any other state that allows Minnesota residents access to its ABLE program, but a person can have only one account open in his or her name.\n\nFor more information about who is eligible to open an ABLE account in Minnesota and the conditions that apply, refer to the Minnesota ABLE website (http://mn.savewithable.com)."},{"chunk_id":"epm:2.3.3.2.7.15#evaluation-of-able-accounts","heading":"Evaluation of ABLE Accounts","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.15#evaluation-of-able-accounts","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.15 Achieving a Better Life Experience (ABLE) Accounts > Evaluation of ABLE Accounts","text":"## Evaluation of ABLE Accounts\n\nA person’s ABLE account is excluded from assets when determining eligibility.\n\nA distribution from an ABLE account is a conversion of an asset and continues to be excluded in the month it is withdrawn.\n\nIf the person retains the distribution beyond the month received, the distribution is treated as follows:\n- It is excluded from assets if the person uses it for a QDE.\n- It continues to be excluded while all the following conditions are met:\n  - It is unspent\n  - It is identifiable\n  - The person attests they intend to use it for a QDE\n  - The ABLE account remains open\n- It is counted as an asset only if the person attests they used it for, or plan to use it for, an expense that is not a QDE"},{"chunk_id":"epm:2.3.3.2.7.15#income-to-able-accounts","heading":"Income to ABLE Accounts","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.15#income-to-able-accounts","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.7 Asset Evaluation > 2.3.3.2.7.15 Achieving a Better Life Experience (ABLE) Accounts > Income to ABLE Accounts","text":"## Income to ABLE Accounts\n\nIncome a person receives and then deposits into an ABLE account is counted or excluded in accordance with standard Minnesota Health Care Programs (MHCP) policies about the treatment of income. See information in Section 2.3.3.3.2 MA-ABD Income Methodology for more information.\n\nThe following is excluded for the person who owns the ABLE account:\n- Money deposited into the ABLE account by anyone other than the person who owns the account\n- Transfers into the ABLE account from the account owner’s special needs trust, supplemental needs trust, or pooled trust\n- Distributions from the ABLE account\n- Earnings from interest, dividends, or appreciation in value of the ABLE account"}]},{"id":"epm:2.3.3.2.8","number":"2.3.3.2.8","title":"Asset Verification","parent":"2.3.3.2","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.8 Asset Verification","summary":"To qualify for certain Minnesota Health Care Programs (MHCP), applicants and enrollees must have countable assets not greater than the program asset limit. The following MHCP have asset limits:","effective_date":"2025-11-26","last_modified":"2026-10-03T03:51:58.594961+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.8","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.2.8","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_2_8.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.945","Code of Federal Regulations, title 42, section 435.948","Code of Federal Regulations, title 42, section 435.952","Minnesota Rules, part 9505.0095"],"chunks":[{"chunk_id":"epm:2.3.3.2.8#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.8","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.8 Asset Verification","text":"To qualify for certain Minnesota Health Care Programs (MHCP), applicants and enrollees must have countable assets not greater than the program asset limit. The following MHCP have asset limits:\n- Medical Assistance for People who are Age 65 or Older, are Blind, or who Have a disability (MA-ABD)\n- Medical Assistance for parents or caretaker relatives with a spenddown\n- Medicare Savings Programs (MSP) including Qualified Medicare Beneficiaries (QMB), Service Limited Medicare Beneficiaries (SLMB), Qualified Individuals (QI) and Qualified Working Disabled (QWD)\n\nSee [EPM 2.1.3.1 MA Asset Limits](https://bot-corpus.mn-dhs.online/s/epm/2.1.3.1) for additional information regarding asset limits for MA programs.\n\nMHCP applicants and enrollees subject to an asset limit must report their assets, asset values, and account numbers (if applicable) at application, renewal and between renewals if a new asset is reported or the value of an asset has increased or decreased.\n\nAn individual’s assets must be verified before the eligibility determination is made.\n- At Application: All countable, excluded, or unavailable assets must be verified.\n- At Renewal: All countable assets must be verified. Agencies must not re-verify an excluded asset, an unavailable asset, or an asset unlikely to increase in value that was previously verified unless the asset becomes countable or becomes available.\n- Between Renewals: Asset verification is required when there is a new asset reported by an enrollee, there is a change reported to an existing countable asset, an unavailable asset becomes available, or when an excluded asset becomes countable."},{"chunk_id":"epm:2.3.3.2.8#electronic-verification-of-assets","heading":"Electronic Verification of Assets","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.8#electronic-verification-of-assets","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.8 Asset Verification > Electronic Verification of Assets","text":"## Electronic Verification of Assets\n\nThe agency must attempt to electronically verify attested asset values through an available electronic data source, including the Asset Verification Service (AVS), before requesting paper proofs from an applicant or enrollee."},{"chunk_id":"epm:2.3.3.2.8#paper-proof","heading":"Paper Proof","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.8#paper-proof","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.8 Asset Verification > Paper Proof","text":"## Paper Proof\n\nApplicants and enrollees must provide paper proof(s) to verify assets if asset values cannot be electronically verified because electronic data sources do not verify that type of asset, or if the electronic sources do not return any results. Paper proofs to verify assets include, but are not limited to:\n- Bank, financial institution, and automated teller machine (ATM) statements\n- Agency-initiated verification forms\n- Copies of bonds\n- Stock ownership statements\n- Copies of life insurance policies, including statements of cash surrender value, from life insurance companies\n- Copies of burial purchase agreements\n- An estimate of fair market value from a licensed dealer\n- An estimate from a licensed appraiser\n- Property tax assessments\n- Contracts\n- Trust documents\n\nPaper proof(s) submitted by an applicant or enrollee to verify assets must be the most recent paper proof available. The most recent proof available will vary depending on the asset type. County and tribal servicing agencies must assist applicants and enrollees who are unable to provide paper proof(s) with obtaining those proofs.\n\nSelf-attestation of asset values may be accepted if electronic data sources are unsuccessful or unavailable and paper proof(s) does not exist or is not available. See [EPM 2.3.1.1 MA-](https://bot-corpus.mn-dhs.online/s/epm/2.3.1.1)[ABD Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/2.3.1.1).\n\nIf paper proof(s) submitted to verify an asset shows an amount or value different from what the applicant or enrollee reported, the dollar value shown on the paper proof(s) is used to determine asset eligibility.\n\nApplicants and enrollees who have countable assets in excess of the asset limit may reduce their assets to be eligible. See [EPM 2.3.3.2.6 MA-ABD Excess Assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.6). If an applicant or enrollee reduces excess assets, they must submit proof of the assets reduced to verify that the person is below the asset limit."},{"chunk_id":"epm:2.3.3.2.8#assets-unlikely-to-increase-in-value","heading":"Assets Unlikely to Increase in Value","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.8#assets-unlikely-to-increase-in-value","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.8 Asset Verification > Assets Unlikely to Increase in Value","text":"## Assets Unlikely to Increase in Value\n\nAssets unlikely to increase in value that were previously verified must not be verified again at renewal. County and tribal servicing agencies must instead rely on the previously verified value of the asset.\n\nAssets unlikely to increase in value are:\n- Vehicles, including but not limited to:\n  - Cars\n  - Trucks\n  - Vans\n  - Campers\n  - Motorcycles\n  - Trailers\n  - Boats\n  - Off-road vehicles\n- Tools and equipment that are not used in the home."},{"chunk_id":"epm:2.3.3.2.8#asset-verification-for-retroactive-coverage","heading":"Asset Verification for Retroactive Coverage","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.8#asset-verification-for-retroactive-coverage","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.2 Assets > 2.3.3.2.8 Asset Verification > Asset Verification for Retroactive Coverage","text":"## Asset Verification for Retroactive Coverage\n\nIncome and assets are considered verified for the retroactive months if all of the following are met:\n- An applicant or enrollee reports that their income and assets are below the income and asset limits in the application month.\n- The applicant or enrollee reports that their income and asset values were the same in the retroactive months requested as in the application month.\n- Income for the application month is verified electronically or with paper proof.\n- Assets for the application month are verified electronically or with paper proof.\n  - AVS will provide results for retroactive months. AVS results for retroactive months should not be used unless the results indicate the applicant or enrollee is above the asset limit. In such cases, the inconsistent information must be resolved before determining eligibility.\n\nIf the applicant or enrollee attests that either their income or asset values were not the same in the retroactive months, verification of actual income and assets for each retroactive month requested is required.\n\nIncome verification for retroactive coverage policies do not apply to people who request MA for Long-Term Care Services (MA-LTC) and who use a long-term care (LTC) income calculation to determine their LTC spenddown or waiver obligation. See [2.3.3.3.2.4 MA-ABD Income Verification](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.4) and [2.4.2.5 Income Calculations for Long-Term Care Services](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5) for more information."}]},{"id":"epm:2.3.3.3","number":"2.3.3.3","title":"Income","parent":"2.3.3","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income","summary":"This subchapter provides policy about a person’s income for Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or have a Disability (MA-ABD). The income methodology policies also apply to Medicare Savings Programs (MSP) with some exceptions. See the MSP chapter for more information.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:58:40.685104+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_3.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.3.3.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income","text":"This subchapter provides policy about a person’s income for Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or have a Disability (MA-ABD). The income methodology policies also apply to [Medicare Savings Programs](https://bot-corpus.mn-dhs.online/s/epm/4.2) (MSP) with some exceptions. See the MSP chapter for more information.\n1. [MA-ABD Income Limits](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.1) [MA-ABD Income Methodology](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2)\n  1. [MA-ABD Countable Income](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1) [MA-ABD Disregards and Deductions](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.2) [MA-ABD Excluded Income](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.3)\n    1. [MA-ABD Income Deeming](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1.1) [MA-ABD Sponsor Income Deeming](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1.2)"}]},{"id":"epm:2.3.3.3.1","number":"2.3.3.3.1","title":"Income Limits","parent":"2.3.3.3","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.1 Income Limits","summary":"To be eligible for Medical Assistance (MA) for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD), a person’s income must be less than or equal to the applicable income limit. Income limits are based on federal poverty guidelines.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:58.594961+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.3.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_3_1.htm","legal_citations":["Minnesota Statutes, section 256B.056, subdivision 1a","Minnesota Statutes, section 256B.056, subdivision 4","Minnesota Statutes, section 256B.056, subdivision 5"],"chunks":[{"chunk_id":"epm:2.3.3.3.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.1","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.1 Income Limits","text":"To be eligible for Medical Assistance (MA) for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD), a person’s income must be less than or equal to the applicable income limit. Income limits are based on federal poverty guidelines."},{"chunk_id":"epm:2.3.3.3.1#federal-poverty-guidelines","heading":"Federal Poverty Guidelines","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.1#federal-poverty-guidelines","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.1 Income Limits > Federal Poverty Guidelines","text":"## Federal Poverty Guidelines\n\nThe U.S. Department of Health and Human Services (HHS) issues federal poverty guidelines (FPG) each year. New guidelines are used beginning each July 1.\n\nThese guidelines determine income eligibility for MA-ABD. A person’s applicable income limit is based on many factors, including, but not limited to:\n- The basis of eligibility for MA\n- The number of people included in the household size\n- Whether the person has a medical spenddown for MA"},{"chunk_id":"epm:2.3.3.3.1#income-limit-for-ma-abd","heading":"Income Limit for MA-ABD","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.1#income-limit-for-ma-abd","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.1 Income Limits > Income Limit for MA-ABD","text":"## Income Limit for MA-ABD\n\nPeople must have income that is less than or equal to 100% FPG to be eligible MA-ABD. Refer to Minnesota Insurance Affordability Programs Income and Asset Guidelines ([DHS-3461A](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3461A-ENG)) for information about household size and income limits.\n\nMA for Employed Persons with Disabilities (MA-EPD) has no income limit. See the [MA-EPD](https://bot-corpus.mn-dhs.online/s/epm/2.3.5) subchapter for more information.\n\nA child enrolled in the MA TEFRA Option has an income limit of 100% FPG. See the [MA under the TEFRA Option](https://bot-corpus.mn-dhs.online/s/epm/2.3.6) subchapter for more information.\n\nThere is no income limit for MA eligibility under MA Minnesota Supplemental Aid (MSA) and MA 1619(a) or 161(b). See [MA 1619(a) or 1619(b)](https://bot-corpus.mn-dhs.online/s/epm/2.3.7) for more information."},{"chunk_id":"epm:2.3.3.3.1#excess-income","heading":"Excess Income","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.1#excess-income","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.1 Income Limits > Excess Income","text":"## Excess Income\n\nPeople with one of the bases of eligibility for MA-ABD whose income exceeds 100% FPG and have medical expenses may be eligible for MA with a spenddown. See the [MA-ABD Medical Spenddown](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.4) policy for more information."}]},{"id":"epm:2.3.3.3.2","number":"2.3.3.3.2","title":"Income Methodology","parent":"2.3.3.3","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology","summary":"An income methodology is the way a person’s income is evaluated to determine if they meet the income limit for a program. The methodology includes, but is not limited to whether an income source is counted, deemed to another person, disregarded, deducted or excluded.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:58.594961+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.3.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_3_2.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.3.3.3.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology","text":"An income methodology is the way a person’s income is evaluated to determine if they meet the income limit for a program. The methodology includes, but is not limited to whether an income source is counted, deemed to another person, disregarded, deducted or excluded.\n\nThis subchapter provides the methods for evaluating income in determining a person’s eligibility under Medical Assistance for People Who Are Age 65 or Older or People Who Are Blind or Have a Disability (MA-ABD). These policies also apply to Medicare Savings Programs (MSP) with some exceptions. See the MSP chapter for more information.\n1. [MA-ABD Countable Income](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1)\n  1. [MA-ABD Income Deeming](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1.1)\n  2. [MA-ABD Sponsor Income Deeming](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1.2)\n2. [MA-ABD Disregards and Deductions](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.2)\n3. [MA-ABD Excluded Income](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.3)"}]},{"id":"epm:2.3.3.3.2.1","number":"2.3.3.3.2.1","title":"Countable Income","parent":"2.3.3.3.2","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.1 Countable Income","summary":"This policy provides information on types of income that must be counted when calculating a person’s income for Medical Assistance (MA) for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) and Medicare Savings Programs (MSP). With some exceptions, MA-ABD uses the methodology of the Social Security Income (SSI) program to determine countable income. Some of thes","effective_date":"2026-06-03","last_modified":"2026-10-03T04:10:23.074934+00:00","version":3,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.3.2.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_3_2_1.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.631","Code of Federal Regulations, title 42, section 435.831","Minnesota Statutes, section 256B.056, subdivision 4"],"chunks":[{"chunk_id":"epm:2.3.3.3.2.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.1 Countable Income","text":"This policy provides information on types of income that must be counted when calculating a person’s income for Medical Assistance (MA) for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) and Medicare Savings Programs (MSP). With some exceptions, MA-ABD uses the methodology of the Social Security Income (SSI) program to determine countable income. Some of these types of income are subject to disregards and deductions; see the [MA-ABD Disregards and Deductions](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.2) policy for more information. See the [MSP chapter](https://bot-corpus.mn-dhs.online/s/epm/4.2) for more information.\n\nIncome is counted in the month it is received."},{"chunk_id":"epm:2.3.3.3.2.1#what-is-not-income","heading":"What is not Income","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1#what-is-not-income","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.1 Countable Income > What is not Income","text":"## What is not Income\n\nSome items received by a person are not counted as income in the month received. See [MA-ABD Countable Assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.4) and [MA-ABD Excluded Assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.3) for more information on how these items are treated if retained after the month of receipt. Items that are not income include, but are not limited to:\n- Amounts withheld from unearned income, if both of the following conditions are met:\n  - The income is being reduced to repay a prior overpayment from the same source; and\n  - The overpaid amount was previously counted as unearned income for MA eligibility.\n- Bona fide loans, including student loans, because of the obligation to repay\n- Conversion of assets. This includes, but is not limited to, cash received from the sale of assets, money withdrawn from savings accounts or other liquid assets, reverse mortgages, etc.\n- Distributions from a [Health Flexible Spending Arrangement](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.3.1) (FSA), A Health Reimbursement Arrangement (HRA), or a Health Savings Account (HSA)\n- Free rent in exchange for caretaking duties. If the caretaker receives a paycheck with an amount for rent deducted, the gross earnings are earned income, not in-kind income.\n- Interest and dividends on countable assets\n- In-kind benefits or payments\n- Rebates, refunds, or other return of money that has already been counted."},{"chunk_id":"epm:2.3.3.3.2.1#earned-income","heading":"Earned Income","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1#earned-income","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.1 Countable Income > Earned Income","text":"## Earned Income\n\nEarned income is cash people receive in exchange for work or service, including employment and self-employment. See [Appendix B Types of Income](https://bot-corpus.mn-dhs.online/s/epm/B) for descriptions of the different types of income. The following types of earned income is counted:\n- Employee income, including, but not limited to:\n  - Cash payments to clergy for housing\n  - Commissions\n  - Severance pay, based on accrued leave time\n  - Tips\n  - Vacation donation compensation\n  - Wages\n- Irregular or infrequent earned lump sum, non-gift, or income from an employer, trade or business. See [MA-ABD Disregards and Deductions](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.2), earned lump sum income, for more information.\n- Net earnings from self-employment, which is the gross income minus all expenses the Internal Revenue Service (IRS) allows as a self-employment expense. Self-employment income losses are deducted from other household earned income.\n- Net rental income, which is the gross rental income minus verified rental and repair expenses, when the person spends an average of at least 10 hours per week maintaining or managing the property. See [Rental Income](https://hcopub.dhs.state.mn.us/epm/#Rental)for more information.\n- Other income received in exchange for work or service, including, but not limited to:\n  - Jury duty pay\n  - Picket duty pay\n  - Blood and blood plasma sales\n  - Royalties and honoraria"},{"chunk_id":"epm:2.3.3.3.2.1#unearned-income","heading":"Unearned Income","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1#unearned-income","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.1 Countable Income > Unearned Income","text":"## Unearned Income\n\nUnearned income is cash that people receive without being required to perform work or service. The following types of unearned income is counted in a person’s income calculation:\n- Annuity payments\n- Canadian First Nation settlement or judgment payments\n- Child support and arrearage payments made for a deceased child are counted for the person who receives the payment.\n- Child support and arrearage payments are unearned income for the child, excluding:\n  - Court ordered medical support\n  - Payments to reimburse the custodial parent for medical expenses\n  - Child support and arrearage payments received and retained by the county child support enforcement agency on behalf of a child enrolled in the Minnesota Family Investment Program (MFIP) or foster care\n  - Child support payments received by or on behalf of children who:\n    - Receive services through the Brain Injury (BI), Community Alternative Care (CAC), Community Access for Disability Inclusion (CADI) or Developmental Disabilities (DD) waiver\n    - Are enrolled in MA under the TEFRA option\n- Disability payments that are part of the employer’s benefit package\n- Extended income support payments through the Trade Adjustment Reform Act (TAA)\n- Interest and dividends earned on excluded assets, unless otherwise excluded. See [MA-ABD Countable Assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.4) and [MA-ABD Excluded Assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.3) for more information on how these items are treated.\n- Irregular or infrequent unearned lump sum income from an individual, organization, or investment. See [MA-ABD Disregards and Deductions](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.2), unearned lump sum income, for more information.\n- Net rental income, which is the rental income minus verified rental and repair expenses, when the person spends an average of less than 10 hours per week maintaining or managing the property. See [Rental Income](https://hcopub.dhs.state.mn.us/epm/#Rental)for more information.\n- Regular and frequent gift income\n- Retirement, Survivor's, and Disability Insurance (RSDI). See [MA-ABD Disregards and Deductions](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.2), dependent RSDI benefits, for more information.\n- RSDI or Veterans Benefits for the Elderly reissued because an individual representative payee of 15 or more beneficiaries or an organization representative payee misused benefits is counted as income in the month received only if the original payment was not used to determine eligibility\n- Retroactive RSDI lump sum payments are counted in the month received\n- Pension or retirement benefits from public or private sources\n- Severance pay that is not based on accrued leave time\n- Spousal maintenance\n- Student financial aid, in the following situations:\n  - Earnings through the Federal Work Study program are counted for MA for Employed Persons with Disabilities (MA-EPD) if:\n    - Average gross monthly earnings exceed $65\n    - Social Security and Medicare taxes are withheld\n  - Non-Title IV of the Higher Education Act (HEA) and Non-Bureau of Indian Affairs (BIA) grants, scholarships, fellowships and other non-loan financial aid not used for or set aside for educational expenses.\n  - Distributions from a Coverdell Educational Savings Accounts (ESA) not used for or set aside for educational expenses.\n- Tribal per capita payments from casinos\n- Unemployment Insurance\n- Veteran's Administration (VA) benefits\n- Workers' Compensation"},{"chunk_id":"epm:2.3.3.3.2.1#availability-of-income","heading":"Availability of Income","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1#availability-of-income","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.1 Countable Income > Availability of Income","text":"## Availability of Income\n\nFor MA-ABD and MSP, income is available when the person has a legal interest and the ability to use that income for support and maintenance. Available income is counted unless it is excluded under another policy; income that is not available is not counted toward a person’s income limit. See[MA-ABD Excluded Income](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.3)and [MA-ABD Disregards and Deductions](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.2) for more information about other excluded income provisions. Income is usually available in the following situations:\n- The person receives the income\n- Someone else receives the income on the person’s behalf\n- The employer or other payer owes the person money, but withholds the income at the person or the court’s request\n- Income is withheld from payments due to a garnishment or to pay a legal debt or obligation\n\nFor MA-ABD and MSP, income is unavailable when the person:\n- Cannot gain access to the income\n- Receives money to cover someone else’s expenses and then uses that money to pay those expenses\n- Receives benefits under credit life and disability insurance coverage. Payments under these policies cover payments on loans, mortgages, etc. in the event of death or disability. These insurance payments are sent directly to the loan or mortgage company and are not available to the person.\n\nA person must try to gain access to potentially available income."},{"chunk_id":"epm:2.3.3.3.2.1#rental-income","heading":"Rental Income","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1#rental-income","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.1 Countable Income > Rental Income","text":"## Rental Income\n\nRental income is any payment received by the property owner for the use or occupation of their real property. These policies apply to both earned and unearned rental income.\n- Net rental income is the gross rental income minus verified rental and repair expenses (allowable expenses).\n  - When allowable expenses paid in a month exceed the gross rental income in the same month, the excess expenses can be subtracted from the next month's gross rental income.\n- Security or other deposits held for the tenant are not income while subject to return to the tenant. At the time any amount is used or no longer held for the tenant, it is income.\n\n### Prorating Rental Income\n\nIf expenses are incurred, but only a portion of those expenses apply to the property that is for rent, then the following prorating policies apply:\n- In multiple family residences:\n  - If the units in the building are of approximately equal size, allowable expenses must be prorated on the number of units designated for rent compared to the total number of units.\n  - If the units are not of approximately equal size, allowable expenses must be prorated based on the number of rooms in the rental units compared to the total number of rooms in the building. (The rooms do not have to be occupied).\n  - Any expenses strictly related to a particular rental unit are deduced in total from the rent for that unit. Those expenses are not prorated.\n- In rooms in a single residence:\n  - Allowable expenses must be prorated based on the number of rooms designated for rent compared to the number of rooms in the house.\n  - Bathrooms do not count as rooms in the house. Basements and attics only count if they have been converted to living spaces (e.g., recreation rooms).\n  - Any expenses strictly related to a particular rental room are deducted in total from the rent for that room. Those expenses are not prorated.\n- On Land:\n  - Expenses are prorated based on the percentage of total acres for rent."}]},{"id":"epm:2.3.3.3.2.1.1","number":"2.3.3.3.2.1.1","title":"Income Deeming","parent":"2.3.3.3.2.1","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.1 Countable Income > 2.3.3.3.2.1.1 Income Deeming","summary":"Income deeming requirements are not the same as household composition rules. People may be counted in a person’s household size without having their income deemed to another member of a household.","effective_date":"2020-06-01","last_modified":"2026-10-03T03:51:58.594961+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.3.2.1.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_3_2_1_1.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.602","Minnesota Statutes, section 256B.056, subdivision 1b"],"chunks":[{"chunk_id":"epm:2.3.3.3.2.1.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1.1","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.1 Countable Income > 2.3.3.3.2.1.1 Income Deeming","text":"Income deeming requirements are not the same as household composition rules. People may be counted in a person’s household size without having their income deemed to another member of a household.\n\nWhose income is deemed to a person is determined separately for each person."},{"chunk_id":"epm:2.3.3.3.2.1.1#income-of-a-spouse","heading":"Income of a Spouse","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1.1#income-of-a-spouse","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.1 Countable Income > 2.3.3.3.2.1.1 Income Deeming > Income of a Spouse","text":"## Income of a Spouse\n\nExcept in the situations noted below, the income of a spouse is deemed to a person if the spouses live together. If a person is not divorced but is legally separated from their spouse, and continues to live in the same household, the spouse’s income is deemed.\n\nIn the following situations, the income of a spouse is not deemed to the person:\n- The spouses do not live together.\n- Determining eligibility for Medical Assistance for Employed People with Disabilities (MA-EPD). See the [MA-EPD](https://bot-corpus.mn-dhs.online/s/epm/2.3.5) policy section for more information about MA-EPD eligibility.\n- The person was enrolled in MA-EPD for 24 consecutive months before the month in which they turn age 65 and there has not been a break in MA coverage of more than one calendar month.\n- The person is on a Community Access for Disability Inclusion (CADI), Community Alternative Care (CAC), Developmental Disabilities (DD) or Brain Injury (BI) waiver."},{"chunk_id":"epm:2.3.3.3.2.1.1#income-of-a-parent","heading":"Income of a Parent","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1.1#income-of-a-parent","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.1 Countable Income > 2.3.3.3.2.1.1 Income Deeming > Income of a Parent","text":"## Income of a Parent\n\nExcept in the situations noted below, for MA-ABD eligibility the income of a biological or adoptive parent is deemed to a child under age 18, not emancipated, and living with the parent.\n\nWhen the father is not married to the child’s mother, deem the father’s income only if the father lives with the child and paternity has been established.\n\nThe income of a parent is not deemed to:\n- A child age 18-21 who is blind or has a disability.\n- An auto newborn from birth through the end of the month of the child's first birthday.\n- A person enrolled in MA-EPD, age 18 or older, and lives with one or both biological or adoptive parents.\n- The child is enrolled in MA under the TEFRA Option. See the [MA under the TEFRA Option](https://bot-corpus.mn-dhs.online/s/epm/2.3.6) section for more information.\n- The child is on a CADI, CAC, DD or BI waiver. See the [Home and Community-Based Services Waivers](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.3) section for more information."},{"chunk_id":"epm:2.3.3.3.2.1.1#other-household-members","heading":"Other Household Members","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1.1#other-household-members","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.1 Countable Income > 2.3.3.3.2.1.1 Income Deeming > Other Household Members","text":"## Other Household Members\n\nWhen determining a person’s income for MA-ABD, income is not deemed from a:\n- Child to a parent\n- Sibling to another sibling, or other children under 21 living in the household\n- Stepparent to a stepchild\n- Grandparent to a grandchild\n- Relative caretaker to a child\n- Another person to a person with automatic MA eligibility or other deeming exceptions"}]},{"id":"epm:2.3.3.3.2.1.2","number":"2.3.3.3.2.1.2","title":"Sponsor Income Deeming","parent":"2.3.3.3.2.1","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.1 Countable Income > 2.3.3.3.2.1.2 Sponsor Income Deeming","summary":"Sponsor deeming rules apply to noncitizens who are sponsored by an individual or individuals and have a signed Affidavit of Support (USCIS I-864), unless an exception is met.","effective_date":"2022-09-01","last_modified":"2026-10-03T03:51:58.594961+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.3.2.1.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_3_2_1_2.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.602","Minnesota Statutes, section 256B.06, subdivision 5","Personal Responsibility and Work Opportunity Reconciliation Act of 1996, title IV, Public Law 104–193, section 421 and 422"],"chunks":[{"chunk_id":"epm:2.3.3.3.2.1.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1.2","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.1 Countable Income > 2.3.3.3.2.1.2 Sponsor Income Deeming","text":"Sponsor deeming rules apply to noncitizens who are sponsored by an individual or individuals and have a signed Affidavit of Support (USCIS I-864), unless an exception is met.\n\nIncome of a sponsor and the sponsor’s spouse is deemed to each noncitizen covered by the affidavit regardless of whether the sponsor actually contributes to the noncitizen’s household needs. Income is deemed even if the sponsor or the sponsor’s spouse are receiving public assistance in Minnesota or another state.\n\nThe following sponsor and sponsor’s spouse’s income is deemed to the sponsored noncitizen:\n- Gross income, including any cash assistance received by the sponsor or the sponsor’s spouse\n- Net self-employment income, minus self-employment expenses\n\nIf the sponsor is a member of the household:\n- The sponsor’s income is already deemed to the sponsored noncitizen spouse and family members under the [MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) income deeming rules](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1.1).\n- Applicable MA-ABD [income disregards and deductions](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.2) are applied to the sponsor’s income.\n\nIf the sponsor is not a member of the household or is a household member whose income is not deemed to the sponsored noncitizen under MA-ABD [income deeming rules](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1.1), the following rules apply:\n- The total gross income of the sponsor and the sponsor’s spouse is deemed to each sponsored noncitizen, even if the sponsor and the sponsor's spouse are sponsoring more than one person.\n- The sponsor or the sponsor’s spouse’s income are not considered unavailable or excluded and there are no deductions or prorating for the needs of a sponsor, a sponsor's spouse, or other household members.\n\nApplicants, enrollees, and sponsors must cooperate with supplying or obtaining sponsor information if sponsor deeming applies. If the applicant, enrollee, or sponsor fails to cooperate coverage may be closed. The Sponsor Letter ([DHS-3453](http://edocs.dhs.state.mn.us/lfserver/Legacy/DHS-3453-ENG)) reminds sponsors of their legal obligation to provide support and to request verification from the sponsor."},{"chunk_id":"epm:2.3.3.3.2.1.2#exceptions-to-ma-sponsor-deeming","heading":"Exceptions to MA Sponsor Deeming","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1.2#exceptions-to-ma-sponsor-deeming","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.1 Countable Income > 2.3.3.3.2.1.2 Sponsor Income Deeming > Exceptions to MA Sponsor Deeming","text":"## Exceptions to MA Sponsor Deeming\n\nThe sponsorship ends and sponsor deeming no longer applies when any of the following changes occur:\n- The sponsored immigrant becomes a naturalized citizen\n- The sponsor or sponsored immigrant dies\n- The sponsored noncitizen has attained at least 40 work quarters as determined by the Social Security Administration\n\nSponsor deeming does not apply to sponsored noncitizens when the noncitizen:\n- is under age 21\n- is pregnant. This exception ends when the sponsored pregnant person’s 12 month postpartum period ends. Sponsor deeming applies the month following the end of the postpartum period.\n- is sponsored by someone whose income has already been counted in the MAGI-based MA household, such as the applicant’s spouse\n- has sponsorship deferred by U.S. Citizenship and Immigration Services (USCIS) when their immigration status is changed to Battered Noncitizen\n- needs placement in a facility and placement is jeopardized by the sponsor’s failure or inability to provide support, or inability of the client to locate the sponsor"},{"chunk_id":"epm:2.3.3.3.2.1.2#exceptions-to-form-i-864-sponsorship","heading":"Exceptions to Form I-864 Sponsorship","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1.2#exceptions-to-form-i-864-sponsorship","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.1 Countable Income > 2.3.3.3.2.1.2 Sponsor Income Deeming > Exceptions to Form I-864 Sponsorship","text":"## Exceptions to Form I-864 Sponsorship\n\nNoncitizens who immigrate with a non-family based petition are not subject to sponsorship and sponsor deeming. These include, but are not limited to the following:\n- Battered noncitizens\n- Cuban Haitian entrants\n- Diversity visa recipients\n- Noncitizen sponsored by a business or organization that is not related to an immigrant\n- People with temporary protected status\n- Refugee and asylees"}]},{"id":"epm:2.3.3.3.2.2","number":"2.3.3.3.2.2","title":"Disregards and Deductions","parent":"2.3.3.3.2","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.2 Disregards and Deductions","summary":"This section provides information on disregards and deductions and the conditions that must be met to apply them.","effective_date":"2023-03-01","last_modified":"2026-10-03T04:10:23.247301+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.3.2.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_3_2_2.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.135","Code of Federal Regulations, title 42, section 435.137"],"chunks":[{"chunk_id":"epm:2.3.3.3.2.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.2","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.2 Disregards and Deductions","text":"This section provides information on disregards and deductions and the conditions that must be met to apply them."},{"chunk_id":"epm:2.3.3.3.2.2#unearned-income-deductions","heading":"Unearned Income Deductions","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.2#unearned-income-deductions","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.2 Disregards and Deductions > Unearned Income Deductions","text":"## Unearned Income Deductions\n- [Unearned Lump Sum Income Disregard](https://hcopub.dhs.state.mn.us/epm/#unearned_lump_sum)\n- [Child Support Disregard](https://hcopub.dhs.state.mn.us/epm/#child_support)\n\nThe following disregards and deductions are then deducted in the specific order listed:\n- [Disabled Widow and Widower Disregard](https://hcopub.dhs.state.mn.us/epm/#disabled_widow_widower)\n- [Widow and Widower Disregard](https://hcopub.dhs.state.mn.us/epm/#widow_widower)\n- [Pickle Disregard](https://hcopub.dhs.state.mn.us/epm/#pickle)\n- [Disabled Adult Child Disregard](https://hcopub.dhs.state.mn.us/epm/#dac)\n- [Retirement, Survivor, Disability Insurance (RSDI) Cost of Living Adjustment (COLA) Disregard](https://hcopub.dhs.state.mn.us/epm/#rsdi_cola)\n- [Plan to Achieve Self-Support (PASS) Deduction](https://hcopub.dhs.state.mn.us/epm/#pass)"},{"chunk_id":"epm:2.3.3.3.2.2#earned-income-deductions","heading":"Earned Income Deductions","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.2#earned-income-deductions","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.2 Disregards and Deductions > Earned Income Deductions","text":"## Earned Income Deductions\n\nThis section provides information on the disregards and deductions that are deducted from specific earned income:\n- [Earned Lump Sum Income Disregard](https://hcopub.dhs.state.mn.us/epm/#earned_lump_sum)\n\nThe following disregards and deductions are then deducted in the specific order listed:\n- [Plan to Achieve Self-Support (PASS) Deduction](https://hcopub.dhs.state.mn.us/epm/#pass)\n- [Student Earned Income Exclusion](https://hcopub.dhs.state.mn.us/epm/#student_earned)\n- [Earned Income Disregard](https://hcopub.dhs.state.mn.us/epm/#earned_income)\n- [Impairment Related Work Expense Deduction](https://hcopub.dhs.state.mn.us/epm/#irwe)\n- [Remaining Earned Income Disregard](https://hcopub.dhs.state.mn.us/epm/#remaining_earned_income)\n- [Blind Work Expense Deduction](https://hcopub.dhs.state.mn.us/epm/#blind_work)"},{"chunk_id":"epm:2.3.3.3.2.2#blind-work-expenses","heading":"Blind Work Expenses","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.2#blind-work-expenses","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.2 Disregards and Deductions > Blind Work Expenses","text":"## Blind Work Expenses\n\nBlind Work Expenses (BWE) that are reasonably attributable to earning income are excluded from earned income.\n\nBWEs can be excluded if the blind person:\n- is younger than age 65; or\n- is age 65 or older and received Supplemental Security Income (SSI) payments due to blindness for the month before attaining age 65.\n\nThe BWEs are excluded from earned income after applying all other earned income exclusions except for [PASS](https://hcopub.dhs.state.mn.us/epm/#pass).\n\nWork-related items paid by a blind person may be excluded as BWE regardless of:\n- any non-work benefit that may be derived from the item; or\n- the item’s relationship to the person’s blindness.\n\nBWEs include, but are not limited to:\n- Attendant care services in the:\n  - Home, if related to preparing to go to work or assistance immediately upon returning home from work\n  - Process of assisting a person making the trip to and from work\n  - Work setting\n- Drugs and medical services which are essential to enable the person to work\n- Expendable medical supplies including bandages, catheters, etc.\n- Federal, State and local income taxes\n- Social Security and Medicare taxes\n- Service dog, including cost of dog and associated expenses\n- Fees, including licenses, professional association dues, union dues, etc.\n- Mandatory contributions, including pensions, disability insurance, etc.\n- Meals during work hours\n- Medical devices including wheelchairs, braces, etc.\n- Non-medical equipment and services including child care, uniforms etc.\n- Other work-related equipment and services including job coaching, vision and sensory aids, etc.\n- Physical therapy\n- Prosthesis\n- Structural modifications to the person’s home to create a work space or to allow the person to get to and from work\n- Training reasonably attributable to work. General education courses are not included.\n- Transportation to and from work\n- Vehicle modification\n\nThe following items cannot be excluded as BWE:\n- In-kind payments\n- Expenses deducted under other provisions (e.g., PASS)\n- Expenses which will be reimbursed\n- Life maintenance expenses, including, but not limited to:\n  - meals consumed outside of work hours;\n  - self-care items (including items of cosmetic rather than work-related nature);\n  - general educational development;\n  - savings plans (e.g., Individual Retirement Accounts (IRAs) or voluntary pensions); and\n  - life and health insurance premiums\n- Items furnished by others that are needed in order to work (the value of such items is not income)\n- Expenses claimed on a self-employment tax return"},{"chunk_id":"epm:2.3.3.3.2.2#child-support-payments-exclusion","heading":"Child Support Payments Exclusion","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.2#child-support-payments-exclusion","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.2 Disregards and Deductions > Child Support Payments Exclusion","text":"## Child Support Payments Exclusion\n\nChild support payments are unearned income to the child and one-third of the amount is excluded. Any in-kind child support is not income."},{"chunk_id":"epm:2.3.3.3.2.2#dependent-rsdi-benefit-exclusion","heading":"Dependent RSDI Benefit Exclusion","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.2#dependent-rsdi-benefit-exclusion","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.2 Disregards and Deductions > Dependent RSDI Benefit Exclusion","text":"## Dependent RSDI Benefit Exclusion\n\nRSDI dependent benefits for children who receive MA under the Tax Equity and Fiscal Responsibility Act (TEFRA) option or receive services through a Brain Injury (BI), Community Alternative Care (CAC), Community Access for Disability Inclusion (CADI), or Developmental Disabilities (DD) waiver are excluded."},{"chunk_id":"epm:2.3.3.3.2.2#disabled-adult-child-disregard","heading":"Disabled Adult Child Disregard","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.2#disabled-adult-child-disregard","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.2 Disregards and Deductions > Disabled Adult Child Disregard","text":"## Disabled Adult Child Disregard\n\nThe Disabled Adult Child Disregard allows for the disregard of Disabled Adult Child RSDI benefits.\n\nTo qualify for the Disabled Adult Child Disregard, a person must meet all of the following conditions:\n- Is currently age 18 or older\n- Became blind or disabled before reaching the age of 22\n- Received SSI benefits on the basis of blindness or disability\n- Lost eligibility for SSI on or after July 1, 1987, due to entitlement to RSDI Disabled Adult Child benefits, or increased RSDI Disabled Adult Child benefits based on disability, retirement or death of a parent\n\nFor people who meet the qualifications for the disregard, the Disabled Adult Child RSDI benefits are not counted.\n\nPeople who receive Disabled Adult Child benefits as defined by the Social Security Administration (SSA), but do not meet the criteria above, are not eligible for the Disabled Adult Child Disregard.\n\nDo not use the disregard on any other income, including RSDI benefits the person receives on their own account."},{"chunk_id":"epm:2.3.3.3.2.2#disabled-widow-and-widower-disregard","heading":"Disabled Widow and Widower Disregard","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.2#disabled-widow-and-widower-disregard","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.2 Disregards and Deductions > Disabled Widow and Widower Disregard","text":"## Disabled Widow and Widower Disregard\n\nThe Disabled Widow and Widower Disregard allows for the disregard of RSDI benefits.\n\nTo qualify for the Disabled Widow and Widower Disregard, a person must meet all of the following conditions:\n- Is currently receiving either:\n  - RSDI Disabled Widow or Widower benefits\n  - Disabled Surviving Divorced Spouse benefits\n- Is age 50 but not yet 60 and is certified disabled, or is age 60 but has not yet reached full retirement age\n- Received SSI or Minnesota Supplemental Aid (MSA) benefits the month before the month they began receiving RSDI Disabled Widow or Widower or Disabled Surviving Divorced Spouse benefits\n- Lost SSI or MSA eligibility on or after January 1, 1991, due to the SSI requirement to apply for and receive RSDI Disabled Widow or Widower or Disabled Surviving Divorced Spouse benefits\n- Remaining income would be at or below the current SSI or MSA benefit rate if RSDI income is disregarded\n- Is not entitled to Medicare Part A\n\nEligibility for the disregard ends the first full month a person is eligible for Medicare Part A."},{"chunk_id":"epm:2.3.3.3.2.2#earned-income-disregard","heading":"Earned Income Disregard","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.2#earned-income-disregard","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.2 Disregards and Deductions > Earned Income Disregard","text":"## Earned Income Disregard\n\nThe Earned Income Disregard allows for the disregard of a person’s first $65 of earned income, including income that deems to the person."},{"chunk_id":"epm:2.3.3.3.2.2#earned-lump-sum-income-disregard","heading":"Earned Lump Sum Income Disregard","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.2#earned-lump-sum-income-disregard","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.2 Disregards and Deductions > Earned Lump Sum Income Disregard","text":"## Earned Lump Sum Income Disregard\n\nThe first $30 of irregular or infrequent earned lump sum, non-gift, income from an employer, trade or business is disregarded."},{"chunk_id":"epm:2.3.3.3.2.2#impairment-related-work-expense-deduction","heading":"Impairment-Related Work Expense Deduction","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.2#impairment-related-work-expense-deduction","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.2 Disregards and Deductions > Impairment-Related Work Expense Deduction","text":"## Impairment-Related Work Expense Deduction\n\nThe Impairment-Related Work Expense (IRWE) Deduction allows for the deduction of certain expenses incurred during the course of earning income. It applies to people who are certified disabled and under age 65, or people who received SSI or MSA as a disabled person the month before attaining age 65.\n\nAn IRWE is an expense for items or services that directly enable a person with a disability to work, and are incurred because of a physical or mental impairment.\n\nIRWEs are deducted if all of the following are true:\n- The severity of the impairment requires the person to purchase or rent items and services in order to work.\n- The expense is reasonable.\n- The person pays the cost and is not reimbursed from another source, such as Medicare or private insurance.\n- One of the following occurs:\n  - The person pays the expense in the month he or she receives the earned income, and the income is for work they did in the same month as using the item or service.\n  - The person is working but pays the expense before receiving the earned income.\n\nThe IRWEs are excluded from earned income after applying one-half of the remaining earned income deduction. See [Earned Income Disregard](https://hcopub.dhs.state.mn.us/epm/#earned_income) for more information.\n\nIRWEs include, but are not limited to:\n- Attendant care services in the:\n  - Home, if related to preparing to go to work or assistance immediately upon returning home from work\n  - Process of assisting a person making the trip to and from work\n  - Work setting\n- Drugs and medical services which are essential to enable the person to work\n- Expendable medical supplies including bandages, catheters, etc.\n- Service dog, including cost of dog and associated expenses\n- Medical devices including wheelchairs, braces, etc.\n- Non-medical equipment and services directly related to the impairment\n- Other work-related equipment and services including job coaching, vision and sensory aids, etc.\n- Physical therapy\n- Prosthesis\n- Structural modifications to the person’s home to create a work space or to allow the person to get to and from work\n- Training reasonably attributable to work. General education courses are not included.\n- Transportation to and from work\n- Vehicle modification\n\nExpenses for a transportation method also used by people who are not disabled, such as a bus or unmodified vehicle, is not deductible."},{"chunk_id":"epm:2.3.3.3.2.2#plan-to-achieve-self-support-pass-deduction","heading":"Plan to Achieve Self Support (PASS) Deduction","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.2#plan-to-achieve-self-support-pass-deduction","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.2 Disregards and Deductions > Plan to Achieve Self Support (PASS) Deduction","text":"## Plan to Achieve Self Support (PASS) Deduction\n\nThe Plan to Achieve Self Support (PASS) deduction allows for the deduction of earned and unearned income set aside under an approved PASS plan. The PASS exclusion is not available for people age 65 and older, unless they were receiving SSI payments for the month before they became 65. The PASS plan can only be approved by SSA. For this deduction the PASS plan must be verified."},{"chunk_id":"epm:2.3.3.3.2.2#pickle-disregard","heading":"Pickle Disregard","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.2#pickle-disregard","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.2 Disregards and Deductions > Pickle Disregard","text":"## Pickle Disregard\n\nThe Pickle Disregard allows for the disregard of RSDI cost of living adjustment (COLA) amounts.\n\nTo qualify for the Pickle Disregard, a person must:\n- Currently receive or is entitled to receive RSDI benefits\n- Have been eligible for 1619(b) or was eligible for and received SSI, MSA or 1619(a) benefits while concurrently entitled to or receiving RSDI in any month since April 1, 1977\n- Lost eligibility for SSI, MSA, 1619(a) or 1619(b) for any reason\n\nIf a person meets the above requirements, they are referred to as a “potential Pickle.” The Pickle threshold date must then be determined. A person’s Pickle threshold date is the more recent of the following two dates:\n- April 1, 1977; or\n- The last month the person was eligible for and received at least one of the following benefits at the same time the person received RSDI benefits or was entitled to RSDI benefits:\n  - 1619(a) or 1619(b),\n  - MSA, or\n  - SSI\n\nAfter determining the Pickle threshold date, the amount of the RSDI benefit the person received on the threshold date must be determined. All RSDI COLA increases received back to the Pickle threshold date are excluded.\n\nA person who meets all of the conditions listed must have a net income, with the Pickle Disregard and all applicable earned and unearned income disregards, that is less than the current SSI payment amount. If the person’s net income is greater than the SSI payment amount, they may still receive the Pickle Disregard if their net income is less than the MSA standard.\n\nWhen a person eligible for the Pickle Disregard also has a spouse or parent that is eligible for the Pickle Disregard, the disregard is applied when deeming income."},{"chunk_id":"epm:2.3.3.3.2.2#rsdi-cola-disregard","heading":"RSDI COLA Disregard","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.2#rsdi-cola-disregard","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.2 Disregards and Deductions > RSDI COLA Disregard","text":"## RSDI COLA Disregard\n\nThe RSDI COLA Disregard allows for the disregard of the annual RSDI COLA increase. The COLA increase amount for RSDI benefits is excluded from January 1 through June 30 of each calendar year. Beginning each July 1, all gross RSDI benefits are counted.\n\nThe RSDI COLA Disregard is not available to applicants or enrollees who did not receive RSDI in the previous calendar year. The RSDI COLA Disregard is not applied in the long-term care (LTC) income calculation."},{"chunk_id":"epm:2.3.3.3.2.2#remaining-earned-income-disregard","heading":"Remaining Earned Income Disregard","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.2#remaining-earned-income-disregard","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.2 Disregards and Deductions > Remaining Earned Income Disregard","text":"## Remaining Earned Income Disregard\n\nOne-half of the remaining earned income is excluded."},{"chunk_id":"epm:2.3.3.3.2.2#student-earned-income-exclusion","heading":"Student Earned Income Exclusion","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.2#student-earned-income-exclusion","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.2 Disregards and Deductions > Student Earned Income Exclusion","text":"## Student Earned Income Exclusion\n\nThe student earned income exclusion allows for the limited disregard of a student’s earned income. There is a cap on how much of a student’s earned income is excluded for MA-ABD eligibility in a calendar year. The amount changes annually. See [Appendix F Standards and Guidelines](https://bot-corpus.mn-dhs.online/s/epm/F) for the current cap amount.\n\nTo qualify for the student earned income exclusion a person must:\n- Have earned income\n- Be younger than age 22\n- Be certified as blind or disabled by the SSA or State Medical Review Team (SMRT)\n- Regularly attend school by taking one or more courses of study and attend classes:\n  - in a college or university for at least eight hours per week under a semester or quarter system\n  - in grades 7–12 for at least 12 hours per week\n  - in a course of training to prepare for a paying job at least 15 hours per week if the course involves shop practice, or 12 hours per week if it does not involve shop practice\n  - for less than the required time for reasons beyond the student’s control, such as illness, if the circumstances justify the reduced credit load or attendance\n- A person must meet the following additional requirements in these situations:\n  - Homeschooled students must:\n    - be in grades 7–12, and\n    - follow Minnesota home school laws\n  - Homebound students must:\n    - stay home because of a disability;\n    - study a course or courses given by a school in grades 7–12, college, university, or government agency; and\n    - have a home visitor or tutor from school who directs the studying or training.\n  - Online students must:\n    - study a course or courses given by a school in grades 7–12, college, university, or government agency; and\n    - enroll in an online school authorized by the laws of the state in which the online school is located.\n\nA person maintains status as a student while classes are out on a standard school break if the student attended classes regularly prior to the break and intends to resume classes regularly when school reopens."},{"chunk_id":"epm:2.3.3.3.2.2#unearned-lump-sum-income-disregard","heading":"Unearned Lump Sum Income Disregard","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.2#unearned-lump-sum-income-disregard","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.2 Disregards and Deductions > Unearned Lump Sum Income Disregard","text":"## Unearned Lump Sum Income Disregard\n\nThe first $60 of irregular or infrequent unearned lump sum income is disregarded."},{"chunk_id":"epm:2.3.3.3.2.2#widow-and-widower-disregard","heading":"Widow and Widower Disregard","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.2#widow-and-widower-disregard","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.2 Disregards and Deductions > Widow and Widower Disregard","text":"## Widow and Widower Disregard\n\nThe Widow and Widower’s Disregard allows for the disregard of RSDI COLA increases. To qualify for the disregard, a person must:\n- Currently receive RSDI\n- Have filed an MA application before July 1,1988\n- Has been entitled to receive RSDI continuously since December 1983\n- Have been a disabled widow or widower in January 1984\n- Established a right to receive RSDI benefits before age 60\n- Have been eligible for SSI or MSA benefits before application of the revised actuarial reduction formula\n- Lost eligibility for SSI or MSA benefits as a result of the change in the actuarial reduction formula\n\nIf a person meets the above requirements, all RSDI COLA increases effective on and after January 1, 1984 are excluded."}]},{"id":"epm:2.3.3.3.2.3","number":"2.3.3.3.2.3","title":"Excluded Income","parent":"2.3.3.3.2","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.3 Excluded Income","summary":"Some types of income are excluded when calculating a person’s income for Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) and Medicare Savings Programs (MSP). See the MSP chapter for more information. Descriptions of each type of income are located in Appendix B Income.","effective_date":"2025-04-29","last_modified":"2026-10-03T03:58:41.213627+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.3.2.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_3_2_3.htm","legal_citations":["Minnesota Statutes, section 256B.056, subdivision 1a"],"chunks":[{"chunk_id":"epm:2.3.3.3.2.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.3","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.3 Excluded Income","text":"Some types of income are excluded when calculating a person’s income for Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) and Medicare Savings Programs (MSP). See the [MSP](https://bot-corpus.mn-dhs.online/s/epm/4.2) chapter for more information. Descriptions of each type of income are located in Appendix B Income.\n\nExcluded income includes:\n- Agent Orange Settlement Fund payments\n- AmeriCorps State and National living allowances\n- AmeriCorps National Civilian Community Corps (NCCC) living allowances\n- Blood Product Settlement payments\n- Child Care and Development Block Grant Act payments\n- Clinical trial participation payments excluded by Supplemental Security Income (SSI). The first $2,000 a person receives during a calendar year is excluded.\n- Cobell Settlement payments for American Indians for a period of 12 months beginning with the month of receipt. This exclusion applies to all household members.\n- Community First Services and Supports (CFSS) payments, for the beneficiary.\n  - Starting October 1, 2024, CFSS replaces the Consumer Support Grant (CSG) and Personal Care Assistance (PCA) payments.\n  - For all such payments, CFSS, CSG, and PCA, the payments are excluded income for the beneficiary, but countable income for the person paid to provide services.\n- Corporation for National and Community Service (CNCS) payments. Payments to volunteers, including the following payments authorized under the Domestic Volunteer Services Act:\n  - AmeriCorps\n  - Urban Crime Prevention Program\n  - Special volunteer programs under Title I\n  - Demonstration Programs under Title II\n  - Senior Corps:\n    - Retired Senior Volunteer Program (RSVP)\n    - Foster Grandparent Program\n    - Senior Companion Program\n- Credit life and credit disability insurance payments\n- Crime victim payments\n- Disaster assistance, federal payments\n- Disaster assistance, state payments\n- Employment and training reimbursements and allowances\n- Family Support Grant (FSG) payments\n- Filipino Veterans Equity Compensation Fund payment\n- Food and nutrition program payments. This includes assistance provided by:\n  - Programs established under the Child Nutrition Act, including the Women, Infants, and Children (WIC) Nutrition Program and federally funded school breakfast and milk programs.\n  - National School Lunch program\n  - Supplemental Nutrition Assistance Program (SNAP)\n  - Minnesota Food Assistance Program\n  - Minnesota Grown Supplemental Food Program\n- Gifts to Children with Life Threatening Conditions from 501(c)(3) tax-exempt corporation. This are not considered income of a parent and apply only to children who are under age 18.\n  - Any in-kind gift not converted to cash is excluded.\n  - Cash gifts up to $2,000 in any calendar year are excluded. The amount of total cash payments that exceed $2,000 each year are counted as an asset.\n    - Multiple cash gifts in the same calendar year are added together and up to $2,000 of the total is excluded, even if none of the cash gifts exceeds $2,000 individually.\n- Hostile fire pay\n- Housing and Urban Development (HUD) subsidies\n- Individual Development Accounts (IDA)\n- In-kind income\n- Interest on funds that commingle countable and excluded assets\n- James Zadroga 9/11 Health and Compensation Act of 2010\n- Japanese American and Aleutian Restitution payments\n- Jensen Settlement Agreement payments\n- Long-Term Services and Supports workforce incentive payments under the Minnesota Care Force Incentive program.\n- Low Income Home Energy Assistance Program (LIHEAP) payments\n- Long-Term Services and Supports workforce incentive payments under the Minnesota Care Force Incentive Program.\n- Lump sum income\n  - Some lump sum income that is used to pay for certain expenses is not counted, including:\n    - Costs associated with getting the lump sum, such as attorney’s fees\n    - Any portion of the lump sum earmarked for and used to pay medical expenses not covered by insurance or any Minnesota Health Care Program (MHCP), such as a prosthetic device\n    - Any portion of the lump sum recovered by the DHS Benefit Recovery Section (BRS)\n    - Any portion of the lump sum earmarked for and used to pay funeral and burial costs paid upon the death of a spouse or child\n  - SSI lump sum payments\n    - Retroactive SSI lump sum payments are excluded as income in the month received.\n    - If a person’s SSI is reissued because a representative payee misuses benefits, the reissuance is excluded as income.\n  - Social Security Disability Insurance (SSDI) and Veterans Affairs (VA) payment due to representative payee misuse. If a person’s SSDI or Veterans Benefits for the Elderly is reissued because an individual representative payee misuses benefits, the reissuance is excluded if the original payment of the income was used to determine the eligibility.\n  - Medicare Part B Premium Reimbursements. This lump sum is excluded as income in the month received if the Medicare Part B premiums being reimbursed to the client were not used as an MA spenddown expense.\n- Nazi Persecution payments, including payments inherited from the original recipient, and any interest accrued from these funds.\n- Participation incentive payments\n- Public assistance payments from the following programs:\n  - Minnesota Family Investment Program (MFIP)\n  - Diversionary Work Program (DWP)\n  - General Assistance (GA)\n  - Housing Support (HS)\n  - Minnesota Supplemental Aid (MSA)\n  - Refugee Cash Assistance (RCA)\n  - Title IV-E and non-Title IV-E Kinship Assistance\n  - Title IV-E and non-Title IV-E Adoption Assistance\n  - Foster Care Assistance\n  - SSI and all income used to determine SSI (including deemer income)\n    - VA Aid and Attendance benefits and VA unusual medical expense payments are not excluded, even if the person is receiving SSI.\n- Radiation Exposure Compensation Trust Fund (RECTF) payments\n- Refunds of rental security and utility deposits\n- Reimbursements for out-of-pocket expenses incurred while performing volunteer services, jury duty or employment\n- Reimbursements for medical expenses\n- Reimbursements for replacement of property\n- Relocation assistance payments, federal\n- Ricky Ray Hemophilia Relief Fund payments\n- Student financial aid. The following types of student financial aid income are excluded:\n  - Student financial aid received under Title IV of the Higher Education Act, with the exception of [Federal Work Study earnings](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1) which may count for Medical Assistance for Employed Persons with Disabilities (MA-EPD)\n  - Student financial aid received from the Bureau of Indian Affairs (BIA), with the exception of [Federal Work Study earnings](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1) which may count for MA-EPD\n  - Non-Title IV and non-BIA grants, scholarships, fellowships and other non-loan financial aid, if used or set aside to pay educational expenses. Refer to [MA-ABD Countable Income](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1) for funds that are not used for or set aside for educational expenses.\n  - Distributions from a Coverdell Educational Savings Accounts (ESA) if the funds are used for educational expenses. Refer to [MA-ABD Countable Income](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1) for funds that are not used for educational expenses.\n  - VA benefits designated as educational assistance\n  - Plan to Achieve Self Support (PASS) student financial aid\n  - Training expenses paid by the Trade Adjustment Reform Act of 2002\n- Tax credits, rebates and refunds (State and Federal)\n- Teacher stipends under the Minnesota READ Act\n- Third party vendor payments, which include, but are not limited to:\n  - MSA or GRH payments made directly to a facility\n  - Emergency payments to a utility company made by an emergency assistance program such as Emergency General Assistance (EGA)\n- Tribal payments. The following types of tribal payments are excluded:\n  - Tribal trust or restricted lands, individual interest: Exclude the first $2,000 received from this income source.\n  - Tribal per capita payments from a tribal trust: Exclude all funds from this income source.\n  - Tribal land settlements and judgments: Excluded all funds from this income source.\n  - Mille Lacs Band of Ojibwe Elder Supplement Assistance Program\n  - 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.\n- Veterans’ Children with Certain Birth Defects payments\n- Vietnamese Commando Compensation Act payments\n- Vocational Rehabilitation Payments\n\nMinnesota Statutes, section 256.4764, subdivision 7"}]},{"id":"epm:2.3.3.3.2.4","number":"2.3.3.3.2.4","title":"Income Verification","parent":"2.3.3.3.2","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.4 Income Verification","summary":"Verification of current income is required at application, renewal and when an income change is reported and must occur before an income eligibility determination is made:","effective_date":"2025-05-07","last_modified":"2026-10-03T03:51:58.594961+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.3.2.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_3_2_4.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.945","Code of Federal Regulations, title 42, section 435.948","Code of Federal Regulations, title 42, section 435.952","Minnesota Rules, part 9505.0095"],"chunks":[{"chunk_id":"epm:2.3.3.3.2.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.4","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.4 Income Verification","text":"Verification of current income is required at application, renewal and when an income change is reported and must occur before an income eligibility determination is made:\n- At Application: All countable and excluded income must be verified.\n- At Renewal: All countable income must be verified. Agencies must not re-verify excluded income at renewal.\n- Between Renewals: Any reported change to existing countable income sources must be verified and any new income source (countable or excluded) reported by an enrollee must be verified. Agencies must not re-verify a change to a previously verified excluded income source between renewals."},{"chunk_id":"epm:2.3.3.3.2.4#electronic-verification-of-income","heading":"Electronic Verification of Income","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.4#electronic-verification-of-income","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.4 Income Verification > Electronic Verification of Income","text":"## Electronic Verification of Income\n\nThe agency must attempt to electronically verify attested income before paper proofs may be requested from an applicant or enrollee. The following reliable electronic data sources must be used to verify attested income:\n- The Work Number (TWN) to verify earned income from employment.\n- The State Verification and Eligibility System/Third Party Query (SVES/TPQY) to verify Retirement, Survivors, and Disability Insurance (RSDI) benefit amounts, SSI benefit amounts, and railroad benefit amounts.\n- The Shared Master Index/Social Security Administration State Online Query (SMI/SOLQ) to verify RSDI and SSI benefit amounts."},{"chunk_id":"epm:2.3.3.3.2.4#paper-proof","heading":"Paper Proof","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.4#paper-proof","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.4 Income Verification > Paper Proof","text":"## Paper Proof\n\nIf income cannot be electronically verified because electronic data sources are unavailable for a particular type of income, electronic sources return data that indicates income is above the income limit, or if the electronic sources do not return any results, paper proof from an applicant or enrollee must be requested to verify income. Common proof to verify earned and unearned income includes, but is not limited to, the following:\n- Pay stubs\n- Employer’s statement\n- Award letters\n- Court orders\n- Copies of checks for unearned income\n\nPaper proofs to verify earnings from self-employment include, but are not limited to:\n- Tax forms\n- Business records\n- Accounting records\n- Statements from an outside accountant\n- Ledger books or bookkeeping records\n\nPaper proof(s) submitted by an applicant or enrollee to verify income must be the most recent paper proof available to the applicant or enrollee. County and tribal servicing agencies must assist applicants and enrollees to identify and obtain paper proof(s) that demonstrate current income.\n\nSelf-attestation of income may be accepted if electronic data sources are unsuccessful or unavailable and paper proof does not exist or is not available. See [EPM 2.3.1.1 MA-ABD Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/2.3.1.1).\n\nIf paper proofs submitted to verify income show an amount different from what the applicant or enrollee reported, the dollar value reflected by the paper proof must be used to determine income eligibility. If the applicant or enrollee is above the income limit, before denying eligibility for an applicant or closing eligibility for an enrollee, county and tribal servicing agencies must review the case to determine if the person is eligible for:\n- MA-ABD with a spenddown,\n- MA for Employed Persons with Disabilities (MA-EPD), or\n- Any other MHCP basis of eligibility.\n\nVerification of job loss or termination of income is not required unless the enrollee is an MA-EPD enrollee applying for the job loss extension. See EPM [2.3.5.1.3 MA-EPD Work Requirements](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.3). Job loss or termination of income is a change in circumstances and must be redetermined based on the reported change. See EPM [1.3.2.1 Change in Circumstances.](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)"},{"chunk_id":"epm:2.3.3.3.2.4#income-verified-by-other-public-programs-snap-mfip-or-tribal-tanf","heading":"Income verified by other public programs (SNAP, MFIP, or Tribal TANF)","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.4#income-verified-by-other-public-programs-snap-mfip-or-tribal-tanf","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.4 Income Verification > Income verified by other public programs (SNAP, MFIP, or Tribal TANF)","text":"## Income verified by other public programs (SNAP, MFIP, or Tribal TANF)\n\nWhen an applicant or enrollee is enrolled in the Supplemental Nutrition Assistance Program (SNAP), Minnesota Family Investment Program (MFIP), or Tribal Temporary Assistance for Needy Families (TANF), county and tribal servicing agencies must use income already verified for any of these programs when processing applications and renewals if all of the following apply:\n- One or more of the reported sources of income cannot be verified electronically, and the applicant or enrollee did not submit paper proof of that income with the application or renewal form.\n  - If the applicant or enrollee provided paper proof for any source of income with their application or renewal form, it must be used.\n- An applicant or enrollee receives SNAP, MFIP or Tribal TANF, and the income used to determine eligibility for the program(s) shows a status of verified on the case.\n- The applicant or enrollee reported the same source(s) of income (i.e., the same job, same self-employment, etc.) on the application or renewal form as was already verified for SNAP, MFIP or Tribal TANF within the past six months.\n- The income amount(s) verified for SNAP, MFIP or Tribal TANF results in the applicant or enrollee’s total countable income at or below the applicable income limit."},{"chunk_id":"epm:2.3.3.3.2.4#income-verification-for-retroactive-coverage","heading":"Income Verification for Retroactive Coverage","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.4#income-verification-for-retroactive-coverage","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.3 Income > 2.3.3.3.2 Income Methodology > 2.3.3.3.2.4 Income Verification > Income Verification for Retroactive Coverage","text":"## Income Verification for Retroactive Coverage\n\nIncome and assets are considered verified for the retroactive months if all of the following are met:\n- An applicant reports that their income and assets are below the income and asset limits in the application month.\n- The applicant reports that their income and asset values were the same in the retroactive months requested as in the application month.\n- Income for the application month is verified electronically or with paper proof.\n- Assets for the application month are verified electronically or with paper proof.\n  - The Asset Verification Service (AVS) will provide results for retroactive months. AVS results for retroactive months should not be used unless the results indicate the applicant or enrollee is above the asset limit. In such cases, the county and tribal servicing agency must follow-up with the applicant on the inconsistency before determining eligibility.\n\nIf the applicant attests that income and asset values were not the same in the retroactive months, verification of actual income for each retroactive month requested is required.\n\nThese income verification for retroactive coverage policies do not apply to people who request MA for Long-Term Care Services (MA-LTC) and who use a long-term care (LTC) income calculation to determine their LTC spenddown or waiver obligation. These people must have income verified electronically or with paper proof(s) in each month for which retroactive coverage is requested. See EPM [2.4.2.5](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5)for more information."}]},{"id":"epm:2.3.3.4","number":"2.3.3.4","title":"Medical Spenddowns","parent":"2.3.3","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.4 Medical Spenddowns","summary":"A medical spenddown is a cost-sharing approach that allows Medical Assistance (MA) eligibility for people whose income is greater than the applicable income limit. Federal rules refer to this population as “medically needy.”","effective_date":"2025-05-30","last_modified":"2026-10-03T03:51:58.594961+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_4.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.811","Code of Federal Regulations, title 42, section 435.831","Code of Federal Regulations, title 42, section 435.840","Minnesota Statutes, section 256B.056, subdivision 5"],"chunks":[{"chunk_id":"epm:2.3.3.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.4","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.4 Medical Spenddowns","text":"A medical spenddown is a cost-sharing approach that allows Medical Assistance (MA) eligibility for people whose income is greater than the applicable income limit. Federal rules refer to this population as “medically needy.”\n\nPeople with an aged, blind or disabled basis of eligibility, who are not eligible for Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) because they are over the income limit and who have medical expenses may be eligible for MA-ABD with a spenddown.\n\nSee the [MA for Families and Children Medical Spenddown](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.6) policy for more information about medical spenddowns for parents, pregnant people and children.\n\nTopics included in this section are:\n1. [MA-ABD Medical Spenddown Types](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.4.1)\n2. [MA-ABD Health Care Expenses](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.4.2)"},{"chunk_id":"epm:2.3.3.4#retroactive-eligibility-for-ma-abd-with-a-medical-spenddown","heading":"Retroactive Eligibility for MA-ABD with a Medical Spenddown","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.4#retroactive-eligibility-for-ma-abd-with-a-medical-spenddown","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.4 Medical Spenddowns > Retroactive Eligibility for MA-ABD with a Medical Spenddown","text":"## Retroactive Eligibility for MA-ABD with a Medical Spenddown\n\nA person may qualify for MA-ABD with a Medical Spenddown up to three months before the month of application."},{"chunk_id":"epm:2.3.3.4#ma-abd-with-a-medical-spenddown-and-other-insurance-affordability-programs","heading":"MA-ABD with a Medical Spenddown and Other Insurance Affordability Programs","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.4#ma-abd-with-a-medical-spenddown-and-other-insurance-affordability-programs","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.4 Medical Spenddowns > MA-ABD with a Medical Spenddown and Other Insurance Affordability Programs","text":"## MA-ABD with a Medical Spenddown and Other Insurance Affordability Programs\n\nA person may be eligible for MA-ABD with a Medical Spenddown in the same month they are or were eligible for or enrolled in MinnesotaCare, Advanced Premium Tax Credits (APTC) or qualified health plan (QHP) without subsidy. Eligibility for or enrollment in MinnesotaCare, APTC, or QHP without subsidy is not a barrier to eligibility for MA-ABD with a Medical Spenddown."},{"chunk_id":"epm:2.3.3.4#ma-abd-spenddown-standard","heading":"MA-ABD Spenddown Standard","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.4#ma-abd-spenddown-standard","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.4 Medical Spenddowns > MA-ABD Spenddown Standard","text":"## MA-ABD Spenddown Standard\n\nThe spenddown standard for MA-ABD with a spenddown is:\n- Before June 1, 2019: 80% FPG\n- On or after June 1, 2019 through June 30, 2022: 81% FPG\n- On or after July 1, 2022: 100% FPG"},{"chunk_id":"epm:2.3.3.4#six-month-income-review","heading":"Six-Month Income Review","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.4#six-month-income-review","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.4 Medical Spenddowns > Six-Month Income Review","text":"## Six-Month Income Review\n\nMA-ABD enrollees with a medical spenddown must complete a six-month income review, with the exception of the following people:\n- People whose only source of income is from an unvarying unearned income source that is expected to continue indefinitely. This type of income includes:\n- Retirement, Survivors, and Disability Insurance (RSDI) benefits\n- Private pensions\n- Veterans’ benefits\n- Public assistance benefits, such as Minnesota Family Investment Program (MFIP), General Assistance (GA) and Minnesota Supplemental Aid (MSA)\n- People whose only source of income is from an excluded income source, such as Supplemental Security Income (SSI)"}]},{"id":"epm:2.3.3.4.1","number":"2.3.3.4.1","title":"Medical Spenddown Types","parent":"2.3.3.4","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.4 Medical Spenddowns > 2.3.3.4.1 Medical Spenddown Types","summary":"A medical spenddown is a cost-sharing approach that allows Medical Assistance (MA) eligibility for people whose income is greater than the applicable income limit. Federal rules refer to this population as “medically needy.” People can become income eligible for MA by “spending down” their excess income to the spenddown standard. The person’s excess income is reduced by the amount of certain incur","effective_date":"2026-03-16","last_modified":"2026-10-03T04:45:31.009765+00:00","version":3,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.4.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.4.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_4_1.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.831","Minnesota Statutes, section 256B.056, subdivision 5"],"chunks":[{"chunk_id":"epm:2.3.3.4.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.4.1","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.4 Medical Spenddowns > 2.3.3.4.1 Medical Spenddown Types","text":"A medical spenddown is a cost-sharing approach that allows Medical Assistance (MA) eligibility for people whose income is greater than the applicable income limit. Federal rules refer to this population as “medically needy.” People can become income eligible for MA by “spending down” their excess income to the spenddown standard. The person’s excess income is reduced by the amount of certain incurred health care expenses.\n\nThere are two medical spenddown types: a six-month spenddown and a monthly spenddown.\n\n### Six-month spenddown:\n\nA six-month spenddown is the difference between the person’s net income for a six-month period and the applicable [Federal Poverty Guidelines](https://bot-corpus.mn-dhs.online/s/epm/F) (FPG) for a six-month period. Each household member may have a different spenddown amount depending on their net income and the FPG standard used to determine that member’s eligibility but all household members with a spenddown must use the same spenddown type.\n- Household members whose eligibility is determined using a family size of one are not required to use the same spenddown type as other household members.\n\nAllowable [health care expenses](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.4.2) are applied to the six-month spenddown in a specific order by the date the expense was incurred. The six-month spenddown must be met by the end of the application month or the date the application is processed, whichever is later.\n\nThe date on which the person has incurred medical expenses that meet or exceed the six-month spenddown is called the satisfaction date. The amount of medical expenses the enrollee is responsible to pay on the satisfaction date is called the recipient amount. MA pays for covered services beginning with the first dollar incurred above the recipient amount and for the rest of the six-month period as long as the enrollee continues to meet all eligibility requirements.\n\n### Monthly spenddown:\n\nA monthly spenddown is the difference between the person’s net income for a one-month period and the applicable FPG standard for that month. The spenddown is determined separately for each month of a six-month period. Each household member may have a different spenddown amount depending on their net income and the FPG standard used to determine that member’s eligibility but all household members with a spenddown must use the same spenddown type.\n\nThe monthly spenddown is used when a person cannot meet a six-month spenddown or chooses a monthly spenddown. To use a monthly spenddown the person only needs to meet the spenddown in any one month of the application processing period, or any one retroactive month. There is no satisfaction date for a monthly spenddown. MA pays for covered services beginning with the first dollar incurred above the monthly spenddown amount in each month.\n\n**Client Option Spenddown**\n- People may choose to prepay their monthly medical spenddown to the Minnesota Department of Human Services (DHS). This is called the Client Option Spenddown.\n- Because a person with a monthly spenddown only receives Medical Assistance for those months in which the person has medical expenses that are more than the amount of their spenddown, DHS conducts an 18-Month Reconciliation process to compare the Client Option Spenddown payments to the amount of the claims paid by MA.\n- DHS issues a refund for months in which the spenddown payment was more than the cost of healthcare services received in the same month. The refund is the difference between the spenddown amount and the amount of the claims paid.\n- The 18-Month Reconciliation process begins with the 19th month after the month the Client Option Spenddown begins and will continue for each subsequent month.\n- DHS will notify the enrollee of the refund. No action is required by the enrollee or the servicing agency.\n\n**Designated Provider Option**\n- People, who do not meet their spenddown with incurred health care insurance premiums or the [remedial care expense deduction](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.4.2#types-of-health-care-expenses), can choose to pay the balance of their monthly spenddown amount to the same provider each month. This is called the Designated Provider Option. People may choose the Designated Provider Option if they meet all of the following conditions:\n  - They receive one of the following types of services:\n    - Personal Care Attendant (PCA) services\n    - Child-welfare targeted case management services\n    - One of the following home and community-based waivers:\n      - Brain Injury (BI)\n      - Community Alternatives for Disabled Individuals (CADI)\n      - Community Alternative Care (CAC)\n      - Developmental Disabilities (DD)\n      - Elderly Waiver (EW)\n        - Exception: EW enrollees cannot choose the designated provider option if they are enrolled in MSHO or MSC+\n  - They are the only members of the MA household with a spenddown.\n  - Their spenddown can be met with incurred health care expenses from one provider.\n\nEnrollees can meet their spenddown using a provider other than the designated provider only in emergencies. Enrollees must report the emergency use within five days of incurring the expense to the county or tribal agency.\n\n### Spenddown Adjustments\n\nMedical spenddowns may be adjusted when the person reports a change in income or medical expenses.\n\n### Medical Spenddowns for Minnesota Senior Health Options (MSHO) and Special Needs BasicCare (SNBC) Enrollees\n\nPeople with a medical spenddown are excluded from initial enrollment in managed care, including MSHO and SNBC. However, if a person is already enrolled in MSHO or SNBC and is determined to have a medical spenddown, that person is allowed to remain enrolled in MSHO or SNBC as long as they pay their entire medical spenddown to DHS the month prior to the health care coverage month.\n- Exception: Enrollees who are residing in a nursing facility with a medical spenddown and have elected hospice may newly enroll in MSHO.\n\n### Disenrollment for Unpaid Spenddowns\n\nA person enrolled in MSHO or SNBC who has not paid their monthly spenddown for 3 months or longer must be disenrolled from their MSHO or SNBC plan. This does not affect their Medical Assistance eligibility. In order to reenroll after being disenrolled for not paying a medical spenddown, the person must pay the entire amount of the past due medical spenddown(s) within 90 days to be reenrolled.\n\nA person is not eligible to reenroll in MSHO or SNBC after being disenrolled for unpaid medical spenddowns unless all past due medical spenddowns are paid in full to DHS and the person no longer has a medical spenddown."}]},{"id":"epm:2.3.3.4.2","number":"2.3.3.4.2","title":"Health Care Expenses","parent":"2.3.3.4","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.4 Medical Spenddowns > 2.3.3.4.2 Health Care Expenses","summary":"To be eligible for Medical Assistance (MA) with a spenddown, people may reduce excess net income by deducting allowable health care expenses that are not subject to payment by a third party.","effective_date":"2026-02-06","last_modified":"2026-10-03T04:45:31.224227+00:00","version":3,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.4.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.3.4.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_3_4_2.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.831","Code of Federal Regulations, title 42, section 483.10","Minnesota Statutes, section 256B.056, subdivision 5","Minn. Stat. 256B.0575"],"chunks":[{"chunk_id":"epm:2.3.3.4.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.4.2","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.4 Medical Spenddowns > 2.3.3.4.2 Health Care Expenses","text":"To be eligible for Medical Assistance (MA) with a spenddown, people may reduce excess net income by deducting allowable health care expenses that are not subject to payment by a third party.\n\nThe person, or one of the following family members, can incur the health care expenses:\n- Spouse if the spouse’s income is used to determine the person’s eligibility\n- Legal dependents if they are included in the person’s family size or would have been included when the bills were incurred\n- Siblings, half-siblings, and step-siblings who are included in the person’s family size\n- Parents or stepparents who live with the person if their income is actually used to determine the person’s eligibility or they are included in the person’s family size\n\nThe family members do not have to be applying or eligible for MA to use their health care expenses to meet the spenddown of the family member applying for MA with a spenddown."},{"chunk_id":"epm:2.3.3.4.2#allowable-health-care-expenses-to-meet-a-medical-spenddown","heading":"Allowable Health Care Expenses to Meet a Medical Spenddown","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.4.2#allowable-health-care-expenses-to-meet-a-medical-spenddown","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.4 Medical Spenddowns > 2.3.3.4.2 Health Care Expenses > Allowable Health Care Expenses to Meet a Medical Spenddown","text":"## Allowable Health Care Expenses to Meet a Medical Spenddown\n\nAllowable health care expenses include:\n- Paid or unpaid bills incurred in the current spenddown period\n- Unpaid bills incurred before the current spenddown period\n\nPayments from a health savings account (HSA) funded by the person are not considered third party payments.\n\nHealth care expenses incurred before the spenddown satisfaction date are not eligible for MA payment."},{"chunk_id":"epm:2.3.3.4.2#types-of-health-care-expenses","heading":"Types of Health Care Expenses","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.4.2#types-of-health-care-expenses","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.4 Medical Spenddowns > 2.3.3.4.2 Health Care Expenses > Types of Health Care Expenses","text":"## Types of Health Care Expenses\n\nAllowable health care expenses are deducted from the spenddown in the following order:\n1. Health insurance expenses not paid for or reimbursed by MA and incurred during the current six-month period. This includes:\n  - Health, dental, vision and long-term care (LTC) insurance premiums\n  - Indemnity policy premiums that reimburse health care expenses\n  - Medicare premiums\n  - Medical Assistance for Employed Persons with Disabilities (MA-EPD) obligations\n  - Co-pays\n  - Deductibles, including MA family deductibles\n2. Unpaid health care expenses that the person is still obligated to pay and that were incurred before the six-month period.\n  - The health care expense may be:\n    - An expense charged directly to the person by a medical provider\n    - An expense that a medical provider has transferred for collection to a person or agency actively pursuing the collection\n    - A loan payment owed to a person, financial institution, or credit company for which the loan proceeds are paid to a medical provider. Interest and service charges applied to a loan are not a health care expense.\n  - The health care expense cannot have been:\n    - Used to calculate a spenddown during a prior certification period, whether or not the calculation resulted in the spenddown being met. Except the expense may be used to meet another spenddown if eligibility for the entire certification period was denied.\n    - An MA-covered service incurred in a prior certification period of MA\n3. Non-reimbursable health care expenses that are not covered by MA, incurred during the current six-month period, including: Unused portions of allowable health care expenses incurred during the current six-month period can be carried over and applied to future months.    To qualify as an allowable spenddown expense for MA, the non-reimbursable health care service must meet all the following conditions: A medically necessary service is a health service rendered for any of these situations: People are not required to provide proof of medical necessity for a medical expense provided by a medical provider, such as pharmacist or medical facility. These services are considered medically necessary. For medical expenses not provided by a medical provider, medical necessity must be established through the completion of the Medical Need form, DHS-6112, or a written statement from a medical provider. Once medical necessity is established for an expense via the Medical Need form or other written statement, the enrollee does not need to submit a new Medical Need form for the same expense in the subsequent six-month periods.\n  - Non-reimbursed Health Care Access Services\n  - Health care expenses for dependents or financially responsible relatives who are not eligible for MA\n  - A [remedial care expense](https://bot-corpus.mn-dhs.online/s/epm/F#remedial-care-expense) for people living in a residential living arrangement and there is a Housing Support (HS) agreement with the county agency\n  - Alternative Care (AC) costs to the enrollee\n  - Expenses paid by the Insurance Extension Program that pays health insurance premiums for individuals who are HIV positive.\n  - Expenses for long-term care services paid by the enrollee during full months of MA-LTC ineligibility due to a transfer penalty or when the person fails to name DHS the preferred remainder beneficiary on an annuity.\n  - Prescribed or recommended in writing by the person's physician or dentist.\n  - Directly benefits the person or a member of the person's immediate family.\n  - Available through a licensed medical provider but not necessarily obtained through a licensed medical provider.\n  - Not be reimbursable through the county health care access plan.\n  - Medically necessary.\n  - In response to a life-threatening condition or pain.\n  - To treat an injury, illness, or infection.\n  - To achieve a level of physical or mental function consistent with prevailing community standards for the diagnosis or condition.\n  - To care for a mother and child through the maternity period.\n  - To provide preventive health service.\n  - To treat a condition that could result in physical or mental disability.\n4. MA-covered services received during the current six-month period that will be paid by MA, including:\n  - Waiver services received through a home and community based services waiver\n  - Personal care attendant (PCA) services\n  - Targeted case management services"},{"chunk_id":"epm:2.3.3.4.2#reporting-health-care-expenses","heading":"Reporting Health Care Expenses","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.4.2#reporting-health-care-expenses","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.4 Medical Spenddowns > 2.3.3.4.2 Health Care Expenses > Reporting Health Care Expenses","text":"## Reporting Health Care Expenses\n\nPeople must report and verify all health care expenses used to meet a medical spenddown, except for the remedial care expense.\n\nMA can be approved with a monthly spenddown for people who apply, and have not yet received services sufficient to meet their spenddown, but who document that they will be receiving services sufficient to meet their spenddown."},{"chunk_id":"epm:2.3.3.4.2#health-care-expenses-not-allowed-to-meet-a-spenddown","heading":"Health Care Expenses Not Allowed to Meet a Spenddown","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.3.4.2#health-care-expenses-not-allowed-to-meet-a-spenddown","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.3 Financial Eligibility > 2.3.3.4 Medical Spenddowns > 2.3.3.4.2 Health Care Expenses > Health Care Expenses Not Allowed to Meet a Spenddown","text":"## Health Care Expenses Not Allowed to Meet a Spenddown\n\nThe following are not allowed to meet a spenddown:\n- Room and, when applicable, board charges in a residential living arrangement, including fuel, food, utilities, household supplies and other costs necessary to provide room and board.\n- The additional charge for a private room in a skilled nursing facility (SNF), when not medically necessary, is not covered by MA and is also not an allowable spenddown expense. When the private room is medically necessary, the charge is covered by MA.\n- Cost of care programming charges at a treatment center or institution.\n- Health insurance expenses for future months have not been incurred. Projected health insurance expenses that have not been incurred cannot be deducted when determining a six-month medical spenddown."}]},{"id":"epm:2.3.4","number":"2.3.4","title":"Post-Eligibility","parent":"2.3","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.4 Post-Eligibility","summary":"These policies apply to MA enrollees. This subchapter includes policies that apply to Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) and links to policies that apply to all Medical Assistance (MA) programs and all Minnesota Health Care Programs (MHCP).","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:58.594961+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_4.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.3.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.4","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.4 Post-Eligibility","text":"These policies apply to MA enrollees. This subchapter includes policies that apply to Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) and links to policies that apply to all Medical Assistance (MA) programs and all Minnesota Health Care Programs (MHCP).\n1. [MA Begin and End Dates](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.1)\n2. [MA Benefit Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1)\n  1. [MA Estate Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.1)\n  2. [MA Liens](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.2)\n  3. [MHCP Overpayments](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.5)\n  4. [MA Third Party Liability](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3)\n    1. [MA Cost-Effective Insurance](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.1)\n    2. [MA Medical Support](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.2)\n    3. [MA Other Third Party Liability](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.3)\n3. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n4. [MA Cooperation](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.2)\n5. [MA Cost Sharing](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.3)\n6. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n7. [MA-ABD Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/2.3.4.1)\n8. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n9. [MA Qualifying Health Coverage](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.2)\n10. [MA Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4)\n11. [MA-ABD Renewals](https://hcopub.dhs.state.mn.us/epm/2_3_4_2ar4.htm)"}]},{"id":"epm:2.3.4.1","number":"2.3.4.1","title":"Health Care Delivery","parent":"2.3.4","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.4 Post-Eligibility > 2.3.4.1 Health Care Delivery","summary":"Fee-for-service is a method of payment for health care services used for enrollees not in a managed care plan. See MHCP Health Care Delivery for more information.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:58.594961+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.4.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.4.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_4_1.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.1000","Code of Federal Regulations, title 42, section 438.1","Minnesota Statutes, section 256B.035","Minnesota Statutes, section 256B.0625"],"chunks":[{"chunk_id":"epm:2.3.4.1#fee-for-service","heading":"Fee for Service","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.4.1#fee-for-service","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.4 Post-Eligibility > 2.3.4.1 Health Care Delivery > Fee for Service","text":"## Fee for Service\n\nFee-for-service is a method of payment for health care services used for enrollees not in a managed care plan. See [MHCP Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/1.6) for more information."},{"chunk_id":"epm:2.3.4.1#managed-care","heading":"Managed Care","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.4.1#managed-care","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.4 Post-Eligibility > 2.3.4.1 Health Care Delivery > Managed Care","text":"## Managed Care\n\nManaged care is a health care delivery system under which enrollees receive most medical services through a health plan or network of providers, which coordinates the services provided.\n\n### People who are Aged 65 and Older\n\nMost Medical Assistance (MA) enrollees aged 65 and older must enroll in a managed care plan. Enrollees aged 65 and older have two managed care programs to choose from.\n- Minnesota SeniorCare Plus (MSC+) provides medical services through the health plan of the enrollee’s choice, and enrollees must choose a separate plan for Medicare Part D drug coverage.\n- Minnesota Senior Health Options ([MSHO](http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=id_006271)) is for enrollees who have Medical Assistance and Medicare Parts A and B. MA medical services, Medicare services and drug coverage are all provided through the MSHO health plan.\n\n### People who are Blind or Disabled\n\nEnrollees who are certified blind or disabled are exempt from enrolling in a managed care plan. However, enrollees aged 18-64, who are certified blind or disabled, may voluntarily enroll in Special Needs Basic Care ([SNBC](http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=dhs16_139491)). Some SNBC health plans coordinate health care coverage with Medicare.\n\nDetailed information on managed care is found in the [Prepaid Minnesota Health Care Programs (PMHCP) Manual.](http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=id_016959)"},{"chunk_id":"epm:2.3.4.1#covered-services","heading":"Covered Services","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.4.1#covered-services","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.4 Post-Eligibility > 2.3.4.1 Health Care Delivery > Covered Services","text":"## Covered Services\n\nThe benefit set for people using an aged, blind or disabled basis of eligibility includes a wide range of health care services, from preventive care to hospitalization. Some benefits have limitations on services or level of coverage. This means there may be a limit or maximum dollar amount on specific types of services, like eyeglasses, or on all services in a category, like dental.\n\nServices in a long-term care facility can be covered by MA if the person has a pre-admission screening that indicates the person needs a nursing facility level of care and meets the other requirements to be eligible for [MA for Long-Term Care Services](https://bot-corpus.mn-dhs.online/s/epm/2.4).\n- The Minnesota Health Care Programs (MHCP) Summary of Coverage, Cost Sharing and Limits ([DHS-3860](https://www.google.com/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=1&ved=0CCAQFjAA&url=https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3860-ENG&ei=9WZrVPHVC5OnyASpgIKwBw&usg=AFQjCNFK_Yl9QXapcVWWYTJ5mQfMG7MSVw&bvm=bv.79908130,d.aWw)) explains covered services and cost-sharing requirements.\n- [Minnesota Senior Health Options (MSHO)](http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=id_006271) explains services included in the MSHO managed care plan.\n- [SNBC covered services](https://mn.gov/dhs/people-we-serve/people-with-disabilities/health-care/health-care-programs/programs-and-services/snbc.jsp) explains services included in the SNBC managed care plan."}]},{"id":"epm:2.3.4.2","number":"2.3.4.2","title":"Renewals","parent":"2.3.4","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.4 Post-Eligibility > 2.3.4.2 Renewals","summary":"Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) enrollees must have their eligibility renewed annually.","effective_date":"2025-05-30","last_modified":"2026-10-03T03:51:59.250595+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.4.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.4.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_4_2.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.916","Code of Federal Regulations, title 42, section 435.930(b)","Minnesota Statutes, section 256.01","Minnesota Statutes, section 256B.056"],"chunks":[{"chunk_id":"epm:2.3.4.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.4.2","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.4 Post-Eligibility > 2.3.4.2 Renewals","text":"Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) enrollees must have their eligibility renewed annually.\n\nCertain MA-ABD enrollees with a medical spenddown must also complete a six-month income review. See [2.3.3.4 Medical Spenddowns](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.4) for more information."},{"chunk_id":"epm:2.3.4.2#renewal-month","heading":"Renewal Month","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.4.2#renewal-month","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.4 Post-Eligibility > 2.3.4.2 Renewals > Renewal Month","text":"## Renewal Month\n\nAn enrollee’s renewal month is the month for which eligibility is redetermined when a renewal is conducted. The renewal month is the first month in the enrollee’s new certification period. The first annual renewal month after application is 12 months from the month of application, and renewals occur annually thereafter as long as the enrollee remains eligible for MA.\n\nEligibility for retroactive MA does not affect when an enrollee’s annual renewal month occurs.\n\nA renewal is conducted individually for each enrollee in a household. If there are multiple enrollees due for renewal within a household, a renewal must not be delayed if all required information is available to determine the enrollee’s eligibility, even if additional information or proof is needed for other enrollees in the household."},{"chunk_id":"epm:2.3.4.2#ex-parte-renewals","heading":"Ex Parte Renewals","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.4.2#ex-parte-renewals","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.4 Post-Eligibility > 2.3.4.2 Renewals > Ex Parte Renewals","text":"## Ex Parte Renewals\n\nWhen it is time for an enrollee’s annual renewal, the agency must attempt to confirm an enrollee’s eligibility using information in the case file and from trusted electronic data sources before sending a renewal form and requesting information from the enrollee. When the enrollee’s eligibility cannot be renewed on an ex parte basis, the renewal must be completed using a paper renewal form.\n\nIf eligibility for an enrollee is renewed on an ex parte basis, the enrollee must receive a notice that includes the renewal outcome and a summary of the information used to renew their eligibility. If the information is correct, the enrollee does not need to do anything. If any of the information on the notice is inaccurate, the enrollee must report corrections or changes to their county or tribal servicing agency."},{"chunk_id":"epm:2.3.4.2#paper-renewal-forms","heading":"Paper Renewal Forms","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.4.2#paper-renewal-forms","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.4 Post-Eligibility > 2.3.4.2 Renewals > Paper Renewal Forms","text":"## Paper Renewal Forms\n\nEnrollees whose eligibility is not renewed on an ex parte basis receive a renewal form. The enrollee must be given until the end of the certification period, but no less than 30 days from the issuance date on the renewal notice to respond. The enrollee must complete, sign, and return the renewal form to their county or tribal servicing agency.\n\nThe county or tribal servicing agency must accept a renewal form and any renewal-related verifications received electronically or by mail, fax, telephone, or in person."},{"chunk_id":"epm:2.3.4.2#combined-ex-parte-and-paper-renewals","heading":"Combined Ex Parte and Paper Renewals","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.4.2#combined-ex-parte-and-paper-renewals","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.4 Post-Eligibility > 2.3.4.2 Renewals > Combined Ex Parte and Paper Renewals","text":"## Combined Ex Parte and Paper Renewals\n\nIn households with more than one MA enrollee, some enrollees may be renewed on an ex parte basis while other enrollees may need to complete a renewal form. When this occurs, the household must receive a notice that indicates who was renewed on an ex parte basis and who is required to return a renewal form. A paper renewal form will be included with the notice."},{"chunk_id":"epm:2.3.4.2#changes-in-circumstance-at-renewal","heading":"Changes in Circumstance at Renewal","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.4.2#changes-in-circumstance-at-renewal","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.4 Post-Eligibility > 2.3.4.2 Renewals > Changes in Circumstance at Renewal","text":"## Changes in Circumstance at Renewal\n\nChanges reported on the renewal form or collected in the renewal process may change an enrollee’s eligibility. An enrollee who is no longer eligible under one basis of eligibility must be redetermined for all other potential MA bases of eligibility, without interruption in their coverage.\n\nIf the enrollee is ineligible for MA under any basis, eligibility must be redetermined for other programs such as MinnesotaCare, Advanced Premium Tax Credits, or a Qualified Health Plan. An enrollee must receive at least 10-day advance notice of any adverse change to their MA eligibility. See [EPM 1.3.2.1 MHCP Change in Circumstance](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1) for more information."},{"chunk_id":"epm:2.3.4.2#closure-for-failure-to-renew","heading":"Closure for Failure to Renew","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.4.2#closure-for-failure-to-renew","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.4 Post-Eligibility > 2.3.4.2 Renewals > Closure for Failure to Renew","text":"## Closure for Failure to Renew\n\nMA-ABD eligibility ends for an enrollee who does not complete their renewal or submit required proofs by the last day of the certification period, regardless of whether other enrollees in their household were renewed. The enrollee must receive at least10-day advance notice of closure for failure to renew."}]},{"id":"epm:2.3.4.2.1","number":"2.3.4.2.1","title":"Ex Parte Renewals","parent":"2.3.4.2","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.4 Post-Eligibility > 2.3.4.2 Renewals > 2.3.4.2.1 Ex Parte Renewals","summary":"When it is time for an enrollee’s annual renewal, the agency must attempt to confirm eligibility using information in the case file and from trusted electronic data sources before sending a renewal form and requesting information from the enrollee. This is called an ex parte renewal. If the agency is able to confirm an enrollee’s eligibility using information in the case file and from trusted elec","effective_date":"2026-03-16","last_modified":"2026-10-03T03:51:59.250595+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.4.2.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.4.2.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_4_2_1.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.916","Minnesota Statutes, section 256B.056","Laws of Minnesota 2023, chapter 22"],"chunks":[{"chunk_id":"epm:2.3.4.2.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.4.2.1","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.4 Post-Eligibility > 2.3.4.2 Renewals > 2.3.4.2.1 Ex Parte Renewals","text":"When it is time for an enrollee’s annual renewal, the agency must attempt to confirm eligibility using information in the case file and from trusted electronic data sources before sending a renewal form and requesting information from the enrollee. This is called an ex parte renewal. If the agency is able to confirm an enrollee’s eligibility using information in the case file and from trusted electronic data sources, the enrollee’s MA eligibility is renewed without the enrollee having to complete a renewal form. When the enrollee’s eligibility cannot be confirmed via the ex parte process, a renewal form must be completed by the enrollee and processed by the agency to renew eligibility.\n\nIf eligibility for an MA-ABD enrollee is renewed with the ex parte process, the enrollee must receive a notice that includes their eligibility determination, the basis of their eligibility, and information used to renew their eligibility. If all the information is correct, the enrollee does not need to do anything. If any of the information about the enrollee is inaccurate, the enrollee must report corrections or changes to their county, tribal or state servicing agency."},{"chunk_id":"epm:2.3.4.2.1#enrollees-whose-eligibility-must-be-reviewed-for-an-ex-parte-renewal","heading":"Enrollees whose eligibility must be reviewed for an ex parte renewal","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.4.2.1#enrollees-whose-eligibility-must-be-reviewed-for-an-ex-parte-renewal","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.4 Post-Eligibility > 2.3.4.2 Renewals > 2.3.4.2.1 Ex Parte Renewals > Enrollees whose eligibility must be reviewed for an ex parte renewal","text":"## Enrollees whose eligibility must be reviewed for an ex parte renewal\n\nThe following MA-ABD and MSP enrollees may have their eligibility renewed through the ex parte process. Agencies must attempt to confirm eligibility through the ex parte process before sending a renewal form to:\n- Supplemental Security Income (SSI) beneficiaries who do not receive Veteran’s Administration (VA) Aid and Attendance benefits or VA unusual medical expense payments.\n- TEFRA Option enrollees\n- Enrollees with 1619(a) or 1619(b) status\n- Enrollees whose only income is one or a combination of the following:\n  - SSI (even if the benefit amount is zero),\n  - Retirement, Survivors, and Disability Insurance (RSDI)\n  - Railroad Retirement Benefits (RRB)\n- Enrollees who are also SNAP, MFIP, or Tribal TANF recipients. To confirm income eligibility for ex parte renewal, their SNAP, MFIP or Tribal TANF net income must be at or below 100% FPG and the income must have been verified as part of the SNAP, MFIP, or Tribal TANF determination.\n- Enrollees with zero income reported and verified at application or their most recent eligibility determination. Income eligibility for renewal is confirmed when any of the following occurs:\n  - No income data is returned from any electronic data source.\n  - New income data is returned from trusted electronic data sources, and the income is at or below the MA-ABD income limit of 100% FPG.\n  - New income data is found and was verified as part of the SNAP, MFIP, or Tribal TANF determination, and the income is at or below the MA-ABD income limit of 100% FPG.\n- MSP enrollees who are eligible only for a Medicare Savings Program (MSP), which includes Qualified Medicare Beneficiary (QMB), Service Limited Medicare Beneficiary (SLMB), Qualified Individual (QI), and Qualified Working Disabled (QWD) when any of the following are true:\n  - Their only source(s) of income are SSI, RSDI, or RRB.\n  - They reported and verified having zero income at application or their most recent eligibility determination. Income eligibility for renewal is confirmed if any of the following occur:\n- No income data is returned from any electronic data source.\n- New income data is returned from trusted electronic data sources, and the income is at or below the MSP income limit.\n- New income data is found and was verified as part of the SNAP, MFIP, or Tribal TANF determination, and the income is at or below the MA-ABD income limit of 100% FPG.\n- They are a SNAP, MFIP, or Tribal TANF recipient whose net income is at or below 100% FPG. The income must have been verified as part of the SNAP, MFIP, or Tribal TANF determination.\n\nMA-ABD enrollees with an MSP and whose MA eligibility was renewed through the ex parte process will also have their MSP eligibility renewed through the ex parte process. If during the ex parte process, the enrollee is determined eligible for a different type of MSP than the one the enrollee is enrolled in, the enrollee’s MSP must be changed. The enrollee must be sent a 10-day advance notice if the enrollee moves to an MSP with fewer benefits."},{"chunk_id":"epm:2.3.4.2.1#enrollees-receiving-medical-assistance-for-long-term-care-services","heading":"Enrollees receiving Medical Assistance for Long-Term Care Services","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.4.2.1#enrollees-receiving-medical-assistance-for-long-term-care-services","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.4 Post-Eligibility > 2.3.4.2 Renewals > 2.3.4.2.1 Ex Parte Renewals > Enrollees receiving Medical Assistance for Long-Term Care Services","text":"## Enrollees receiving Medical Assistance for Long-Term Care Services\n\nAgencies must attempt to renew MA eligibility through the ex parte process for enrollees who have an MA-ABD basis of eligibility and are receiving Medical Assistance for Long-Term Care Services (MA-LTC) if they have any of the income listed above that can be verified using information in the case file and from trusted electronic data sources, and meet the following criteria.\n\n### Enrollees who use a community income calculation\n\nFor MA-LTC enrollees with an MA-ABD basis of eligibility who use a community income calculation, agencies must attempt to renew MA eligibility through the ex parte process if they use the remedial care expense and bills for waiver services that are received during the certification period to meet a spenddown. These expenses can be verified without obtaining additional information from the enrollee.\n\n### Enrollees who use a long-term care income calculation\n\nFor MA-LTC enrollees with an MA-ABD basis of eligibility who use a long-term care income calculation, agencies must attempt to renew MA eligibility through the ex parte process if the person has post-eligibility deductions from income that can be verified electronically or are generally unchanging. The following types of deductions may be verified electronically or are generally unchanging:\n- Special SSI\n- Minnesota Supplemental Aid (MSA)\n- Medicare premiums paid by the enrollee\n- Personal needs allowance (PNA)\n- Veteran’s Improved Pension\n- Special Income Standard-Elderly Waiver (SIS-EW) maintenance needs allowance\n- Fees paid to a guardian, conservator, or representative payee\n- Court-ordered child support and court-ordered spousal maintenance\n- Medicare co-payments and deductible\n- Remedial care expense\n\nCertain post-eligibility deductions cannot be verified without requiring additional information from the enrollee. Enrollees with these deductions must not have their eligibility renewed using the ex parte process:\n- Community spouse income allocation\n- Family allocation\n- Health insurance premiums, co-payments and deductibles that cannot be verified without requiring information from the enrollee\n- Medical expenses"},{"chunk_id":"epm:2.3.4.2.1#enrollees-with-certain-types-of-assets","heading":"Enrollees with certain types of assets","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.4.2.1#enrollees-with-certain-types-of-assets","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.4 Post-Eligibility > 2.3.4.2 Renewals > 2.3.4.2.1 Ex Parte Renewals > Enrollees with certain types of assets","text":"## Enrollees with certain types of assets\n\nAssets must be verified for MHCP enrollees who have an asset limit. Agencies must attempt to renew MA and MSP eligibility through the ex parte process for MA-ABD and MSP enrollees listed above if they have any of the following:\n- No assets\n- Assets that can be verified through the Asset Verification Service (AVS), including:\n- Savings accounts\n- Checking accounts\n- Money market accounts\n- Certificates of deposit (CD)\n- Assets unlikely to increase in value:\n- Vehicles, including but not limited to cars, trucks, vans, campers, motorcycles, trailers, boats, and off-road vehicles\n- Tools and equipment that are not used in the home\n- Excluded or unavailable assets unless the asset becomes countable or becomes available\n\nMA-ABD and MSP enrollees with other types of countable assets cannot be renewed through the ex parte process, except for certain SSI beneficiaries. Agencies must attempt an ex parte renewal for SSI beneficiaries even if they have other countable assets, because SSA has already verified these assets.\n\nFor SSI beneficiaries, agencies must also attempt ex parte renewal if they have the following excluded assets, if these assets remain excluded:\n- Life insurance-funded burial arrangements\n- Special needs trusts\n- Pooled trusts"},{"chunk_id":"epm:2.3.4.2.1#enrollees-whose-eligibility-cannot-be-renewed-through-the-ex-parte-process","heading":"Enrollees whose eligibility cannot be renewed through the ex parte process","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.4.2.1#enrollees-whose-eligibility-cannot-be-renewed-through-the-ex-parte-process","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.4 Post-Eligibility > 2.3.4.2 Renewals > 2.3.4.2.1 Ex Parte Renewals > Enrollees whose eligibility cannot be renewed through the ex parte process","text":"## Enrollees whose eligibility cannot be renewed through the ex parte process\n\nSome MA-ABD enrollees cannot have their MA eligibility renewed through the ex parte process, because there is not sufficient information in their case file and via electronic data sources to confirm their continued eligibility or their premium, if a premium applies. This includes the following:\n- Medical Assistance for Employed Persons with Disabilities (MA-EPD) enrollees\n- MA-ABD and MSP enrollees with earned income, who are not:\n- SSI beneficiaries\n- Enrollees with 1619(a) or 1619(b) status\n- SNAP, MFIP, or Tribal TANF recipients with net income at or below 100% FPG verified as part of that determination if they meet the asset requirements\n- MA-ABD enrollees who receive both SSI and VA Aid and Attendance benefits or VA unusual medical expense payments\n- MA-ABD enrollees whose eligibility is reviewed for ex parte renewal, but who do not meet the income or asset criteria above, or who have one or more other eligibility factors that cannot be confirmed using information in the case file and data from trusted electronic data sources."}]},{"id":"epm:2.3.5","number":"2.3.5","title":"","parent":"2.3","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5 ","summary":"Medical Assistance for Employed Persons with Disabilities (MA-EPD) is a work incentive health care program that provides MA coverage to employed people with certified disabilities. A person must earn more than $65 a calendar month to be eligible for MA-EPD. A person must use the blind or disabled basis of eligibility under MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Di","effective_date":"2022-03-01","last_modified":"2026-10-03T03:51:59.250595+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.5","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_5.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.3.5#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5 ","text":"Medical Assistance for Employed Persons with Disabilities (MA-EPD) is a work incentive health care program that provides MA coverage to employed people with certified disabilities. A person must earn more than $65 a calendar month to be eligible for MA-EPD. A person must use the blind or disabled basis of eligibility under MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD). An MA-EPD consumer brochure ([DHS-2087L](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-2087L-ENG)) is available.\n\nPeople may continue to be eligible for MA-EPD after reaching the age of 65, as long as they continue to meet the other eligibility requirements. To be eligible for MA-EPD, applicants age 65 or older must have been certified disabled prior to age 65.\n\nThe following people are not eligible for MA-EPD:\n- SSI recipients\n- People with 1619a or 1619b status\n\nPeople who are eligible for MA-EPD may also be eligible for other Minnesota Health Care Programs (MHCP). MHCPs include MA under different bases of eligibility, MinnesotaCare and Advance Premium Tax Credits. Each person’s unique situation determines which MHCP is most affordable and provides the services the person needs. MA-EPD has unique financial eligibility policies that may be beneficial for people nearing age 63.\n\nHome and Community-Based Services Waivers are available to people enrolled in MA-EPD. People must meet the general long-term care eligibility requirements. MA-EPD eligibility and premium policies apply to the person.\n\nMA-EPD eligibility is determined using a variety of non-financial, financial and post-eligibility requirements. This subchapter includes policies that apply to MA-EPD and links to the policies that apply to all MA programs, MA-ABD, and all Minnesota Health Care Programs (MHCP) programs.\n1. [MA-EPD General Requirements](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1)\n  1. [MA-ABD General Requirements](https://bot-corpus.mn-dhs.online/s/epm/2.3.1)\n  2. [MA-EPD Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.1)\n  3. [MA-EPD Premiums and Cost Sharing](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.2)\n  4. [MA-EPD Work Requirements](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.3)\n2. [MA-EPD Non-Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.2)\n  1. [MA-ABD Non-Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.2)\n  2. [MA-EPD Living Arrangement](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.2.2)\n3. [MA-EPD Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.3)\n  1. [MA-EPD Assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.3.1)\n4. [MA-EPD Post-Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.4)\n  1. [MA-EPD Medicare](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.4.1)\n  2. [MA-ABD Post-Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.4)"}]},{"id":"epm:2.3.5.1","number":"2.3.5.1","title":"General Requirements","parent":"2.3.5","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.1 General Requirements","summary":"This subchapter provides general policy information that applies to Medical Assistance for Employed Persons with Disabilities (MA-EPD). In general, MA-EPD follows the MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) general requirements policies. Specific differences are indicated in the MA-EPD policies listed below.","effective_date":"2024-05-30","last_modified":"2026-10-03T03:51:59.250595+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.5.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_5_1.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.3.5.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.1 General Requirements","text":"This subchapter provides general policy information that applies to Medical Assistance for Employed Persons with Disabilities (MA-EPD). In general, MA-EPD follows the MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) general requirements policies. Specific differences are indicated in the MA-EPD policies listed below.\n\nThis subchapter includes policies that apply to MA-EPD and links to policies that apply to MA-ABD.\n\nTopics covered in this subchapter are:\n1. [MA-ABD General Requirements](https://bot-corpus.mn-dhs.online/s/epm/2.3.1)\n2. [MA-EPD Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.1)\n3. [MA-EPD Premiums and Cost Sharing](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.2)\n4. [MA-EPD Work Requirements](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.3)"}]},{"id":"epm:2.3.5.1.1","number":"2.3.5.1.1","title":"Mandatory Verifications","parent":"2.3.5.1","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.1 General Requirements > 2.3.5.1.1 Mandatory Verifications","summary":"Mandatory verifications must be verified through an available electronic data source or by paper proof, if electronic data sources are unsuccessful or unavailable. Self-attestation of certain eligibility factors may be accepted if electronic data sources are unsuccessful or unavailable and paper proof does not exist or is not available.","effective_date":"2024-11-15","last_modified":"2026-10-03T03:51:59.250595+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.5.1.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_5_1_1.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.3.5.1.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.1","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.1 General Requirements > 2.3.5.1.1 Mandatory Verifications","text":"Mandatory verifications must be verified through an available electronic data source or by paper proof, if electronic data sources are unsuccessful or unavailable. Self-attestation of certain eligibility factors may be accepted if electronic data sources are unsuccessful or unavailable and paper proof does not exist or is not available."},{"chunk_id":"epm:2.3.5.1.1#pre-eligibility-verification","heading":"Pre-Eligibility Verification","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.1#pre-eligibility-verification","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.1 General Requirements > 2.3.5.1.1 Mandatory Verifications > Pre-Eligibility Verification","text":"## Pre-Eligibility Verification\n\nThe following eligibility factors must be verified prior to the eligibility determination:\n- Certification of Disability through the Social Security Administration (SSA) or State Medical Review Team (SMRT)\n- Income from employment\n  - Verification of income is required at application, renewal, and when an income change is reported.\n  - For wage income, only the following forms of verification are acceptable:\n    - Pay stubs that include:\n      - The employee's name or Social Security Number (SSN)\n      - Hours worked\n      - Gross pay\n      - Social Security and Medicare taxes withheld\n      - Net pay\n      - Period covered by earnings\n      - Employer's name\n    - A completed Authorization for Release of Employment Information (DHS-2146). This form is only required when the employee does not provide pay stubs containing the required information, or any other statement from the employer that provides the necessary information.\n  - For self-employment income, one of the following must be provided as verification of earnings:\n    - Federal tax forms if the client has been in business long enough to file taxes and was required to file federal income tax for the previous year. Tax forms must include any of the following:\n      - Quarterly Schedules ES (Form 1040) Estimated Tax for Individuals, if they were required to pay quarterly self0employment taxes.\n      - Form 1040 U.S. Individual Income Tax Return with the \"Self-Employment Tax\" line completed.\n      - Schedule SE (Form 1040) Self-Employment Tax.\n    - Business Records if the client has not been in business long enough to file a federal income tax return, quarterly estimated taxes, or if the tax forms do not accurately reflect the self-employment income.\n  - An enrollee must submit a copy of the federal tax return when it becomes available at the next renewal.\n    - \n      - Business records may include:\n        - Business financial statement\n        - Detailed records of gross receipts and expenses\n        - Business quarterly report\n        - Computer printout showing gross receipts and expenses\n        - Signed statement from the business's accountant verifying projected business income or expenses\n- Royalties, Honoraria, and Stipends\n  - Documentation of royalty, honoraria, or stipend income must show:\n    - \n      - The nature and amount of payments\n      - Dates of payments\n      - Frequency of payments\n      - Social Security and Medicare tax withholding\n  - This income can be verified with:\n    - \n      - Tax forms for previous year identifying royalties, honoraria, or stipends with Medicare and Social Security taxes paid via entries on:\n        - Federal Tax form 1040\n        - Schedule C\n        - Schedule SE\n        - Form 1099-Misc\n  - Pay stubs or written statement from the source of payment showing:\n    - \n      - Social Security and Medicare taxes withheld\n      - Person's name or Social Security Number\n      - Amount of payment\n      - Dates of payment\n      - Name of issuer\n  - Quarterly Schedule ES (Form 1040) Estimated Tax for Individuals\n  - Schedule SE (Form 1040) Self-Employment Tax\n- Social Security and Medicare taxes paid"},{"chunk_id":"epm:2.3.5.1.1#post-eligibility-verification","heading":"Post-Eligibility Verification","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.1#post-eligibility-verification","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.1 General Requirements > 2.3.5.1.1 Mandatory Verifications > Post-Eligibility Verification","text":"## Post-Eligibility Verification\n\nIf the following factors cannot be verified at application, they can be verified after eligibility has been approved so long as the applicant meets all other eligibility requirements. If proof is not provided by the conclusion of the reasonable opportunity period (ROP), eligibility may end.\n- Social Security number: See [2.1.2.5 MA Social Security Number](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5)\n- Citizenship: See [2.1.2.2.1 MA Citizenship](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2.1)\n- Immigration status: See [2.1.2.2.2 MA Immigration Status](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2.2)\n- American Indian and Alaska Native enrollees need to provide proof of status to be exempt from paying MA-EPD premiums."},{"chunk_id":"epm:2.3.5.1.1#self-attestation","heading":"Self-Attestation","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.1#self-attestation","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.1 General Requirements > 2.3.5.1.1 Mandatory Verifications > Self-Attestation","text":"## Self-Attestation\n\nSelf-attestation, either verbal or in writing, of the following eligibility factors may be accepted if electronic data sources are unsuccessful or unavailable and paper proof does not exist or is not available:\n- Income\n- Assets\n- Medical expenses to meet a spenddown\n- Certification of Disability through Social Security Administration (SSA)\n- Exceptions to having a Social Security Number\n\nPaper proof is considered not available if neither the applicant or enrollee, nor the agency can obtain it. The county, tribal and state servicing agency must make efforts to assist the applicant or enrollee in obtaining the requested paper proof, if it exists. This includes obtaining authorization from the applicant or enrollee to contact a third party on their behalf, if appropriate. Decisions to accept an applicant’s or enrollee’s self-attestation must be based on the individual case circumstances.\n\nSelf-attestation cannot be accepted in lieu of electronic verification or paper documentation of an applicant or enrollee’s citizenship, immigration status, or social security number.\n\nMinnesota Statutes, section 256B.057"}]},{"id":"epm:2.3.5.1.2","number":"2.3.5.1.2","title":"Premiums","parent":"2.3.5.1","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.1 General Requirements > 2.3.5.1.2 Premiums","summary":"People enrolled in Medical Assistance for Employed Persons with Disabilities (MA-EPD) must pay monthly premiums to establish and maintain eligibility.","effective_date":"2026-03-16","last_modified":"2026-10-03T03:57:10.724855+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.5.1.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_5_1_2.htm","legal_citations":["Minnesota Statutes, section 256B.057, subdivision 9"],"chunks":[{"chunk_id":"epm:2.3.5.1.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.2","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.1 General Requirements > 2.3.5.1.2 Premiums","text":"People enrolled in Medical Assistance for Employed Persons with Disabilities (MA-EPD) must pay monthly premiums to establish and maintain eligibility.\n\nAn American Indian or Alaska Native who has provided verification of American Indian or Alaska Native status is exempt from paying a premium for MA-EPD. The premium exemption begins the first month after the month the verification was received unless the verification was received when the application was processed.\n\nAn American Indian is defined as a person who is:\n- A member of a federally recognized Indian tribe;\n- Considered by the Secretary of the interior to be an Indian for any purpose; or\n- Determined to be an Indian under regulations promulgated by the U.S. Secretary of Health and Human Services.\n\nAny formal documentation from a tribe, Indian Health Services (HIS), or the Bureau of Indian Affairs (BIA) that verifies a person is an American Indian is acceptable as verification."},{"chunk_id":"epm:2.3.5.1.2#premium-calculation","heading":"Premium Calculation","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.2#premium-calculation","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.1 General Requirements > 2.3.5.1.2 Premiums > Premium Calculation","text":"## Premium Calculation\n\nMA-EPD premiums are determined by a person's gross countable income (earned and unearned income) and family size.\n- For individuals with gross income at or below 300% of the Federal Poverty Guidelines (FPG), a sliding scale determines the premium amount.\n- If income is greater than 300% FPG, the premium is 7.5% of gross income.\n- For individuals that receive unearned income, an additional fee of 0.5% of unearned income is applied.\n\nThe total MA-EPD premium is the combined amount.The minimum premium amount is $35 per month.\n\nAt renewal, the average anticipated gross monthly countable income for the new 6-month budget period is used to calculate the MA-EPD premium amount for the 12-month certification period.\n\nWhen determining premiums at annual renewal during a medical leave or four-month job loss where the client intends to return to their job, the enrollee’s last verified income must be used to estimate the average anticipated gross monthly countable income for the renewal month and 5 future months.\n\n### EXAMPLE\n\nJorge is a teacher whose annual renewal occurs in July. They qualify for a job loss extension from June through August while the school is on summer break, and have reported that they will be returning to their teaching position in September. Jorge’s income in May was verified to be $1500. To determine Jorge’s premium at renewal:\n- Add anticipated income for July through December: July ($0) + August ($0) + September ($1500) + October ($1500) + November ($1500) + December ($1500) = $6000\n- Divide by 6 months: $6000 ÷ 6 = $1000 average anticipated monthly income\n\nMA-EPD premiums must be recalculated at annual renewal based on the six-month budget period. However, the premium amount remains the same for the 12 month certification period, unless there is a change that requires the premium be re-calculated. See Monthly Premium Invoices below for more information.\n\nAn online [MA-EPD premium estimator](https://mn.db101.org/mn/programs/health_coverage/ma-epd/program2a.htm) is available. A person’s county or tribal servicing agency is responsible for collecting the initial MA-EPD premium. The Minnesota Department of Human Services (DHS) bills for ongoing MA-EPD premiums monthly.\n\nMA-EPD applicants must pay the initial premium in full within 30 days, before coverage can begin. People can choose which retroactive months they want coverage for, and the months do not have to be consecutive. If the initial premium is not paid within 30 days, MA-EPD eligibility is denied and eligibility is redetermined under all MA bases. An MA-EPD applicant who is denied for failure to pay the premium and who is not eligible for Minnesota Health Care Programs (MHCP) under any basis must reapply to qualify for MA-EPD again."},{"chunk_id":"epm:2.3.5.1.2#gross-countable-income","heading":"Gross Countable Income","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.2#gross-countable-income","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.1 General Requirements > 2.3.5.1.2 Premiums > Gross Countable Income","text":"## Gross Countable Income\n\nGross countable income includes countable earned and unearned income of the person and anyone whose income deems to the person, without any disregards or deductions applied. See the [MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) Countable Income](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1) policy for more information.\n\n### Excluded Income\n\nThe MA-ABD excluded income policy applies to MA-EPD. See the [MA-ABD Excluded Income](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.3) policy for more information.\n\n### Deeming\n\nOnly the MA-EPD enrollee’s income is counted for adults age 18 and older. No spousal income is deemed to the MA-EPD spouse. Parental income is deemed for MA-EPD applicants and enrollees younger than age 18.\n\n### Disregards and Deductions\n\nMA-EPD enrollees do not use standard MA-ABD deductions and disregards, because premiums are calculated using the gross countable income.\n\nThe only deduction that applies to the MA-EPD income calculation is the RSDI Cost of Living Adjustments (COLA) disregard. See 2.3.3.3.2.2 MA-ABD Disregards and Deductions for more information about the RSDI COLA disregard."},{"chunk_id":"epm:2.3.5.1.2#family-size","heading":"Family Size","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.2#family-size","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.1 General Requirements > 2.3.5.1.2 Premiums > Family Size","text":"## Family Size\n\nFamily size is used to determine premium rates. Family size is determined for each person separately. Family size may be different for each person on an application or in a household.\n\nFor MA-EPD enrollees age 21 or older, family size includes the following, if they are living with the person:\n- Enrollee\n- Spouse (unless they are enrolled in MA-EPD)\n- Biological or adopted children younger than age 21, including those who are temporarily absent\n- Spouse's biological or adopted children younger than age 21, including those who are temporarily absent\n- Unborn children of the person or their spouse\n\nFor MA-EPD enrollees under age 21, family size includes the following if they are living with the person:\n- Enrollee\n- Spouse (unless they are enrolled in MA-EPD)\n- Biological or adoptive parents\n- Stepparent, if the biological or adoptive parent also lives with the person\n- Siblings (biological, adopted, or step siblings)\n- Unborn children of the person, their spouse or their biological, adoptive or stepparents listed above"},{"chunk_id":"epm:2.3.5.1.2#premium-payments","heading":"Premium Payments","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.2#premium-payments","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.1 General Requirements > 2.3.5.1.2 Premiums > Premium Payments","text":"## Premium Payments\n\nThe first premium must be paid to the county or tribal agency. Ongoing payments can be made by mail, in person, or online. For more information about MA-EPD premium payments see: [How do I pay my MA-EPD premium?](https://mn.gov/dhs/people-we-serve/people-with-disabilities/health-care/health-care-programs/programs-and-services/ma-epd-premiums.jsp)\n\nThe servicing agency must determine, bill, and collect the initial MA-EPD premium. The initial premium may include premiums for more than one month of coverage. MA-EPD applicants must pay the initial premium in full within 30 days from the date of the Initial Premium Notice (DHS-3547) before coverage can begin. People can choose which retroactive months they want coverage for, and the months do not have to be consecutive.\n\nCounty and tribal agencies must not open MA-EPD coverage until all months of the initial premium is paid.\n\nIf the initial premium is not paid within 30 days from the date of the Initial Premium Notice, MA-EPD eligibility is denied and eligibility is redetermined under all MA bases. An MA-EPD applicant who is denied for failure to pay the initial premium and who is not eligible for Minnesota Health Care Programs (MHCP) under any basis must reapply to qualify for MA-EPD again."},{"chunk_id":"epm:2.3.5.1.2#monthly-premium-invoices","heading":"Monthly Premium Invoices","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.2#monthly-premium-invoices","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.1 General Requirements > 2.3.5.1.2 Premiums > Monthly Premium Invoices","text":"## Monthly Premium Invoices\n\nThe Minnesota Department of Human Services (DHS) bills for ongoing MA-EPD premiums monthly. DHS will mail a monthly MA-EPD invoice to enrollees after the initial premium payment is received by the county or tribal agency. MA-EPD enrollees receive an invoice every month showing the amount of the monthly MA-EPD premium and the due date. Any past-due amount or credit is not shown on the invoice.\n\nThe actual gross monthly income is used to calculate the MA-EPD premium amount during any retroactive months.\n\nThe premium amount is the same for each month of the certification period, because the premium is based on average anticipated income.\n\nMA-EPD premiums must be recalculated at annual renewal.\n\nIn between annual renewals, workers must recalculate MA-EPD premiums when\n- An enrollee reports a change that results in a decreased premium. The decreased premium is effective the first day of the month after the change is reported.\n- FPG changes are applied. FPG changes occur in January but are applied by the agency to EPD premius effective July 1 each year.\n- Social Security RSDI benefits are increased and the RSDI cost of living adjustment (COLA) disregard ends, effective July 1 each year."},{"chunk_id":"epm:2.3.5.1.2#premium-payment-schedule","heading":"Premium Payment Schedule","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.2#premium-payment-schedule","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.1 General Requirements > 2.3.5.1.2 Premiums > Premium Payment Schedule","text":"## Premium Payment Schedule\n\nOngoing MA-EPD premiums are due by the fourth day of the month, but can be paid through the last working day of the month. If an MA-EPD enrollee’s coverage is closed due to non-payment of a premium, then in the month after the month in which coverage was closed they must pay a premium for two months to have coverage reinstated. The enrollee’s MA-EPD coverage remains closed if they do not pay a premium for two months to have coverage reinstated. Premiums should be paid on time to avoid a gap in coverage.\n\n| Date Invoice Mailed | Date Premium is Due | For Coverage in this Month |\n| --- | --- | --- |\n| December 4 | January 4 | February |\n| January 4 | February 4 | March |\n| February 4 | March 4 | April |\n| March 4 | April 4 | May |\n| April 4 | May 4 | June |\n| May 4 | June 4 | July |\n| June 4 | July 4 | August |\n| July 4 | August 4 | September |\n| August 4 | September 4 | October |\n| September 4 | October 4 | November |\n| October 4 | November 4 | December |\n| November 4 | December 4 | January |"},{"chunk_id":"epm:2.3.5.1.2#premium-payments","heading":"Premium Payments","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.2#premium-payments","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.1 General Requirements > 2.3.5.1.2 Premiums > Premium Payments","text":"## Premium Payments\n\nThe first premium must be paid to the county or tribal agency. Ongoing payments can be made by mail, in person, or online. For more information about MA-EPD premium payments, see: [How do I pay my MA-EPD premium](https://mn.gov/dhs/people-we-serve/people-with-disabilities/health-care/health-care-programs/programs-and-services/ma-epd-premiums.jsp)?"}]},{"id":"epm:2.3.5.1.2.1","number":"2.3.5.1.2.1","title":"Good Cause for Non-Payment of Ongoing Premiums","parent":"2.3.5.1.2","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.1 General Requirements > 2.3.5.1.2 Premiums > 2.3.5.1.2.1 Good Cause for Non-Payment of Ongoing Premiums","summary":"An enrollee who is unable to pay their ongoing MA-EPD premium due to circumstances beyond their control may request good cause for non-payment of a monthly premium.","effective_date":"2025-07-02","last_modified":"2026-10-03T03:51:59.250595+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.2.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.5.1.2.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_5_1_2_1.htm","legal_citations":["Minnesota Statutes, section 256B.057, subdivision 9"],"chunks":[{"chunk_id":"epm:2.3.5.1.2.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.2.1","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.1 General Requirements > 2.3.5.1.2 Premiums > 2.3.5.1.2.1 Good Cause for Non-Payment of Ongoing Premiums","text":"An enrollee who is unable to pay their ongoing MA-EPD premium due to circumstances beyond their control may request good cause for non-payment of a monthly premium.\n\nGood cause is defined as circumstances beyond a person's control or not reasonably foreseeable resulting in the enrollee being unable or failing to pay the premium when it was due. Life events that cause unexpected expenses include, but are not limited to, the following:\n- Natural disasters\n- Illness\n- Job loss\n- Family emergency\n- Unexpected home or car repair\n\nGood cause must be requested before the enrollee’s coverage is closed for failure to pay the premium. DHS determines whether good cause exists based on the evidence provided by the enrollee to support their claim.\n\nGood cause will not be granted for:\n- non-payment of an initial premium, including any retroactive months.\n- a month in which the premium has already been paid.\n- choosing to pay other regular or anticipated expenses instead of the premium."},{"chunk_id":"epm:2.3.5.1.2.1#requesting-good-cause","heading":"Requesting Good Cause","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.2.1#requesting-good-cause","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.1 General Requirements > 2.3.5.1.2 Premiums > 2.3.5.1.2.1 Good Cause for Non-Payment of Ongoing Premiums > Requesting Good Cause","text":"## Requesting Good Cause\n\nAn enrollee must request good cause using the MA-EPD Good Cause Application ([DHS-6939](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-6939-ENG)). To submit the MA-EPD Good Cause Application, the enrollee can:\n- Submit the form electronically, or\n- Mail to DHS MA-EPD Good Cause, P.O. Box 64967, Saint Paul, MN 55164-0967. This address is for MA-EPD Good Cause Applications only. Do not mail premium payments to this address.\n\nEnrollees can get help to complete the form by calling [Disability Hub MN](https://disabilityhubmn.org/) at 866-333-2466.\n\nDHS provides the person with written notice of the good cause decision within 30 days. People may request an appeal if they do not agree with a good cause decision. See the [MHCP Appeals](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.1) policy for more information."}]},{"id":"epm:2.3.5.1.3","number":"2.3.5.1.3","title":"Work Requirements","parent":"2.3.5.1","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.1 General Requirements > 2.3.5.1.3 Work Requirements","summary":"A person must be employed to be eligible for Medical Assistance for Employed Persons with Disabilities (MA-EPD). This policy describes specific employment requirements for MA-EPD.","effective_date":"2024-09-10","last_modified":"2026-10-03T03:51:59.250595+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.5.1.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_5_1_3.htm","legal_citations":["Minnesota Statutes, section 256B.057, subdivision 9"],"chunks":[{"chunk_id":"epm:2.3.5.1.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.3","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.1 General Requirements > 2.3.5.1.3 Work Requirements","text":"A person must be employed to be eligible for Medical Assistance for Employed Persons with Disabilities (MA-EPD). This policy describes specific employment requirements for MA-EPD."},{"chunk_id":"epm:2.3.5.1.3#employment-income","heading":"Employment Income","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.3#employment-income","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.1 General Requirements > 2.3.5.1.3 Work Requirements > Employment Income","text":"## Employment Income\n\nA person must have earned income from wages or self-employment greater than $65 per month on average for the six-month eligibility period at application and renewal. MA-EPD enrollees must receive employment income or must engage in self-employment activities each month and meet the criteria for the type of income below to be eligible.\n\n### Wage Income\n- Social Security and Medicare taxes must be withheld from wages, unless the person works for an employer that by law is not required to withhold those taxes.\n- State and federal income taxes need only be paid if the person earns enough to be required to pay those taxes.\n- The person must receive wages each month of eligibility.\n- Earned income is monthly average gross income.\n\n### Self Employment\n\nFor self-employment income, earned income is net earnings from self-employment, which is the gross income minus all expenses the Internal Revenue Service (IRS) allows as a self-employment expense.\n\nA person cannot become eligible for MA-EPD or retain eligibility for MA-EPD simply by filing a federal self-employment tax return. Self-employed people generally must:\n- Pay Social Security and Medicare taxes at least annually.\n- Pay quarterly estimated state and federal income taxes, if the person earns enough to be required to pay those taxes.\n- Work for themselves and engage in self-employment activities each month.\n- Be responsible for their own work schedule.\n- Not be covered under an employer's liability insurance or Workers' Compensation.\n\n### Seasonal Employment\n\nSeasonal employment income is counted only in the months in which the person is engaged in the work activity"},{"chunk_id":"epm:2.3.5.1.3#not-considered-employment-income-for-ma-epd","heading":"Not Considered Employment income for MA-EPD","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.3#not-considered-employment-income-for-ma-epd","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.1 General Requirements > 2.3.5.1.3 Work Requirements > Not Considered Employment income for MA-EPD","text":"## Not Considered Employment income for MA-EPD\n\nThe following are not considered employment income for MA-EPD:\n- Gratuitous money allowances\n- Honoraria or stipends that only reimburse expenses or do not have Medicare and Social Security taxes withheld or paid annually\n- Payments for participation in a clinical trial\n- Payments for the sale of blood or blood plasma"},{"chunk_id":"epm:2.3.5.1.3#multiple-sources-of-income","heading":"Multiple Sources of Income","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.3#multiple-sources-of-income","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.1 General Requirements > 2.3.5.1.3 Work Requirements > Multiple Sources of Income","text":"## Multiple Sources of Income\n\nIndividuals with two sources of employment income, one source that has taxes withheld and one source that does not, are eligible for MA-EPD. The gross monthly earnings from which taxes are withheld must exceed $65.\n\nIndividuals with both wage employment and self-employment income may be eligible for MA-EPD. Their combined earned income must exceed $65 per month."},{"chunk_id":"epm:2.3.5.1.3#verification-of-employment-income","heading":"Verification of Employment Income","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.3#verification-of-employment-income","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.1 General Requirements > 2.3.5.1.3 Work Requirements > Verification of Employment Income","text":"## Verification of Employment Income\n\nEmployment income must be verified at application, at six months, and at renewal. See [MA-EPD Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.1) for more information\n\nOnly verification of employment income is required when the premium is recalculated at six months. Verification of assets is not required unless the enrollee reports a change in assets. See [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1) for more information"},{"chunk_id":"epm:2.3.5.1.3#medical-leave-or-job-loss-extension","heading":"Medical Leave or Job Loss Extension","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.3#medical-leave-or-job-loss-extension","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.1 General Requirements > 2.3.5.1.3 Work Requirements > Medical Leave or Job Loss Extension","text":"## Medical Leave or Job Loss Extension\n\nMA-EPD enrollees must receive employment income or must engage in self-employment activities each month unless they meet specific medical leave or job loss criteria. However, medical leave and job loss provisions do not pertain to the month of application or in any retroactive month. An MA-EPD applicant must be employed at application and during any retroactive months.\n\nMA-EPD enrollees are still considered employed if they change jobs and receive no paychecks for one month because of different pay periods in each job.\n\n### Four-Month Medical Leave\n\nAn MA-EPD enrollee may maintain eligibility, without earnings, for up to four calendar months due to a verified medical condition.\n- A physician’s statement is necessary to verify the need for medical leave before continuing coverage under MA-EPD.\n- The four-month medical leave begins the month after the enrollee is unable to work.\n- The four-month medical leave ends the last day of the fourth month in which the enrollee is unable to work, even if the physician's statement states the enrollee is expected to be unable to work for more than four calendar months.\n\n### Four-Month Job Loss\n\nAn MA-EPD enrollee may maintain eligibility, without earnings, for up to four months due to job loss that was not caused by or attributed to the enrollee. Situations that would allow a four-month extension include, but are not limited to, layoffs due to lack of work or business closing.\n- Verification of the reason the enrollee became unemployed is required before continuing coverage under MA-EPD.\n- The four-month job loss leave begins after the enrollee stops working or receives the last paycheck, whichever is later.\n\nMA-EPD enrollees who become unemployed for reasons attributable to them, such as poor work performance, discharge for misconduct, or resignation for reasons other than medical leave, are not eligible for the four-month extension.\n\nEmployees who become unemployed while on medical leave from their jobs may remain enrolled for four additional months following the month in which they are terminated or laid off.\n\nThere is no annual limit on the number of times the MA-EPD medical leave or job loss extensions can be used. The enrollee must return to work between leaves and meet all requirements. Enrollees who remain eligible for MA-EPD due to the four-month job loss extension may not extend eligibility with a medical leave without returning to work between leaves.\n\nEnrollees must continue to pay MA-EPD premiums during the four-month medical leave or job loss extension."}]},{"id":"epm:2.3.5.2","number":"2.3.5.2","title":"Non-Financial Eligibility","parent":"2.3.5","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.2 Non-Financial Eligibility","summary":"This subchapter includes non-financial eligibility policies. This covers eligibility factors not related to a person’s income. In general, MA-EPD follows the MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) non-financial eligibility policies. Specific differences are indicated in the MA-EPD policies indicated below.","effective_date":"2024-11-15","last_modified":"2026-10-03T03:51:59.250595+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.5.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_5_2.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.3.5.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.2","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.2 Non-Financial Eligibility","text":"This subchapter includes non-financial eligibility policies. This covers eligibility factors not related to a person’s income. In general, MA-EPD follows the MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) non-financial eligibility policies. Specific differences are indicated in the MA-EPD policies indicated below.\n\nThis subchapter includes policies that apply to Medical Assistance for Employed Persons with Disabilities (MA-EPD) and links to policies that apply to MA-ABD.\n\nTopics covered in this subchapter are:\n1. [MA-ABD Non-Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.2)\n2. [MA-EPD Bases of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.2.1)\n3. [MA-EPD Living Arrangement](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.2.2)"}]},{"id":"epm:2.3.5.2.1","number":"2.3.5.2.1","title":"Bases of Eligibility","parent":"2.3.5.2","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.2 Non-Financial Eligibility > 2.3.5.2.1 Bases of Eligibility","summary":"In general, MA for Employed Persons with Disabilities (MA-EPD) follows the MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) non-financial eligibility policies. People must be certified disabled and use the disabled or blind basis of eligibility to enroll in MA-EPD. Disability or blindness must be certified by the Social Security Administration (SSA) or t","effective_date":"2025-03-26","last_modified":"2026-10-03T03:58:41.599036+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.2.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.5.2.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_5_2_1.htm","legal_citations":["Minnesota Statutes, section 256B.057"],"chunks":[{"chunk_id":"epm:2.3.5.2.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.2.1","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.2 Non-Financial Eligibility > 2.3.5.2.1 Bases of Eligibility","text":"In general, MA for Employed Persons with Disabilities (MA-EPD) follows the MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) non-financial eligibility policies. People must be certified disabled and use the disabled or blind basis of eligibility to enroll in MA-EPD. Disability or blindness must be certified by the Social Security Administration (SSA) or the State Medical Review Team (SMRT)."},{"chunk_id":"epm:2.3.5.2.1#changing-basis-of-eligibility-after-job-loss","heading":"Changing Basis of Eligibility after Job Loss","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.2.1#changing-basis-of-eligibility-after-job-loss","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.2 Non-Financial Eligibility > 2.3.5.2.1 Bases of Eligibility > Changing Basis of Eligibility after Job Loss","text":"## Changing Basis of Eligibility after Job Loss\n\nWhen an MA-EPD enrollee stops working other than during a four-month job loss or four-month medical leave, or no longer meets the work requirements, their eligibility must be redetermined under another MA basis of eligibility. If the MA-EPD enrollee is redetermined eligible under an MA-ABD basis, the enrollee is eligible for MA-ABD with no asset limit for 12 consecutive months. Standard MA-ABD asset limits and policies apply after the 12 months. If during the12 consecutive months of no asset limit the enrollee loses MA-ABD eligibility for one month or more, the MA-ABD asset limit applies to all subsequent months and MA-ABD eligibility determinations."},{"chunk_id":"epm:2.3.5.2.1#changing-basis-of-eligibility-after-age-65","heading":"Changing Basis of Eligibility after Age 65","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.2.1#changing-basis-of-eligibility-after-age-65","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.2 Non-Financial Eligibility > 2.3.5.2.1 Bases of Eligibility > Changing Basis of Eligibility after Age 65","text":"## Changing Basis of Eligibility after Age 65\n\nSome MA-EPD income and asset rules continue to apply when redetermining basic MA eligibility for an enrollee, age 65 or older, who loses eligibility for MA-EPD for any reason and who was enrolled in MA-EPD during each of the 24 consecutive months before their 65th birthday.\n\nWhen redetermining MA-ABD eligibility under these circumstances:\n- The income of a spouse is not deemed to the person\n- The assets of a spouse are not deemed to the person\n\nMA-EPD enrollees who are redetermined eligible for MA for People Age 65 or Older will qualify for MA-ABD with no asset limit for up to 12 months, followed by MA-ABD eligibility with an asset limit of $20,000. This will apply to MA-EPD enrollees who:\n- become ineligible for MA-EPD at age 65 or older because they have stopped working or no longer meet work requirements, and\n- were enrolled in MA-EPD for the 24 consecutive months before turning age 65.\n\nIn addition to the asset limit of $20,000, the following assets will remain excluded for MA-EPD enrollees who meet the criteria above and are determined eligible for MA-ABD after turning 65:\n- Retirement accounts including:\n  - Individual retirement accounts (IRA), including IRAs held in the form of annuity\n  - 401(k) plans\n  - 403(b) plans\n  - Keogh plans\n  - Pension plans\n- Medical expense accounts set up through an employer, including Health Savings Accounts (HAS)\n- Spousal assets, including the spouse’s share of jointly held assets\n\nAsset limits still apply to Medicare Savings Programs. See [4.2.3.1 MSP Assets](https://bot-corpus.mn-dhs.online/s/epm/4.2.3.1) for more information."},{"chunk_id":"epm:2.3.5.2.1#redetermination-under-all-bases","heading":"Redetermination Under All Bases","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.2.1#redetermination-under-all-bases","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.2 Non-Financial Eligibility > 2.3.5.2.1 Bases of Eligibility > Redetermination Under All Bases","text":"## Redetermination Under All Bases\n\nEligibility must be redetermined under all bases, including MA with a spenddown, when MA-EPD eligibility ends for any reason (for example, non-payment of a premium). MA-EPD eligibility and coverage is not continued while eligibility is being redetermined for any month in which a premium was not paid."}]},{"id":"epm:2.3.5.2.2","number":"2.3.5.2.2","title":"Living Arrangement","parent":"2.3.5.2","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.2 Non-Financial Eligibility > 2.3.5.2.2 Living Arrangement","summary":"Medical Assistance for Employed Persons with Disabilities (MA-EPD) enrollees may live in a variety of living arrangements. This policy discusses living arrangements and MA-EPD.","effective_date":"2023-06-01","last_modified":"2026-10-03T04:10:23.950498+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.2.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.5.2.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_5_2_2.htm","legal_citations":["Minnesota Statutes, section 256B.055, subdivisions 11 to 14"],"chunks":[{"chunk_id":"epm:2.3.5.2.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.2.2","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.2 Non-Financial Eligibility > 2.3.5.2.2 Living Arrangement","text":"Medical Assistance for Employed Persons with Disabilities (MA-EPD) enrollees may live in a variety of living arrangements. This policy discusses living arrangements and MA-EPD."},{"chunk_id":"epm:2.3.5.2.2#community-living-arrangement","heading":"Community Living Arrangement","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.2.2#community-living-arrangement","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.2 Non-Financial Eligibility > 2.3.5.2.2 Living Arrangement > Community Living Arrangement","text":"## Community Living Arrangement\n\nCommunity living arrangements have no impact on MA eligibility. See [Appendix D Community Living Arrangements](https://bot-corpus.mn-dhs.online/s/epm/D) for more information."},{"chunk_id":"epm:2.3.5.2.2#institutions-for-mental-diseases","heading":"Institutions for Mental Diseases","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.2.2#institutions-for-mental-diseases","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.2 Non-Financial Eligibility > 2.3.5.2.2 Living Arrangement > Institutions for Mental Diseases","text":"## Institutions for Mental Diseases\n\nAn Institution for Mental Diseases (IMD) is a hospital, nursing facility, or other institution or residential program that has 17 or more beds and is primarily engaged in providing diagnosis, treatment or care of people with mental diseases. [A list of IMDs that provide treatment for people with mental illness](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-4164B-ENG) (MI) is also available online. MA-EPD enrollees may continue MA-EPD while living in an IMD, as long as they meet the MA-EPD work requirements."},{"chunk_id":"epm:2.3.5.2.2#long-term-care-facility","heading":"Long Term Care Facility","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.2.2#long-term-care-facility","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.2 Non-Financial Eligibility > 2.3.5.2.2 Living Arrangement > Long Term Care Facility","text":"## Long Term Care Facility\n\nA long-term care facility (LTCF) is a place such as a skilled nursing facility, Intermediate Care Facility for the Developmentally Disabled (ICF/DD) or medical hospital in which the person receives skilled nursing services (swing bed). People who live in a LTCF while working, even during the four-month medical leave period may continue MA-EPD, as long as they continue to pay the premium."}]},{"id":"epm:2.3.5.3","number":"2.3.5.3","title":"Financial Eligibility","parent":"2.3.5","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.3 Financial Eligibility","summary":"Financial eligibility requirements involve a person’s income. Medical Assistance for Employed Persons with Disabilities (MA-EPD) enrollees must have earned income greater than $65 per month on average for the six-month period used at application and renewal from wages or self-employment earnings to be eligible.","effective_date":"2024-11-15","last_modified":"2026-10-03T03:51:59.250595+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.5.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_5_3.htm","legal_citations":["Minnesota Statutes, section 256B.057"],"chunks":[{"chunk_id":"epm:2.3.5.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.3","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.3 Financial Eligibility","text":"Financial eligibility requirements involve a person’s income. Medical Assistance for Employed Persons with Disabilities (MA-EPD) enrollees must have earned income greater than $65 per month on average for the six-month period used at application and renewal from wages or self-employment earnings to be eligible.\n\nEffective January 1, 2024, MA-EPD applicants and enrollees no longer have an asset limit."}]},{"id":"epm:2.3.5.3.1","number":"2.3.5.3.1","title":"Assets","parent":"2.3.5.3","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.3 Financial Eligibility > 2.3.5.3.1 Assets","summary":"Assets are items of value that people own like bank accounts, stocks and bonds, cars, and real estate.","effective_date":"2024-11-15","last_modified":"2026-10-03T03:51:59.250595+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.3.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.5.3.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_5_3_1.htm","legal_citations":["Minnesota Statutes, section 256B.057"],"chunks":[{"chunk_id":"epm:2.3.5.3.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.3.1","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.3 Financial Eligibility > 2.3.5.3.1 Assets","text":"Assets are items of value that people own like bank accounts, stocks and bonds, cars, and real estate."},{"chunk_id":"epm:2.3.5.3.1#asset-limit","heading":"Asset Limit","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.3.1#asset-limit","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.3 Financial Eligibility > 2.3.5.3.1 Assets > Asset Limit","text":"## Asset Limit\n\nThere is no asset limit for Medical Assistance for Employed Persons with Disabilities (MA-EPD)"}]},{"id":"epm:2.3.5.3.2","number":"2.3.5.3.2","title":"Income","parent":"2.3.5.3","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.3 Financial Eligibility > 2.3.5.3.2 Income","summary":"This subchapter provides policy about a person’s income for Medical Assistance for Employed Persons with Disabilities (MA-EPD).","effective_date":"2024-01-19","last_modified":"2026-10-03T03:52:16.030711+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.3.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.5.3.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_5_3_2.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.3.5.3.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.3.2","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.3 Financial Eligibility > 2.3.5.3.2 Income","text":"This subchapter provides policy about a person’s income for Medical Assistance for Employed Persons with Disabilities (MA-EPD)."},{"chunk_id":"epm:2.3.5.3.2#income","heading":"Income","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.3.2#income","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.3 Financial Eligibility > 2.3.5.3.2 Income > Income","text":"## Income\n\nMA-EPD has no income limit. Applicants and enrollees cannot be terminated for having too much income. However, enrollees must report changes in income because changes in income can impact an enrollee’s premium. See [MHCP 1.3.2.1 Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1 circumstance&rhsearch=circumstances).\n\nIncome of the individual is used only to calculate an MA-EPD premium. See [MA-EPD 2.3.5.1.2 Premiums and Cost Sharing](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.2).\n\nMinnesota Statutes, section 256B.057"},{"chunk_id":"epm:2.3.5.3.2#part-2","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.3.2","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.3 Financial Eligibility > 2.3.5.3.2 Income","text":"##"}]},{"id":"epm:2.3.5.4","number":"2.3.5.4","title":"Post-Eligibility","parent":"2.3.5","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.4 Post-Eligibility","summary":"These policies apply to Medical Assistance for Employed Persons with Disabilities (MA-EPD) enrollees. In general, MA-EPD follows the MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) post-eligibility policies. Specific differences are indicated in the MA-EPD post-eligibility policies.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:59.250595+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.5.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_5_4.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.3.5.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.4","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.4 Post-Eligibility","text":"These policies apply to Medical Assistance for Employed Persons with Disabilities (MA-EPD) enrollees. In general, MA-EPD follows the MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) post-eligibility policies. Specific differences are indicated in the MA-EPD post-eligibility policies.\n\nThis subchapter includes policies that apply to MA-EPD and links to policies that apply to MA-ABD.\n1. [MA-EPD Medicare](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.4.1)\n2. [MA-ABD Post-Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.4)"}]},{"id":"epm:2.3.5.4.1","number":"2.3.5.4.1","title":"Medicare Part B for MA-EPD Enrollees","parent":"2.3.5.4","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.4 Post-Eligibility > 2.3.5.4.1 Medicare Part B for MA-EPD Enrollees","summary":"People enrolled in Medical Assistance for Employed Persons with Disabilities (MA-EPD) must enroll in Medicare if eligible.","effective_date":"2024-08-07","last_modified":"2026-10-03T03:58:41.774098+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.4.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.5.4.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_5_4_1.htm","legal_citations":["Minnesota Statutes, section 256B.057"],"chunks":[{"chunk_id":"epm:2.3.5.4.1#medicare-eligibility","heading":"Medicare Eligibility","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.4.1#medicare-eligibility","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.4 Post-Eligibility > 2.3.5.4.1 Medicare Part B for MA-EPD Enrollees > Medicare Eligibility","text":"## Medicare Eligibility\n\nPeople enrolled in Medical Assistance for Employed Persons with Disabilities (MA-EPD) must enroll in Medicare if eligible.\n\nIf not enrolled in Medicare at the time they apply for MA-EPD, Medicare eligible people must apply for Medicare during the next available Medicare general enrollment period (January-March of each year), to continue MA-EPD eligibility."},{"chunk_id":"epm:2.3.5.4.1#payment-for-medicare-part-b-premiums","heading":"Payment for Medicare Part B Premiums","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.5.4.1#payment-for-medicare-part-b-premiums","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.5  > 2.3.5.4 Post-Eligibility > 2.3.5.4.1 Medicare Part B for MA-EPD Enrollees > Payment for Medicare Part B Premiums","text":"## Payment for Medicare Part B Premiums\n\nMA-EPD enrollees may have their Medicare Part B premiums paid for or reimbursed with an effective date of MA-EPD eligibility for enrollees who meet one of the following:\n- Meets the requirements for Qualified Medicare Beneficiary (QMB) or Service Limited Medicare Beneficiary (SLMB) programs. See EPM section [4.2 Medicare Savings Programs](https://bot-corpus.mn-dhs.online/s/epm/4.2) for more information.\n- If not eligible for QMB or SLMB, has income at or below 200% FPG using the [MA-EPD income](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.3.2) methodology.\n\nFor the eligible MA-EPD enrollees not eligible for QMB or SLMB with income at or below 200% FPG, Medicare Part B premium reimbursements must be processed and reimbursed by the county or tribal servicing agency at application, renewal, or when an enrollee reports a change that makes them eligible for reimbursement. DHS reimburses Medicare Part B premium reimbursement payments made to an eligible MA-EPD enrollee by the county or tribal servicing agency.\n\nMA-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](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-8555-ENG)).\n\nMA-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](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-8556-ENG))."}]},{"id":"epm:2.3.6","number":"2.3.6","title":"Medical Assistance under the TEFRA Option","parent":"2.3","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.6 Medical Assistance under the TEFRA Option","summary":"Medical Assistance (MA) under the TEFRA option is for children with a disability who are otherwise ineligible for MA because household income is above the MA for Families with Children and Adults (MA-FCA) income limit. The TEFRA option for children with a disability is named after the Tax Equity and Fiscal Responsibility Act (TEFRA) of 1982 that created the option.","effective_date":"2024-11-27","last_modified":"2026-10-03T03:51:59.250595+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.6","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.6","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_6.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.3.6#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.6","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.6 Medical Assistance under the TEFRA Option","text":"Medical Assistance (MA) under the TEFRA option is for children with a disability who are otherwise ineligible for MA because household income is above the MA for Families with Children and Adults (MA-FCA) income limit. The TEFRA option for children with a disability is named after the Tax Equity and Fiscal Responsibility Act (TEFRA) of 1982 that created the option.\n\nUnder the MA TEFRA option, children who are otherwise ineligible for MA due to household income may become eligible. Only the income of the child is counted when determining eligibility for MA. Parents’ income is not counted.\n\nMA under the TEFRA option is available for children who meet all of the following:\n- Are under age 19\n- Live with at least one biological or adoptive parent\n- Require a level of care:\n  - comparable to that provided in a hospital, nursing home or an intermediate care facility for people with developmental disabilities (ICF/DD), and\n  - for which the cost for home care would not be more than MA would pay for the child's care in a medical institution.\n- Are certified disabled\n\nChildren who are eligible for MA when counting parental income do not need to use the TEFRA option. Children approved under a home and community-based services waiver do not need to use the TEFRA option.\n\nIn general, MA eligibility under the TEFRA option follows the policies for MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD). Specific differences are indicated in the policies for MA under the TEFRA option listed below.\n\nMA under the TEFRA option eligibility is determined using a variety of non-financial, financial and post-eligibility requirements. This subchapter includes policies that apply to the MA under the TEFRA option and links to policies that apply to all MA programs, MA-ABD, and all Minnesota Health Care Programs (MHCP) programs.\n1. [TEFRA General Requirements](https://bot-corpus.mn-dhs.online/s/epm/2.3.6.1)\n  1. [TEFRA Applications](https://bot-corpus.mn-dhs.online/s/epm/2.3.6.1.1)\n  2. [MA Cooperation](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.2)\n  3. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n  4. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n  5. [MA Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4)\n  6. [MHCP Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1)\n  7. [MA Third Party Liability](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3)\n    1. [MA Cost Effective Insurance](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.1)\n    2. [MA Medical Support](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.2)\n    3. [MA Other Third Party Liability](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.3)\n2. [TEFRA Non-Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.6.2)\n  1. [MA-ABD Non-Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.2)\n    1. [MA-ABD Bases of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.2.1)\n    2. [MA-ABD Certification of Disability](https://bot-corpus.mn-dhs.online/s/epm/2.3.2.2)\n    3. [MA Citizenship and Immigration Status](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2)\n    4. [MA County Residency](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.3)\n    5. [MHCP State Residency](https://bot-corpus.mn-dhs.online/s/epm/1.4)\n    6. [MA Social Security Number](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5)\n  2. [TEFRA Level of Care](https://bot-corpus.mn-dhs.online/s/epm/2.3.6.2.1)\n3. [TEFRA Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.6.3)\n4. [TEFRA Post-Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.6.4)\n  1. [MA Begin and End Dates](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.1)\n  2. [MHCP Overpayments](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.5)\n  3. [MA Third Party Liability](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3)\n  4. [MA Cost-Effective Insurance](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.1)\n  5. [MA Medical Support](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.2)\n  6. [MA Other Third Party Liability](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.3)\n  7. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n  8. [MA Cooperation](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.2)\n  9. [MA Cost Sharing](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.3)\n  10. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n  11. [MA-ABD Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/2.3.4.1)\n  12. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n  13. [MA Qualifying Health Coverage](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.2)\n  14. [MA Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4)\n  15. [MA-ABD Renewals](https://hcopub.dhs.state.mn.us/epm/2_3_4_2ar4.htm)"}]},{"id":"epm:2.3.6.1","number":"2.3.6.1","title":"General Requirements","parent":"2.3.6","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.6 Medical Assistance under the TEFRA Option > 2.3.6.1 General Requirements","summary":"Medical Assistance (MA) under the TEFRA option is for children with a disability who are otherwise ineligible for MA because household income is above the MA for Families with Children and Adults (MA-FCA) income limit. The TEFRA option for children with a disability is named after the Tax Equity and Fiscal Responsibility Act (TEFRA) of 1982 that created the option.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:59.250595+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.6.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.6.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_6_1.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.3.6.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.6.1","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.6 Medical Assistance under the TEFRA Option > 2.3.6.1 General Requirements","text":"Medical Assistance (MA) under the TEFRA option is for children with a disability who are otherwise ineligible for MA because household income is above the MA for Families with Children and Adults (MA-FCA) income limit. The TEFRA option for children with a disability is named after the Tax Equity and Fiscal Responsibility Act (TEFRA) of 1982 that created the option.\n\nThis subchapter provides general policy information that applies to the MA under the TEFRA option. In general, MA under the TEFRA option follows the MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) general requirements policies. Specific differences are indicated in the MA under the TEFRA option policies listed below.\n\nThis subchapter includes policies that apply to MA under the TEFRA option and links to policies that apply to all MA programs, MA-ABD, and all Minnesota Health Care Programs (MHCP) programs.\n\nTopics covered in this subchapter are:\n1. [TEFRA Applications](https://bot-corpus.mn-dhs.online/s/epm/2.3.6.1.1)\n2. [MA Cooperation](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.2)\n3. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n4. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n5. [MA Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4)\n6. [MHCP Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1)\n7. [MA Third Party Liability](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3)\n  1. [MA Cost Effective Insurance](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.1)\n  2. [MA Medical Support](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.2)\n  3. [MA Other Third Party Liability](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.3)"}]},{"id":"epm:2.3.6.1.1","number":"2.3.6.1.1","title":"Applications","parent":"2.3.6.1","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.6 Medical Assistance under the TEFRA Option > 2.3.6.1 General Requirements > 2.3.6.1.1 Applications","summary":"Medical Assistance (MA) under the TEFRA option is for children with a disability who are otherwise ineligible for MA because household income is above the MA for Families with Children and Adults (MA-FCA) income limit. The TEFRA option for children with a disability is named after the Tax Equity and Fiscal Responsibility Act (TEFRA) of 1982 that created the option.","effective_date":"2023-08-08","last_modified":"2026-10-03T03:51:59.250595+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.6.1.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.6.1.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_6_1_1.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.225","Code of Federal Regulations, title 42, section 435.907","Code of Federal Regulations, title 45, section 155.405","Code of Federal Regulations, title 45, section 155.310","Minnesota Statutes, section 256B.08","Minnesota Statutes, section 256B.055, subdivision 12","The Tax Equity and Fiscal Responsibility Act (TEFRA), Public Law 97-248, section 134","United States Code, title 42, section 1396a, subdivision e"],"chunks":[{"chunk_id":"epm:2.3.6.1.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.6.1.1","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.6 Medical Assistance under the TEFRA Option > 2.3.6.1 General Requirements > 2.3.6.1.1 Applications","text":"Medical Assistance (MA) under the TEFRA option is for children with a disability who are otherwise ineligible for MA because household income is above the MA for Families with Children and Adults (MA-FCA) income limit. The TEFRA option for children with a disability is named after the Tax Equity and Fiscal Responsibility Act (TEFRA) of 1982 that created the option.\n\nBecause the MA under the TEFRA option is only available to children with a disability who are not eligible because household income is above the MA for Families with Children and Adults (MA-FCA) income limit, children must first apply for MA using the [MNsure online application](https://www.mnsure.org/) or the paper MNsure Application for Health Coverage and Help Paying Costs ([DHS-6696](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-6696-ENG)).\n\nA determination must be made for MA under the TEFRA option when MA is denied because the household income exceeds the child’s income limit, and the child has a certified disability or a condition that may qualify as a disability.\n\nThe county or tribal agency will use the information provided on the DHS-6696 application and request any additional information or verifications as needed to determine eligibility for MA under the TEFRA option.\n\nThe county, tribal or state servicing agency must complete a State Medical Review Team (SMRT) referral, evenwhen the person is approved for Social Security, to make a level of care determination. See the [MA-ABD Certification of Disability](https://bot-corpus.mn-dhs.online/s/epm/2.3.2.2) policy and [TEFRA Level of Care](https://bot-corpus.mn-dhs.online/s/epm/2.3.6.2.1) policy for more information."}]},{"id":"epm:2.3.6.2","number":"2.3.6.2","title":"Non-Financial Eligibility Requirements","parent":"2.3.6","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.6 Medical Assistance under the TEFRA Option > 2.3.6.2 Non-Financial Eligibility Requirements","summary":"Medical Assistance (MA) under the TEFRA option is for children with a disability who are otherwise ineligible for MA because household income is above the MA for Families with Children and Adults (MA-FCA) income limit. The TEFRA option for children with a disability is named after the Tax Equity and Fiscal Responsibility Act (TEFRA) of 1982 that created the option.","effective_date":"2021-06-01","last_modified":"2026-10-03T04:10:24.28314+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.6.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.6.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_6_2.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.225"],"chunks":[{"chunk_id":"epm:2.3.6.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.6.2","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.6 Medical Assistance under the TEFRA Option > 2.3.6.2 Non-Financial Eligibility Requirements","text":"Medical Assistance (MA) under the TEFRA option is for children with a disability who are otherwise ineligible for MA because household income is above the MA for Families with Children and Adults (MA-FCA) income limit. The TEFRA option for children with a disability is named after the Tax Equity and Fiscal Responsibility Act (TEFRA) of 1982 that created the option.\n\nThis subchapter includes non-financial eligibility policies. This covers eligibility factors not related to a person’s income or assets.\n\nMA under the TEFRA option is only available to children living in the community with at least one biological, natural, adoptive or stepparent. See [Appendix D Community Living Arrangements](https://bot-corpus.mn-dhs.online/s/epm/D) for more information. Children who would otherwise live in the community who are temporarily absent due to hospitalization or another reason, remain eligible for MA under the TEFRA option. See [EPM 1.4.4 MHCP Temporary Absence](https://bot-corpus.mn-dhs.online/s/epm/1.4.4) for more information.\n\nIn general, MA under the TEFRA option follows the MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) general requirements policies. Specific differences are indicated in MA under the TEFRA option policies listed below.\n\nThis subchapter includes policies that apply to MA under the TEFRA option and links to policies that apply to all MA programs, MA-ABD, and all Minnesota Health Care Programs (MHCP).\n\nTopics covered in this subchapter are:\n1. [MA-ABD Non-Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.2)\n  1. [MA-ABD Bases of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.2.1)\n  2. [MA-ABD Certification of Disability](https://bot-corpus.mn-dhs.online/s/epm/2.3.2.2)\n  3. [MA Citizenship and Immigration Status](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2)\n  4. [MA County Residency](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.3)\n  5. [MHCP State Residency](https://bot-corpus.mn-dhs.online/s/epm/1.4)\n  6. [MA Social Security Number](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5)\n2. [TEFRA Level of Care](https://bot-corpus.mn-dhs.online/s/epm/2.3.6.2.1)"}]},{"id":"epm:2.3.6.2.1","number":"2.3.6.2.1","title":"Level of Care","parent":"2.3.6.2","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.6 Medical Assistance under the TEFRA Option > 2.3.6.2 Non-Financial Eligibility Requirements > 2.3.6.2.1 Level of Care","summary":"Medical Assistance (MA) under the TEFRA option is for children with a disability who are otherwise ineligible for MA because household income is above the MA for Families with Children and Adults (MA-FCA) income limit. The TEFRA option for children with a disability is named after the Tax Equity and Fiscal Responsibility Act (TEFRA) of 1982 that created the option.","effective_date":"2022-12-01","last_modified":"2026-10-03T03:51:59.250595+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.6.2.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.6.2.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_6_2_1.htm","legal_citations":["United States Code, title 42, section 1396A, subdivision e","Code of Federal Regulations, title 42, section 435.225","Minnesota Statutes, section 256B.055, subdivision 12","Minnesota Statutes, section 256B.092","The Tax Equity and Fiscal Responsibility Act (TEFRA), Public Law 97-248, section 134"],"chunks":[{"chunk_id":"epm:2.3.6.2.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.6.2.1","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.6 Medical Assistance under the TEFRA Option > 2.3.6.2 Non-Financial Eligibility Requirements > 2.3.6.2.1 Level of Care","text":"Medical Assistance (MA) under the TEFRA option is for children with a disability who are otherwise ineligible for MA because household income is above the MA for Families with Children and Adults (MA-FCA) income limit. The TEFRA option for children with a disability is named after the Tax Equity and Fiscal Responsibility Act (TEFRA) of 1982 that created the option.\n\nThe State Medical Review Team (SMRT) reviews all referrals for MA under the TEFRA option to determine:\n- if the child is considered disabled according to the Social Security standards, and\n- if the child's needs meet the level of care requirements.\n\nThe child must meet one of the following level of care requirements:\n- Hospital (including, but not limited to, Severe Emotional Disturbance)\n- Intermediate care facility for people with developmental disabilities (ICF-DD)\n- Nursing facility (including, but not limited to, Severe Emotional Disturbance)\n\nSee the [MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) Certification of Disability](https://bot-corpus.mn-dhs.online/s/epm/2.3.2.2) policy for more information."}]},{"id":"epm:2.3.6.3","number":"2.3.6.3","title":"Financial Eligibility","parent":"2.3.6","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.6 Medical Assistance under the TEFRA Option > 2.3.6.3 Financial Eligibility","summary":"Medical Assistance (MA) under the TEFRA option is for children with a disability who are otherwise ineligible for MA because household income is above the MA for Families with Children and Adults (MA-FCA) income limit. The TEFRA option for children with a disability is named after the Tax Equity and Fiscal Responsibility Act (TEFRA) of 1982 that created the option.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:59.250595+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.6.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.6.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_6_3.htm","legal_citations":["Code of Federal Regulations, title 42, section 1396A, subdivision e","The Tax Equity and Fiscal Responsibility Act (TEFRA), Public Law 97-248, section 134"],"chunks":[{"chunk_id":"epm:2.3.6.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.6.3","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.6 Medical Assistance under the TEFRA Option > 2.3.6.3 Financial Eligibility","text":"Medical Assistance (MA) under the TEFRA option is for children with a disability who are otherwise ineligible for MA because household income is above the MA for Families with Children and Adults (MA-FCA) income limit. The TEFRA option for children with a disability is named after the Tax Equity and Fiscal Responsibility Act (TEFRA) of 1982 that created the option.\n\nThis subchapter includes financial eligibility requirements. Financial eligibility requirements involve a person’s income or assets.\n\nIn general, MA under the TEFRA option follows the MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) financial eligibility policies. Specific differences are indicated below.\n\nThis subchapter includes policies that apply to MA under the TEFRA option and links to policies that apply to all MA programs, MA-ABD, and all Minnesota Health Care Programs (MHCP)."},{"chunk_id":"epm:2.3.6.3#ma-under-the-tefra-option-assets","heading":"MA under the TEFRA Option Assets","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.6.3#ma-under-the-tefra-option-assets","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.6 Medical Assistance under the TEFRA Option > 2.3.6.3 Financial Eligibility > MA under the TEFRA Option Assets","text":"## MA under the TEFRA Option Assets\n\nThere is no asset limit for children younger than 21."},{"chunk_id":"epm:2.3.6.3#ma-under-the-tefra-option-household-composition","heading":"MA under the TEFRA Option Household Composition","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.6.3#ma-under-the-tefra-option-household-composition","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.6 Medical Assistance under the TEFRA Option > 2.3.6.3 Financial Eligibility > MA under the TEFRA Option Household Composition","text":"## MA under the TEFRA Option Household Composition\n\nThe household size is one, only the child."},{"chunk_id":"epm:2.3.6.3#ma-under-the-tefra-option-income","heading":"MA under the TEFRA Option Income","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.6.3#ma-under-the-tefra-option-income","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.6 Medical Assistance under the TEFRA Option > 2.3.6.3 Financial Eligibility > MA under the TEFRA Option Income","text":"## MA under the TEFRA Option Income\n\nIncome eligibility is determined based only on the child’s income. If a child has income above 100% FPG, they may be eligible with a medical spenddown. See the [MA-ABD Medical Spenddown](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.4) policy for more information."},{"chunk_id":"epm:2.3.6.3#ma-under-the-tefra-option-financial-eligibility","heading":"MA under the TEFRA Option Financial Eligibility","url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.6.3#ma-under-the-tefra-option-financial-eligibility","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.6 Medical Assistance under the TEFRA Option > 2.3.6.3 Financial Eligibility > MA under the TEFRA Option Financial Eligibility","text":"## MA under the TEFRA Option Financial Eligibility\n\nThe MA-ABD income policies are used to determine the child’s income eligibility. See [MA-ABD Income](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3) section for more information."}]},{"id":"epm:2.3.6.4","number":"2.3.6.4","title":"Post-Eligibility","parent":"2.3.6","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.6 Medical Assistance under the TEFRA Option > 2.3.6.4 Post-Eligibility","summary":"Medical Assistance (MA) under the TEFRA option is for children with a disability who are otherwise ineligible for MA because household income is above the MA for Families with Children and Adults (MA-FCA) income limit. The TEFRA option for children with a disability is named after the Tax Equity and Fiscal Responsibility Act (TEFRA) of 1982 that created the option.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:59.250595+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.6.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.6.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_6_4.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.3.6.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.6.4","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.6 Medical Assistance under the TEFRA Option > 2.3.6.4 Post-Eligibility","text":"Medical Assistance (MA) under the TEFRA option is for children with a disability who are otherwise ineligible for MA because household income is above the MA for Families with Children and Adults (MA-FCA) income limit. The TEFRA option for children with a disability is named after the Tax Equity and Fiscal Responsibility Act (TEFRA) of 1982 that created the option.\n\nThese policies apply to MA under the TEFRA option. In general, MA under the TEFRA option follows the MA for People Who Are Age 65 or Older and People Who are Blind or Have a Disability (MA-ABD) post-eligibility policies.\n\nThis subchapter includes links to policies that apply to all MA programs, MA-ABD, and all Minnesota Health Care Programs (MHCP).\n1. [MA-Begin and End Dates](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.1)\n2. [MHCP Overpayments](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.5)\n3. [MA Third Party Liability](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3)\n4. [MA Cost-Effective Insurance](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.1)\n5. [MA Medical Support](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.2)\n6. [MA Other Third Party Liability](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.3)\n7. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n8. [MA Cooperation](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.2)\n9. [MA Cost Sharing](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.3)\n10. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n11. [MA-ABD Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/2.3.4.1)\n12. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n13. [MA Qualifying Health Coverage](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.2)\n14. [MA Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4)\n15. [MA-ABD Renewals](https://hcopub.dhs.state.mn.us/epm/2_3_4_2ar4.htm)"}]},{"id":"epm:2.3.7","number":"2.3.7","title":"Medical Assistance 1619(a) or 1619(b)","parent":"2.3","breadcrumb":"2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.7 Medical Assistance 1619(a) or 1619(b)","summary":"Supplemental Security Income (SSI) is a federal program administered by the Social Security Administration (SSA) that provides monthly cash payments to people age 65 or older and people who are or certified blind or disabled and have little or no income.","effective_date":"2026-02-06","last_modified":"2026-10-03T04:46:27.480507+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.7","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.3.7","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_3_7.htm","legal_citations":["Minnesota Statutes, section 256B.056, subdivision 1a","Code of Federal Regulations, title 42 section 435.121","Social Security Act, section 1619"],"chunks":[{"chunk_id":"epm:2.3.7#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.3.7","context":"EPM > 2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.7 Medical Assistance 1619(a) or 1619(b)","text":"Supplemental Security Income (SSI) is a federal program administered by the Social Security Administration (SSA) that provides monthly cash payments to people age 65 or older and people who are or certified blind or disabled and have little or no income.\n\nSSI has a work incentive provision under section 1619 of the Social Security Act for people whose earnings reduce or eliminate their SSI cash benefit. People who are eligible for SSI under section 1619 are eligible for Medical Assistance (MA) without requiring verification of their income or assets. 1619(a) is for people who receive a partial SSI cash benefit. 1619(b) is for people who no longer receive an SSI cash benefit and maintain their disability status.\n\nThe SSA determines 1619(a) and 1619(b) non-financial eligibility.\n\nThis page outlines the general, financial, non-financial, and post eligibility requirements for people under a 1619(a) or 1619(b) status. It describes policies that apply to MA-1619(a) and 1619(b) and links to policies that apply to all MA programs, MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD), and all Minnesota Health Care Programs (MHCP) programs.\n1. General Requirements\n  1. MA Applications\n  2. People currently enrolled in MA who gain 1619(a) or 1619 (b) status are not required to submit a new application to continue MA eligibility. People not currently enrolled in MA who gain 1619(a) or 1619(b) status must submit a new application to apply for MA. Refer to [Section 1.2 Minnesota Health Care Programs (MHCP) Applications](https://bot-corpus.mn-dhs.online/s/epm/1.2) for more information about applications.\n  3. [MA Responsibilities](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2)\n    1. [MA Benefit Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1)\n      1. [MA Estate Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.1)\n      2. [MA Liens](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.2)\n      3. [MA Third Party Liability](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3)\n      4. [MA Cost Effective Insurance](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.1)\n      5. [MA Medical Support](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.2)\n      6. [MA Other Third Party Liability](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.3)\n    2. [MA Cooperation](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.2)\n    3. [MA Cost Sharing](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.3)\n    4. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n    5. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n    6. [MA Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4)\n  4. [MHCP Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1)\n    1. [MHCP Appeals](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.1)\n    2. [MHCP Authorized Representative](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.2)\n    3. [MHCP Civil Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.3)\n    4. [MHCP Data Privacy](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.4)\n    5. [MHCP Notices](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.5)\n2. Non-Financial Eligibility\n  1. The person's 1619(a) or 1619(b) status must be verified at application and renewal.\n3. [MA-ABD Non-Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.2)\n- Financial Eligibility\n  1. SSI beneficiaries who received Medical Assistance (MA) the month before the initial month they were certified for special SSI status under sections 1619(a) and 1619(b) of the Social Security Act are eligible for MA without requiring verificaiton of their income or assets. SSA makes determinations and redeterminations of a person’s 1619 (a) or 1619 (b) status.\n  2. Verification of income and assets are not required while the person remains under the 1619(a) or 1619(b) status.\n  3. See the [SSA Continued Medicaid Eligibility](https://www.ssa.gov/disabilityresearch/wi/1619b.htm) web page for more information.\n- Post-Eligibility\n  1. [MA Benefit Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1)\n    1. [MA Estate Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.1)\n    2. [MA Liens](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.2)\n    3. [MHCP Overpayments](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.5)\n    4. [MA Third Party Liability](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3)\n    5. [MA Cost-Effective Insurance](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.1)\n    6. [MA Medical Support](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.2)\n    7. [MA Other Third Party Liability](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.3)\n  2. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n  3. [MA Cooperation](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.2)\n  4. [MA Cost Sharing](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.3)\n  5. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n  6. [MA-ABD Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/2.3.4.1)\n  7. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n  8. [MA Qualifying Health Coverage](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.2)\n  9. [MA Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4)\n  10. [MA-ABD Renewals](https://hcopub.dhs.state.mn.us/epm/2_3_4_2ar4.htm)\n\nDHS pays Medicare Part B premiums for 1619(a) and 1619(b) recipients enrolled in Medicare and receiving Retirement, Survivors, or Disability Insurance (RSDI) benefits."}]},{"id":"epm:2.4","number":"2.4","title":"Medical Assistance for Long-Term Care Services","parent":"2","breadcrumb":"2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services","summary":"Medical Assistance for Long-Term Care Services (MA-LTC) eligibility is available for people who are eligible for MA and meet specific eligibility requirements.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:59.250595+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_4.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services","text":"Medical Assistance for Long-Term Care Services (MA-LTC) eligibility is available for people who are eligible for MA and meet specific eligibility requirements.\n\nLTC services include:\n- Skilled nursing facility (SNF) services\n- Nursing facility services in an inpatient medical hospital\n- Intermediate care facility for Persons with Developmental Disabilities (ICF/DD) services\n- Services covered by home and community-based service waivers (Brain Injury (BI), Community Alternative Care (CAC), Community Access Disability Inclusion (CADI), Developmental Disability (DD), and Elderly Waiver (EW))\n\nThis chapter includes policies that apply to MA-LTC and links to relevant MA and Minnesota Health Care Programs (MHCP) policies.\n1. [MA-LTC Eligibility Requirements](https://bot-corpus.mn-dhs.online/s/epm/2.4.1)\n  1. [MA-LTC Long-Term Care Consultation](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.1)\n  2. [MA-LTC Long-Term Care Home Equity](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.2)\n  3. [MA-LTC Uncompensated Transfers](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3)\n    1. [MA-LTC Lookback Period and Transfer Date](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.1)\n    2. [MA-LTC Transfer Penalty](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.2)\n    3. [MA-LTC Transfer Penalty Exceptions and Hardship Waiver](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.3)\n    4. [MA-LTC Other Asset Transfer Consideration](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.4)\n  4. [MA-LTC Annuities](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.4)\n    1. [MA-LTC Annuity Disclosures](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.4.1)\n    2. [MA-LTC Naming DHS a Preferred Remainder Beneficiary](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.4.2)\n2. [MA-LTC Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.4.2)\n  1. [MA-LTC Asset Assessment](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.1.1)\n    1. [MA-LTC Community Spouse Asset Allowance](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.1.2)\n    2. [MA-LTC Asset Eligibility for the Long-Term Care Spouse](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.1)\n  2. [MA-LTC LTC Partnership Insurance](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.2)\n  3. [MA-LTC HCBS Waivers](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.3)\n    1. [MA-LTC HCBS Waivers for People with Disabilities](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.3.1)\n    2. [MA-LTC HCBS for People Age 65 or Older](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.3.2) (Elderly Waiver)\n  4. [MA-LTC Long-Term Care Facilities](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.4)\n  5. [MA-LTC Income Calculations for Long-Term Care Services](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5)\n    1. [MA-LTC Income Calculation Deductions](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5.1)"}]},{"id":"epm:2.4.1","number":"2.4.1","title":"Eligibility Requirements","parent":"2.4","breadcrumb":"2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements","summary":"This subchapter provides general policy information that applies to Medical Assistance for Long-Term Care Services (MA-LTC).","effective_date":"2023-06-01","last_modified":"2026-10-03T03:51:59.250595+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.4.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_4_1.htm","legal_citations":["Minnesota Statutes, section 256B.056, subdivision 2a","Minnesota Statutes, section 256B.056, subdivision 11","Minnesota Statutes, section 256B.057","Minnesota Statutes, section 256B.0595","Minnesota Statutes, section 256B.0911","Code of Federal Regulations, title 42, section 435.916","United States Code, title 42, section 1396p"],"chunks":[{"chunk_id":"epm:2.4.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements","text":"This subchapter provides general policy information that applies to Medical Assistance for Long-Term Care Services (MA-LTC).\n\nIf an enrollee is no longer eligible for MA under their current basis, they must be redetermined for all health care programs they are potentially eligible for, without interruption in their coverage. See EPM [1.3.2.1 Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1) for more information."},{"chunk_id":"epm:2.4.1#ltc-eligibility-factors","heading":"LTC Eligibility Factors","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1#ltc-eligibility-factors","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > LTC Eligibility Factors","text":"## LTC Eligibility Factors\n\nPeople requesting MA-LTC must meet all of the following eligibility factors to be eligible:\n- Must be eligible for [MA](https://hcopub.dhs.state.mn.us/epm/#eligibility_for_ma)\n- Requires a nursing facility level-of-care as determined through a [Long-Term Care Consultation (LTCC)](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.1)\n- Must have home equity at or below the [home equity limit](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.2)\n- Must not be subject to a period of ineligibility under the [uncompensated transfer rules](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3)\n- Must [name the state the remainder beneficiary](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.4.2) of certain annuities"},{"chunk_id":"epm:2.4.1#eligibility-for-ma","heading":"Eligibility for MA","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1#eligibility-for-ma","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > Eligibility for MA","text":"## Eligibility for MA\n\nPeople who request MA-LTC are required to meet all of the eligibility requirements for MA before determining if the person meets the LTC Eligibility Factors. MA eligibility is determined under MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD), MA for Employed Persons with Disabilities (MA-EPD) or MA with Families with Children and Adults (FCA)."},{"chunk_id":"epm:2.4.1#bases-of-eligibility","heading":"Bases of Eligibility","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1#bases-of-eligibility","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > Bases of Eligibility","text":"## Bases of Eligibility\n\nPeople enrolled in MA are eligible to receive MA-LTC if they meet the LTC Eligiblity Factors.\n\nPeople enrolled in MA who meet the LTC Eligibility Factors are eligible to receive MA-LTC in a long-term care facility (LTCF) only. People eligible for MA-FCA are not eligible to receive services through a home and community-based services (HCBS) waiver. If a person with an FCA basis of eligibility needs services through an HCBS waiver, the person must be determined eligible under MA-ABD.\n\nPeople enrolled in MA for Employed Persons with Disabilities (MA-EPD) who meet the LTC Eligibility Factors are eligible to receive MA-LTC. People who are enrolled in MA-EPD and meet the LTC Eligibility Factors use the MA-ABD income methodology and are subject to MA-EPD asset limits. See EPM [2.3.5.3.1 MA-EPD Assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.3.1)."},{"chunk_id":"epm:2.4.1#minnesota-health-care-programs-applications","heading":"Minnesota Health Care Programs Applications","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1#minnesota-health-care-programs-applications","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > Minnesota Health Care Programs Applications","text":"## Minnesota Health Care Programs Applications\n\nMA applicants who are requesting MA-LTC should use one of the following forms:\n- Application for Payment of Long-Term Care Services ([DHS-3531](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-3531-ENG))\n\nMA enrollees who are requesting LTC services should use one of the following forms:\n- Minnesota Health Care Programs Request for Payment of Long-Term Care Services ([DHS-3543](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-3543-ENG))\n- Minnesota Health Care Programs Payment of Long-Term Care Services for MA for Families with Children and Adults ([DHS-3543A](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-3543A-ENG))\n\nMA enrollees who are requesting MA-LTC coverage of HCBS waiver services should submit one of the following forms:\n- MA-ABD enrollees: Minnesota Health Care Programs Request for Payment of Long-Term Care Services ([DHS-3543](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-3543-ENG))\n- MA-FCA enrollees (to be determined for MA-ABD): Supplement to MNsure Application for Health Coverage and Help Paying for ([DHS-6696A](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-6696A-ENG))\n\nClaims for MA-LTC services cannot be paid until the enrollee is determined eligible for MA-LTC.\n- If the enrollee is requesting services because of a move to an LTCF, eligibility can begin the date the enrollee moved into the LTCF or the date that all eligibility requirements for MA-LTC are met, whichever is later.\n- If the enrollee is requesting services through an HCBS waiver, eligibility can begin no earlier than the date of the LTCC or the date the enrollee meets all eligibility requirements for MA-LTC, whichever is later.\n\n### Notification\n\nPeople who request MA-LTC are notified of the results of the eligibility determination through either a system generated or a manual notice. ”Notice of Action for Medical Assistance (MA) Payment of Long-Term Care Services” ([DHS-4915](http://edocs.dhs.state.mn.us/lfserver/public/DHS-4915-ENG)).\n\nThe lead agency assessor or case manager, or the LTCF, is notified when the person becomes eligible so that LTC services can begin."}]},{"id":"epm:2.4.1.1","number":"2.4.1.1","title":"Long-Term Care Consultation","parent":"2.4.1","breadcrumb":"2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.1 Long-Term Care Consultation","summary":"People requesting Medical Assistance for Long-Term Care Services (MA-LTC) must meet the level of care requirements in order for MA to pay for LTC services. The level of care is documented through a Long-Term Care Consultation (LTCC). The preadmission screening (PAS) of all people seeking admission to a long-term care facility (LTCF) is a component of the LTCC.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:59.250595+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.4.1.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_4_1_1.htm","legal_citations":["Minnesota Statutes, section 256B.0911","Minnesota Statutes, section 256B.0926"],"chunks":[{"chunk_id":"epm:2.4.1.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.1","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.1 Long-Term Care Consultation","text":"People requesting Medical Assistance for Long-Term Care Services (MA-LTC) must meet the level of care requirements in order for MA to pay for LTC services. The level of care is documented through a Long-Term Care Consultation (LTCC). The preadmission screening (PAS) of all people seeking admission to a long-term care facility (LTCF) is a component of the LTCC.\n\nThe intention of the LTCC is the following:\n- Ensure persons are made aware of available home and community-based options\n- Prevent long-term placement of persons in nursing facilities, hospital swing beds and certified boarding care facilities\n- Provide options to persons so they can make informed decisions about where they want to live\n\nUpon request, any person with long-term or chronic care needs is entitled to receive LTCC services regardless of their age or eligibility for Minnesota Health Care Programs (MHCP). The county where the person is located at the time of request or referral for LTCC services is responsible to provide the LTCC services.\n\nIndividuals, families, human services and health professionals, hospital and nursing facility staff may make referrals for LTCC services.\n\nMA will not pay for nursing facility or certified boarding care services received before the PAS date."}]},{"id":"epm:2.4.1.2","number":"2.4.1.2","title":"Long-Term Care Home Equity Limit","parent":"2.4.1","breadcrumb":"2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.2 Long-Term Care Home Equity Limit","summary":"People who request or renew Medical Assistance for Long-Term Care Services (MA-LTC) and own a home must have an equity interest in their home that is at or below the applicable home equity limit to be eligible for MA-LTC. The amount of the home equity limit is indexed annually based on the percentage increase in the consumer price index for all urban consumers.","effective_date":"2016-06-01","last_modified":"2026-10-03T04:45:29.363432+00:00","version":3,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.4.1.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_4_1_2.htm","legal_citations":["Minnesota Statutes, section 256B.056, subdivision 2a","United States Code, title 42, section 1396p, subdivision (f)"],"chunks":[{"chunk_id":"epm:2.4.1.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.2","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.2 Long-Term Care Home Equity Limit","text":"People who request or renew Medical Assistance for Long-Term Care Services (MA-LTC) and own a home must have an equity interest in their home that is at or below the applicable [home equity limit](https://bot-corpus.mn-dhs.online/s/epm/F#home-equity-limit) to be eligible for MA-LTC. The amount of the home equity limit is indexed annually based on the percentage increase in the consumer price index for all urban consumers.\n\nHome equity is the fair market value (FMV) less any encumbrances. A person’s home equity interest must be verified each time a person requests or renews MA-LTC unless an exception applies."},{"chunk_id":"epm:2.4.1.2#definition-of-home-for-home-equity-limit","heading":"Definition of Home for Home Equity Limit","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.2#definition-of-home-for-home-equity-limit","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.2 Long-Term Care Home Equity Limit > Definition of Home for Home Equity Limit","text":"## Definition of Home for Home Equity Limit\n\nA home is defined for the home equity limit as the primary dwelling a person owns in whole or in part, and in which he or she lives or lived immediately prior to receiving LTC services. A home includes the primary dwelling, all surrounding land and any building on that land, provided the land is not separated from the dwelling by property owned by another person. Land separated from the dwelling by a public right-of-way is included in the definition of the home.\n\nHome equity is determined by subtracting the encumbrances on the home from the person's interest in the market value of the home.\n\nSee [Agricultural Homestead](https://hcopub.dhs.state.mn.us/epm/#agricultural_homestead) to evaluate a home located on agricultural land."},{"chunk_id":"epm:2.4.1.2#verification-requirements","heading":"Verification Requirements","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.2#verification-requirements","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.2 Long-Term Care Home Equity Limit > Verification Requirements","text":"## Verification Requirements\n\nThe fair market value (FMV) or estimated market value (EMV) of a person’s home must be verified at the time the home equity limit is applied. If the FMV or EMV is greater than the applicable home equity limit, then encumbrances must also be verified to determine the home equity interest.\n\nThe county, tribal or state agency verifies the EMV through the county assessor’s website. The person must provide verification of the FMV if the information cannot be obtained from the county assessor’s website or the person disputes the EMV.\n\nPeople who dispute the EMV must provide real estate appraisal as the verification.\n\nFMV or EMV may be found on the following:\n- A real estate tax statement\n- A statement from the county property tax appraiser\n- An estimate of value from a licensed real estate appraiser\n\nEncumbrances may be one of the following:\n- Mortgages\n- Contracts for deed\n- Mechanic’s liens\n- Home equity loans\n- Other legally binding debts that are secured on the home"},{"chunk_id":"epm:2.4.1.2#application-of-the-home-equity-limit-policy","heading":"Application of the Home Equity Limit Policy","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.2#application-of-the-home-equity-limit-policy","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.2 Long-Term Care Home Equity Limit > Application of the Home Equity Limit Policy","text":"## Application of the Home Equity Limit Policy\n\nThe home equity limit does not apply in the following situations:\n- Dependent relative lives in the home. The home equity limit does not apply if a dependent relative of the person lives in the person’s home. For purposes of the home equity limit policy, dependent relatives include:\n  - Spouse\n  - Children of the person or the person’s spouse who are either:\n    - Under 21 years of age\n    - Of any age and who are blind or permanently and totally disabled\n- A demonstrated [home equity limit hardship](https://hcopub.dhs.state.mn.us/epm/#agricultural_homestead) exists. The home equity limit does not apply when an imminent threat to a person’s health and well-being exists if MA-LTC is denied.\n\nThe home equity limit does apply:\n- When a request for MA-LTC is made after a break in LTC services, regardless of when the first request for payment was made\n- At annual renewal for enrollees approved for MA-LTC\n- When an exception no longer applies"},{"chunk_id":"epm:2.4.1.2#agricultural-homestead","heading":"Agricultural Homestead","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.2#agricultural-homestead","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.2 Long-Term Care Home Equity Limit > Agricultural Homestead","text":"## Agricultural Homestead\n\nAn agricultural homestead is property located on agricultural land that meets the definition of \"home\" and includes the dwelling, the garage, if any, and one acre of land immediately surrounding the dwelling.\n\nA determination of whether a home is considered an agricultural homestead is only needed when the person’s home equity interest is determined to be greater than the home equity limit.\n\nThe equity value of an agricultural homestead is determined by subtracting the verified encumbrances from the EMV listed on the property tax records. The EMV listed on the property tax records is used, rather than the FMV, for agricultural homesteads. Tax records verify that the homestead qualifies as an agricultural homestead.\n\nIf any farm buildings or structures are located on the agricultural homestead, the market value of those structures are not included in the value of the agricultural homestead."},{"chunk_id":"epm:2.4.1.2#waiver-of-home-equity-limit-for-demonstrated-hardship","heading":"Waiver of Home Equity Limit for Demonstrated Hardship","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.2#waiver-of-home-equity-limit-for-demonstrated-hardship","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.2 Long-Term Care Home Equity Limit > Waiver of Home Equity Limit for Demonstrated Hardship","text":"## Waiver of Home Equity Limit for Demonstrated Hardship\n\nA demonstrated home equity limit hardship is an imminent threat to a person’s health and well-being if MA-LTC is denied. A hardship is demonstrated by supporting documentation provided by the person or the person’s authorized representative. Documentation of a hardship is evaluated on a case-by-case basis.\n\nRequests for a waiver of the home equity limit based on hardship must be made in writing by either the person or the person’s representative.\n\n### Verification of Hardship\n\nThe person must provide documentation showing that there are no other resources available to pay for LTC services and one of the following conditions apply:\n- At least two financial institutions have turned down the person’s application for a reverse mortgage or home equity loan.\n- The person is a joint owner of a home and one or more joint owners refuse to apply for a reverse mortgage or home equity loan in a joint application with the person.\n  - A hardship is not demonstrated if the person’s spouse is the only joint owner refusing to apply for a reverse mortgage or home equity loan.\n- There is a legal barrier to the sale of the person’s ownership interest in the home or to the approval of a reverse mortgage or home equity loan.\n\n### Hardship Waiver Decision\n\nThe facts and documentation provided by the person or the person’s authorized representative must be reviewed to determine whether a waiver of the home equity limit should be granted.\n- A decision must be provided within 30 days of the written request if all necessary information has been provided.\n- An extension may be granted if more time is needed to provide the documentation.\n- Written notice of the decision using the Notice of Action for Payment of LTC Services (DHS-4915) is required to be sent to the person and, if applicable, the authorized representative."}]},{"id":"epm:2.4.1.3","number":"2.4.1.3","title":"Uncompensated Transfers","parent":"2.4.1","breadcrumb":"2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.3 Uncompensated Transfers","summary":"The transfer of an asset or income without adequate compensation, known as an uncompensated transfer, may result in a period of ineligibility for Medical Assistance for Long-Term Care Services (MA-LTC). The transfer of an asset or income is assumed to be for the purpose of obtaining or maintaining eligibility for MA-LTC unless the person provides convincing evidence that proves otherwise. County, ","effective_date":"2018-04-01","last_modified":"2026-10-03T04:45:31.946242+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.4.1.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_4_1_3.htm","legal_citations":["Minnesota Statutes, section 256B.0595","United States Code, title 42, section 1396p(c)"],"chunks":[{"chunk_id":"epm:2.4.1.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.3 Uncompensated Transfers","text":"The transfer of an asset or income without adequate compensation, known as an uncompensated transfer, may result in a period of ineligibility for Medical Assistance for Long-Term Care Services (MA-LTC). The transfer of an asset or income is assumed to be for the purpose of obtaining or maintaining eligibility for MA-LTC unless the person provides [convincing evidence](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.3#convincing-evidence) that proves otherwise. County, tribal, or state agency workers must only evaluate transfers that are disclosed on an application or are discovered through a fraud investigation.\n\nThe period of ineligibility that may result due to an uncompensated transfer is known as a [transfer penalty](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.2), and occurs if all of the following apply:\n- the transfer was made by any of the following people:\n  - The person\n  - The person’s spouse\n  - A person’s authorized representative acting on behalf of the person or the person’s spouse\n  - A court or administrative body acting at the direction of the person or the person’s spouse\n  - A court or administrative body with legal authority to act in place of the person or the person’s spouse\n- The transfer occurred within the [lookback period](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.1) or while the person is receiving MA-LTC,\n- The person did not receive adequate compensation, and\n- No [transfer penalty exception](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.3) applies.\n\nTransactions that occur outside the lookback period are not evaluated and are not subject to transfer penalties.\n\nThis section of the manual details the uncompensated transfer."},{"chunk_id":"epm:2.4.1.3#transfer-of-ownership","heading":"Transfer of Ownership","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3#transfer-of-ownership","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.3 Uncompensated Transfers > Transfer of Ownership","text":"## Transfer of Ownership\n\nA transfer occurs when a person or the person's spouse gives away, sells, conveys ownership, and/or reduces control, or disposes of any asset or income or an interest in an asset or income.\n\n### Uncompensated transfers may include, but are not limited to:\n- Transferring an interest in a life estate to another person\n- Establishing an interest in a [life estate](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.4#life-estates-interest-evaluated-under-the-transfer-policy)\n- Annuitizing an [annuity](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.4#annuities-evaluated-under-the-transfer-policy)\n- Transferring assets or income into a client-funded [trust](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.4#trusts-evaluated-under-the-transfer-policy)\n- Transferring assets or income into a special needs or pooled [trust](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.4#trusts-evaluated-under-the-transfer-policy) after the person turns age 65\n- Assigning the right to an income stream to another person\n- Reducing or eliminating ownership or control of income or assets held in common with another person or persons\n- Placing an asset into joint ownership with another person thereby reducing or eliminating ownership, interest, control or right to sell or dispose of an asset\n- Any action that results in a person giving up the right to income or assets to which the person is entitled, unless:\n  - The person cannot afford to take action to obtain the asset or income.\n  - The cost of taking the action is more than the asset or income is worth.    Examples of this type of transfer include:\n    - Refusing to accept an inheritance or testamentary gift, unless the costs associated with accepting it exceed the value of the gift.\n    - A spouse’s refusal to take an action to receive his or her elective share of a spouse’s estate when the value of the elective share is greater than the provisions for the surviving spouse in a will.\n- Waiving pension income or diverting it to a trust or similar device for the benefit of another\n- Refusing to take affordable legal action to obtain court-ordered payments that are not being paid, such as child support or spousal support\n- Not accepting or taking action to obtain a right to personal injury settlements\n- Diverting personal injury settlements by the defendant into a trust or similar legal device to be held for the benefit of the plaintiff\n- [Certain purchases](https://hcopub.dhs.state.mn.us/epm/#certain_purchases)\n\n### Uncompensated transfers do not include:\n- A distribution of assets as directed by a court order\n- Any actions taken during a person's lifetime that does not result in a transfer of ownership until after the person's death including:\n  - Creating or modifying a transfer on death deed (TODD)\n  - Creating or modifying a will\n  - Changing a designation on a life insurance policy"},{"chunk_id":"epm:2.4.1.3#certain-purchases-as-transfers","heading":"Certain Purchases as Transfers","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3#certain-purchases-as-transfers","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.3 Uncompensated Transfers > Certain Purchases as Transfers","text":"## Certain Purchases as Transfers\n\nA transfer takes place when a person purchases personal care or other types of services, personal or real property, a life estate interest, or an interest in a financial arrangement such as a promissory note, loan, or mortgage. The purchase may be made with cash or with another asset that has a value equivalent to the agreed upon purchase price. When a person pays more than the fair market value (FMV) of the item they are purchasing, an uncompensated transfer may have occurred. This section discusses how to evaluate purchases under transfer rules.\n\n### Purchase of Personal Care Services\n\nThe purchase of personal care services is paying another person to provide services that aid the purchaser in performing their activities of daily living. Payment for these services is not an uncompensated transfer when:\n- The care or services directly benefit the person; and\n- The purchaser provides compensation in an amount consistent with customary fees charged for providing similar services in the community in which the purchaser resides; and\n- When a relative of the purchaser provides the care or services, a written and notarized agreement is in place on or before the date the care or services begin. The agreement must:\n  - Be signed by the person receiving the care or services and the relative(s) who will be providing the care or services\n  - Include an itemized list of the care or services that will be provided\n  - Specify the amount of time that is anticipated to be spent providing the care and services; and\n  - State the period of time the agreement covers.\n\nThe requirement to have a written agreement prior to services being provided is waived when compensation for the services provided by the relative(s) was made within 60 days after the services were provided.\n\n### Purchase of Other Services\n\nThe purchase of other services occurs when a person pays someone to perform services such as lawn care, snow shoveling, tax preparation, etc. These services are not an uncompensated transfer if:\n- The service directly benefits the person; and\n- The person paid an amount consistent with customary fees charged for similar services in the community in which the person resides.\n\n### Purchase of Interest in Promissory Notes, Loans and Mortgages\n\nThe purchase of an interest in a promissory note, loan, or mortgage occurs when a person buys the right to receive the payments under a contract from another person or entity. These purchases are not an uncompensated transfer if the contract meets all of the following requirements:\n- The terms of the contract provide for payments to be made in equal amounts.\n- There is no provision for deferral of payments.\n- There is no provision for balloon payments.\n- Cancellation of the balance due upon the death of the purchaser is prohibited and\n- The repayment terms are actuarially sound.\n\nRepayment terms are actuarially sound if the person will receive all of the payments within their anticipated life expectancy. To determine the total amount a person expects to receive during their life expectancy, the figure that corresponds to the purchaser’s age at the time of purchase is found on the [Social Security Administration (SSA) Actuarial Table](https://www.ssa.gov/oact/STATS/table4c6.html), and is then multiplied by the total annual payment the purchaser will receive under the contract. If the purchase price of the interest is:\n- Less than or equal to the total amount the purchaser expects to receive in their anticipated lifetime, the purchase is actuarially sound and no further evaluation under transfer rules is required.\n- More than the amount that the purchaser expects to receive in their anticipated lifetime, the purchase is not actuarially sound. The difference between the purchase price and the total amount the purchaser can expect to receive during their anticipated lifetime (including principal and interest), is counted as the uncompensated value.\n\n### Purchase of Personal and Real Property\n\nIn general, a purchase price for personal or real property in an amount that exceeds the FMV of the personal or real property is an uncompensated transfer. The amount of the uncompensated transfer is the difference between the FMV of the personal or real property and the purchase price.\n\n### Purchase of a Life Estate Interest in Another Person’s Home\n\nThe purchase of a life estate interest in another person’s home gives the purchaser the right to occupy the property and may allow the purchaser to retain income earned by the property depending on the terms of the life estate agreement. The purchase of a life estate interest in another person’s home is evaluated to determine if an uncompensated transfer has occurred.\n\nThe purchase of a life estate in another person’s home is not an uncompensated transfer if:\n- The FMV was more than or equal to the purchase price; and\n- The person resided in the home for more than 12 consecutive months.\n\nThe purchase of a life estate in another person’s home is an uncompensated transfer if either of the following occur:\n- The person did not reside in the home for 12 consecutive months following the date of purchase, even if the FMV was more than or equal to the purchase price or\n- The FMV was less than the purchase price of the life estate interest. The uncompensated amount is the difference between the value of the life estate interest and the purchase price."}]},{"id":"epm:2.4.1.3.1","number":"2.4.1.3.1","title":"Lookback Period and Transfer Date","parent":"2.4.1.3","breadcrumb":"2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.3 Uncompensated Transfers > 2.4.1.3.1 Lookback Period and Transfer Date","summary":"The lookback period is a specific period of time before the date a person requests Medical Assistance for Long-Term Care Services (MA-LTC) and is either residing in a long-term care facility (LTCF) or has been screened and been found to need services provided through a home and community-based services (HCBS) waiver program. The date these conditions are met is referred to as the baseline date.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:59.250595+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.4.1.3.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_4_1_3_1.htm","legal_citations":["Minnesota Statutes, section 256B.0595","United States Code, title 42, section 1396p(c)"],"chunks":[{"chunk_id":"epm:2.4.1.3.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.1","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.3 Uncompensated Transfers > 2.4.1.3.1 Lookback Period and Transfer Date","text":"The lookback period is a specific period of time before the date a person requests Medical Assistance for Long-Term Care Services (MA-LTC) and is either residing in a long-term care facility (LTCF) or has been screened and been found to need services provided through a home and community-based services (HCBS) waiver program. The date these conditions are met is referred to as the baseline date.\n\nAll transfers made during the lookback period must be evaluated to determine if the transfer was [uncompensated](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3) and if a [transfer penalty](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.2) applies."},{"chunk_id":"epm:2.4.1.3.1#determining-the-lookback-period","heading":"Determining the Lookback Period","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.1#determining-the-lookback-period","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.3 Uncompensated Transfers > 2.4.1.3.1 Lookback Period and Transfer Date > Determining the Lookback Period","text":"## Determining the Lookback Period\n\nThe lookback period is 60 months prior to the baseline date. A new lookback period is established each time a person requests MA-LTC following a break in LTC services. A break in LTC services is a gap of one calendar month or more in receiving MA-LTC because the person either:\n- Became ineligible for MA-LTC services\n- Stopped residing in a LTCF or receiving services through an HCBS waiver program.\n\nA new lookback period is established with each new request for MA-LTC following a break in LTC services."},{"chunk_id":"epm:2.4.1.3.1#transfer-date","heading":"Transfer Date","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.1#transfer-date","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.3 Uncompensated Transfers > 2.4.1.3.1 Lookback Period and Transfer Date > Transfer Date","text":"## Transfer Date\n\nThe following criteria determine whether a transfer occurred during the lookback period:\n- When the transfer occurs via a personal check, the transfer date is the date the check clears the bank.\n- The transfer date for an [annuity](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.4) is one of the following, depending on the type of transaction:\n  - Date of annuitization\n  - Date the annuity owner transfers ownership of the annuity to someone else\n  - Date annuity payments are transferred to someone else\n- The transfer of real property is completed when both execution and delivery have taken place. The transfer date is the earliest verified delivery date.\n  - Execution is the signing of the deed by the person selling (seller) or transferring (donor) the property.\n  - Delivery is the giving of the deed to the buyer or donee (or their representative), or recording the deed in the county recorder’s office.\n- To determine the date of transfer into a client-funded trust:\n  - The date of transfer into an irrevocable client-funded trust created before July 1, 2005 is the date the trust is funded. A new transfer occurs each time the beneficiary adds additional funds to the trust. The date of transfer is the date the additional funds are deposited into the trust.\n    - Assets transferred into an irrevocable trust established on or after July 1, 2005 are treated as available assets. Assets transferred into these trusts are not evaluated as uncompensated transfers.\n  - The date of the transfer from a client-funded trust to or for the benefit of someone other than the beneficiary is the date the payment is made.\n  - The date of transfer by a person age 65 or older into a special needs trust or pooled trust is the date the trust is funded or the beneficiary’s funds are added to an existing trust after the date the beneficiary reaches age 65.\n- A signed consent agreement stating the person will not elect against a spouse's will when the person does not receive assets equal to or greater than the spouse’s share under the intestacy laws is a transfer at the time of signing or at the death of the testator, whichever is later."}]},{"id":"epm:2.4.1.3.2","number":"2.4.1.3.2","title":"Transfer Penalty","parent":"2.4.1.3","breadcrumb":"2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.3 Uncompensated Transfers > 2.4.1.3.2 Transfer Penalty","summary":"The transfer penalty for uncompensated transfers is a period of ineligibility for Medical Assistance for Long-Term Care Services (MA-LTC). The transfer penalty only applies to people who meet all of the other criteria to receive MA-LTC. See MA-LTC Eligibility Requirements for more information regarding MA-LTC eligibility. Therefore, the transfer penalty cannot start until a person would be otherwi","effective_date":"2023-06-01","last_modified":"2026-10-03T04:45:32.47729+00:00","version":3,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.4.1.3.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_4_1_3_2.htm","legal_citations":["Minnesota Statutes, section 256B.0595","United States Code, title 42, section 1396p(c)","Social Security Act §1917(c)"],"chunks":[{"chunk_id":"epm:2.4.1.3.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.2","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.3 Uncompensated Transfers > 2.4.1.3.2 Transfer Penalty","text":"The transfer penalty for uncompensated transfers is a period of ineligibility for Medical Assistance for Long-Term Care Services (MA-LTC). The transfer penalty only applies to people who meet all of the other criteria to receive MA-LTC. See [MA-LTC Eligibility Requirements](https://bot-corpus.mn-dhs.online/s/epm/2.4.1) for more information regarding MA-LTC eligibility. Therefore, the transfer penalty cannot start until a person would be otherwise eligible for MA-LTC. This section discusses how the transfer penalty is calculated."},{"chunk_id":"epm:2.4.1.3.2#uncompensated-transfer-amount","heading":"Uncompensated Transfer Amount","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.2#uncompensated-transfer-amount","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.3 Uncompensated Transfers > 2.4.1.3.2 Transfer Penalty > Uncompensated Transfer Amount","text":"## Uncompensated Transfer Amount\n\nThe calculation for the transferred penalty starts by determining the uncompensated transfer amount.\n\nThe amount of the uncompensated transfer varies for certain assets. See [Other Asset Transfer Considerations](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.4) for transfers involving the following assets:\n- An annuity\n- A life estate\n- A trust\n\nThe uncompensated amount of all other transfers is the amount of income transferred or the fair market value (FMV) of the asset transferred, less any encumbrances and compensation received, on the transfer date."},{"chunk_id":"epm:2.4.1.3.2#determining-the-transfer-penalty","heading":"Determining the Transfer Penalty","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.2#determining-the-transfer-penalty","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.3 Uncompensated Transfers > 2.4.1.3.2 Transfer Penalty > Determining the Transfer Penalty","text":"## Determining the Transfer Penalty\n\nThe transfer penalty begin date depends on several factors, including:\n- When the transfer took place\n- When the transfer was reported or discovered\n- When the person first applied for or requested MA-LTC\n- When the person was otherwise eligible\n- Whether the person was receiving LTC services at the time the transfer was reported or discovered\n\nThe transfer penalty is applied differently for applicants and enrollees.\n\n### Applicants Requesting MA-LTC\n\nFor applicants, the transfer penalty may be imposed for transfers made during the lookback period. The transfer penalty is calculated by adding together all uncompensated transfers and dividing that amount by the [MA Statewide Average Payment for a Skilled Nursing Facility](https://bot-corpus.mn-dhs.online/s/epm/F) (SAPSNF) in effect in the month the applicant was found to be otherwise eligible for MA-LTC. The penalty period is the full number of months plus any partial months resulting from this calculation.\n- The partial month is an amount that the MA-LTC payment is reduced in that month.\n- If the transfer penalty amount is less than a full month of eligibility for MA-LTC, the MA-LTC payments are reduced by the transfer penalty amount.\n\nThe transfer penalty period begins with the first month for which the person is requesting and is otherwise eligible for MA-LTC. Once the transfer penalty has started it runs uninterrupted until it expires, even if the person is no longer in a long term care facility (LTCF) or receiving MA or MA LTC services.\n\n### Enrollees Receiving MA-LTC\n\nFor enrollees, a transfer penalty may be imposed for transfers made during the lookback period but not previously reported and transfers made while the person was enrolled in MA-LTC. The transfer penalty is calculated by adding together all uncompensated transfers and dividing by the SAPSNF in effect at the time of the last renewal. The penalty period is the full number of months plus any partial months resulting from this calculation.\n- The partial month is an amount that the MA-LTC payment is reduced in that month.\n- If the transfer penalty amount is less than a full month of eligibility for MA-LTC, the MA-LTC payments is reduced by the transfer penalty amount.\n\nThe transfer penalty period begins with the first month following the month in which a 10-day notice is provided. In order to impose the full transfer penalty, the agency must send the 10-day notice no later than three calendar months after the uncompensated transfer is reported or otherwise discovered. If the agency does not send the 10-day notice within those three calendar months, only the remaining months of the transfer penalty following the month the 10-day notice is sent can be imposed. Once the transfer penalty has been started it runs uninterrupted until it expires, even if the person is no longer in a LTCF or receiving MA or MA LTC services."},{"chunk_id":"epm:2.4.1.3.2#imposing-a-transfer-penalty-for-people-who-are-married","heading":"Imposing a Transfer Penalty for People who are Married","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.2#imposing-a-transfer-penalty-for-people-who-are-married","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.3 Uncompensated Transfers > 2.4.1.3.2 Transfer Penalty > Imposing a Transfer Penalty for People who are Married","text":"## Imposing a Transfer Penalty for People who are Married\n\nThe policy below describes how a transfer penalty is applied when one or both spouses of a married couple receive MA-LTC.\n\nThe transfer penalty is applied as follows if only one spouse is requesting MA-LTC:\n- If only one spouse is applying for or enrolled in MA-LTC, the entire transfer penalty is applied to the spouse who is applying for or enrolled in MA-LTC, regardless of which spouse transferred the asset.\n\nTransfer penalties are divided between spouses when they are both requesting MA-LTC and receiving LTC services.\n- If one spouse is subject to an existing transfer penalty period at the time the other spouse requests MA-LTC, any remaining transfer penalty is divided evenly between the spouses.\n- If the transfer penalty is not exhausted when one spouse’s MA-LTC ends, the remaining balance is applied to the remaining spouse receiving MA-LTC until the penalty expires."},{"chunk_id":"epm:2.4.1.3.2#ma-eligibility-during-the-transfer-penalty","heading":"MA Eligibility During the Transfer Penalty","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.2#ma-eligibility-during-the-transfer-penalty","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.3 Uncompensated Transfers > 2.4.1.3.2 Transfer Penalty > MA Eligibility During the Transfer Penalty","text":"## MA Eligibility During the Transfer Penalty\n\nA person may still be eligible for MA with an ABD basis of eligibility or MA with an FCA basis of eligibility during the transfer penalty period. A person’s eligibility must be evaluated for other MA bases of eligibility and other health care programs before closing or denying coverage. A person may be subject to a medical spenddown when applicable.\n\nMA will only pay for non-LTC services during the transfer period if the person is eligible for MA."},{"chunk_id":"epm:2.4.1.3.2#income-calculations-during-a-period-of-ineligibility","heading":"Income Calculations During a Period of Ineligibility","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.2#income-calculations-during-a-period-of-ineligibility","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.3 Uncompensated Transfers > 2.4.1.3.2 Transfer Penalty > Income Calculations During a Period of Ineligibility","text":"## Income Calculations During a Period of Ineligibility\n\nMA-LTC income methodologies do not apply during full months of MA-LTC ineligibility, however, a person may still be eligible for MA with an ABD basis of eligibility or MA with an FCA basis of eligibility during the transfer penalty period. A person must be determined eligible based on the income methodology associated with their basis:\n- [MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD)](https://bot-corpus.mn-dhs.online/s/epm/2.3)\n- [MA for Employed Persons with Disaibilities](https://bot-corpus.mn-dhs.online/s/epm/2.3.5)[(MA-EPD)](https://bot-corpus.mn-dhs.online/s/epm/2.3.5)\n- [MA for Families With Children and Adults (MA-FCA)](https://bot-corpus.mn-dhs.online/s/epm/2.2)"},{"chunk_id":"epm:2.4.1.3.2#eliminating-a-transfer-penalty","heading":"Eliminating a Transfer Penalty","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.2#eliminating-a-transfer-penalty","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.3 Uncompensated Transfers > 2.4.1.3.2 Transfer Penalty > Eliminating a Transfer Penalty","text":"## Eliminating a Transfer Penalty\n\nA transfer penalty is imposed on the date the agency calculates a transfer penalty and sends the person a notice regarding the penalty period. Once the penalty is imposed, it runs continuously and without interruption until it expires. The transfer penalty cannot be reduced or shortened. The only way to eliminate a transfer penalty is if the person receives a full return of the transferred assets. A transfer penalty is not eliminated if assets are partially returned.\n\n### Clarification of Full Return\n\nA transfer penalty cannot end unless the transferor(s) receives a full return of the transferred assets. When the transferee is returning the same transferred asset, the value of the asset at the time of the return must be equal to or greater than the value of the asset at the time of the transfer in order to be considered a full return.\n\nFor non-cash transfers, the transferee has the option to substitute a cash payment in exchange for the return of the transferred asset. The amount of the cash payment must be equal to or greater than the uncompensated amount used to calculate the transfer penalty. If the value of the transferred asset has decreased or the transferee no longer has the transferred asset, the only way the transfer penalty can end is if the transferee provides a cash payment to the transferor. A transferee cannot substitute a non-cash asset in exchange for the transferred asset.\n\nIn order to return transferred assets, the transferee must make the returned asset or its cash equivalent available to the transferor. It is available if the transferor has both the legal authority and the actual ability to use the asset or to convert it to cash. A direct payment of the transferor’s obligations by the transferee (such as payment of his or her nursing home bill) is not a return of transferred assets because the assets are never actually available to the transferor.\n\n### Verification Requirements\n\nThe transfer penalty cannot end due to full return of the asset(s) unless a person has verified that:\n- The transferee returned all of the transferred assets or their cash equivalent to the transferor.\n- The value of the returned asset at the time of the return is equal to or greater than the value of the asset at the time of the transfer.\n\nUpon receipt of the verification, the transfer penalty ends the first of the month following the month of the full return.\n\n### Effect of Returned Assets on Eligibility for MA\n\nAsset eligibility is evaluated when the assets are returned to determine a person’s ongoing eligibility for MA. If the return of assets results in excess countable assets, the enrollee must be provided the opportunity to reduce excess countable assets. If the enrollee is unable to reduce assets to within the asset limit, MA eligibility must be redetermined and if appropriate, closed with advanced notice. See [MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) Excess Assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.6) for more information.\n\n### Eligibility for MA-LTC\n\nA person is not automatically eligible for MA-LTC upon the end of a transfer penalty. Ending the transfer penalty only eliminates a barrier for MA-LTC identified in a previous request. When a transfer penalty ends (or is eliminated), a determination must be made to ensure the person currently meets all eligibility requirements for MA-LTC.\n- People not enrolled in MA when the transfer penalty ends must reapply for MA if it is outside the application processing period associated with the last completed application\n- People enrolled in MA when the transfer penalty ends must submit a Minnesota Health Care Programs (MHCP) Request for Payment of Long-Term Care Services ([DHS-3543](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3543-ENG)) if they had a gap of one calendar month or more between the date the transfer penalty was imposed and the date of the request for MA-LTC."}]},{"id":"epm:2.4.1.3.3","number":"2.4.1.3.3","title":"Transfer Penalty Exceptions and Hardship Waiver","parent":"2.4.1.3","breadcrumb":"2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.3 Uncompensated Transfers > 2.4.1.3.3 Transfer Penalty Exceptions and Hardship Waiver","summary":"Not all uncompensated transfers result in a transfer penalty. Some uncompensated transfers meet an exception, which means a penalty is not imposed.","effective_date":"2026-02-06","last_modified":"2026-10-03T04:45:32.122127+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.4.1.3.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_4_1_3_3.htm","legal_citations":["Minnesota Statutes, section 256B.0595","United States Code, title 42, section 1396p(c)"],"chunks":[{"chunk_id":"epm:2.4.1.3.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.3","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.3 Uncompensated Transfers > 2.4.1.3.3 Transfer Penalty Exceptions and Hardship Waiver","text":"Not all uncompensated transfers result in a transfer penalty. Some uncompensated transfers meet an exception, which means a penalty is not imposed.\n\nThe following uncompensated transfers are exempt from a transfer penalty:\n- Uncompensated transfers made prior to the lookback period\n- The transferred assets are excluded assets (other than a homestead)\n- Uncompensated transfers granted a hardship waiver\n- There is convincing evidence of intent to receive fair market value (FMV)\n- There is convincing evidence to show the purpose of the transfer was exclusively for a reason other than to obtain or maintain Medical Assistance (MA)\n- Assets are transferred to an applicant or enrollee’s spouse or another person for the sole benefit of the applicant or enrollee’s spouse\n- Assets are transferred to a child of either the person or the person’s spouse, regardless of the child’s age, if the child is blind or certified disabled.\n- Assets are transferred into a trust established for the sole benefit of a child of either the person or the person’s spouse, regardless of the child’s age, if the child is blind or certified disabled\n- Assets are transferred into a trust established for the sole benefit of any person under age 65 certified disabled by Social Security Administration (SSA) or the State Medical Review Team (SMRT)"},{"chunk_id":"epm:2.4.1.3.3#homestead-transfers","heading":"Homestead Transfers","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.3#homestead-transfers","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.3 Uncompensated Transfers > 2.4.1.3.3 Transfer Penalty Exceptions and Hardship Waiver > Homestead Transfers","text":"## Homestead Transfers\n\nAn uncompensated transfer of a homestead is exempt from a transfer penalty when the transfer is made to:\n- A spouse\n- A child under age 21 of the person or the person’s spouse\n- A child (of any age) of the person or the person’s spouse if the child is blind or certified disabled.\n- A child (of any age) of the person or person’s spouse, when both of the following occur:\n  - The child lived in the home for at least two years immediately before the person entered a Long-Term Care Facility (LTCF) or began receiving services through a home and community-based services (HCBS) waiver program.\n  - The child provided verifiable care that allowed the person to remain at home rather than enter an LTCF or begin receiving services through a HCBS waiver. A statement provided by the attending physician, advanced practice registered nurse, or physician’s assistant that verifies the care provided by the child allowed the person to remain at home is required.\n- A sibling of the person or person’s spouse, when that sibling meets both of the following:\n  - The sibling has an equity interest in the home.\n  - The sibling lived in the home at least one year immediately before the person entered an LTCF or began receiving services through a HCBS.\n\nThe homestead is not required to be the primary residence of the transferee or be occupied by the transferee at the time of the transfer.\n\nThe exemption from a transfer penalty for the transfer of a homestead applies even if the homestead has lost its excluded status because the person has lived in a LTCF for more than six months. See [MA for People Age 65 or Older and People who are Blind or have a Disability (ABD) Homestead Exclusion](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.1#homestead-real-property-exclusion) for more information."},{"chunk_id":"epm:2.4.1.3.3#transfers-made-for-purposes-other-than-to-qualify-for-medical-assistance","heading":"Transfers Made for Purposes Other than to Qualify for Medical Assistance","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.3#transfers-made-for-purposes-other-than-to-qualify-for-medical-assistance","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.3 Uncompensated Transfers > 2.4.1.3.3 Transfer Penalty Exceptions and Hardship Waiver > Transfers Made for Purposes Other than to Qualify for Medical Assistance","text":"## Transfers Made for Purposes Other than to Qualify for Medical Assistance\n\nThe presumption is that an uncompensated transfer is made for the purpose of obtaining MA eligibility unless the person provides convincing evidence that it was made exclusively for another reason.\n\nA person cannot overcome the presumption that an uncompensated transfer was made for the following reasons:\n- Preserving an estate for heirs\n- Avoiding probate\n- Reducing taxes\n\n### Convincing Evidence\n\nConvincing evidence that a transfer was not made for the purpose of obtaining or maintaining MA eligibility may include:\n- Assets owned by the person would be below the applicable limit even if the transferred asset had been retained\n  - For people requesting MA-LTC, total countable assets including the transferred asset were within the asset limit at all times from the month in which the transfer occurred through the month in which the person requests MA-LTC.\n  - For people receiving MA-LTC, total countable assets including the transferred asset were within the asset limit in the month in which the transfer occurred.\n- The person documents that the transfer was beyond his or her control, such as a court-ordered payment.\n- The person demonstrates that the need for LTC services could not have been anticipated at the time of the transfer.\n- The person demonstrates that after the time of the transfer, an unexpected loss of other assets or income resulted in an inability to pay for LTC services.\n- The person demonstrates a well-established history, which began prior to the lookback period, of making regular contributions to a religious or charitable nonprofit organization to which he or she belongs.\n- The person provides proof of intent to receive FMV.\n\nVerbal assurances and statements signed by the person are not sufficient without further documentation."},{"chunk_id":"epm:2.4.1.3.3#waiver-of-transfer-penalty","heading":"Waiver of Transfer Penalty","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.3#waiver-of-transfer-penalty","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.3 Uncompensated Transfers > 2.4.1.3.3 Transfer Penalty Exceptions and Hardship Waiver > Waiver of Transfer Penalty","text":"## Waiver of Transfer Penalty\n\nA county, tribal, or state agency must waive a transfer penalty if there is an [imminent threat](https://hcopub.dhs.state.mn.us/epm/#Imminent_Threat_to_Health_and_Well-Being) to the person’s health and well-being and waiving the transfer penalty will resolve the imminent threat.\n\n### Notification Requirement\n\nA notice is required whenever the county, tribal, or state agency has determined that the person is ineligible for MA-LTC due to a transfer penalty. The notice must inform the person of his or her right to request a waiver of the transfer penalty if it will cause an undue hardship.\n\n### Requests to Waive a Transfer Penalty\n\nThe following people can request a waiver of a transfer penalty:\n- The applicant or enrollee\n- The applicant or enrollee’s authorized representative\n- The LTCF in which the applicant or enrollee resides. In order to accept a request from an LTCF, the request must include a signed statement from the applicant or enrollee or their authorized representative acknowledging approval of the request.\n  - An LTCF’s role is limited to requesting a waiver of a transfer penalty on behalf of the applicant or enrollee. Once an agency receives a request, it must work with the applicant or enrollee or their authorized representative to obtain the information needed to make a determination. A release of information signed by the applicant or enrollee or their authorized representative is required to share any information with the agency.\n\nThe request to waive a transfer penalty received from an applicant or enrollee’s authorized representative can be verbal or written. A request from an LTCF must be in writing because an applicant or enrollee’s signed statement must accompany it.\n\nThe information needed to make the determination should be requested from the applicant or enrollee or their authorized representative if the agency receives a request to waive a transfer penalty.\n\n### Imminent Threat to Health and Well-Being\n\nA person who resides in an LTCF has an imminent threat to his or her health and well-being when all of the following conditions exist:\n- The person receives a 30-day notice of discharge/transfer from the LTCF.\n- The reason for the discharge/transfer is due to non-payment.\n- The location to which the person will be discharged/transferred would endanger the person’s health or life or cause serious deprivation of food, clothing or shelter.\n  - An LTCF is required to include the reason for the discharge/transfer as well as the location to which it will discharge/transfer the person in its 30-day notice.\n  - The person or their authorized representative can support his or her claim of imminent threat by providing a copy of the 30-day discharge/transfer notice and proof that the location to which the LTCF will discharge/transfer the person will endanger them.\n\nA waiver request cannot be approved when there is no imminent threat. There is no imminent threat in situations where:\n- The person has not received a 30-day notice of discharge/transfer from the LTCF.\n- The reason for discharge/transfer from the LTCF is something other than non-payment.\n- The LTCF is discharging/transferring the person to another LTCF.\n- The person files a timely appeal of the discharge/transfer from the LTCF. When a person files an appeal timely, the LTCF cannot discharge/transfer the person until resolution of the appeal.\n\nA person who resides in the community has an imminent threat to his or her health and well-being when the person or their authorized representative provides convincing evidence that the person’s health and well-being is in immediate danger because he or she:\n- Can no longer receive services through an HCBS waiver program\n- Cannot access other community supports\n- Is unable to move to an LTCF because he or she is ineligible for MA-LTC\n\n### No Other Alternative for Payment of LTC Services\n\nThe person or their authorized representative must provide proof that no other alternatives for payment of his or her LTC services exist that will resolve the imminent threat. This requires proof of the dollar amount needed for LTC services to resolve the imminent threat.\n\n### Hardship Waiver Decision\n\nA county, tribal, or state agency must make a decision as soon as possible but no later than 30 calendar days from the date all of the necessary information is received and notify the person and their authorized representative in writing.\n\nIf the hardship waiver is denied, the notice will include the person’s right to appeal within 30-days of the denial.\n\nIf the hardship waiver is approved, the county, tribal, or state agency will refer the matter to a county attorney to determine if a cause of action exists against the person who received the transferred asset.\n\n### Cause of Action Referral\n\nIn order to determine if a cause of action may exist against the transferee, it first must be determined if:\n- The transferee actively solicited the transfer with the intent to assist the person to obtain or maintain MA-LTC.\n- The transferee knew or should have known that the transfer was being made to assist a person in obtaining or maintaining MA, or that the person was receiving MA-LTC as a resident of an LTCF or recipient of HCBS through a waiver program.\n\nThe following criteria must then be established:\n- MA-LTC was approved and MA-LTC paid for services during the time period the transfer penalty was waived.\n- And the transfer was not reported timely, which means:\n  - For an applicant: the applicant, or the applicant’s representative, failed to report a transfer at the time of application\n  - For an enrollee: the enrollee, or the enrollee’s representative, failed to report a transfer within 10 days of the transfer.\n\nThe maximum amount that can be collected under a cause of action is the cost of LTC services during the transfer period or the value of the transferred asset, whichever amount is less."}]},{"id":"epm:2.4.1.3.4","number":"2.4.1.3.4","title":"Other Asset Transfer Considerations","parent":"2.4.1.3","breadcrumb":"2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.3 Uncompensated Transfers > 2.4.1.3.4 Other Asset Transfer Considerations","summary":"This section describes if a person has received adequate compensation for transfers involving the following types of assets:","effective_date":"2026-01-12","last_modified":"2026-10-03T04:45:31.771637+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.4.1.3.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_4_1_3_4.htm","legal_citations":["Minnesota Statutes, section 256B.056","Minnesota Statutes, section 256B.0595","Minnesota Statutes, sections 524.2-202 -215","United States Code, title 42, section 1396p","Pfoser v. Harpstead, 953 N.W.2d 507 (Minn. 2021)"],"chunks":[{"chunk_id":"epm:2.4.1.3.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.4","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.3 Uncompensated Transfers > 2.4.1.3.4 Other Asset Transfer Considerations","text":"This section describes if a person has received adequate compensation for transfers involving the following types of assets:\n- Annuities\n- Coverdell Education Savings Account\n- Life Estates\n- Trusts\n- Spousal Elective Share"},{"chunk_id":"epm:2.4.1.3.4#annuities-not-evaluated-under-the-transfer-policy","heading":"Annuities not Evaluated under the Transfer Policy","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.4#annuities-not-evaluated-under-the-transfer-policy","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.3 Uncompensated Transfers > 2.4.1.3.4 Other Asset Transfer Considerations > Annuities not Evaluated under the Transfer Policy","text":"## Annuities not Evaluated under the Transfer Policy\n\nAnnuities are not evaluated under the uncompensated transfer policy in the following situations:\n- The annuity is a deferred annuity in the accumulation phase. An annuity in the accumulation phase is evaluated as an available asset.\n- Revocable or assignable annuities are evaluated as an available asset. See [Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) Annuities](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.8) for information on verifying these annuities.\n- The annuity is an employer sponsored retirement fund. See [MA-ABD Retirement Funds and Retirement Plans](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.2) for more information.\n- Annuities that meet a transfer exception are not evaluated for a transfer penalty; however, any annuity that meets an exception is evaluated for availability. See [MA-ABD Annuities](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.8) for more information.\n\nIf an annuity is not evaluated under the transfer analysis, it is evaluated to determine whether it is an available asset or if it provides unearned income."},{"chunk_id":"epm:2.4.1.3.4#annuities-evaluated-under-the-transfer-policy","heading":"Annuities Evaluated under the Transfer Policy","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.4#annuities-evaluated-under-the-transfer-policy","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.3 Uncompensated Transfers > 2.4.1.3.4 Other Asset Transfer Considerations > Annuities Evaluated under the Transfer Policy","text":"## Annuities Evaluated under the Transfer Policy\n\nCertain annuitized annuities purchased by or on behalf of the person requesting MA for Long-Term Care (LTC) or the person’s spouse must be evaluated to determine if an uncompensated transfer occurred within the lookback period.\n\nAn annuity is evaluated to determine if an uncompensated transfer occurred if it includes all the following elements:\n- The annuity was purchased with the funds of the person requesting MA-LTC.\n- The person requesting MA-LTC is a payee under the annuity contract.\n- An annuity transaction occurred within the lookback period. See EPM section [2.4.1.4.1 MA-LTC Annuity Disclosures](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.4.1) for the definition of an annuity transaction.\n- The annuity is in the annuitization phase.\n\nFor annuities that include these elements, an uncompensated transfer occurred unless all of the following criteria are met:\n1. **The annuity is a commercial annuity**\n2. **The annuity provides for payments in equal amounts during the term of the annuity with no deferral of payments and no balloon payments.**\n  - If either, or both, of these criteria are not met the value of the uncompensated transfer is the total amount of funds annuitized less any payments the person or his or her spouse already received.\n3. **The annuity is actuarially sound using the life expectancy tables published by the Chief Actuary of the Social Security Administration (SSA). The current [actuarial life table](https://www.ssa.gov/oact/STATS/table4c6.html) is found on SSA's website.**\n  - If this criteria is not met, the value of the uncompensated transfer is the total amount of the funds annuitized that will not be returned to the person requesting MA-LTC, or the person's spouse, within the applicable life expectancy.\n\nAn uncompensated transfer also occurred if the ownership interest or payments the person or their spouse were entitled to receive is transferred or assigned to a third party without receiving adequate compensation. The amount of the uncompensated transfer is the cash value of the ownership interest or payments the person or their spouse was entitled to receive, as of the [transfer date](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.1), after subtracting any compensation received.\n\n### Actuarial Soundness\n\nAn annuity is actuarially sound if the cash value, on the date it was annuitized, is less than or equal to the amount of payments the person will receive during the payee’s life expectancy. If both the person and their spouse are listed as payees under the annuity contract, the person with the longest life expectancy is used to determine actuarial soundness.\n\nThe life expectancy of the person requesting or receiving MA-LTC or their spouse is determined using the [actuarial life table](https://www.ssa.gov/OACT/STATS/table4c6.html) found on the SSA website.\n\nAny portion of the annuity that is funded with money contributed by a third party is not included in the cash value used to determine actuarial soundness."},{"chunk_id":"epm:2.4.1.3.4#coverdell-education-savings-accounts-evaluated-under-the-transfer-policy","heading":"Coverdell Education Savings Accounts Evaluated under the Transfer Policy","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.4#coverdell-education-savings-accounts-evaluated-under-the-transfer-policy","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.3 Uncompensated Transfers > 2.4.1.3.4 Other Asset Transfer Considerations > Coverdell Education Savings Accounts Evaluated under the Transfer Policy","text":"## Coverdell Education Savings Accounts Evaluated under the Transfer Policy\n\nFunds in a Coverdell Education Savings Account (ESA) may be transferred or “rolled over” to a member of the beneficiary’s family. When a designated beneficiary “rolls over” funds in a Coverdell ESA to a family member, the rollover must be evaluated as an uncompensated transfer."},{"chunk_id":"epm:2.4.1.3.4#life-estates-interest-evaluated-under-the-transfer-policy","heading":"Life Estates Interest Evaluated under the Transfer Policy","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.4#life-estates-interest-evaluated-under-the-transfer-policy","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.3 Uncompensated Transfers > 2.4.1.3.4 Other Asset Transfer Considerations > Life Estates Interest Evaluated under the Transfer Policy","text":"## Life Estates Interest Evaluated under the Transfer Policy\n\nThere are several instances when the transfer of a life estate must be evaluated to determine if an uncompensated transfer occurred. See [Uncompensated Transfers](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3) for more information on transfer policy. See [Purchases as Transfers](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3#certain-purchases-as-transfers) for more information when a person purchases a life estate interest in another person's home.\n\nA life estate must be evaluated to determine if an uncompensated transfer occurred when:\n- The life estate interest is established during the lookback period.\n  - The amount of the uncompensated transfer is the value of the remainder interest, at the time the life estate was established, less any compensation received. See [MA-ABD Life Estate and Remainder Interests](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.3).\n- The life estate interest is sold prior to the death of the life estate owner or terminated prior to expiration under the terms of the life estate.\n  - The amount of the uncompensated transfer is the value of the life estate interest on the date of the sale or termination, less any allowable costs related to the sale of the property, and less any compensation received. See [MA-ABD Life Estate and Remainder Interests](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.3)."},{"chunk_id":"epm:2.4.1.3.4#allowable-costs-of-the-sale-of-property-held-in-life-estate","heading":"Allowable costs of the sale of property held in life estate","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.4#allowable-costs-of-the-sale-of-property-held-in-life-estate","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.3 Uncompensated Transfers > 2.4.1.3.4 Other Asset Transfer Considerations > Allowable costs of the sale of property held in life estate","text":"## Allowable costs of the sale of property held in life estate\n\nPayment of a pro rata or proportional share of allowable costs related to the sale of a property held in life estate is not considered an uncompensated transfer so long as the costs are divided pro rata between the life estate owner and the remainderman. Allowable costs for the life estate owner are limited to the following:\n- Seller's closing costs, including real estate broker fees\n- Expenses required by the county or state\n- Repairs necessary for the sale\n- Buyer's closing costs, including real estate broker fees, so long as the life estate owner receives no less than two-thirds the value of the life estate interest\n\nPayment of costs associated with making improvements (rather than repairs) to the property by the life estate owner is considered an uncompensated transfer. See [MA-ABD Life Estate and Remainder Interests](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.3)"},{"chunk_id":"epm:2.4.1.3.4#trusts-evaluated-under-the-transfer-policy","heading":"Trusts Evaluated under the Transfer Policy","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.4#trusts-evaluated-under-the-transfer-policy","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.3 Uncompensated Transfers > 2.4.1.3.4 Other Asset Transfer Considerations > Trusts Evaluated under the Transfer Policy","text":"## Trusts Evaluated under the Transfer Policy\n\n### Client Funded Trusts\n\nIf a non-excluded asset is placed in a trust, during the lookback period or while the person is receiving MA-LTC, an uncompensated transfer takes place if the grantor is no longer able to access all or a portion of the trust income or trust corpus. The amount of the uncompensated transfer is the portion of the trust income or trust corpus that is considered unavailable.\n\nAny distributions from the trust that are not to or for the benefit of the beneficiary are an uncompensated transfer. The amount of the uncompensated transfer is the amount of the distribution that is to or for the benefit of someone other than the beneficiary.\n\n### Special Needs Trusts\n\nSpecial needs trusts are excluded assets when determining eligibility for MA. However, funds entering and leaving the trusts must be evaluated to determine if an uncompensated transfer occurred.\n- The establishment, or addition to a special needs trust before the beneficiary reaches age 65 is not considered an uncompensated transfer and a penalty cannot be imposed.\n- A distribution from a special needs trust that does not meet the sole benefit requirement is an uncompensated transfer. The amount of the uncompensated transfer is the amount of the distribution that is not for the sole benefit of the trust beneficiary.\n- A special needs trust cannot be added to after the beneficiary reaches age 65. Additions to the trust after the beneficiary reaches age 65 are not considered excluded assets. The value of any non-excluded assets added to the trust after the beneficiary reaches age 65 are considered available to the beneficiary.\n\nSee [MA-ABD Special Needs Trusts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.4) for more information.\n\n### Pooled Trusts\n\nA trust that meets the legal requirements to be considered a valid pooled trusts is unavailable for purposes of MA eligibility. See EPM [section 2.3.3.2.7.9.5 MA-ABD Pooled Trusts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.9.5) for more information. However, funds entering and leaving a pooled trust while a person is receiving MA-LTC or during the lookback period must be evaluated to determine if an uncompensated transfer occurred.\n\nThe establishment, or addition to a pooled trust before the applicant or enrollee reaches age 65 is not considered an uncompensated transfer and a penalty cannot be imposed.\n\nThe establishment or addition to pooled trust after the applicant or enrollee reaches age 65 is an uncompensated transfer unless a transfer penalty exception applies. A transfer penalty exception applies if the trust beneficiary intended to receive valuable consideration for the transferred asset or income. Valuable consideration is compensation that is approximately equal to the fair market value of the transferred asset or income.\n\nTo show that the valuable consideration exception applies, the applicant or enrollee must provide documentation that describes how the trust beneficiary intends that the trustee make disbursements from the trust sub-account. The documentation must show to the agency’s satisfaction that:\n- The trust beneficiary intends that the trustee disburse all funds transferred to the trust sub-account within the trust beneficiary’s expected lifetime as determined by the [Social Security Administration’s Actuarial Life Table](https://www.ssa.gov/oact/STATS/table4c6.html);\n- The trust beneficiary intends that the trustee make disbursements for goods, services or trust fees and expenses in amounts that are reasonable and customary; and\n- The trust beneficiary intends that the trustee make disbursements only for goods and services for the benefit of the beneficiary that are not otherwise covered by MA.\n\nIf, after reviewing the documentation, the agency determines that the trust beneficiary intended to receive valuable consideration in exchange for the amount transferred to the pooled trust sub-account, the applicant or enrollee has met the valuable consideration intent exception and no penalty may be imposed.\n\nIf the applicant or enrollee does not provide documentation or if, after reviewing the documentation provided, the applicant or enrollee does not show to the agency’s satisfaction that the trust beneficiary intended to receive valuable consideration in exchange for the transfer, then the agency must impose a penalty based on the uncompensated amount of the transfer. The uncompensated amount may include any of the following components:\n- Any amount for which the documentation provided lacks specificity sufficient to determine for what goods, services, or trust fees and expenses the trust beneficiary intends for the trustee to make disbursements, the amount of those intended disbursements, and when those disbursements are intended to occur;\n- Any amounts the trust beneficiary intends the trustee to disburse for goods, services or trust fees and expenses that are not reasonable and customary; Examples:\n  - Where the trust beneficiary intends that the trustee disburse funds to pay $75 per day for a private room in a nursing facility, and the fair market value for a private room is $30 per day, the uncompensated amount is equivalent to $45 per day.\n  - Where the trust beneficiary intends that the trustee disburse $3,000 for adaptive equipment not covered by MA, and the fair market value of the adaptive equipment is $2,000, the uncompensated amount is $1,000.\n- Any amount the trust beneficiary intends that the trustee disburse after the beneficiary’s expected lifetime as measured in accordance with the [SSA’s Actuarial Life Table](https://www.ssa.gov/oact/STATS/table4c6.html); or\n- Any amount that the trust beneficiary intends that the trustee disburse for goods or services that are covered by MA.\n\nThe “Pooled Trust Transfer Evaluation Worksheet” ([DHS-8144](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-8144-ENG)) may be used to assist in evaluating any documentation that is provided by the applicant or enrollee.\n\nThe agency must follow ONEsource procedures, “[Evaluating](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-0923)[Transfers to a Pooled Trust for MA-LTC and AC](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-0923)” to evaluate transfers to a pooled trust sub-account by a person age 65 or older who is applying for or enrolled in MA-LTC."},{"chunk_id":"epm:2.4.1.3.4#spousal-elective-share-evaluated-under-the-transfer-policy","heading":"Spousal Elective Share Evaluated under the Transfer Policy","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.4#spousal-elective-share-evaluated-under-the-transfer-policy","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.3 Uncompensated Transfers > 2.4.1.3.4 Other Asset Transfer Considerations > Spousal Elective Share Evaluated under the Transfer Policy","text":"## Spousal Elective Share Evaluated under the Transfer Policy\n\n**Reporting the Death of a Spouse and Required Verification**\n\nThe death of the spouse of an MA-LTC applicant or enrollee is a change in circumstance and must be reported to the servicing agency. See [Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1) policy for more information. When the death of a spouse is reported or otherwise discovered by the servicing agency, the agency must request verification of the augmented estate to evaluate for an uncompensated transfer.\n\n**Determining the Elective Share and the Augmented Estate**\n\nWhen the spouse of an MA-LTC applicant or enrollee dies, the applicant or enrollee (the surviving spouse) is generally entitled to a percentage of the couple’s augmented estate. This percentage is called an “elective share” and varies according to the length of the marriage. See [Minn. Stat. 524.2-202](https://www.revisor.mn.gov/statutes/cite/524.2-202) for detailed percentages, and [Minn. Stat. 524.2-203](https://www.revisor.mn.gov/statutes/cite/524.2-203) for the meaning of augmented estate. Under Minnesota law, the augmented estate includes the property of and transfers to others made by both the deceased spouse and the MA-LTC applicant or enrollee. This includes but is not limited to:\n- Property that was controlled by the deceased spouse prior to death\n- Property that was transferred to someone other than the MA-LTC applicant or enrollee, such as with a transfer on death deed (TODD), at the time of the spouse’s death\n- Life insurance, annuities, pensions, or retirement benefits paid to non-spouse beneficiaries at the spouse’s death\n- Transfers made during marriage where the deceased spouse retained rights or granted others control over property or income\n- Transfers made within two years before death such as gifts exceeding $10,000 per year to non-spouse recipients, or property that passed due to termination of a right or power\n\n**Requirement to Seek Elective Share in Probate Proceeding**\n\nIf the MA-LTC applicant or enrollee does not receive an amount via non-probate transfers upon the death of their spouse that in combination with their own property is at least equal to the elective share, they must seek the elective share in a probate proceeding. When the probate case is complete, the applicant or enrollee must verify that they received the elective share by providing a court order. The only exceptions to this requirement are:\n- If the applicant or enrollee cannot afford to start or participate in an existing probate proceeding to claim their elective share, or\n- The cost to the applicant or enrollee to participate in the probate proceeding (e.g., attorney’s fees if they wish to be represented) is more than the elective share is worth.\n\n**Determining the Uncompensated Amount**\n\nAn uncompensated transfer occurs if, during the lookback period or while enrolled in MA-LTC, the surviving spouse does not receive an amount equal to or greater than the value of the elective share and they do not seek it in a probate proceeding. The uncompensated amount is the difference between the proceeds that were disbursed to the applicant or enrollee by will or otherwise, and the amount they were entitled to receive under elective share law.\n\nIf a probate proceeding is initiated for the deceased spouse, and a request for an elective share has been made by the surviving LTC spouse, any uncompensated transfer cannot be evaluated relative to the elective share until probate is complete."}]},{"id":"epm:2.4.1.4","number":"2.4.1.4","title":"Annuities","parent":"2.4.1","breadcrumb":"2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.4 Annuities","summary":"An annuity is a purchase contract where the purchasing party generally pays a lump sum of money or periodic payments to an entity issuing the annuity (a bank or insurance company) in return for an expectation of future regular payments in certain amounts. See Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) Annuities for more information.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:59.250595+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.4.1.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_4_1_4.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.4.1.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.4","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.4 Annuities","text":"An annuity is a purchase contract where the purchasing party generally pays a lump sum of money or periodic payments to an entity issuing the annuity (a bank or insurance company) in return for an expectation of future regular payments in certain amounts. See [Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) Annuities](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.8) for more information.\n\nSeveral different policies may apply to the evaluation of annuities.\n1. [MA-ABD Burial Contracts](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.11)\n2. [MA-LTC Other Asset Transfer Considerations](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.4)\n3. [MA-LTC Asset Assessment](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.1.1)\n4. [MA-LTC Annuity Disclosures](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.4.1)\n5. [MA-LTC Naming DHS a Preferred Remainder Beneficiary](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.4.2)"}]},{"id":"epm:2.4.1.4.1","number":"2.4.1.4.1","title":"Annuity Disclosures","parent":"2.4.1.4","breadcrumb":"2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.4 Annuities > 2.4.1.4.1 Annuity Disclosures","summary":"People must disclose if they own an annuity or have the right to receive income from an annuity. A person who requests Medical Assistance for Long-Term Care (MA-LTC) services must disclose any interest the person or their spouse has in an annuity and provide additional information about any annuity transactions.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:59.250595+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.4.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.4.1.4.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_4_1_4_1.htm","legal_citations":["Minnesota Statutes, section 256B.056, subdivision 11","United States Code, title 42, section 1396p(e)"],"chunks":[{"chunk_id":"epm:2.4.1.4.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.4.1","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.4 Annuities > 2.4.1.4.1 Annuity Disclosures","text":"People must disclose if they own an annuity or have the right to receive income from an annuity. A person who requests Medical Assistance for Long-Term Care (MA-LTC) services must disclose any interest the person or their spouse has in an annuity and provide additional information about any annuity transactions.\n\nThe policies described in this section do not apply to employment-based pension plans held in the form of an annuity. See [MA for People who are Age 65 or Older and People who are Blind or Have a Disability (ABD) Retirement Accounts and Retirement Plans](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.2)."},{"chunk_id":"epm:2.4.1.4.1#disclosure-requirements","heading":"Disclosure Requirements","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.4.1#disclosure-requirements","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.4 Annuities > 2.4.1.4.1 Annuity Disclosures > Disclosure Requirements","text":"## Disclosure Requirements\n\nA person requesting MA-LTC and his or her spouse must:\n- provide information to determine whether an annuity transaction occurred within the lookback period for all annuities owned by a person requesting MA-LTC and his or her spouse; and\n- report all annuities for which either spouse is an owner, annuitant, payee or beneficiary."},{"chunk_id":"epm:2.4.1.4.1#annuity-transactions","heading":"Annuity Transactions","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.4.1#annuity-transactions","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.4 Annuities > 2.4.1.4.1 Annuity Disclosures > Annuity Transactions","text":"## Annuity Transactions\n\nAn annuity transaction is an action taken by an annuity owner related to an annuity. The following annuity transactions that occurred during the person’s lookback period result in the annuity being subject to the policies described in [Naming Minnesota Department of Human Services (DHS) a Preferred Remainder Beneficiary](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.4.2) and [Other Asset Transfer Considerations](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.4).\n\n### Purchasing an annuity\n\nPurchasing an annuity includes setting up a new annuity, converting an existing annuity into another type of annuity or converting an account-based financial arrangement or other type of fund into an annuity. Examples of an account-based financial arrangement include:\n- Rolling over a deferred annuity into an immediate annuity\n- Rolling over a 401(k) into an individual retirement annuity\n- Rolling over an Individual Retirement Account into an annuity\n\n### Exercising an annuity election\n\nExercising an annuity includes the following:\n- Annuitizing the annuity\n- Adding an unscheduled contribution to an annuity, including the rollover of another financial arrangement into an annuity\n- Elective withdrawals - payments made in addition to the scheduled payments provided in the annuity contract (a partial surrender is a type of elective withdrawal if the annuity owners must elect to receive the partial surrender)\n- Changing the distribution from the annuity (that is, how, the amount, or to whom payments are made)\n- Changing the annuity owner, annuitant, payee, or beneficiary, including transferring ownership of the annuity in whole or in part to a trust (assigning a new beneficiary upon the death of a current beneficiary is an annuity transaction)\n\n### Changes not treated as annuity transactions\n\nChanges not treated as annuity transactions for purposes of evaluation include:\n- A request to name DHS a preferred remainder beneficiary of an annuity\n- Providing an annuity issuer with updated contact information\n- Notification of the death of a named beneficiary\n- Changes that occur automatically based on terms of the annuity contract that do not require a decision, election or action by the annuity owners to take effect\n- Changes to the annuity beyond the control of the person, including but not limited to changes required by law, operational changes instituted by the issuer, or a judgment of divorce or legal separation"},{"chunk_id":"epm:2.4.1.4.1#verification-documents","heading":"Verification Documents","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.4.1#verification-documents","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.4 Annuities > 2.4.1.4.1 Annuity Disclosures > Verification Documents","text":"## Verification Documents\n\nEligibility for MA-LTC cannot be determined until verification is provided. The following types of documentation are acceptable for verification purposes if they alone, or together, provide the required information:\n- A copy of the annuity contract\n- A written statement from the annuity issuer\n- If applicable, a written statement from the employer, employer association or union"}]},{"id":"epm:2.4.1.4.2","number":"2.4.1.4.2","title":"Naming DHS a Preferred Remainder Beneficiary","parent":"2.4.1.4","breadcrumb":"2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.4 Annuities > 2.4.1.4.2 Naming DHS a Preferred Remainder Beneficiary","summary":"After a person is determined eligible for MA for Long-Term Care Services (MA-LTC), the person and his or her spouse must name Minnesota Department of Human Services (DHS) as a preferred remainder beneficiary of their annuity, if the annuity meets certain requirements, prior to approval of MA-LTC.","effective_date":"2023-06-01","last_modified":"2026-10-03T04:45:29.732583+00:00","version":3,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.4.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.4.1.4.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_4_1_4_2.htm","legal_citations":["Minnesota Statutes, section 256B.056, subdivision 11","Minnesota Statutes, section 256B.0595(e)","United States Code, title 42, section 1396p(e)"],"chunks":[{"chunk_id":"epm:2.4.1.4.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.4.2","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.4 Annuities > 2.4.1.4.2 Naming DHS a Preferred Remainder Beneficiary","text":"After a person is determined eligible for MA for Long-Term Care Services (MA-LTC), the person and his or her spouse must name Minnesota Department of Human Services (DHS) as a preferred remainder beneficiary of their annuity, if the annuity meets certain requirements, prior to approval of MA-LTC.\n\nThe policies described in this section do not apply to employment-based pension plans held in the form of an annuity. See [MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) Retirement Accounts and Retirement Plans](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.2)."},{"chunk_id":"epm:2.4.1.4.2#preferred-remainder-beneficiary","heading":"Preferred Remainder Beneficiary","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.4.2#preferred-remainder-beneficiary","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.4 Annuities > 2.4.1.4.2 Naming DHS a Preferred Remainder Beneficiary > Preferred Remainder Beneficiary","text":"## Preferred Remainder Beneficiary\n\nThe preferred remainder beneficiary is the person or entity required to be named as a beneficiary of a death benefit under an annuity. A preferred remainder beneficiary has preferential rights to the death benefit. As the preferred remainder beneficiary, DHS may receive up to the total amount of MA paid on behalf of the person and their spouse when a death benefit becomes payable under the terms of the annuity contract.\n\nDHS is a secondary beneficiary if the person’s spouse, child under 18, or a child of any age who is certified disabled (based upon the criteria of the Supplemental Security Income (SSI) program) is named a beneficiary under the annuity and is alive at the time the death benefit is payable."},{"chunk_id":"epm:2.4.1.4.2#a-person-must-name-dhs-a-preferred-remainder-beneficiary","heading":"A Person Must Name DHS a Preferred Remainder Beneficiary","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.4.2#a-person-must-name-dhs-a-preferred-remainder-beneficiary","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.4 Annuities > 2.4.1.4.2 Naming DHS a Preferred Remainder Beneficiary > A Person Must Name DHS a Preferred Remainder Beneficiary","text":"## A Person Must Name DHS a Preferred Remainder Beneficiary\n\nPeople who request or renew eligibility for MA-LTC and their spouses are required to designate DHS as a preferred remainder beneficiary for each annuity that meets all of the following criteria:\n- they have an ownership interest in the annuity;\n- at least one annuity transaction occurred within the lookback period; and\n- the annuity provides for a death benefit and allows someone other than a surviving spouse to be named a beneficiary.\n\nVerification from the annuity issuer is required if a person or their spouse claims it is not possible for DHS to be named a preferred remainder beneficiary.\n\n### Failure to Name DHS the Preferred Remainder Beneficiary\n\nIf a person or their spouse fails to name DHS the preferred remainder beneficiary, and they are otherwise eligible for MA-LTC, the appropriate value of the annuity must be determined to calculate a period of ineligibility based upon the phase of the annuity as follows:\n- The value of the annuity is the current cash value (cash surrender value) of the annuity if the annuity is in the accumulation phase.\n- The value of the annuity is the total amount of money annuitized if the annuity is in the annuitization phase.\n\nThe period of ineligibility is calculated by dividing the value of the annuity by the [MA Statewide Average Payment for a Skilled Nursing Facility](https://bot-corpus.mn-dhs.online/s/epm/F) (SAPSNF) in effect in the month the applicant was found to be otherwise eligible for MA-LTC. The period of ineligibility is the full number of months plus any partial months resulting from this calculation.\n- The partial month is an amount that the MA-LTC payment is reduced in that month.\n- If the period of ineligibility is less than a full month of eligibility for MA-LTC, the MA-LTC payments is reduced by the remaining amount.\n\nThe period of ineligibility begins with the first month for which the person is requesting and meets all of the other criteria to receive MA-LTC. The Notice of Action for Payment of Long-Term Care Services ([DHS-4915](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-4915-ENG)) is a required notice when a person fails to name DHS a preferred remainder beneficiary. This is the official notification of denial or ending of MA-LTC.\n\nIf the person is eligible for MA during the period of ineligibility, MA will pay for non-LTC services."},{"chunk_id":"epm:2.4.1.4.2#ma-eligibility-during-the-period-of-ineligiblity","heading":"MA Eligibility During the Period of Ineligiblity","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.4.2#ma-eligibility-during-the-period-of-ineligiblity","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.4 Annuities > 2.4.1.4.2 Naming DHS a Preferred Remainder Beneficiary > MA Eligibility During the Period of Ineligiblity","text":"## MA Eligibility During the Period of Ineligiblity\n\nA person may still be eligible for MA with an ABD basis of eligibility or MA with an FCA basis of eligibility during the transfer penalty period. A person’s eligibility must be evaluated for other MA bases of eligibility and other health care programs before closing or denying coverage. A person may be subject to a medical spenddown when applicable.\n\nMA will only pay for non-LTC services during the transfer period if the person is eligible for MA."},{"chunk_id":"epm:2.4.1.4.2#income-calculations-during-a-period-of-ineligibility","heading":"Income Calculations During a Period of Ineligibility","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.4.2#income-calculations-during-a-period-of-ineligibility","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.4 Annuities > 2.4.1.4.2 Naming DHS a Preferred Remainder Beneficiary > Income Calculations During a Period of Ineligibility","text":"## Income Calculations During a Period of Ineligibility\n\nMA-LTC income methodologies do not apply during full months of MA-LTC ineligibility, however, a person may still be eligible for MA with an ABD basis of eligibility or MA with an FCA basis of eligibility during the transfer penalty period. A person must be determined eligible based on the income methodology associated with their basis:\n- [MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD)](https://bot-corpus.mn-dhs.online/s/epm/2.3)\n- [MA for Employed Persons with Disabilities](https://bot-corpus.mn-dhs.online/s/epm/2.3.5)[(MA-EPD)](https://bot-corpus.mn-dhs.online/s/epm/2.3.5)\n- [MA for Families With Children and Adults (MA-FCA)](https://bot-corpus.mn-dhs.online/s/epm/2.2)"},{"chunk_id":"epm:2.4.1.4.2#cooperation-after-a-period-of-ineligibility-is-imposed","heading":"Cooperation after a Period of Ineligibility is Imposed","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.4.2#cooperation-after-a-period-of-ineligibility-is-imposed","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.4 Annuities > 2.4.1.4.2 Naming DHS a Preferred Remainder Beneficiary > Cooperation after a Period of Ineligibility is Imposed","text":"## Cooperation after a Period of Ineligibility is Imposed\n\nWhen a person cooperates after a period of ineligibility for MA-LTC due to failure to name DHS a preferred remainder beneficiary, eligibility for MA-LTC begins no earlier than the first day of the month in which the person:\n- cooperates and names DHS a preferred remainder beneficiary, and\n- meets all other eligibility requirements.\n\nA person is not automatically eligible for MA-LTC upon the end of a period of ineligibility. Ending the period of ineligibility only eliminates a barrier for MA-LTC identified in a previous request. When a period of ineligibility ends, a determination must be made to ensure the person currently meets all eligibility requirements for MA-LTC.\n- People not enrolled in MA when the period of ineligibility ends must reapply for MA if it is outside the application-processing period associated with the last completed application.\n- People enrolled in MA when the period of ineligibility ends must submit a MHCP Request for Payment of Long-Term Care Services ([DHS-3543](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3543-ENG)) if they had a gap of one calendar month or more between the date the period of ineligibility was imposed and the date of the request for MA-LTC."},{"chunk_id":"epm:2.4.1.4.2#requirements-for-annuity-issuers","heading":"Requirements for Annuity Issuers","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.4.2#requirements-for-annuity-issuers","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.4 Annuities > 2.4.1.4.2 Naming DHS a Preferred Remainder Beneficiary > Requirements for Annuity Issuers","text":"## Requirements for Annuity Issuers\n\nAnnuity issuers are required to communicate certain information to county, tribal, and state agencies about annuities that designate DHS as a preferred remainder beneficiary. Annuity issuers who receive a signed and dated \"Issuer of Annuity Notice of Obligation\" ([DHS-5037](http://edocs.dhs.state.mn.us/lfserver/Legacy/DHS-5037-ENG)) are required to:\n- Confirm that DHS has been named a preferred remainder beneficiary.\n- Notify the county agency of changes made to the amount of income or principal being withdrawn from the annuity and to the beneficiary designation by the annuity owner.\n- Inform DHS when the death benefit becomes payable and request the amount of MA subject to recovery by DHS.\n- If applicable, describe a valid reason why it is not possible to name DHS a preferred remainder beneficiary.\n\nNon-cooperation by the issuer to name DHS a preferred remainder beneficiary of the annuity is not a valid reason for DHS not to be named a preferred remainder beneficiary."},{"chunk_id":"epm:2.4.1.4.2#forms-required-to-name-dhs-a-preferred-remainder-beneficiary","heading":"Forms Required to Name DHS a Preferred Remainder Beneficiary","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.4.2#forms-required-to-name-dhs-a-preferred-remainder-beneficiary","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.4 Annuities > 2.4.1.4.2 Naming DHS a Preferred Remainder Beneficiary > Forms Required to Name DHS a Preferred Remainder Beneficiary","text":"## Forms Required to Name DHS a Preferred Remainder Beneficiary\n\nUpon request of the county, tribal, or state agency aperson must complete the Annuity Designation for MA LTC Applicants (DHS-5036). This form is used when the person requesting MA LTC, or their spouse, owns the annuity.\n\nThe county, tribal, or state agency will send an Issuer of Annuity Notice of Obligation ([DHS-5037](http://edocs.dhs.state.mn.us/lfserver/Legacy/DHS-5037-ENG)) to the annuity issuer along with the signed [DHS-5036](http://edocs.dhs.state.mn.us/lfserver/Legacy/DHS-5036-ENG). The [DHS-5037](http://edocs.dhs.state.mn.us/lfserver/Legacy/DHS-5037-ENG) provides the annuity issuer instructions regarding:\n- Naming DHS as a preferred remainder beneficiary\n- Completing the Confirmation/Status of Request portion of the form and returning it to the county agency within 30 days\n- The annuity issuer’s ongoing obligation to communicate with the county and state agency under federal and state laws when DHS is named a preferred remainder beneficiary."},{"chunk_id":"epm:2.4.1.4.2#change-in-annuity-income-or-preferred-remainder-beneficiary","heading":"Change in Annuity Income or Preferred Remainder Beneficiary","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.1.4.2#change-in-annuity-income-or-preferred-remainder-beneficiary","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.1 Eligibility Requirements > 2.4.1.4 Annuities > 2.4.1.4.2 Naming DHS a Preferred Remainder Beneficiary > Change in Annuity Income or Preferred Remainder Beneficiary","text":"## Change in Annuity Income or Preferred Remainder Beneficiary\n\nAny information that indicates a change since the last request for MA-LTC in either the amount of income or principal the person or their spouse is withdrawing from the annuity, or that DHS is no longer named as a preferred remainder beneficiary, must be evaluated to determine if:\n- An uncompensated transfer has occurred\n- A penalty period applies\n- A change in the amount of available income from the annuity has occurred"}]},{"id":"epm:2.4.2","number":"2.4.2","title":"Financial Eligibility","parent":"2.4","breadcrumb":"2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility","summary":"This subchapter describes financial eligibility policies that apply to Medical Assistance for Long-Term Care Services (MA-LTC).","effective_date":"2024-06-11","last_modified":"2026-10-03T03:51:59.250595+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.4.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_4_2.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.4.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility","text":"This subchapter describes financial eligibility policies that apply to Medical Assistance for Long-Term Care Services (MA-LTC).\n\nMarried people with an [MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) basis of eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.2.1) and married people with an [MA for Families and Children with a Medical Spenddown](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.6) basis of eligibility who are requesting MA-LTC may be required to complete an asset evaluation to determine if any of their spouse’s assets affect their asset limit.\n\nPeople who have used benefits from a qualifying LTC Partnership (LTCP) insurance policy may have assets that do not count toward their asset limit and may be protected from estate recovery.\n\nPeople who meet the eligibility requirements for MA-LTC may be obligated to contribute income toward the cost of the LTC services they receive. The amount of income that a person must contribute to the cost of LTC services is based on an LTC income calculation or a community income calculation. These calculations determine the amount of a person’s LTC spenddown, medical spenddown, or waiver obligation and depend on whether the person is receiving services through a Home and Community Based Services (HCBS) waiver or live in a long-term care facility (LTCF).\n\nTopics covered in this subchapter are:\n1. [MA-LTC Asset Assessments](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.1.1)\n2. [MA-LTC LTC Partnership Insurance](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.2)\n3. [MA-LTC HCBS Waivers](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.3)\n4. [MA-LTC LTCF](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.4)\n5. [MA-LTC Income Calculations for Long-Term Care Services](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5)"}]},{"id":"epm:2.4.2.1","number":"2.4.2.1","title":"Asset Evaluation for Married Couples","parent":"2.4.2","breadcrumb":"2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.1 Asset Evaluation for Married Couples","summary":"An asset evaluation is required for married couples when one spouse is requesting Medical Assistance (MA) for Long-Term Care (LTC) and the other spouse is considered a community spouse.","effective_date":"2024-06-11","last_modified":"2026-10-03T03:51:59.250595+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.4.2.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_4_2_1.htm","legal_citations":["United States Code, title 42, Section 1396r-5(h)","Minnesota Statutes 256B.059"],"chunks":[{"chunk_id":"epm:2.4.2.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.1","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.1 Asset Evaluation for Married Couples","text":"An asset evaluation is required for married couples when one spouse is requesting Medical Assistance (MA) for Long-Term Care (LTC) and the other spouse is considered a community spouse."},{"chunk_id":"epm:2.4.2.1#long-term-care-ltc-spouse","heading":"Long Term Care (LTC) Spouse","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.1#long-term-care-ltc-spouse","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.1 Asset Evaluation for Married Couples > Long Term Care (LTC) Spouse","text":"## Long Term Care (LTC) Spouse\n\nAn LTC spouse is a married person who:\n- Resides in a long term care facility (LTCF) or receives Elderly Waiver program services, and is expected to remain in the LTCF or receive EW services for at least 30 consecutive days; and\n- Has a community spouse"},{"chunk_id":"epm:2.4.2.1#community-spouse","heading":"Community Spouse","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.1#community-spouse","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.1 Asset Evaluation for Married Couples > Community Spouse","text":"## Community Spouse\n\nThe community spouse is someone who:\n- Is married to an LTC spouse; and\n- Who does not reside in a LTCF and does not receive waiver services from Brain Injury (BI), Community Alternative Care (CAC), Community Access for Disability Inclusion (CADI), Developmental Disability (DD), or Elderly Waiver (EW) programs.\n\nA community spouse can receive MA, MinnesotaCare or services through the Alternative Care (AC) program."},{"chunk_id":"epm:2.4.2.1#asset-evaluation","heading":"Asset Evaluation","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.1#asset-evaluation","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.1 Asset Evaluation for Married Couples > Asset Evaluation","text":"## Asset Evaluation\n\nAt the time of a request for MA-LTC, the LTC spouse and community spouse must report and verify all assets individually or jointly owned by either spouse, regardless of whether the asset is excluded.\n\nThe asset evaluation:\n- Determines the amount of the couple’s total assets.\n  - The couple uses the amount to determine which assets they will protect for the community spouse, known as a Community Spouse Asset Allowance (CSAA).\n    - The remaining assets that are not designated toward the CSAA are evaluated in an asset eligibility determination for the LTC spouse, See section [2.4.2.1.2.1 MA-LTC Asset Eligibility for a Long-Term Care Spouse](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.1.2.1)\n- Is only required when the LTC spouse’s basis of eligibility is MA for:\n  - People Who Are Age 65 or Older or People Who Are Blind or Have a Disability (MA-ABD), or\n  - Families and Children with a Medical Spenddown.\n- Is not required when the LTC spouse’s basis of eligibility is MA for:\n  - Families with Children and Adults (MA-FCA) without a spenddown, or\n  - Employed Persons with Disabilities (MA-EPD)"},{"chunk_id":"epm:2.4.2.1#whereabouts-of-the-community-spouse-are-unknown","heading":"Whereabouts of the Community Spouse are Unknown","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.1#whereabouts-of-the-community-spouse-are-unknown","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.1 Asset Evaluation for Married Couples > Whereabouts of the Community Spouse are Unknown","text":"## Whereabouts of the Community Spouse are Unknown\n\nWhen an asset evaluation is required and the LTC spouse does not know the whereabouts of the community spouse, the LTC spouse must make a reasonable effort to locate the community spouse.\n\nIf reasonable efforts to locate the community spouse do not succeed, eligibility for MA-LTC for the LTC spouse is still possible. The LTC spouse must report assets on the application based on the information they know about the community spouse’s assets."},{"chunk_id":"epm:2.4.2.1#notification-requirements-and-appeal-rights","heading":"Notification Requirements and Appeal Rights","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.1#notification-requirements-and-appeal-rights","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.1 Asset Evaluation for Married Couples > Notification Requirements and Appeal Rights","text":"## Notification Requirements and Appeal Rights\n\nThe LTC spouse, the LTC spouse’s authorized representative, if applicable, and the community spouse must be notified of the results of the asset evaluation using DHS-3340A. Any of these people may appeal the results."},{"chunk_id":"epm:2.4.2.1#new-asset-evaluation","heading":"New Asset Evaluation","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.1#new-asset-evaluation","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.1 Asset Evaluation for Married Couples > New Asset Evaluation","text":"## New Asset Evaluation\n\nA new asset evaluation is required if a person has a break in LTC eligibility of one calendar month or more and the county or tribal nation servicing agency receives a new request for MA-LTC. An asset evaluation is not used to determine asset eligibility if an enrollee receiving MA-LTC marries a person who meets the definition of a community spouse after eligibility for MA-LTC is approved.\n1. [MA-LTC Asset Assessment](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.1.1)\n2. [MA-LTC Community Spouse Asset Allowance](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.1.2)"}]},{"id":"epm:2.4.2.1.1","number":"2.4.2.1.1","title":"Asset Assessment for Planning Purposes","parent":"2.4.2.1","breadcrumb":"2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.1 Asset Evaluation for Married Couples > 2.4.2.1.1 Asset Assessment for Planning Purposes","summary":"An asset assessment is an evaluation of assets owned individually or jointly by a married couple as of a specific date. The Asset Verification Service (AVS) cannot be used for planning purposes. The couple must document and provide proof of these assets.","effective_date":"2024-05-30","last_modified":"2026-10-03T03:51:59.250595+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.1.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.4.2.1.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_4_2_1_1.htm","legal_citations":["Minnesota Statutes, section 256B.059","United States Code, title 42, section 1396r-5"],"chunks":[{"chunk_id":"epm:2.4.2.1.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.1.1","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.1 Asset Evaluation for Married Couples > 2.4.2.1.1 Asset Assessment for Planning Purposes","text":"An asset assessment is an evaluation of assets owned individually or jointly by a married couple as of a specific date. The Asset Verification Service (AVS) cannot be used for planning purposes. The couple must document and provide proof of these assets.\n\nA couple may request an asset assessment even if they are not applying for Medical Assistance for Long-Term Care Services (MA-LTC) when one spouse has or anticipates needing LTC services for 30 or more continuous days. County and tribal agencies are required to complete the assessment telling the couple which assets would count and which assets would not count if the couple had applied for MA-LTC. This will help the couple estimate how much of their assets must be spent before the LTC spouse may be eligible for MA-LTC. The Asset Assessment for Medical Assistance (MA) Payment of Long-Term Care (LTC) Services ([DHS-3340](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-3340-ENG)) form is used to document the couple's assets when the couple is not applying for MA-LTC.\n\nThe LTC spouse, the LTC spouse's authorized representative, if applicable, and the community spouse must be notified of the results of the asset assessment."}]},{"id":"epm:2.4.2.1.2","number":"2.4.2.1.2","title":"Community Spouse Asset Allowance","parent":"2.4.2.1","breadcrumb":"2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.1 Asset Evaluation for Married Couples > 2.4.2.1.2 Community Spouse Asset Allowance","summary":"The Community Spouse Asset Allowance (CSAA) is the amount of assets the community spouse can retain. A couple must consider many factors when deciding which assets to include in the CSAA including tax implications as well as personal factors such as the desire to retain ownership of a particular asset.","effective_date":"2022-09-01","last_modified":"2026-10-03T03:51:59.250595+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.1.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.4.2.1.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_4_2_1_2.htm","legal_citations":["Minnesota Statutes, section 256B.059","Minnesota Statutes, section 256B.0913, subdivision 12"],"chunks":[{"chunk_id":"epm:2.4.2.1.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.1.2","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.1 Asset Evaluation for Married Couples > 2.4.2.1.2 Community Spouse Asset Allowance","text":"The Community Spouse Asset Allowance (CSAA) is the amount of assets the community spouse can retain. A couple must consider many factors when deciding which assets to include in the CSAA including tax implications as well as personal factors such as the desire to retain ownership of a particular asset."},{"chunk_id":"epm:2.4.2.1.2#determining-the-community-spouse-asset-allowance","heading":"Determining the Community Spouse Asset Allowance","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.1.2#determining-the-community-spouse-asset-allowance","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.1 Asset Evaluation for Married Couples > 2.4.2.1.2 Community Spouse Asset Allowance > Determining the Community Spouse Asset Allowance","text":"## Determining the Community Spouse Asset Allowance\n\nThe couple must decide for themselves which assets to designate to the CSAA. The couple can contact a tax accountant, an attorney, or some who specializes in estate planning for questions about which assets they should include. The amount of the couple's total assets, as determined by the asset evaluation, is compared to the maximum CSAA. The community spouse may keep up to the maximum CSAA in effect on the date of the request for MA-LTC. The maximum CSAA is updated annually.\n\n### Treatment of Non-Homestead Life Estates in the CSAA\n\nThe value of a non-homestead life estates interest owned by the community spouse cannot be excluded unless the interest is transferred to the LTC spouse. Otherwise, the value is counted toward the maximum CSAA limit.\n\n### Notification requirements\n\nThe LTC spouse, community spouse, and the LTC spouse's authorized representative, if applicable, must be sent the Designation of Assets ([DHS-3340C](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3340C-ENG)), to provide written notice of the assets the couple designated toward the CSAA."},{"chunk_id":"epm:2.4.2.1.2#increased-community-spouse-asset-allowance","heading":"Increased Community Spouse Asset Allowance","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.1.2#increased-community-spouse-asset-allowance","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.1 Asset Evaluation for Married Couples > 2.4.2.1.2 Community Spouse Asset Allowance > Increased Community Spouse Asset Allowance","text":"## Increased Community Spouse Asset Allowance\n\nThe CSAA is increased beyond the maximum CSAA in the following situations:\n- A court, due to a legal separation, orders an amount of the couple’s assets for the community spouse that is greater than the CSAA.\n- The community spouse qualifies for additional income-producing assets to meet the community spouse’s monthly maintenance needs."},{"chunk_id":"epm:2.4.2.1.2#additional-income-producing-assets-to-meet-community-spouses-monthly-maintenance-needs","heading":"Additional Income-Producing Assets to Meet Community Spouse’s Monthly Maintenance Needs","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.1.2#additional-income-producing-assets-to-meet-community-spouses-monthly-maintenance-needs","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.1 Asset Evaluation for Married Couples > 2.4.2.1.2 Community Spouse Asset Allowance > Additional Income-Producing Assets to Meet Community Spouse’s Monthly Maintenance Needs","text":"## Additional Income-Producing Assets to Meet Community Spouse’s Monthly Maintenance Needs\n\nA community spouse may keep additional income-producing assets above the CSAA, if he or she cannot meet his or her monthly maintenance needs with the income allocated from the LTC spouse combined with his or her own income.\n\nThe couple must meet the following requirements for the community spouse to keep additional income-producing assets above the CSAA:\n- The community spouse’s income, combined with any income allocation from the LTC spouse, is less than the [calculated monthly maintenance needs](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5.1).\n- The CSAA must already include as many income-producing assets as possible.\n- The LTC spouse must make available, and the community spouse must accept, the community spouse income allocation. The couple cannot refuse to make or accept a community spouse income allocation as a way to reduce the community spouse’s income in order to qualify for additional income-producing assets.\n- The purchase of an income-producing asset for the benefit of the community spouse, under this provision, must occur before MA-LTC may be approved.\n- The amount of assets above the CSAA is limited to an amount necessary to produce the additional income needed to meet the community spouse's monthly maintenance needs.\n- Assets already producing an income cannot be used to purchase another income-producing asset, unless the asset purchased produces more income than the original asset."},{"chunk_id":"epm:2.4.2.1.2#transfers-from-the-ltc-spouse-to-the-community-spouse","heading":"Transfers from the LTC Spouse to the Community Spouse","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.1.2#transfers-from-the-ltc-spouse-to-the-community-spouse","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.1 Asset Evaluation for Married Couples > 2.4.2.1.2 Community Spouse Asset Allowance > Transfers from the LTC Spouse to the Community Spouse","text":"## Transfers from the LTC Spouse to the Community Spouse\n\nAssets considered available to the community spouse through the CSAA must be put in the community spouse’s name no later than the LTC spouse’s next annual renewal. At the LTC spouse’s next annual renewal, all assets still in the name of the LTC spouse are evaluated in order to determine asset eligibility.\n- Income from an asset in the LTC spouse’s name is counted in the LTC income calculation even if it is income produced by an asset that is considered part of the CSAA."}]},{"id":"epm:2.4.2.1.2.1","number":"2.4.2.1.2.1","title":"Asset Eligibility for a Long-Term Care Spouse","parent":"2.4.2.1.2","breadcrumb":"2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.1 Asset Evaluation for Married Couples > 2.4.2.1.2 Community Spouse Asset Allowance > 2.4.2.1.2.1 Asset Eligibility for a Long-Term Care Spouse","summary":"The couple’s remaining assets that are not designated toward the CSAA are evaluated in an asset eligibility determination for the LTC spouse, to determine whether the LTC spouse meets the MA asset limit.","effective_date":"2022-09-01","last_modified":"2026-10-03T03:51:59.785796+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.1.2.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.4.2.1.2.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_4_2_1_2_1.htm","legal_citations":["United States Code, title 42, Section 1396r-5","Minnesota Statutes 256B.059"],"chunks":[{"chunk_id":"epm:2.4.2.1.2.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.1.2.1","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.1 Asset Evaluation for Married Couples > 2.4.2.1.2 Community Spouse Asset Allowance > 2.4.2.1.2.1 Asset Eligibility for a Long-Term Care Spouse","text":"The couple’s remaining assets that are not designated toward the CSAA are evaluated in an asset eligibility determination for the LTC spouse, to determine whether the LTC spouse meets the MA asset limit."},{"chunk_id":"epm:2.4.2.1.2.1#transfers-from-the-community-spouse-to-the-ltc-spouse","heading":"Transfers from the Community Spouse to the LTC Spouse","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.1.2.1#transfers-from-the-community-spouse-to-the-ltc-spouse","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.1 Asset Evaluation for Married Couples > 2.4.2.1.2 Community Spouse Asset Allowance > 2.4.2.1.2.1 Asset Eligibility for a Long-Term Care Spouse > Transfers from the Community Spouse to the LTC Spouse","text":"## Transfers from the Community Spouse to the LTC Spouse\n\nCountable assets the couple has chosen not to protect in the CSAA are considered available to the LTC spouse when determining MA eligibility for the LTC spouse. These assets must be transferred to the LTC spouse. Transfer of ownership must be verified before MA-LTC eligibility may be approved."},{"chunk_id":"epm:2.4.2.1.2.1#availability-of-assets","heading":"Availability of Assets","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.1.2.1#availability-of-assets","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.1 Asset Evaluation for Married Couples > 2.4.2.1.2 Community Spouse Asset Allowance > 2.4.2.1.2.1 Asset Eligibility for a Long-Term Care Spouse > Availability of Assets","text":"## Availability of Assets\n\nThe LTC spouse’s assets are evaluated using the applicable policy:\n- [MA for People Who Are Age 65 or Older and People Who Are blind or Have a Disability (MA-ABD) asset rules](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2), or\n- [MA for Families with Children and Adults with a Medical Spenddown.](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.6)\n\nAssets that are excluded or unavailable are not counted toward the LTC spouse’s asset limit.\n\nWhen the LTC spouse has excess countable assets, they must reduce those assets before approval of MA. See EPM [2.3.3.2.6 MA-ABD Excess Assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.6) for more information."},{"chunk_id":"epm:2.4.2.1.2.1#community-spouse-does-not-make-assets-available-to-the-ltc-spouse","heading":"Community Spouse Does Not Make Assets Available to the LTC Spouse","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.1.2.1#community-spouse-does-not-make-assets-available-to-the-ltc-spouse","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.1 Asset Evaluation for Married Couples > 2.4.2.1.2 Community Spouse Asset Allowance > 2.4.2.1.2.1 Asset Eligibility for a Long-Term Care Spouse > Community Spouse Does Not Make Assets Available to the LTC Spouse","text":"## Community Spouse Does Not Make Assets Available to the LTC Spouse\n\nThe community spouse must make assets owned jointly or individually in excess of the CSAA available to the LTC spouse. If the community spouse does not make those assets available, the LTC spouse may still be found eligible for MA-LTC if the LTC spouse cannot use those assets without the consent of the community spouse, and if any of the following occurs:\n- the LTC spouse assigns the right to support from the community spouse to the Minnesota Department of Human Services (DHS) (this is done by signing the Minnesota Health Care Programs Application for Long-Term Care Services ([DHS-3531](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3531-ENG)));\n- the LTC spouse is unable to assign the right to support due to a physical or mental impairment; or\n- the denial of eligibility would cause an imminent threat to the LTC spouse's health and well-being.\n\nA person whose request for a hardship waiver is denied can appeal the denial. When MA-LTC is approved under this provision, the county or tribal nation servicing agency makes a referral to the county attorney’s office to determine if a cause of action exists against the community spouse."},{"chunk_id":"epm:2.4.2.1.2.1#treatment-of-the-community-spouses-assets-after-ma-ltc-approval","heading":"Treatment of the Community Spouse’s Assets after MA-LTC Approval","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.1.2.1#treatment-of-the-community-spouses-assets-after-ma-ltc-approval","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.1 Asset Evaluation for Married Couples > 2.4.2.1.2 Community Spouse Asset Allowance > 2.4.2.1.2.1 Asset Eligibility for a Long-Term Care Spouse > Treatment of the Community Spouse’s Assets after MA-LTC Approval","text":"## Treatment of the Community Spouse’s Assets after MA-LTC Approval\n\nOnce MA-LTC has been approved, any additional assets acquired by the community spouse are not available to the LTC spouse unless:\n- there is a break in MA-LTC for one calendar month or more; and\n- the county or tribal nation servicing agency receives a new request for MA-LTC."}]},{"id":"epm:2.4.2.2","number":"2.4.2.2","title":"Long-Term Care Partnership Insurance","parent":"2.4.2","breadcrumb":"2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.2 Long-Term Care Partnership Insurance","summary":"Long-Term Care (LTC) insurance provides coverage for services such as custodial care, nursing care, personal care, and assistance with activities of daily living for persons who need such care due to common conditions associated with old age, chronic mental or physical illness, or injury or cognitive impairment. LTC insurance covers services provided in settings that may include, but are not limit","effective_date":"2023-10-25","last_modified":"2026-10-03T03:51:59.785796+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.4.2.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_4_2_2.htm","legal_citations":["Minnesota Statutes, section 256B.0571","United States Code, title 42, section 1396p(c)"],"chunks":[{"chunk_id":"epm:2.4.2.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.2","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.2 Long-Term Care Partnership Insurance","text":"Long-Term Care (LTC) insurance provides coverage for services such as custodial care, nursing care, personal care, and assistance with activities of daily living for persons who need such care due to common conditions associated with old age, chronic mental or physical illness, or injury or cognitive impairment. LTC insurance covers services provided in settings that may include, but are not limited to, the beneficiary’s home, assisted living, or long-term care facilities. LTC insurance includes both individual policies and certificates issued under a group insurance contract.\n\nSome LTC insurance is qualified under the Minnesota Long-Term Care Partnership (LTCP) Program. A long-term care insurance policy that qualifies under the LTCP is known as a “partnership policy.”\n\nThe LTCP Program is a public-private arrangement between Minnesota’s Medical Assistance program and long-term care insurers. It enables people who buy certain qualified LTC insurance policies to keep more assets if they later need to request MA-LTC. It allows people to exclude assets and protect assets from MA recoveries in an amount equal to the benefits paid out by a partnership policy as of the effective date of eligibility for MA-LTC. This is called LTCP asset protection.\n\nFor more information, see the [Minnesota Long-Term Care Partnership Program](https://mn.gov/commerce/insurance/other/long-term-care/partnership.jsp)."},{"chunk_id":"epm:2.4.2.2#individuals-eligible-for-asset-protection-under-the-long-term-care-partnership-program","heading":"Individuals Eligible for Asset Protection under the Long-Term Care Partnership Program","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.2#individuals-eligible-for-asset-protection-under-the-long-term-care-partnership-program","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.2 Long-Term Care Partnership Insurance > Individuals Eligible for Asset Protection under the Long-Term Care Partnership Program","text":"## Individuals Eligible for Asset Protection under the Long-Term Care Partnership Program\n\nTo be eligible for LTCP asset protection under the LTCP program, a person must be:\n- A beneficiary of a LTC insurance policy that was qualified as a partnership policy at the time of purchase, or has been converted to a partnership policy through an endorsement, exchange or rider, and has been a Minnesota resident at the time the partnership policy was purchased; or\n- A beneficiary of a partnership policy established by another state that has a reciprocity agreement with Minnesota. The person must have been a resident of the other state on the date the policy was purchased."},{"chunk_id":"epm:2.4.2.2#verifying-a-partnership-policy","heading":"Verifying A Partnership Policy","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.2#verifying-a-partnership-policy","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.2 Long-Term Care Partnership Insurance > Verifying A Partnership Policy","text":"## Verifying A Partnership Policy\n\nPeople who request MA-LTC and believe they have a LTC insurance policy that qualifies as a partnership policy must reach out to their insurer to verify that the policy qualifies as a partnership policy. The insurer is responsible for verifying this qualification by completing the [LTC Partnership Insurance Policy Evaluation Form (DHS-5426B)](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-5426B-ENG), or by providing other documentation signed by a representative of the insurer that includes all of the following information:\n- Whether the policy qualifies as a partnership policy;\n- The amount of benefits the insurer has paid out since July 1, 2006; and\n- Whether the beneficiary or policyholder has exhausted all benefits.\n\nThe servicing agency must give the beneficiary or policyholder at least 30 days to collect and return the verification that a policy qualifies for the partnership program."},{"chunk_id":"epm:2.4.2.2#processing-a-request-for-ma-ltc-when-the-person-may-have-a-partnership-policy","heading":"Processing a Request for MA-LTC When the Person May Have a Partnership Policy","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.2#processing-a-request-for-ma-ltc-when-the-person-may-have-a-partnership-policy","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.2 Long-Term Care Partnership Insurance > Processing a Request for MA-LTC When the Person May Have a Partnership Policy","text":"## Processing a Request for MA-LTC When the Person May Have a Partnership Policy\n\nServicing agencies must process the MA-LTC application or request within the processing period if the person is otherwise eligible and has countable assets within the applicable asset limit, even if the person has not verified that the policy qualifies for the partnership program. If the verification is returned after the application or request has been approved, the worker must determine the amount of assets the person can designate for protection.\n\nIf the person is not otherwise eligible for MA-LTC due to excess assets, the servicing agency must give the beneficiary or policyholder 30 days to return the verification that a policy qualifies for the partnership program. If the verification is not returned within 30 days, the agency may extend the processing period so long as the person is working to obtain the verification as outlined in the [Minnesota Health Care Programs Eligibility Policy Manual (EPM) 1.2.4 MHCP Processing Period](https://bot-corpus.mn-dhs.online/s/epm/1.2.4). If the person is not cooperating, the agency must assume the insurance policy does not qualify for the partnership program.\n\nServicing agencies must follow the step-by-step ONEsource procedures, “Instructions for Long-Term Care Insurance,” when processing a request for MA-LTC when a person may have a partnership policy."},{"chunk_id":"epm:2.4.2.2#partnership-policy-notice-requirement","heading":"Partnership Policy Notice Requirement","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.2#partnership-policy-notice-requirement","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.2 Long-Term Care Partnership Insurance > Partnership Policy Notice Requirement","text":"## Partnership Policy Notice Requirement\n\nAfter verification of partnership policy is received, a notice must be provided to the person explaining:\n- Whether the person is eligible for asset protection, and\n- The amount of assets that can be designated for protection after receiving verification that the person has a qualified partnership policy."},{"chunk_id":"epm:2.4.2.2#protected-assets-under-the-long-term-care-partnership-program","heading":"Protected Assets under the Long-Term Care Partnership Program","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.2#protected-assets-under-the-long-term-care-partnership-program","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.2 Long-Term Care Partnership Insurance > Protected Assets under the Long-Term Care Partnership Program","text":"## Protected Assets under the Long-Term Care Partnership Program\n\nA person with a partnership policy may designate assets for protection up to the amount of benefits that had been paid out under policy. Protected assets are not counted when establishing MA-LTC eligibility and cannot be recovered by the state to repay MA costs when a person dies.\n\nAssets can be designated for protection when MA-LTC eligibility is established, while receiving MA-LTC, or during the estate recovery process after a person dies.\n\nA person may protect assets up to his or her Protected Asset Limit (PAL). If the value of the protected assets exceeds the PAL, the excess value is counted against the MA asset limit and is not protected from estate recovery. The excess value can be reduced to maintain MA-LTC eligibility."},{"chunk_id":"epm:2.4.2.2#rules-for-protected-assets","heading":"Rules for Protected Assets","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.2#rules-for-protected-assets","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.2 Long-Term Care Partnership Insurance > Rules for Protected Assets","text":"## Rules for Protected Assets\n\nThe following rules apply to protected assets under the LTCP program:\n- Enrollees may keep protected assets.\n- The value of protected assets a person keeps is updated each year at the time of the MA-LTC renewal. The updated value counts against the PAL.\n- Enrollees may transfer a protected asset to another person without a transfer penalty. A transferred asset counts against the PAL based on the value of the asset on the day the asset is transferred.\n- Enrollees may use a protected asset to obtain another asset, which then becomes protected.\n- An enrollee may deplete or spend a protected asset. The asset continues to be protected and is counted against the PAL even though the person no longer has it.\n- After an asset is designated for protection, it cannot be undesignated in favor of protecting another asset.\n- Enrollees must report changes in the status of protected assets at the time of the MA-LTC renewal. Changes include, but are not limited to, transferring, depleting or spending an asset, or using one asset to obtain another asset.\n- Certain assets include provisions to reimburse Minnesota Department of Human Services (DHS). Due to this payback provision, these assets cannot be protected:\n  - Special needs trust or a pooled trust\n  - Annuity interests on which the state must be named a preferred remainder beneficiary"},{"chunk_id":"epm:2.4.2.2#unused-asset-protection","heading":"Unused Asset Protection","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.2#unused-asset-protection","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.2 Long-Term Care Partnership Insurance > Unused Asset Protection","text":"## Unused Asset Protection\n\nAn enrollee may have unused asset protection for a number of reasons, including:\n- Not all available asset protections may have been used at the time of request for MA-LTC.\n- Increases in the PAL may occur when a person continues to receive benefits from a partnership policy while receiving MA-LTC.\n  - If the value of a protected asset increases, unused asset protection will automatically apply to protect the increased value. Additional designation is not necessary.\n- Unused asset protection can be used to:\n  - more fully protect an asset that is only partially protected;\n  - protect additional assets that become available during a person’s lifetime; and\n  - protect assets in a person’s estate after the person dies."},{"chunk_id":"epm:2.4.2.2#interaction-with-ma-ltc-and-other-policies-and-programs","heading":"Interaction with MA-LTC and Other Policies and Programs","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.2#interaction-with-ma-ltc-and-other-policies-and-programs","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.2 Long-Term Care Partnership Insurance > Interaction with MA-LTC and Other Policies and Programs","text":"## Interaction with MA-LTC and Other Policies and Programs\n\nA person must be eligible for MA-LTC or eligible for MA during a transfer penalty in order to protect assets under a partnership policy. When an applicant designates assets for protection and is denied MA eligibility, the asset designation is void. The person will have to designate assets again when reapplying in the future. Once protected, assets remain protected even if a person is no longer receiving MA services.\n- Community Spouse Asset Allowance (CSAA)\n  - In cases where an LTC spouse has a partnership policy, the calculation of the CSAA and the division of assets should occur before assets are designated for protection under the LTCP Program. Assets attributable to the LTC spouse may be designated for protection.\n- Transfer Penalty\n  - If a person requesting MA-LTC is subject to a penalty due to an uncompensated transfer, the person may still designate assets for protection if he or she is otherwise eligible for MA-LTC. Protecting assets does not shorten the length of a penalty period.\n- Third-Party Liability\n  - LTC insurance is considered third-party liability for a person receiving MA-LTC.\n- Alternative Care (AC)\n  - Asset protection under the LTCP Program does not apply to eligibility under the AC program. However, once a person qualifies for MA-LTC, protected assets are protected from recovery by the state as repayment for either MA or AC costs the person incurred."},{"chunk_id":"epm:2.4.2.2#estate-recovery-and-ma-liens","heading":"Estate Recovery and MA Liens","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.2#estate-recovery-and-ma-liens","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.2 Long-Term Care Partnership Insurance > Estate Recovery and MA Liens","text":"## Estate Recovery and MA Liens\n\nWhen a person with a partnership policy who has received MA-LTC dies, assets in the person’s estate that the person protected under the LTCP Program during his or her lifetime are protected from estate recovery up to the PAL. When a person dies who has unused asset protection, the deceased person’s personal representative may designate additional assets in the estate, up to the PAL, to be protected from recovery by the state.\n\nProtected assets cannot be recovered for the MA costs of the deceased spouse from the estate of the surviving spouse when protected assets of a deceased person with a partnership policy are transferred to a surviving spouse outside of probate. Protected assets transferred to a surviving spouse can be recovered for the MA costs of the surviving spouse unless the surviving spouse also protected the assets."}]},{"id":"epm:2.4.2.3","number":"2.4.2.3","title":"Home and Community-Based Service Waivers","parent":"2.4.2","breadcrumb":"2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.3 Home and Community-Based Service Waivers","summary":"Some people who have disabilities, who are age 65 or older, or who have chronic medical needs may receive services in addition to those already covered by Medical Assistance (MA). See the Community-Based Services Manual / Disability Services Program Manual for more information. The additional home and community-based services (HCBS) enable the person to receive care in the community rather than in","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:59.785796+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.4.2.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_4_2_3.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.4.2.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.3","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.3 Home and Community-Based Service Waivers","text":"Some people who have disabilities, who are age 65 or older, or who have chronic medical needs may receive services in addition to those already covered by Medical Assistance (MA). See the [Community-Based Services Manual / Disability Services Program Manual](http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=id_000402) for more information. The additional home and community-based services (HCBS) enable the person to receive care in the community rather than in an institution.\n\nPeople who are eligible for MA may also be eligible for one of the following waiver programs:\n- Brain Injury Waiver (BI)\n- Community Alternative Care (CAC)\n- Community Access for Disability Inclusion (CADI)\n- Developmental Disabilities (DD)\n- Elderly Waiver (EW)"},{"chunk_id":"epm:2.4.2.3#waiver-programs","heading":"Waiver Programs","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.3#waiver-programs","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.3 Home and Community-Based Service Waivers > Waiver Programs","text":"## Waiver Programs\n\n### Brain Injury Waiver (BI)\n\nBI is a federally approved HCBS program for people who have an acquired or traumatic brain injury requiring a level of care provided in a specialized nursing facility or neurobehavioral hospital. These people may be eligible to receive services in community settings rather than in a nursing facility or neurobehavioral hospital.\n\n### Community Alternative Care (CAC)\n\nCAC is a federally approved HCBS program for people who are chronically ill and choose to receive services in the community.\n\n### Community Access for Disability Inclusion (CADI)\n\nCADI is a federally approved HCBS program that allows people with disabilities who require the level of care provided in a nursing facility to receive services in the community rather than in a nursing facility.\n\n### Developmental Disabilities (DD)\n\nDD is a federally approved HCBS program for children and adults with a developmental disability or related condition who require the level of care provided in an Intermediate Care Facility for Persons with Developmental Disabilities (ICF/DD) but choose to reside in the community.\n\n### Elderly Waiver (EW)\n\nEW is a federally approved HCBS program for people age 65 or older who require the level of medical care provided in a nursing home but choose to reside in the community.\n\nThe following sections discuss the MA-LTC eligibility rules for the HCBS waiver programs.\n1. [HCBS Waiver Programs for People with Disabilities](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.3.1)\n2. [HCBS Waiver Programs for People Age 65 or Older](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.3.2)"}]},{"id":"epm:2.4.2.3.1","number":"2.4.2.3.1","title":"Home and Community-Based Services Waivers for People with Disabilities","parent":"2.4.2.3","breadcrumb":"2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.3 Home and Community-Based Service Waivers > 2.4.2.3.1 Home and Community-Based Services Waivers for People with Disabilities","summary":"Home and Community-Based Services (HCBS) waivers for people with disabilities include the following HCBS waivers:","effective_date":"2026-06-12","last_modified":"2026-10-03T04:45:31.587632+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.3.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.4.2.3.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_4_2_3_1.htm","legal_citations":["Minnesota Statutes, section 256B.056","Minnesota Statutes, section 256B.0913","Minnesota Statutes, section 256B.092","Minnesota Statutes, section 256B.093","Minnesota Statutes, section 256B.49"],"chunks":[{"chunk_id":"epm:2.4.2.3.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.3.1","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.3 Home and Community-Based Service Waivers > 2.4.2.3.1 Home and Community-Based Services Waivers for People with Disabilities","text":"Home and Community-Based Services (HCBS) waivers for people with disabilities include the following HCBS waivers:\n- Brain Injury (BI)\n- Community Alternative Care (CAC)\n- Community Access for Disability Inclusion (CADI)\n- Developmental Disabilities (DD)\n\nThis section discusses rules for determining a person’s household composition and family size. It also discusses the income limits and methodology used to determine income eligibility for HCBS waivers for people with disabilities.\n\nChildren and youth enrolled in the following MA bases of eligibility continue to use these bases when they have been determined disabled by the Social Security Administration (SSA) or State Medical Review Team (SMRT), even when receiving HCBS. They do not need to use the disabled basis of eligibility.\n- [MA for Children in Foster Care](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3)\n- [MA Northstar Kinship Assistance](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2)\n- [MA Northstar Adoption Assistance](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1)\n- [MA for Former Foster Care Youth](https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1.3)"},{"chunk_id":"epm:2.4.2.3.1#household-composition-and-family-size","heading":"Household Composition and Family Size","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.3.1#household-composition-and-family-size","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.3 Home and Community-Based Service Waivers > 2.4.2.3.1 Home and Community-Based Services Waivers for People with Disabilities > Household Composition and Family Size","text":"## Household Composition and Family Size\n\nHousehold composition means the people included in a person’s household. Household composition determines the family size. Household composition and family size are factors used to determine financial eligibility.\n\nHousehold composition and family size are determined for each person separately and may be different for each person on an application or in a household.\n\nThe HCBS waiver programs allow a child or a married person to be treated as a household of one, and have only their own income and assets count in their Medical Assistance (MA) eligibility determination, when they are otherwise not eligible using the regular household composition, income and asset deeming rules for [MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD)](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.1).\n\nIf a person enrolled in MA for Employed Persons with Disabilities (MA-EPD) requests HCBS waivers, the [MA-EPD family size rules](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.2) are used."},{"chunk_id":"epm:2.4.2.3.1#income-limits-and-methodology","heading":"Income Limits and Methodology","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.3.1#income-limits-and-methodology","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.3 Home and Community-Based Service Waivers > 2.4.2.3.1 Home and Community-Based Services Waivers for People with Disabilities > Income Limits and Methodology","text":"## Income Limits and Methodology\n\nThe MA-ABD [income limits](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.1) and [methodology](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2) are used to determine eligibility for MA for Long-Term Care Services (MA-LTC) through the HCBS waivers for people with disabilities. However, if the person is enrolled in MA-EPD, the [MA-EPD income limits](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.2) and [methodology](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.2) rules are used."}]},{"id":"epm:2.4.2.3.2","number":"2.4.2.3.2","title":"Home and Community-Based Services Waiver for People Age 65 or Older","parent":"2.4.2.3","breadcrumb":"2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.3 Home and Community-Based Service Waivers > 2.4.2.3.2 Home and Community-Based Services Waiver for People Age 65 or Older","summary":"Home and Community-Based Services (HCBS) waiver for people age 65 or older is the Elderly Waiver (EW).","effective_date":"2016-06-01","last_modified":"2026-10-03T04:45:32.656821+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.3.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.4.2.3.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_4_2_3_2.htm","legal_citations":["Minnesota Statutes, section 256B.058","Minnesota Statutes, section 256B.0915"],"chunks":[{"chunk_id":"epm:2.4.2.3.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.3.2","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.3 Home and Community-Based Service Waivers > 2.4.2.3.2 Home and Community-Based Services Waiver for People Age 65 or Older","text":"Home and Community-Based Services (HCBS) waiver for people age 65 or older is the Elderly Waiver (EW).\n\nThis section discusses rules for determining a person’s household composition and family size. It also refers to the income limits and cost-sharing calculations used to determine income eligibility for EW."},{"chunk_id":"epm:2.4.2.3.2#household-composition-and-family-size","heading":"Household Composition and Family Size","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.3.2#household-composition-and-family-size","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.3 Home and Community-Based Service Waivers > 2.4.2.3.2 Home and Community-Based Services Waiver for People Age 65 or Older > Household Composition and Family Size","text":"## Household Composition and Family Size\n\nHousehold composition means the people included in a person’s household. Household composition determines the family size. Household composition and family size are factors used to determine financial eligibility.\n\nHousehold composition and family size are determined for each person separately and may be different for each person on an application or in a household.\n\nThe EW program allows special rules to be applied to people age 65 or older who are not eligible for Medical Assistance (MA) using the MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) household composition and family size and deeming rules. These people are treated as a household of one, and only their income counts.\n\nIf a person enrolled in MA for Employed Persons with Disabilities (MA-EPD) requests EW, the [MA-EPD family size rules](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.2) are used."},{"chunk_id":"epm:2.4.2.3.2#income-limits-and-cost-sharing","heading":"Income Limits and Cost-Sharing","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.3.2#income-limits-and-cost-sharing","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.3 Home and Community-Based Service Waivers > 2.4.2.3.2 Home and Community-Based Services Waiver for People Age 65 or Older > Income Limits and Cost-Sharing","text":"## Income Limits and Cost-Sharing\n\nThis section covers the income limits and refers to the cost-sharing calculations used to determine eligibility for MA for Long-Term Care Services (MA-LTC) through EW.\n\n### Income Limits\n\nThe income limit for EW is 300% of the federal benefit rate (FBR) known as the special income standard (SIS). People who are eligible for EW due to income at or below the SIS are referred to as being eligible for SIS-EW.\n\nIf the gross income of the person requesting MA-LTC through EW is greater than the SIS, the person may still be eligible for EW. This group is referred to as being eligible for EW. Two income methodologies may be used to determine eligibility for MA-LTC for people who are eligible for EW with income above the SIS.\n\n### Cost-Sharing\n\nCost-sharing refers to the amount of income the person is required to contribute to their cost of care. People eligible for SIS-EW, with or without a community spouse, use an LTC income calculation to determine eligibility for MA-LTC.\n\nPeople eligible for EW because they have income greater than the SIS use one of the following cost-sharing calculations, based on whether or not there is a community spouse, to determine eligibility for MA-LTC:\n- [Community Income Calculation](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5#community-income-calculation) is used for people who do not have a community spouse.\n- [LTC Income Calculation](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5#ltc-income-calculation) is used for people who have a community spouse."}]},{"id":"epm:2.4.2.4","number":"2.4.2.4","title":"Long-Term Care Facility Services","parent":"2.4.2","breadcrumb":"2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.4 Long-Term Care Facility Services","summary":"A long-term care facility (LTCF) is a place such as a skilled nursing facility, Intermediate Care Facility for the Developmentally Disabled (ICF/DD) or medical hospital in which the individual receives skilled nursing services (swing bed). For more information regarding these facility types, refer to the Minnesota Health Care Provider Manual Intermediate Care Facilities (ICF/DD) and Swing Bed Hosp","effective_date":"2024-06-11","last_modified":"2026-10-03T03:57:11.306151+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.4.2.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_4_2_4.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.726","Code of Federal Regulations, title 42, section 435.733","Code of Federal Regulations, title 42, section 435.735","Code of Federal Regulations, title 42, section 435.832","Minnesota Statues, section 256B.057"],"chunks":[{"chunk_id":"epm:2.4.2.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.4","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.4 Long-Term Care Facility Services","text":"A long-term care facility (LTCF) is a place such as a skilled nursing facility, Intermediate Care Facility for the Developmentally Disabled (ICF/DD) or medical hospital in which the individual receives skilled nursing services (swing bed). For more information regarding these facility types, refer to the [Minnesota Health Care Provider Manual Intermediate Care Facilities (ICF/DD)](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=dhs16_147317) and [Swing Bed Hospital Services](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=MNDHS-061576).\n- An MA enrollee who is absent from a LTCF on a leave day is still considered to be residing in a LTCF.\n- Housing Support and Housing with Services Establishments are not LTCFs"},{"chunk_id":"epm:2.4.2.4#household-composition-and-family-size","heading":"Household Composition and Family Size","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.4#household-composition-and-family-size","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.4 Long-Term Care Facility Services > Household Composition and Family Size","text":"## Household Composition and Family Size\n\nFinancial eligibility rules vary depending on MA basis of eligibility when a person who resides in a LTCF and meets the [LTC eligibility factors](https://bot-corpus.mn-dhs.online/s/epm/2.3.4.1), requests Medical Assistance for Long-Term Care Services (MA-LTC). The varying rules for household composition and family size, contribution to the person’s cost of care, type of income calculation used, and the program asset limit that applies are in the chart below.\n\n|  | **Household composition and Family Size** | **May need to contribute to cost of care** | **Income Calculation used** | **Asset limit** |\n| --- | --- | --- | --- | --- |\n| MA for People Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) | Household of 1 (no deeming) | Yes | LTC income calculation (to determine LTC spenddown) | Yes, MA-ABD asset limit. If married then also subject to an asset evaluation. |\n| MA for Employed Persons with Disabilities (MA-EPD) | Household of 1 (no deeming) | No | ABD income methodology (to determine premium amount) | None |\n| MA for Families with Children and Adults (MA-FCA) no medical spenddown | FCA household composition determines family size if temporary stay. Household of 1 (no deeming) if their stay in the LTCF is permanent. | No | None. No contribution toward cost of care | None |\n| MA-Families and Children with a Medical Spenddown | Household of 1 (no deeming) | Yes | LTC income calculation (to determine LTC spenddown) | Yes, MA-Families and Children with a Medical Spenddown asset limit. If married then also subject to an asset evaluation. |"}]},{"id":"epm:2.4.2.5","number":"2.4.2.5","title":"Income Calculations for Long-Term Care Services","parent":"2.4.2","breadcrumb":"2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.5 Income Calculations for Long-Term Care Services","summary":"The community income calculation or the LTC income calculation is used to determine what amount, if any, a person must contribute from their income toward the cost of their long-term care (LTC) services.","effective_date":"2024-11-01","last_modified":"2026-10-03T03:51:59.785796+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.4.2.5","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_4_2_5.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.726","Code of Federal Regulations, title 42, section 435.733","Code of Federal Regulations, title 42, section 435.735","Code of Federal Regulations, title 42, section 435.832","Minnesota Statutes, section 256B.0575","Minnesota Statutes, section 256B.058","Minnesota Statutes, section 256S.05"],"chunks":[{"chunk_id":"epm:2.4.2.5#income-calculations","heading":"Income Calculations","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5#income-calculations","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.5 Income Calculations for Long-Term Care Services > Income Calculations","text":"## Income Calculations\n\nThe community income calculation or the LTC income calculation is used to determine what amount, if any, a person must contribute from their income toward the cost of their long-term care (LTC) services."},{"chunk_id":"epm:2.4.2.5#income-contribution","heading":"Income Contribution","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5#income-contribution","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.5 Income Calculations for Long-Term Care Services > Income Contribution","text":"## Income Contribution\n\n**An income contribution may be required for long-term care services:**\n- MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD), or\n- MA for Families and Children with a Medical Spenddown\n\n**An income contribution is not required for long-term care services for:**\n- MA for Families with Children and Adults (MA-FCA) without a medical spenddown, or\n- MA for Employed Persons with Disabilities (MA-EPD).\n\nThe following policies do not apply during full months of MA-LTC ineligibility due to a transfer penalty or when the person fails to name DHS the preferred remainder beneficiary on an annuity. Refer to sections [2.4.1.3.2 Transfer Penalty](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.3.2) and [2.4.1.4.2 Naming DHS a Preferred Remainder Beneficiary](https://bot-corpus.mn-dhs.online/s/epm/2.4.1.4.2) for more information.\n\n### Community Income Calculation\n\nA community income calculation determines the amount, if any, of the income contribution for people that:\n- Request home and community-based services (HCBS) through a waiver program for persons with disabilities (Brain Injury (BI), Community Alternative Care (CAC), Community Access for Disability Inclusion (CADI), Developmental Disabilities (DD))\n- Request HCBS through the Elderly Waiver (EW) program and have gross income above the Special Income Standard (SIS) but do not have a community spouse\n- Are expected to reside in a long-term care facility (LTCF) for less than 30 consecutive days\n\nA community income calculation is determined using the MA-ABD income methodology and may result in a medical spenddown. The person can use the cost of their LTC services to meet the medical spenddown, if applicable.\n\nA community income calculation is also used for the months a person requests MA coverage prior to the month in which LTC services begin.\n\n### LTC Income Calculation\n\nA LTC income calculation determines the amount, if any, of the income contribution for people that:\n- Are expected to reside in a LTCF for at least 30 consecutive days\n  - An MA enrollee who is absent from an LTCF on a leave day is still considered to be residing in a LTCF.\n  - Housing Support (HS), assisted living, or a non-Medicaid certified facility, is not an LTCF.\n- Request EW and have income at or below the SIS\n- Request EW and have income above the SIS and have a community spouse\n- Have an MA for Families and Children with a Medical Spenddown basis of eligibility\n\nA LTC income calculation starts with the amount of a person’s total income and applies certain deductions. This calculation may result in an LTC spenddown, waiver obligation or medical spenddown. The LTC income calculation determines the LTC spenddown, waiver obligation or medical spenddown, if any, based on anticipated total income and deductions for each month of a six-month period.\n\nThe person is responsible for payment of the amount of the LTC spenddown or waiver obligation, if any, toward the cost of their LTC services."},{"chunk_id":"epm:2.4.2.5#total-income","heading":"Total Income","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5#total-income","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.5 Income Calculations for Long-Term Care Services > Total Income","text":"## Total Income\n- Excluded Income\n  - Unless a person is residing in a LTCF, Supplemental Security Income (SSI) and Minnesota Supplemental Aid (MSA) are counted in the month of receipt. See [2.4.2.5.1 MA-LTC Income Calculation Deductions](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5.1) for more information.\n- The person's spouse's income\n- Sponsor Income if the sponsor is the person's community spouse\n- LTC insurance payments (LTC insurance payments are considered third-party liability)\n\nTotal income is not averaged or annualized; it is a month by month calculation. The Retirement, Survivors, Disability Insurance (RSDI) cost of living adjustment (COLA) disregard is not applied in the LTC income calculation.\n\nTotal income must be verified at each request for MA-LTC, at each renewal and when a change is reported. People in an LTCF who have earned income in excess of $80 per month must use the Household Report Form ([DHS-2120](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-2120-ENG)) to report and verify their income monthly.\n\nRetroactive adjustments are made for each month in the six month period of a LTC income calculation where the actual income or deductions differ from the anticipated income or deductions including months in which SSI benefits are retroactively reduced by SSA because the person was in an LTCF, resulting in an SSI overpayment."},{"chunk_id":"epm:2.4.2.5#beginning-and-ending-the-ltc-income-calculation","heading":"Beginning and Ending the LTC Income Calculation","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5#beginning-and-ending-the-ltc-income-calculation","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.5 Income Calculations for Long-Term Care Services > Beginning and Ending the LTC Income Calculation","text":"## Beginning and Ending the LTC Income Calculation\n\nOnce a person is found eligible for MA-LTC, the LTC income calculation begins:\n- The month the person with a community spouse begins receiving LTC services\n- The month following the month the person without a community spouse begins receiving LTC services\n\nThe LTC income calculation ends:\n- The month the person with a community spouse stops receiving LTC services\n- The month before the month the person without a community spouse stops receiving LTC services\n\nThe LTC income calculation continues through the month in which a person who lives in an LTCF or receives EW dies."},{"chunk_id":"epm:2.4.2.5#ltc-spenddown","heading":"LTC Spenddown","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5#ltc-spenddown","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.5 Income Calculations for Long-Term Care Services > LTC Spenddown","text":"## LTC Spenddown\n\nThe LTC spenddown is the amount a person must contribute toward the cost of LTC services when the person resides in an LTCF.\n\nA person’s MA eligibility cannot be closed for failure to pay the LTC spenddown to the LTCF. A county, tribal or state agency may disqualify an authorized representative who fails to pay the LTCF and the agency must assist the person in finding another authorized representative.\n\nThe LTC spenddown may be adjusted retroactively without providing 10-day notice. See EPM [1.3.1.5 MHCP Notices](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.5).\n\n### Interaction with Medicare Part A Payments\n\nMedicare Part A covers care provided in an LTCF when a person is admitted to the LTCF immediately following three or more consecutive days of hospitalization. In these situations, the MA enrollee must pay the LTC spenddown or the Medicare coinsurance obligation, whichever is less.\n\nThe LTC spenddown may be collected before the Medicare payment is known. As a result, the LTCF may have received a higher LTC spenddown than the MA enrollee should have paid. The LTCF may refund the excess LTC spenddown to the MA enrollee or, with the agreement of the MA enrollee, retain the excess spenddown for payment of a past due obligation. Any amount of an LTC spenddown that is refunded to an MA enrollee is treated as follows:\n- The refund is not counted as income or as an asset in the month received.\n- Any amount refunded to the MA enrollee is counted as an asset beginning with the month following the month the refund is received.\n\nIf the refund results in the enrollee having excess assets, MA-LTC may be closed."},{"chunk_id":"epm:2.4.2.5#waiver-obligation","heading":"Waiver Obligation","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5#waiver-obligation","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.5 Income Calculations for Long-Term Care Services > Waiver Obligation","text":"## Waiver Obligation\n\nA waiver obligation is the amount a person must contribute toward the cost of EW services when the person has income at or below the SIS.\n\nEW enrollees with a waiver obligation who are enrolled in a managed care plan cannot use the designated provider option.\n\nSIS-EW enrollees who access EW services that cost less than the waiver obligation may keep the income that is not contributed to the cost of their EW services."},{"chunk_id":"epm:2.4.2.5#medical-spenddown","heading":"Medical Spenddown","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5#medical-spenddown","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.5 Income Calculations for Long-Term Care Services > Medical Spenddown","text":"## Medical Spenddown\n\nA medical spenddown for a person eligible for MA-LTC is the amount the person must contribute toward the cost of LTC services."}]},{"id":"epm:2.4.2.5.1","number":"2.4.2.5.1","title":"LTC Income Calculation Deductions","parent":"2.4.2.5","breadcrumb":"2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.5 Income Calculations for Long-Term Care Services > 2.4.2.5.1 LTC Income Calculation Deductions","summary":"Certain deductions from countable gross income are allowed in the long-term care (LTC) income calculation to determine the amount a person is required to contribute toward the cost of LTC services, if any. Deductions, like income, count in the month in which they occur. Deductions must be verified at each request for Medical Assistance for Long-Term Care Services (MA-LTC), at each renewal, and whe","effective_date":"2022-03-01","last_modified":"2026-10-03T04:45:29.914088+00:00","version":3,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.4.2.5.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_4_2_5_1.htm","legal_citations":["Code of Federal Regulations, title 42 section 435.733","Code of Federal Regulations, title 42, section 435.735","Code of Federal Regulations, title 42, section 435.832","Code of Federal Regulations, title 42, section 483.10(f)","Minnesota Statutes, section 256B.0575","Minnesota Statutes, section 256B.058","Minnesota Statues, section 256B.35","Minnesota Statues, section 256B.36","Minnesota Statutes, section 256S.05"],"chunks":[{"chunk_id":"epm:2.4.2.5.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5.1","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.5 Income Calculations for Long-Term Care Services > 2.4.2.5.1 LTC Income Calculation Deductions","text":"Certain deductions from countable gross income are allowed in the long-term care (LTC) income calculation to determine the amount a person is required to contribute toward the cost of LTC services, if any. Deductions, like income, count in the month in which they occur. Deductions must be verified at each request for Medical Assistance for Long-Term Care Services (MA-LTC), at each renewal, and when a change is reported.\n\nA person’s eligibility for MA-LTC is not denied or closed if the person does not provide required proof of a deduction. However, the deduction is not used in the LTC income calculation if it is not verified.\n\nThe following deductions are subtracted from [gross countable income](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5#ltc-income-calculation) in the LTC income calculation in the order listed below:\n1. [Special Supplemental Security Income (SSI) Deduction](https://hcopub.dhs.state.mn.us/epm/#SSI_Income)\n2. [Minnesota Supplemental Aid (MSA) Deduction](https://hcopub.dhs.state.mn.us/epm/#MSA)\n3. [Special Personal Allowance from earned income](https://hcopub.dhs.state.mn.us/epm/#SPA)\n4. [Medicare premiums paid by the enrollee](https://hcopub.dhs.state.mn.us/epm/#Medicare)\n5. [Applicable LTC Needs Allowance](https://hcopub.dhs.state.mn.us/epm/#LTC_Allowance)\n6. [Fees paid to a guardian, conservator, or representative payee](https://hcopub.dhs.state.mn.us/epm/#Fees_Paid)\n7. [Community Spouse Income Allocation](https://hcopub.dhs.state.mn.us/epm/#CSAA)\n8. [Family Allocation](https://hcopub.dhs.state.mn.us/epm/#Family_Allocation)\n9. [Court-ordered child support](https://hcopub.dhs.state.mn.us/epm/#CO_CS)\n10. [Court-ordered spousal maintenance](https://hcopub.dhs.state.mn.us/epm/#CO_SM)\n11. [Health insurance premiums, co-payments and deductibles](https://hcopub.dhs.state.mn.us/epm/#HPremiums)\n12. [Remedial Care Expense](https://hcopub.dhs.state.mn.us/epm/#RCE)\n13. [Medical expenses](https://hcopub.dhs.state.mn.us/epm/#Medical)"},{"chunk_id":"epm:2.4.2.5.1#special-supplemental-security-income-ssi-deduction","heading":"Special Supplemental Security Income (SSI) Deduction","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5.1#special-supplemental-security-income-ssi-deduction","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.5 Income Calculations for Long-Term Care Services > 2.4.2.5.1 LTC Income Calculation Deductions > Special Supplemental Security Income (SSI) Deduction","text":"## Special Supplemental Security Income (SSI) Deduction\n\nSupplemental Security Income (SSI) payments received by an enrollee are deducted in the LTC income calculation."},{"chunk_id":"epm:2.4.2.5.1#minnesota-supplemental-aid-msa-deduction","heading":"Minnesota Supplemental Aid (MSA) Deduction","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5.1#minnesota-supplemental-aid-msa-deduction","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.5 Income Calculations for Long-Term Care Services > 2.4.2.5.1 LTC Income Calculation Deductions > Minnesota Supplemental Aid (MSA) Deduction","text":"## Minnesota Supplemental Aid (MSA) Deduction\n\nMinnesota Supplemental Aid (MSA) payments received by en enrollee are deducted in the LTC income calculation."},{"chunk_id":"epm:2.4.2.5.1#special-personal-allowance-from-earned-income","heading":"Special Personal Allowance from Earned Income","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5.1#special-personal-allowance-from-earned-income","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.5 Income Calculations for Long-Term Care Services > 2.4.2.5.1 LTC Income Calculation Deductions > Special Personal Allowance from Earned Income","text":"## Special Personal Allowance from Earned Income\n\nA special personal allowance from earned income are deducted for a person who is:\n- certified disabled by SSA or the State Medical Review Team (SMRT);\n- employed under an Individual Plan of Rehabilitation; and\n- living in an LTCF.\n\nThe following deductions are applied in the order listed but cannot reduce income to less than zero:\n- The first $80 of earned income\n- Actual FICA tax withheld\n- Actual transportation costs\n- Actual employment expenses, such as tools and uniforms\n- State and federal taxes if the person is not exempt from withholding"},{"chunk_id":"epm:2.4.2.5.1#medicare-premiums","heading":"Medicare Premiums","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5.1#medicare-premiums","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.5 Income Calculations for Long-Term Care Services > 2.4.2.5.1 LTC Income Calculation Deductions > Medicare Premiums","text":"## Medicare Premiums\n\nMedicare premiums incurred by an enrollee are deducted when not paid by another program. Medicare premiums paid by another program include:\n- The county, state or tribal agency reimburse to the enrollee\n- Paid through the Medicare Buy-In\n- Paid through Medicare Part D Extra Help"},{"chunk_id":"epm:2.4.2.5.1#ltc-needs-allowances","heading":"LTC Needs Allowances","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5.1#ltc-needs-allowances","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.5 Income Calculations for Long-Term Care Services > 2.4.2.5.1 LTC Income Calculation Deductions > LTC Needs Allowances","text":"## LTC Needs Allowances\n\nOne of the following allowances is deducted:\n\n### Clothing and Personal Needs Allowance (PNA)\n\nThe [Clothing and Personal Needs Allowance](https://bot-corpus.mn-dhs.online/s/epm/F#clothing-and-personal-needs-allowance) (PNA) is used when the enrollee is not eligible for any of the other LTC needs allowances. The PNA is adjusted each year on January 1.\n\n### Veteran’s Improved Pension\n\nA $90 veteran’s improved pension is available to people who are:\n- veterans but who do not have a spouse or dependent child(ren)\n- the surviving spouse of a veteran who does not have a dependent child(ren)\n\n### Home Maintenance Allowance (HMA)\n\nA person who is eligible for the HMA is also eligible for the PNA. The [Home Maintenance Allowance](https://bot-corpus.mn-dhs.online/s/epm/F#home-maintenance-allowance) (HMA) amount, listed in Appendix F, combines the allowed amount for home maintenance with the PNA. The HMA is adjusted each year on July 1.\n\nThe HMA is used when all of the following apply:\n- the person lives in an LTCF;\n- the person is expected to be discharged from the LTCF within three full calendar months from the month in which MA-LTC is requested to begin;\n- the person has expenses to maintain a home (owned or rented) in the community, including room and board charges in Housing Support (HS) or assisted living; and\n- the person meets one of the following conditions:\n  - The person did not live with a spouse, a child under age 21, or a person who could be claimed as a dependent of the person for federal income tax purposes at the time he or she was admitted to an LTCF.\n  - The person lived with a spouse at the time he or she was admitted to an LTCF, and the person’s spouse was admitted to an LTCF on the same day.\n\nOnly one spouse can receive the HMA when both spouses live in an LTCF. The HMA is used for the spouse for which it is most advantageous.\n\nEligibility for the HMA is based on the anticipated discharge date at the time eligibility for MA-LTC is determined. Eligibility for the HMA is not delayed to see if the person will actually be discharged on the anticipated discharge date and is not retroactively adjusted if the person lives in the LTCF for more than three full calendar months.\n\nA person must be discharged from an LTCF for a full calendar month before the HMA may be used again.\n\n### Special Income Standard Elderly Waiver (SIS-EW) Maintenance Needs Allowance (MNA)\n\nThe [Special Income Standard Elderly Waiver](https://bot-corpus.mn-dhs.online/s/epm/F#special-income-standard-for-elderly-waiver-maintenance-needs-allowance) (SIS-EW) maintenance needs allowance (MNA) is used for people requesting Elderly Waiver (EW) services and who have income at or below the Special Income Standard (SIS). The SIS-EW MNA is updated annually in July. The SIS-EW MNA is not used for a person with income above the SIS.\n\nWhen an SIS-EW enrollee moves to or from an LTCF:\n- The PNA or veteran’s improved pension allowance is used beginning the month following the month the SIS-EW enrollee moves into the LTCF.\n- The SIS-EW MNA is used beginning the month following the month the person is discharged from the LTCF and begins receiving EW services."},{"chunk_id":"epm:2.4.2.5.1#fees-paid-to-a-guardian-conservator-or-representative-payee","heading":"Fees Paid to a Guardian, Conservator, or Representative Payee","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5.1#fees-paid-to-a-guardian-conservator-or-representative-payee","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.5 Income Calculations for Long-Term Care Services > 2.4.2.5.1 LTC Income Calculation Deductions > Fees Paid to a Guardian, Conservator, or Representative Payee","text":"## Fees Paid to a Guardian, Conservator, or Representative Payee\n\nFive percent of the enrollee’s gross monthly income, up to a maximum of $100, for fees paid to a guardian, conservator or representative payee is deducted. This deduction cannot be increased over $100 even if a higher amount is allowed to be paid by SSA or a court."},{"chunk_id":"epm:2.4.2.5.1#community-spouse-income-allocation","heading":"Community Spouse Income Allocation","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5.1#community-spouse-income-allocation","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.5 Income Calculations for Long-Term Care Services > 2.4.2.5.1 LTC Income Calculation Deductions > Community Spouse Income Allocation","text":"## Community Spouse Income Allocation\n\nAn LTC spouse may allocate a portion of their income to the community spouse when the community spouse’s income is insufficient to meet their monthly maintenance needs. The community spouse income allocation is calculated by comparing the community spouse’s gross monthly income to the [minimum monthly allowance](https://bot-corpus.mn-dhs.online/s/epm/F#minimum-monthly-income-allowance) plus any excess shelter costs. The income allocation cannot exceed the [maximum monthly allowance](https://bot-corpus.mn-dhs.online/s/epm/F#maximum-monthly-income-allowance).\n\nThe community spouse’s gross monthly income includes all earned and unearned income, including income received from income-producing assets. No exclusions, disregards or deductions apply. If the community spouse’s gross monthly income is greater than or equal to the community spouse’s monthly maintenance needs, the community spouse does not qualify for an income allocation. If the community spouse’s gross monthly income is less than the community spouse’s monthly maintenance needs, the community spouse qualifies for an income allocation.\n\n### Calculation of the Community Spouse’s Shelter Costs\n\nThe community spouse’s shelter costs, in excess of the [basic shelter allowance](https://bot-corpus.mn-dhs.online/s/epm/F#basic-shelter-allowance), are added to the [minimum monthly allowance](https://bot-corpus.mn-dhs.online/s/epm/F#minimum-monthly-income-allowance) to calculate the community spouse income allocation. Shelter costs include:\n- Rent\n- Mortgage payments, including principal and interest\n- Real estate taxes\n- Homeowner’s or renter’s insurance\n- Required maintenance charges for a cooperative or condominium\n- [Utility allowance](https://bot-corpus.mn-dhs.online/s/epm/F#utility-allowance)\n\nThe amount of a shelter expense is based on the full amount that the community spouse must pay. Shelter expenses do not include charges for services received by a person who resides in a residential living arrangement. An itemized statement of monthly charges to identify the amount the community spouse must pay for rent or any other shelter expense is required.\n\n### Verification Requirements\n\nA community spouse income allocation cannot be deducted unless the person, or their authorized representative, provides verification of the community spouse’s income and shelter expenses at the time of the request for MA-LTC and at each renewal. The community spouse, or the community spouse’s authorized representative, must report and verify changes in the income or shelter expenses of the community spouse.\n\n### When to Deduct the Community Spouse Income Allocation\n\nThe calculated community spouse income allocation is deducted when there is a community spouse at any time in a given month unless:\n- There is a court order for spousal support for an amount that is greater than the calculated community spouse income allocation. When this occurs, the court ordered amount replaces the community spouse income allocation as a deduction. This only applies when a court order establishes support while the couple remains married. It does not apply to a court order in a divorce action.\n- The LTC spouse does not have enough income remaining, after other allowable deductions, to allocate to the community spouse.\n- Exceptional or unusual circumstances have occurred that result in a temporary financial hardship to the community spouse. In these cases, the community spouse income allocation may be temporarily increased while the community spouse takes the necessary steps to resolve the situation. The increased deduction cannot be applied if the situation is not temporary or the community spouse does not take the needed actions to resolve the situation.\n- The LTC spouse can choose not to make an income allocation to the community spouse. A deduction can only be made if the income is actually made available to the community spouse.\n- The community spouse chooses to accept a reduced income allocation or chooses not to accept any income allocation. The community spouse income allocation is counted as unearned income for the community spouse when determining eligibility for any Minnesota Health Care Program (MHCP). A community spouse may choose to not accept the income allocation if it will result in ineligibility for MA."},{"chunk_id":"epm:2.4.2.5.1#family-allocation","heading":"Family Allocation","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5.1#family-allocation","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.5 Income Calculations for Long-Term Care Services > 2.4.2.5.1 LTC Income Calculation Deductions > Family Allocation","text":"## Family Allocation\n\nA person may allocate a portion of their income to the following family members who have a calculated need:\n- A minor child, who does not live with a community spouse\n- The following relatives who live with a community spouse:\n  - A child under age 21\n  - A child age 21 or older who is claimed as a tax dependent\n  - Parents who are claimed as tax dependents\n  - Siblings who are claimed as tax dependents\n\n### Children Not Living with a Community Spouse\n\nA family allocation may be made to the minor children of the person who does not live with a community spouse. The allocation is calculated by adding together the gross monthly earned and unearned income of all minor children not living with a community spouse and comparing it to [100% of the FPG](https://bot-corpus.mn-dhs.online/s/epm/F) for a family size equal to the number of minor children not living with the community spouse. No exclusions, disregards or deductions apply. The amount of the allocation is the difference between the gross income of the children and the applicable FPG amount. No allocation is allowed if the gross income of the children exceeds the applicable FPG standard.\n\n### Family Members Who Live with a Community Spouse\n\nA separate family allocation may be made for each family member who lives with a community spouse. The allocation is calculated by adding together the gross monthly earned and unearned income of the family member who lives with the community spouse and subtracting it from the [minimum monthly income allowance](https://bot-corpus.mn-dhs.online/s/epm/F#minimum-monthly-income-allowance) for a community spouse. No exclusions, disregards or deductions apply. No allocation is allowed if the gross income of the family member exceeds the minimum monthly income allowance for a community spouse.\n\n### Verification Requirements\n\nThe family allocation cannot be deducted unless the person, or their authorized representative, provides verification of the family member’s income at the time of the request for MA-LTC and at each renewal. Changes in income for the family member must be reported and verified.\n\n### When to Deduct the Family Allocation\n\nA family allocation is deducted in the LTC income calculation in each month that there is a family member eligible to receive an allocation. The family allocation is deducted regardless of whether it is made available to the family member if the income of the family member is verified.\n\nA family allocation is counted as unearned income to the family member when determining eligibility for any MHCP."},{"chunk_id":"epm:2.4.2.5.1#court-ordered-child-support","heading":"Court-Ordered Child Support","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5.1#court-ordered-child-support","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.5 Income Calculations for Long-Term Care Services > 2.4.2.5.1 LTC Income Calculation Deductions > Court-Ordered Child Support","text":"## Court-Ordered Child Support\n\nCourt-ordered child support that is garnished from the person’s income up to a maximum of $250 per month is deducted. The garnishment can be for current child support or arrearages. The garnishment must be verified.\n\nThis deduction does not apply when a family allocation is deducted for the child for whom the court-ordered child support obligation is due unless the calculated family allocation is less than $250. The difference between the calculated family allocation and $250 may be deducted."},{"chunk_id":"epm:2.4.2.5.1#court-ordered-spousal-maintenance","heading":"Court-Ordered Spousal Maintenance","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5.1#court-ordered-spousal-maintenance","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.5 Income Calculations for Long-Term Care Services > 2.4.2.5.1 LTC Income Calculation Deductions > Court-Ordered Spousal Maintenance","text":"## Court-Ordered Spousal Maintenance\n\nCourt-ordered spousal maintenance is deducted for people who reside in a long-term care facility (LTCF) when the spousal maintenance is:\n- court-ordered under a judgement and decree for dissolution or marriage; and\n- garnished from a source of the person's income\n\nIn addition to the spousal maintenance amount, the fees associated with the garnishment can be deducted if also garnished from the person's income.\n\nThe garnishment of spousal maintenance and fees must be verified."},{"chunk_id":"epm:2.4.2.5.1#health-insurance-premiums-co-payments-and-deductibles","heading":"Health Insurance Premiums, Co-payments and Deductibles","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5.1#health-insurance-premiums-co-payments-and-deductibles","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.5 Income Calculations for Long-Term Care Services > 2.4.2.5.1 LTC Income Calculation Deductions > Health Insurance Premiums, Co-payments and Deductibles","text":"## Health Insurance Premiums, Co-payments and Deductibles\n\nThe cost of health insurance premiums, co-payments and deductibles incurred by the person that are not subject to payment by MA or a third party, including Extra Help through SSA for Medicare Advantage Plan or Part D coverage or premium reimbursement through MA, are allowable deductions. Health insurance includes Medicare Advantage plans, dental and LTC insurance policies. Only the portion of the premium that reflects coverage for the person is an allowable deduction."},{"chunk_id":"epm:2.4.2.5.1#remedial-care-expense","heading":"Remedial Care Expense","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5.1#remedial-care-expense","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.5 Income Calculations for Long-Term Care Services > 2.4.2.5.1 LTC Income Calculation Deductions > Remedial Care Expense","text":"## Remedial Care Expense\n\nA [remedial care expense](https://bot-corpus.mn-dhs.online/s/epm/F#remedial-care-expense) deduction is an amount allowed for people who reside in a residential living arrangement or a housing with services establishment where a county agency has an HS agreement. The amount can change twice a year, on January 1 and July 1."},{"chunk_id":"epm:2.4.2.5.1#medical-expenses","heading":"Medical Expenses","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5.1#medical-expenses","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.5 Income Calculations for Long-Term Care Services > 2.4.2.5.1 LTC Income Calculation Deductions > Medical Expenses","text":"## Medical Expenses\n\nVerified medical expenses incurred by the person that meet the criteria below are deductions in the LTC income calculation:\n\n### The medical expenses must be medically necessary and recognized under state law\n\nMedically necessary expenses include medical services, supplies, devices or equipment that are provided in any of these situations:\n- In response to a life-threatening condition or pain\n- To treat an injury, illness or infection\n- To achieve a level of physical or mental function consistent with prevailing community standards for the diagnosis or condition\n- To care for a mother and child through the maternity period\n- To provide preventive health service\n- To treat a condition that could result in physical or mental disability\n\nPeople are not required to provide proof of medical necessity for a medical expense provided by a medical provider, such as a pharmacist or medical facility. These services are assumed to be medically necessary.\n\n### The medical expenses must not be covered by MA\n\nMedical expenses for MA covered services that the person incurred in a month that MA will pay because the person is, or will be, approved for MA are not deductions. A medical expense incurred in a month in which the person is or will be an MA enrollee is assumed an MA covered service unless the person provides proof that it is not.\n\nMedical expenses that are included in the daily rate that MA pays to a Skilled Nursing Facility (SNF) or an Intermediate Care Facility for the Developmentally Disabled (ICF/DD) are medical expenses that MA will pay.\n\n### The medical expenses must not be covered by a third party\n\nA medical expense is not a deduction if it is subject to payment by a third party. Third parties include people, entities or benefits that are, or may be, liable to pay the expense. This includes:\n- Other health care coverage, such as coverage through Medicare, private or group health insurance, long-term care insurance or through the Veterans Administration (VA) health system\n- Automobile insurance\n- Court judgments or settlements\n- Workers’ compensation benefits\n\nThe person must provide proof of the exact amount of the third party payment, such as an Explanation of Medical Benefits (EOMB) statement. The person can also sign a release form so the county, tribal, or state agency can contact the third party directly.\n\nIf not yet known, the amount of the medical expense that will be covered by a third party is estimated at the time of the eligibility determination so that application processing is not delayed. The LTC income calculation is adjusted for the applicable month once the actual amount of the expense is verified. If not verified before, the person must provide proof of the actual amount of estimated medical expenses that were used in the LTC income calculation at the time of their next renewal. The deduction is removed from the applicable month if proof is not provided.\n\n### The medical expense was incurred during a month in which the person is receiving MA-LTC or during any of the three months prior to the month in which the person requested MA-LTC\n\nDeductions are allowed for verified medical expenses the person incurred during the month the person requested MA-LTC or while the person is receiving MA-LTC, regardless of whether retroactive MA coverage was requested or approved. Medical expenses incurred during a retroactive month must be unpaid as of the date of the request for MA-LTC. Medical expenses incurred during the month the person requested MA may be paid or unpaid."},{"chunk_id":"epm:2.4.2.5.1#medical-expenses-not-allowed-as-a-deduction","heading":"Medical Expenses not Allowed as a Deduction","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5.1#medical-expenses-not-allowed-as-a-deduction","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.5 Income Calculations for Long-Term Care Services > 2.4.2.5.1 LTC Income Calculation Deductions > Medical Expenses not Allowed as a Deduction","text":"## Medical Expenses not Allowed as a Deduction\n\nMedical expenses are not allowed as a deduction when:\n- The medical expense is for LTC services incurred in a month that is included in a transfer penalty period or period of ineligibility for failure to name Minnesota Department of Human Services (DHS) a remainder beneficiary of certain annuities.\n- The person paid the medical expense to reduce excess assets.\n- The medical expenses were incurred more than three months before the month of application associated with the current period of eligibility.\n- The nursing facility expenses were incurred without a required preadmission screening.\n- The medical expense was previously used:\n  - As a deduction in an LTC income calculation. However, the amount of a medical expense that exceeds the amount of the person’s income remaining after all other deductions in one month can be carried forward to future months\n  - To meet a medical spenddown\n\n### The following services received by a person who lives in an LTCF are not medical expenses:\n- Personal care items such as shampoo, toothpaste or dental floss that are included in the daily rate (also referred to as a “per diem rate”) paid through MA\n- Oral hygiene instruction\n- Certain house/extended care facility call charges. A charge for a provider to travel to a person’s residence is not an allowable medical expense deduction unless the provider delivers a medical service on the same day.\n- A charge for a provider to travel to a person’s residence is also not an allowable medical expense deduction if the LTCF pays the cost for the provider to travel to the LTCF through an agreement between the LTCF and the provider.\n- The additional charge for a private room in a skilled nursing facility (SNF) when it is not medically necessary."},{"chunk_id":"epm:2.4.2.5.1#notification","heading":"Notification","url":"https://bot-corpus.mn-dhs.online/s/epm/2.4.2.5.1#notification","context":"EPM > 2 Medical Assistance > 2.4 Medical Assistance for Long-Term Care Services > 2.4.2 Financial Eligibility > 2.4.2.5 Income Calculations for Long-Term Care Services > 2.4.2.5.1 LTC Income Calculation Deductions > Notification","text":"## Notification\n\nPeople who report medical expenses must be notified of the:\n- Medical expenses that were not allowed as a deduction and the reason(s) why they were not allowed\n- Medical expenses that were deducted in the LTC income calculation based on estimated third party payments\n- Amount of the allowed medical expense deduction\n- Amount of medical expenses that can be carried forward as a deduction to future months"}]},{"id":"epm:2.5","number":"2.5","title":"Medical Assistance for Certain Populations","parent":"2","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations","summary":"Medical Assistance (MA) eligibility is determined using a variety of non-financial, financial and post-eligibility requirements. Different types of MA have different eligibility policies. This chapter covers MA for certain populations. Many of the people covered by these types of MA are not otherwise eligible for MA for Families with Children and Adults (MA-FCA) or MA for People Who Are Age 65 or ","effective_date":"2023-01-01","last_modified":"2026-10-03T03:51:59.785796+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.5#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations","text":"Medical Assistance (MA) eligibility is determined using a variety of non-financial, financial and post-eligibility requirements. Different types of MA have different eligibility policies. This chapter covers MA for certain populations. Many of the people covered by these types of MA are not otherwise eligible for MA for Families with Children and Adults (MA-FCA) or MA for People Who Are Age 65 or Older or People Who Are Blind or Have a Disability (MA-ABD).\n1. [MA for People with Breast or Cervical Cancer](https://bot-corpus.mn-dhs.online/s/epm/2.5.1) (MA-BC)\n2. [MA for People Receiving Services at the Center for Victims of Torture](https://bot-corpus.mn-dhs.online/s/epm/2.5.2) (MA-CVT)\n3. [Emergency MA](https://bot-corpus.mn-dhs.online/s/epm/2.5.3) (EMA)\n4. [MA for People receiving services at an Institution for Mental Diseases](https://bot-corpus.mn-dhs.online/s/epm/2.5.4) (IMD), also called Program IM\n5. [MA for People Who Are Incarcerated](https://bot-corpus.mn-dhs.online/s/epm/2.5.5)\n6. [MA for Children Receiving Northstar Adoption Assistance, Northstar Kinship Assistance and Children in Foster Care](https://bot-corpus.mn-dhs.online/s/epm/2.5.6)\n  1. [MA for Children Receiving Northstar Adoption Assistance](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1) (MA-NAA)\n  2. [MA for Children Receiving Northstar Kinship Assistance](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2) (MA-NKA)\n  3. [MA for Children in Foster Care](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3) (MA-FC)\n7. [Refugee MA (RMA)](https://bot-corpus.mn-dhs.online/s/epm/2.5.7)"}]},{"id":"epm:2.5.1","number":"2.5.1","title":"Medical Assistance for a Person with Breast or Cervical Cancer","parent":"2.5","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.1 Medical Assistance for a Person with Breast or Cervical Cancer","summary":"Medical Assistance for a person with Breast or Cervical Cancer (MA-BC) is a basis of eligibility for people who need treatment for breast or cervical cancer, including precancerous conditions and early stage cancer.","effective_date":"2020-12-01","last_modified":"2026-10-03T03:51:59.785796+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_1.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.5.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.1","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.1 Medical Assistance for a Person with Breast or Cervical Cancer","text":"Medical Assistance for a person with Breast or Cervical Cancer (MA-BC) is a basis of eligibility for people who need treatment for breast or cervical cancer, including precancerous conditions and early stage cancer.\n\nTo be eligible for MA-BC, a person must be screened and diagnosed through a Centers for Disease Control and Prevention (CDC) National Breast and Cervical Cancer Early Detection Program (NBCCEEDP).\n\nMinnesota has two screening programs:\n- Minnesota Department of Health's [Sage Screening Program](https://www.health.state.mn.us/diseases/cancer/sage/index.html)    Sage is a statewide comprehensive breast and cervical cancer screening program administered by the Minnesota Department of Health. For eligible people, Sage provides free office visits for breast and cervical exams, as well as a screening mammogram and Pap smears.\n- American Indian Cancer Foundation's [Screen Our Circle](https://americanindiancancer.org/screen-our-circle/)    Screen Our Circle is the American Indian Cancer Foundation’s National Breast and Cervical Cancer Early Detection Program. Screen Our Circle works with urban American Indian and Alaskan Native clinics to increase cancer screening and early cancer detection rates.\n\nThis subchapter includes policies that apply to MA-BC and links to policies that apply to all MA programs and all Minnesota Health Care Programs (MHCP) programs.\n1. [MA-BC General Requirements](https://bot-corpus.mn-dhs.online/s/epm/2.5.1.1)\n  1. [MA-BC Applications](https://bot-corpus.mn-dhs.online/s/epm/2.5.1.1)\n  2. [MA-BC Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/2.5.1.1)\n  3. [MHCP Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1)\n  4. [MA Responsibilities](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2)\n  5. [MHCP Retroactive Coverage](https://bot-corpus.mn-dhs.online/s/epm/1.2.5)\n2. [MA-BC Non-Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.1.2)\n  1. [MA-BC Basis of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.1.2.1)\n  2. [MA Citizenship and Immigration](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2)\n  3. [MA County Residency](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.3)\n  4. [MA Living Arrangement](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.4)\n  5. [MA Social Security Number](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5)\n  6. [MHCP State Residency](https://bot-corpus.mn-dhs.online/s/epm/1.4)\n3. [MA-BC Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.1.3)\n4. [MA-BC Post-Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.1.4)\n  1. [MA Begin and End Dates](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.1)\n  2. [MA Benefit Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1)\n  3. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n  4. [MA Cooperation](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.2)\n  5. [MA Cost Sharing](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.3)\n  6. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n  7. [MA-BC Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/2.5.1.4.1)\n  8. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n  9. [MA Qualifying Health Coverage](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.2)\n  10. [MA Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4)\n  11. [MA-BC Renewals](https://bot-corpus.mn-dhs.online/s/epm/2.5.1.4.2)"}]},{"id":"epm:2.5.1.1","number":"2.5.1.1","title":"General Requirements","parent":"2.5.1","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.1 Medical Assistance for a Person with Breast or Cervical Cancer > 2.5.1.1 General Requirements","summary":"This subchapter provides general policy information that applies to Medical Assistance for people with Breast or Cervical Cancer (MA-BC) and links to related Medical Assistance and Minnesota Health Care Programs (MHCP) policies.","effective_date":"2025-04-29","last_modified":"2026-10-03T03:51:59.785796+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.1.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.1.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_1_1.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.5.1.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.1.1","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.1 Medical Assistance for a Person with Breast or Cervical Cancer > 2.5.1.1 General Requirements","text":"This subchapter provides general policy information that applies to Medical Assistance for people with Breast or Cervical Cancer (MA-BC) and links to related Medical Assistance and Minnesota Health Care Programs (MHCP) policies.\n\nTopics covered in this subchapter are:\n1. [MA-BC Applications](https://bot-corpus.mn-dhs.online/s/epm/2.5.1.1.1)\n2. [MA-BC Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/2.5.1.1.2)\n3. [MA Responsibilities](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2)\n4. [MHCP Retroactive Eligibility](https://bot-corpus.mn-dhs.online/s/epm/1.2.5)\n5. [MHCP Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1)"}]},{"id":"epm:2.5.1.1.1","number":"2.5.1.1.1","title":"Applications","parent":"2.5.1.1","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.1 Medical Assistance for a Person with Breast or Cervical Cancer > 2.5.1.1 General Requirements > 2.5.1.1.1 Applications","summary":"People, who are screened through the Minnesota Department of Health (MDH) Sage Screening Program or the American Indian Cancer Foundation (AICAF) Screen Our Circle Program and are found to need treatment or diagnostic services for breast or cervical cancer, are potentially eligible for Medical Assistance for People with Breast or Cervical Cancer (MA-BC).","effective_date":"2025-04-29","last_modified":"2026-10-03T03:51:59.785796+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.1.1.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.1.1.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_1_1_1.htm","legal_citations":["Code of Federal Regulations, title 42, section 1100-1103","Code of Federal Regulations, title 42, section 435.213","Code of Federal Regulations, title 42, section 1396r–1b","Public Law 106-354 October 24, 2000","Public Law 107-121 January 15, 2002"],"chunks":[{"chunk_id":"epm:2.5.1.1.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.1.1.1","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.1 Medical Assistance for a Person with Breast or Cervical Cancer > 2.5.1.1 General Requirements > 2.5.1.1.1 Applications","text":"People, who are screened through the Minnesota Department of Health (MDH) Sage Screening Program or the American Indian Cancer Foundation (AICAF) Screen Our Circle Program and are found to need treatment or diagnostic services for breast or cervical cancer, are potentially eligible for Medical Assistance for People with Breast or Cervical Cancer (MA-BC)."},{"chunk_id":"epm:2.5.1.1.1#application-paths","heading":"Application Paths","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.1.1.1#application-paths","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.1 Medical Assistance for a Person with Breast or Cervical Cancer > 2.5.1.1 General Requirements > 2.5.1.1.1 Applications > Application Paths","text":"## Application Paths\n\nThe person must apply for MA-BC. There are two paths to requesting an MA-BC eligibility determination.\n1. A temporary eligibility determination, referred to as presumptive eligibility (PE), may be granted by a Minnesota Health Care Programs (MHCP) provider participating in the Sage Screening Program or Screen Our Circle Program.\n2. Some people do not have presumptive eligibility determined and directly apply for MA-BC using the Minnesota MA Application/Renewal Breast and Cervical Cancer (DHS-3525) form."},{"chunk_id":"epm:2.5.1.1.1#forms","heading":"Forms","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.1.1.1#forms","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.1 Medical Assistance for a Person with Breast or Cervical Cancer > 2.5.1.1 General Requirements > 2.5.1.1.1 Applications > Forms","text":"## Forms\n\n### Temporary Medical Assistance Authorization ([DHS-3525B](https://edocs.dhs.state.mn.us/lfserver/Legacy/DHS-3525B-ENG))\n\nThe Temporary Medical Assistance Authorization (DHS-3525B) is completed by the provider and authorizes presumptive eligibility.\n\n### Minnesota MA Application/Renewal Breast and Cervical Cancer ([DHS-3525](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-3525-ENG))\n\nThe Minnesota MA Application/Renewal Breast and Cervical Cancer (DHS-3525) form is for people who were screened by the Sage Screening Program or Screen Our Circle Program, need treatment or diagnostic services for breast or cervical cancer and are seeking MA-BC coverage. Enrollees also use this form to renew eligibility for coverage."},{"chunk_id":"epm:2.5.1.1.1#application-filer","heading":"Application Filer","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.1.1.1#application-filer","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.1 Medical Assistance for a Person with Breast or Cervical Cancer > 2.5.1.1 General Requirements > 2.5.1.1.1 Applications > Application Filer","text":"## Application Filer\n\nThe applicant or an authorized representative is the application filer. Only a person meeting the definition of an application filer or an authorized representative can sign the application or renewal. See section [1.3.1.2 MHCP Authorized Representative](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.2) policy for more information."},{"chunk_id":"epm:2.5.1.1.1#date-of-application","heading":"Date of Application","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.1.1.1#date-of-application","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.1 Medical Assistance for a Person with Breast or Cervical Cancer > 2.5.1.1 General Requirements > 2.5.1.1.1 Applications > Date of Application","text":"## Date of Application\n\nThe date of application is the date the county, tribal or state servicing agency receives DHS-3525."},{"chunk_id":"epm:2.5.1.1.1#presumptive-eligibility","heading":"Presumptive Eligibility","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.1.1.1#presumptive-eligibility","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.1 Medical Assistance for a Person with Breast or Cervical Cancer > 2.5.1.1 General Requirements > 2.5.1.1.1 Applications > Presumptive Eligibility","text":"## Presumptive Eligibility\n\nPE provides immediate MA-BC coverage for people who need to begin treatment. PE is granted to people who meet the MA-BC presumptive eligibility criteria as determined by a Sage or Screen Our Circle PE provider.\n\nOnce a Sage or Screen Our Circle PE provider has granted PE, no additional eligibility criteria may be applied. A person approved for PE cannot be required to attest to or provide more information about her state residency,citizenship or immigration status, household composition, income or other factors. All eligibility factors relevant to PE have been considered by the Sage or Screen Our Circle PE provider when PE is granted.\n\nTemporary MA-BC eligibility is effective on the first day of the month PE is approved by a Sage or Screen Our Circle PE provider and continues through the end of the month following the month it was approved.\n\nThe Sage PE provider must complete and submit to the county, tribal or state servicing agency:\n- MDH Sage Enrollment form or AICAF Screen Our Circle Enrollment form\n- Copy of Temporary Medical Assistance Authorization (DHS-3525B)\n\nThe county, tribal or state servicing agency must enter MA-BC eligibility in MAXIS and MMIS per the DHS-3525B the day the form is submitted. MA-BC must be opened for a person approved for PE by a Sage PE provider, in accordance with the date of the Temporary Medical Assistance Authorization, regardless of other health care applications that are pending.\n\nIf a person who has PE does not submit an application for on-going MA-BC coverage or is not eligible for ongoing MA-BC, PE ends the last day of the month following the month PE was approved.\n\nA person approved for PE who is denied ongoing MA-BC eligibility is entitled to receive coverage for the full PE period."},{"chunk_id":"epm:2.5.1.1.1#ongoing-eligibility-for-ma-bc","heading":"Ongoing Eligibility for MA-BC","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.1.1.1#ongoing-eligibility-for-ma-bc","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.1 Medical Assistance for a Person with Breast or Cervical Cancer > 2.5.1.1 General Requirements > 2.5.1.1.1 Applications > Ongoing Eligibility for MA-BC","text":"## Ongoing Eligibility for MA-BC\n\nTo have an ongoing eligibility determination for MA-BC, a person approved for PE must complete the Minnesota MA Application/Renewal Breast and Cervical Cancer ([DHS-3525](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3525-ENG)) form. The DHS-3525 must be submitted to the county, tribal or state servicing agency within 30 days of the date the presumptive eligibility is approved by a Sage or Screen Our Circle PE provider. The county, tribal or state servicing agency must process the application for ongoing MA-BC within 45 days. An applicant may complete and submit the DHS-3525 on the same date PE is approved."},{"chunk_id":"epm:2.5.1.1.1#retroactive-coverage","heading":"Retroactive Coverage","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.1.1.1#retroactive-coverage","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.1 Medical Assistance for a Person with Breast or Cervical Cancer > 2.5.1.1 General Requirements > 2.5.1.1.1 Applications > Retroactive Coverage","text":"## Retroactive Coverage\n\nA person may request retroactive coverage. The earliest date of eligibility is three months before the date of application or the first day of the month in which the person was screened by Sage or Screen Our Circle, whichever is later. The person must have paid or unpaid medical expenses during the retroactive period that would be covered by MA. People who are granted presumptive eligibility for MA-BC must be found eligible for ongoing MA-BC before retroactive eligibility is granted."}]},{"id":"epm:2.5.1.1.2","number":"2.5.1.1.2","title":"Mandatory Verifications","parent":"2.5.1.1","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.1 Medical Assistance for a Person with Breast or Cervical Cancer > 2.5.1.1 General Requirements > 2.5.1.1.2 Mandatory Verifications","summary":"Mandatory verifications must be verified through an available electronic data source or by paper proof, if electronic data sources are unsuccessful or unavailable. Self-attestation of certain eligibility factors may be accepted if electronic data sources are unsuccessful or unavailable and paper proof does not exist or is not available.","effective_date":"2022-09-01","last_modified":"2026-10-03T03:51:59.785796+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.1.1.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.1.1.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_1_1_2.htm","legal_citations":["Minnesota Statutes, section 265B.056, subdivision 10"],"chunks":[{"chunk_id":"epm:2.5.1.1.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.1.1.2","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.1 Medical Assistance for a Person with Breast or Cervical Cancer > 2.5.1.1 General Requirements > 2.5.1.1.2 Mandatory Verifications","text":"Mandatory verifications must be verified through an available electronic data source or by paper proof, if electronic data sources are unsuccessful or unavailable. Self-attestation of certain eligibility factors may be accepted if electronic data sources are unsuccessful or unavailable and paper proof does not exist or is not available."},{"chunk_id":"epm:2.5.1.1.2#presumptive-eligibility-period","heading":"Presumptive Eligibility Period","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.1.1.2#presumptive-eligibility-period","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.1 Medical Assistance for a Person with Breast or Cervical Cancer > 2.5.1.1 General Requirements > 2.5.1.1.2 Mandatory Verifications > Presumptive Eligibility Period","text":"## Presumptive Eligibility Period\n\nFor presumptive eligibility for MA-BC, the following must be verified:\n- Screened by the Minnesota Department of Health Sage Screening Program or the American Indian Cancer Foundation Screen Our Circle Program\n- Need for treatment or further diagnostic services for breast or cervical cancer\n\nA Sage Enrollment form or Screen Our Circle Enrollment form are acceptable proof of both Sage screening and the need for treatment.\n\nA Social Security number (SSN) or verification of an SSN is not required for PE. Verification of US citizenship and immigration status is not required for PE."},{"chunk_id":"epm:2.5.1.1.2#on-going-ma-bc-eligibility","heading":"On-going MA-BC Eligibility","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.1.1.2#on-going-ma-bc-eligibility","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.1 Medical Assistance for a Person with Breast or Cervical Cancer > 2.5.1.1 General Requirements > 2.5.1.1.2 Mandatory Verifications > On-going MA-BC Eligibility","text":"## On-going MA-BC Eligibility\n\nFor on-going MA-BC coverage, the following must be verified:\n- Screened by the Minnesota Department of Health Sage Screening Program or the American Indian Cancer Foundation Screen Our Circle Program\n- Need for treatment or further diagnostic services for breast or cervical cancer\n\nA Minnesota Department of Health Sage Enrollment form or American Indian Cancer Foundation Screen Our Circle Enrollment form are acceptable proof of both Sage screening and the need for treatment.\n- [U.S. Citizenship](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2.1)\n- [Immigration Status](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2.2)\n- [Social Security Number](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5)\n\nCounty, tribal and state servicing agencies must retain verification documentation in accordance with the County Human Service Records Retention Schedule ([DHS-6928](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-6928-ENG))."}]},{"id":"epm:2.5.1.2","number":"2.5.1.2","title":"Non-Financial Eligibility","parent":"2.5.1","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.1 Medical Assistance for a Person with Breast or Cervical Cancer > 2.5.1.2 Non-Financial Eligibility","summary":"This subchapter includes non-financial eligibility policies. This covers eligibility factors not related to a person’s income or assets.","effective_date":"2025-04-29","last_modified":"2026-10-03T03:51:59.785796+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.1.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.1.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_1_2.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.5.1.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.1.2","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.1 Medical Assistance for a Person with Breast or Cervical Cancer > 2.5.1.2 Non-Financial Eligibility","text":"This subchapter includes non-financial eligibility policies. This covers eligibility factors not related to a person’s income or assets.\n\nThis subchapter includes policies that apply to Medical Assistance for People with Breast or Cervical Cancer (MA-BC) and links to policies that apply to all MA programs and all Minnesota Health Care Programs (MHCP).\n\nTopics covered in this subchapter are:\n1. [MA-BC Basis of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.1.2.1)\n2. [MA Citizenship and Immigration](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2)\n3. [MA County Residency](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.3)\n4. [MA Living Arrangement](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.4)\n5. [MA Social Security Number](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5)\n6. [MHCP State Residency](https://bot-corpus.mn-dhs.online/s/epm/1.4)"}]},{"id":"epm:2.5.1.2.1","number":"2.5.1.2.1","title":"Basis of Eligibility","parent":"2.5.1.2","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.1 Medical Assistance for a Person with Breast or Cervical Cancer > 2.5.1.2 Non-Financial Eligibility > 2.5.1.2.1 Basis of Eligibility","summary":"The basis of eligibility for Medical Assistance for people with Breast or Cervical Cancer (MA-BC) requires the person must be:","effective_date":"2020-12-01","last_modified":"2026-10-03T03:51:59.785796+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.1.2.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.1.2.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_1_2_1.htm","legal_citations":["Breast and Cervical Cancer Prevention and Treatment Act of 2000","Breast and Cervical Cancer Mortality Prevention Act of 1990 (Public Law 101-354)","Minnesota Statutes, section 256B.057 subdivision 10","United States Code, title 42, section 300gg-3(c)"],"chunks":[{"chunk_id":"epm:2.5.1.2.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.1.2.1","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.1 Medical Assistance for a Person with Breast or Cervical Cancer > 2.5.1.2 Non-Financial Eligibility > 2.5.1.2.1 Basis of Eligibility","text":"The basis of eligibility for Medical Assistance for people with Breast or Cervical Cancer (MA-BC) requires the person must be:\n- Screened by the Minnesota Department of Health Sage Screening Program or by the American Indian Cancer Foundation Screen Our Circle Program\n- In need of treatment or further diagnostic services for breast or cervical cancer\n- Age 64 or younger\n- Not otherwise eligible for MA under the following bases:\n  - Parents and relative caretakers, without a spenddown\n  - Children younger than age 19, without a spenddown\n  - Pregnant people, without a spenddown\n  - People who are blind of have a disability including:\n    - Supplemental Security Income (SSI) recipients\n    - 1619 (a) 1619 (b)\n    - Minnesota Supplemental Aid (MSA) recipients\n    - People eligible for a Disabled Adult Child, Widow or Widowers’ or Pickle disregard\n- Not otherwise covered under the following healthcare coverage:\n  - Group health care coverage, unless the plan does not cover the needed treatment\n  - Individual health care coverage, unless the plan does not cover the needed treatment\n  - Medicare\n  - Armed forces insurance (TRICARE, CHAMPVA)\n  - Peace Corps volunteers health plan\n  - Federal employees group health plan"}]},{"id":"epm:2.5.1.3","number":"2.5.1.3","title":"Financial Eligibility","parent":"2.5.1","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.1 Medical Assistance for a Person with Breast or Cervical Cancer > 2.5.1.3 Financial Eligibility","summary":"Financial eligibility requirements involve a person’s income or assets. Medical Assistance for People with Breast or Cervical Cancer (MA-BC) has no income or asset limit.","effective_date":"2025-04-29","last_modified":"2026-10-03T03:51:59.785796+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.1.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.1.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_1_3.htm","legal_citations":["Minnesota Statutes, section 256B.057 Subd.10(c)"],"chunks":[{"chunk_id":"epm:2.5.1.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.1.3","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.1 Medical Assistance for a Person with Breast or Cervical Cancer > 2.5.1.3 Financial Eligibility","text":"Financial eligibility requirements involve a person’s income or assets. Medical Assistance for People with Breast or Cervical Cancer (MA-BC) has no income or asset limit."}]},{"id":"epm:2.5.1.4","number":"2.5.1.4","title":"Post-Eligibility","parent":"2.5.1","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.1 Medical Assistance for a Person with Breast or Cervical Cancer > 2.5.1.4 Post-Eligibility","summary":"These policies apply to Medical Assistance for People with Breast or Cervical Cancer (MA-BC) enrollees. This subchapter includes policies that apply to MA-BC and links to policies that apply to all MA programs and all Minnesota Health Care Programs (MHCP) programs.","effective_date":"2025-04-29","last_modified":"2026-10-03T03:51:59.785796+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.1.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.1.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_1_4.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.5.1.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.1.4","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.1 Medical Assistance for a Person with Breast or Cervical Cancer > 2.5.1.4 Post-Eligibility","text":"These policies apply to Medical Assistance for People with Breast or Cervical Cancer (MA-BC) enrollees. This subchapter includes policies that apply to MA-BC and links to policies that apply to all MA programs and all Minnesota Health Care Programs (MHCP) programs.\n\nTopics covered in this sub-chapter are:\n1. [MA Begin and End Dates](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.1)\n2. [MA Benefit Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1)\n3. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n4. [MA Cooperation](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.2)\n5. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n6. [MA-BC Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/2.5.1.4)\n7. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n8. [MA Qualifying Health Coverage](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.2)\n9. [MA Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4)\n10. [MA-BC Renewals](https://bot-corpus.mn-dhs.online/s/epm/2.5.1.4.2)"}]},{"id":"epm:2.5.1.4.1","number":"2.5.1.4.1","title":"Health Care Delivery","parent":"2.5.1.4","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.1 Medical Assistance for a Person with Breast or Cervical Cancer > 2.5.1.4 Post-Eligibility > 2.5.1.4.1 Health Care Delivery","summary":"Medical Assistance Breast or Cervical Cancer (MA-BC) enrollees must follow guidelines for receiving medically necessary services. MA-BC medical services are provided via fee for service.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:59.785796+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.1.4.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.1.4.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_1_4_1.htm","legal_citations":["Minnesota Statutes, Section 256B.056","Minnesota Statutes, Section 256B.0625","Minnesota Statutes, Section 256B.0631"],"chunks":[{"chunk_id":"epm:2.5.1.4.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.1.4.1","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.1 Medical Assistance for a Person with Breast or Cervical Cancer > 2.5.1.4 Post-Eligibility > 2.5.1.4.1 Health Care Delivery","text":"Medical Assistance Breast or Cervical Cancer (MA-BC) enrollees must follow guidelines for receiving medically necessary services. MA-BC medical services are provided via fee for service."},{"chunk_id":"epm:2.5.1.4.1#fee-for-service","heading":"Fee for Service","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.1.4.1#fee-for-service","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.1 Medical Assistance for a Person with Breast or Cervical Cancer > 2.5.1.4 Post-Eligibility > 2.5.1.4.1 Health Care Delivery > Fee for Service","text":"## Fee for Service\n\nFee-for-service is a method of payment where the medical provider bills MHCP for specific, individual services. Enrollees must use a medical provider enrolled with MHCP, except in special circumstances. A [directory of enrolled providers](http://mhcpproviderdirectory.dhs.state.mn.us/) is available online."},{"chunk_id":"epm:2.5.1.4.1#covered-services","heading":"Covered Services","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.1.4.1#covered-services","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.1 Medical Assistance for a Person with Breast or Cervical Cancer > 2.5.1.4 Post-Eligibility > 2.5.1.4.1 Health Care Delivery > Covered Services","text":"## Covered Services\n\nThe MHCP Summary of Coverage, Cost Sharing and Limits ([DHS-3860](https://www.google.com/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=1&ved=0CCAQFjAA&url=https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3860-ENG&ei=9WZrVPHVC5OnyASpgIKwBw&usg=AFQjCNFK_Yl9QXapcVWWYTJ5mQfMG7MSVw&bvm=bv.79908130,d.aWw)) explains covered services. MA-BC has no cost sharing."}]},{"id":"epm:2.5.1.4.2","number":"2.5.1.4.2","title":"Renewals","parent":"2.5.1.4","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.1 Medical Assistance for a Person with Breast or Cervical Cancer > 2.5.1.4 Post-Eligibility > 2.5.1.4.2 Renewals","summary":"Enrollees in Medical Assistance for people with Breast or Cervical Cancer (MA-BC) must have eligibility renewed every 12 months. Renewing eligibility means redetermining eligibility.","effective_date":"2023-06-01","last_modified":"2026-10-03T03:51:59.785796+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.1.4.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.1.4.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_1_4_2.htm","legal_citations":["Code of Feeral Regulations, Title 42, 435.916","Minnesota Statutes, section 256B.057, subdivision 10(c)"],"chunks":[{"chunk_id":"epm:2.5.1.4.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.1.4.2","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.1 Medical Assistance for a Person with Breast or Cervical Cancer > 2.5.1.4 Post-Eligibility > 2.5.1.4.2 Renewals","text":"Enrollees in Medical Assistance for people with Breast or Cervical Cancer (MA-BC) must have eligibility renewed every 12 months. Renewing eligibility means redetermining eligibility."},{"chunk_id":"epm:2.5.1.4.2#annual-renewal-month","heading":"Annual Renewal Month","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.1.4.2#annual-renewal-month","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.1 Medical Assistance for a Person with Breast or Cervical Cancer > 2.5.1.4 Post-Eligibility > 2.5.1.4.2 Renewals > Annual Renewal Month","text":"## Annual Renewal Month\n\nThe annual renewal month is the month in which eligibility is redetermined for the next 12 months. The first annual renewal month after application is 12 months from the month of application for ongoing MA-BC and occurs annually thereafter as long as the enrollee remains eligible for MA-BC.\n\nThe enrollee must complete the Minnesota MA Application/Renewal Breast and Cervical Cancer ([DHS-3525](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-3525-ENG)) and Certification of Further Treatment Required ([DHS-3525A](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3525A-ENG)) and submit the forms to their county, tribal or state servicing agency. The form and any required proofs are due before the renewal date. Enrollees can submit the original renewal form or a photocopy, fax or scanned form to their county, tribal or state servicing agency."},{"chunk_id":"epm:2.5.1.4.2#when-eligibility-ends-at-renewal","heading":"When Eligibility Ends at Renewal","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.1.4.2#when-eligibility-ends-at-renewal","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.1 Medical Assistance for a Person with Breast or Cervical Cancer > 2.5.1.4 Post-Eligibility > 2.5.1.4.2 Renewals > When Eligibility Ends at Renewal","text":"## When Eligibility Ends at Renewal\n\nChanges reported during an enrollee’s renewal may affect an MA enrollee's basis of eligibility. Enrollees who lose eligibility under one basis must be redetermined for all health care programs they are potentially eligible for, without interruption in their coverage. See EPM [1.3.2.1 Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1) for more information."}]},{"id":"epm:2.5.2","number":"2.5.2","title":"Medical Assistance for People Receiving Services at the Center for Victims of Torture","parent":"2.5","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.2 Medical Assistance for People Receiving Services at the Center for Victims of Torture","summary":"Medical Assistance (MA) eligibility is determined using a variety of non-financial, financial and post-eligibility requirements. MA for people receiving services at the Center for Victims of Torture (MA-CVT) is available for those who are not otherwise eligible for MA. MA-CVT ends the month after the month a person stops receiving CVT services.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:59.785796+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_2.htm","legal_citations":["Minnesota Statutes, section 256B.06, subdivision 4"],"chunks":[{"chunk_id":"epm:2.5.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.2","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.2 Medical Assistance for People Receiving Services at the Center for Victims of Torture","text":"Medical Assistance (MA) eligibility is determined using a variety of non-financial, financial and post-eligibility requirements. MA for people receiving services at the Center for Victims of Torture (MA-CVT) is available for those who are not otherwise eligible for MA. MA-CVT ends the month after the month a person stops receiving CVT services.\n\nCVT is a Minnesota-based private, nonprofit, nonpartisan organization founded in 1985. CVT exists to heal the wounds of government-sponsored torture on individuals, families and communities and to stop its practice.\n\nThis subchapter includes policies that apply to MA-CVT and links to policies that apply to all MA programs and all Minnesota Health Care Programs (MHCP) programs.\n1. [MA-CVT General Requirements](https://bot-corpus.mn-dhs.online/s/epm/2.5.2.1)\n  1. [MHCP Applications](https://bot-corpus.mn-dhs.online/s/epm/1.2)\n  2. [MA-CVT Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/2.5.2.1.1)\n  3. [MA Responsibilities](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2)\n  4. [MHCP Retroactive Eligibility](https://bot-corpus.mn-dhs.online/s/epm/1.2.5)\n  5. [MHCP Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1)\n2. [MA-CVT Non-Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.2.2)\n  1. [MA-CVT Bases of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.2.2.1)\n  2. [MA County Residency](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.3)\n  3. [MA Living Arrangement](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.4)\n  4. [MHCP State Residency](https://bot-corpus.mn-dhs.online/s/epm/1.4)\n3. [MA-CVT Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.2.3)\n4. [MA-CVT Post-Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.1.4)\n  1. [MA Begin and End Dates](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.1)\n  2. [MA Benefit Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1)\n  3. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n  4. [MA Cooperation](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.2)\n  5. [MA Cost Sharing](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.3)\n  6. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n  7. [MA-CVT Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/2.5.2.4.1)\n  8. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n  9. [MA Qualifying Health Coverage](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.2)\n  10. [MA Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4)\n  11. [MA-CVT Renewals](https://bot-corpus.mn-dhs.online/s/epm/2.5.2.4.2)"},{"chunk_id":"epm:2.5.2#part-1","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.2","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.2 Medical Assistance for People Receiving Services at the Center for Victims of Torture","text":"## Legal Citation"}]},{"id":"epm:2.5.2.1","number":"2.5.2.1","title":"General Requirements","parent":"2.5.2","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.2 Medical Assistance for People Receiving Services at the Center for Victims of Torture > 2.5.2.1 General Requirements","summary":"This subchapter provides general policy information that applies to Medical Assistance for people receiving services at the Center for Victims of Torture (MA-CVT).","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:59.785796+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.2.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.2.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_2_1.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.5.2.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.2.1","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.2 Medical Assistance for People Receiving Services at the Center for Victims of Torture > 2.5.2.1 General Requirements","text":"This subchapter provides general policy information that applies to Medical Assistance for people receiving services at the Center for Victims of Torture (MA-CVT).\n\nThis subchapter includes policies that apply to MA-CVT and links to policies that apply to all MA programs and all Minnesota Health Care Programs (MHCP).\n\nTopics covered in this subchapter are:\n1. [MHCP Applications](https://bot-corpus.mn-dhs.online/s/epm/1.2)\n2. [MA-CVT Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/2.5.2.1.1)\n3. [MA Responsibilities](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2)\n4. [MHCP Retroactive Eligibility](https://bot-corpus.mn-dhs.online/s/epm/1.2.5)\n5. [MHCP Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1)"}]},{"id":"epm:2.5.2.1.1","number":"2.5.2.1.1","title":"Mandatory Verifications","parent":"2.5.2.1","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.2 Medical Assistance for People Receiving Services at the Center for Victims of Torture > 2.5.2.1 General Requirements > 2.5.2.1.1 Mandatory Verifications","summary":"Mandatory verifications must be verified through an available electronic data source or by paper verification, if electronic data sources are unsuccessful or unavailable. Self-attestation of certain eligibility factors may be accepted if electronic data sources are unsuccessful or unavailable and paper proof does not exist or is not available.","effective_date":"2022-09-01","last_modified":"2026-10-03T03:51:59.785796+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.2.1.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.2.1.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_2_1_1.htm","legal_citations":["Minnesota Statutes, section 256B.06, subdivision 4"],"chunks":[{"chunk_id":"epm:2.5.2.1.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.2.1.1","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.2 Medical Assistance for People Receiving Services at the Center for Victims of Torture > 2.5.2.1 General Requirements > 2.5.2.1.1 Mandatory Verifications","text":"Mandatory verifications must be verified through an available electronic data source or by paper verification, if electronic data sources are unsuccessful or unavailable. Self-attestation of certain eligibility factors may be accepted if electronic data sources are unsuccessful or unavailable and paper proof does not exist or is not available.\n\nApplicants for Medical Assistance for people receiving services at the Center for Victims of Torture (MA-CVT) have one mandatory verification. A copy of the CVT acceptance letter dated within the past 30 days must be submitted in order to determine if the applicant is receiving services.\n\nCounty, tribal and state servicing agencies must retain verification documentation in accordance with the County Human Service Records Retention Schedule ([DHS-6928](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-6928-ENG))."}]},{"id":"epm:2.5.2.2","number":"2.5.2.2","title":"Non-Financial Eligibility","parent":"2.5.2","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.2 Medical Assistance for People Receiving Services at the Center for Victims of Torture > 2.5.2.2 Non-Financial Eligibility","summary":"This subchapter provides non-financial policy information that applies to Medical Assistance for people receiving services at the Center for Victims of Torture (MA-CVT). Non-financial eligibility requirements are not related to a person’s income or assets.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:59.785796+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.2.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.2.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_2_2.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.5.2.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.2.2","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.2 Medical Assistance for People Receiving Services at the Center for Victims of Torture > 2.5.2.2 Non-Financial Eligibility","text":"This subchapter provides non-financial policy information that applies to Medical Assistance for people receiving services at the Center for Victims of Torture (MA-CVT). Non-financial eligibility requirements are not related to a person’s income or assets."},{"chunk_id":"epm:2.5.2.2#ma-cvt-immigration-status","heading":"MA-CVT Immigration Status","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.2.2#ma-cvt-immigration-status","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.2 Medical Assistance for People Receiving Services at the Center for Victims of Torture > 2.5.2.2 Non-Financial Eligibility > MA-CVT Immigration Status","text":"## MA-CVT Immigration Status\n\nPeople receiving services at the Center for Victims of Torture (CVT), who are not otherwise eligible for Medical Assistance (MA), may be eligible for MA-CVT regardless of their date of entry into the United States, including undocumented people. Verification of citizenship or immigration status is not required for MA-CVT."},{"chunk_id":"epm:2.5.2.2#ma-cvt-social-security-number","heading":"MA-CVT Social Security Number","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.2.2#ma-cvt-social-security-number","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.2 Medical Assistance for People Receiving Services at the Center for Victims of Torture > 2.5.2.2 Non-Financial Eligibility > MA-CVT Social Security Number","text":"## MA-CVT Social Security Number\n\nUndocumented people and nonimmigrants are not required to provide SSNs for Medical Assistance Center for Victims of Torture (MA-CVT). Verification of a Social Security number is not required for undocumented and nonimmigrant MA-CVT applicants and enrollees.\n\nThis subchapter include the policies above that apply to MA-CVT and links to policies that apply to all MA programs and all Minnesota Health Care Programs (MHCP).\n\nTopics covered in this subchapter are:\n1. [MA-CVT Bases of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.2.2.1)\n2. [MA County Residency](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.3)\n3. [MA Living Arrangement](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.4)\n4. [MHCP State Residency](https://bot-corpus.mn-dhs.online/s/epm/1.4)"}]},{"id":"epm:2.5.2.2.1","number":"2.5.2.2.1","title":"Bases of Eligibility","parent":"2.5.2.2","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.2 Medical Assistance for People Receiving Services at the Center for Victims of Torture > 2.5.2.2 Non-Financial Eligibility > 2.5.2.2.1 Bases of Eligibility","summary":"Minnesota provides Medical Assistance (MA) to certain groups of people as allowed under law. These groups are referred to as a basis of eligibility. A person’s basis of eligibility determines the non-financial criteria and financial methodology used to determine MA eligibility.","effective_date":"2018-06-01","last_modified":"2026-10-03T03:51:59.785796+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.2.2.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.2.2.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_2_2_1.htm","legal_citations":["Minnesota Statutes, section 256B.06, subdivision 4"],"chunks":[{"chunk_id":"epm:2.5.2.2.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.2.2.1","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.2 Medical Assistance for People Receiving Services at the Center for Victims of Torture > 2.5.2.2 Non-Financial Eligibility > 2.5.2.2.1 Bases of Eligibility","text":"Minnesota provides Medical Assistance (MA) to certain groups of people as allowed under law. These groups are referred to as a basis of eligibility. A person’s basis of eligibility determines the non-financial criteria and financial methodology used to determine MA eligibility.\n\nMA for people receiving services at the Center for Victims of Torture (MA-CVT) has one basis of eligibility. MA-CVT enrollees may not have another MA basis of eligibility.\n\nPeople who an MA-CVT basis of eligibility may also be eligible for [Emergency Medical Assistance (EMA)](https://bot-corpus.mn-dhs.online/s/epm/2.5.3) if they have a medical emergency. This allows the Minnesota Department of Human Services (DHS) to claim federal reimbursement for the medical emergency costs."},{"chunk_id":"epm:2.5.2.2.1#beginning-and-ending-bases-of-eligibility","heading":"Beginning and Ending Bases of Eligibility","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.2.2.1#beginning-and-ending-bases-of-eligibility","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.2 Medical Assistance for People Receiving Services at the Center for Victims of Torture > 2.5.2.2 Non-Financial Eligibility > 2.5.2.2.1 Bases of Eligibility > Beginning and Ending Bases of Eligibility","text":"## Beginning and Ending Bases of Eligibility\n\nThe MA-CVT basis of eligibility begins the month the person began receiving CVT services. The MA-CVT basis of eligibility ends the month after the month the enrollee stops receiving CVT services."},{"chunk_id":"epm:2.5.2.2.1#change-in-basis-of-eligibility-for-enrollees","heading":"Change in Basis of Eligibility for Enrollees","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.2.2.1#change-in-basis-of-eligibility-for-enrollees","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.2 Medical Assistance for People Receiving Services at the Center for Victims of Torture > 2.5.2.2 Non-Financial Eligibility > 2.5.2.2.1 Bases of Eligibility > Change in Basis of Eligibility for Enrollees","text":"## Change in Basis of Eligibility for Enrollees\n\nA change in circumstances may affect an MA-CVT enrollee's basis of eligibility. A person whose CVT basis of eligibility ends is evaluated for other Minnesota Health Care Programs (MHCP) when coverage ends.\n\nAdditional information may be required to determine continued eligibility under another basis or for other MHCPs. Some changes that may affect an enrollee's basis of eligibility include, but are not limited to:\n- CVT services end\n- Change in immigration status\n- Pregnancy"}]},{"id":"epm:2.5.2.3","number":"2.5.2.3","title":"Financial Eligibility","parent":"2.5.2","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.2 Medical Assistance for People Receiving Services at the Center for Victims of Torture > 2.5.2.3 Financial Eligibility","summary":"This page provides financial eligibility policy for Medical Assistance for people receiving services at the Center for Victims of Torture (MA-CVT). This includes eligibility factors that involve a person’s income or assets.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:59.785796+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.2.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.2.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_2_3.htm","legal_citations":["Minnesota Statutes, section 256B.06, subdivision 4"],"chunks":[{"chunk_id":"epm:2.5.2.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.2.3","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.2 Medical Assistance for People Receiving Services at the Center for Victims of Torture > 2.5.2.3 Financial Eligibility","text":"This page provides financial eligibility policy for Medical Assistance for people receiving services at the Center for Victims of Torture (MA-CVT). This includes eligibility factors that involve a person’s income or assets.\n\nMA-CVT has no asset and no income limits."}]},{"id":"epm:2.5.2.4","number":"2.5.2.4","title":"Post-Eligibility","parent":"2.5.2","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.2 Medical Assistance for People Receiving Services at the Center for Victims of Torture > 2.5.2.4 Post-Eligibility","summary":"These policies apply to MA-CVT enrollees. This subchapter includes policies that apply to Medical Assistance for people receiving services at the Center for Victims of Torture (MA-CVT) and links to policies that apply to all MA programs and all Minnesota Health Care Programs (MHCP) programs.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:59.785796+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.2.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.2.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_2_4.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.5.2.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.2.4","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.2 Medical Assistance for People Receiving Services at the Center for Victims of Torture > 2.5.2.4 Post-Eligibility","text":"These policies apply to MA-CVT enrollees. This subchapter includes policies that apply to Medical Assistance for people receiving services at the Center for Victims of Torture (MA-CVT) and links to policies that apply to all MA programs and all Minnesota Health Care Programs (MHCP) programs.\n1. [MA Begin and End Dates](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.1)\n2. [MA Benefit Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1)\n3. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n4. [MA Cooperation](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.2)\n5. [MA Cost Sharing](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.3)\n6. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n7. [MA-CVT Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/2.5.2.4.1)\n8. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n9. [MA Qualifying Health Coverage](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.2)\n10. [MA Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4)\n11. [MA-CVT Renewals](https://bot-corpus.mn-dhs.online/s/epm/2.5.2.4.2)"}]},{"id":"epm:2.5.2.4.1","number":"2.5.2.4.1","title":"Health Care Delivery","parent":"2.5.2.4","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.2 Medical Assistance for People Receiving Services at the Center for Victims of Torture > 2.5.2.4 Post-Eligibility > 2.5.2.4.1 Health Care Delivery","summary":"Medical Assistance for people who receive services at the Center for Victims of Torture (MA-CVT) enrollees must follow guidelines for receiving medically necessary services. People who receive MA-CVT are excluded from managed care enrollment. MA-CVT medical services are provided via fee for service.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:59.785796+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.2.4.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.2.4.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_2_4_1.htm","legal_citations":["Minnesota Statute 256B"],"chunks":[{"chunk_id":"epm:2.5.2.4.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.2.4.1","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.2 Medical Assistance for People Receiving Services at the Center for Victims of Torture > 2.5.2.4 Post-Eligibility > 2.5.2.4.1 Health Care Delivery","text":"Medical Assistance for people who receive services at the Center for Victims of Torture (MA-CVT) enrollees must follow guidelines for receiving medically necessary services. People who receive MA-CVT are excluded from managed care enrollment. MA-CVT medical services are provided via fee for service."},{"chunk_id":"epm:2.5.2.4.1#fee-for-service","heading":"Fee for Service","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.2.4.1#fee-for-service","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.2 Medical Assistance for People Receiving Services at the Center for Victims of Torture > 2.5.2.4 Post-Eligibility > 2.5.2.4.1 Health Care Delivery > Fee for Service","text":"## Fee for Service\n\nFee-for-service is a method of payment where the medical provider bills the Minnesota Health Care Programs (MHCP) for specific, individual services. Enrollees must use a medical provider enrolled with MHCP, except in special circumstances. A [directory of enrolled providers](http://mhcpproviderdirectory.dhs.state.mn.us/) is available online."},{"chunk_id":"epm:2.5.2.4.1#covered-services","heading":"Covered Services","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.2.4.1#covered-services","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.2 Medical Assistance for People Receiving Services at the Center for Victims of Torture > 2.5.2.4 Post-Eligibility > 2.5.2.4.1 Health Care Delivery > Covered Services","text":"## Covered Services\n\nThe MHCP Summary of Coverage, Cost Sharing and Limits ([DHS-3860](https://www.google.com/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=1&ved=0CCAQFjAA&url=https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3860-ENG&ei=9WZrVPHVC5OnyASpgIKwBw&usg=AFQjCNFK_Yl9QXapcVWWYTJ5mQfMG7MSVw&bvm=bv.79908130,d.aWw)) explains covered services."}]},{"id":"epm:2.5.2.4.2","number":"2.5.2.4.2","title":"Renewals","parent":"2.5.2.4","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.2 Medical Assistance for People Receiving Services at the Center for Victims of Torture > 2.5.2.4 Post-Eligibility > 2.5.2.4.2 Renewals","summary":"Enrollees in Medical Assistance for people receiving services from the Center for Victims of Torture (MA-CVT) must have eligibility redetermined every 12 months. The first annual renewal is 12 months from the month of application and renewals occur annually thereafter as long as the enrollee remains eligible for MA. Eligibility for retroactive coverage months do not affect when an enrollee’s annua","effective_date":"2023-06-01","last_modified":"2026-10-03T03:51:59.785796+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.2.4.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.2.4.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_2_4_2.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.916","Minnesota Statutes, section 256B.06, subdivision 4"],"chunks":[{"chunk_id":"epm:2.5.2.4.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.2.4.2","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.2 Medical Assistance for People Receiving Services at the Center for Victims of Torture > 2.5.2.4 Post-Eligibility > 2.5.2.4.2 Renewals","text":"Enrollees in Medical Assistance for people receiving services from the Center for Victims of Torture (MA-CVT) must have eligibility redetermined every 12 months. The first annual renewal is 12 months from the month of application and renewals occur annually thereafter as long as the enrollee remains eligible for MA. Eligibility for retroactive coverage months do not affect when an enrollee’s annual renewal occurs.\n\nMA-CVT enrollees receive a renewal form. Enrollees must complete, sign and return the renewal form to their county, tribal or state servicing agency. They must include proof they are continuing to receive CVT services. The proof must be dated within 30 days of the date of renewal."},{"chunk_id":"epm:2.5.2.4.2#annual-renewal-month","heading":"Annual Renewal Month","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.2.4.2#annual-renewal-month","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.2 Medical Assistance for People Receiving Services at the Center for Victims of Torture > 2.5.2.4 Post-Eligibility > 2.5.2.4.2 Renewals > Annual Renewal Month","text":"## Annual Renewal Month\n\nThe annual renewal month is the month in which eligibility is redetermined for the next 12 months. The first annual renewal month after application is 12 months from the month of application and occurs annually thereafter as long as the enrollee remains eligible for MA-CVT."},{"chunk_id":"epm:2.5.2.4.2#when-eligibility-ends-at-renewal","heading":"When Eligibility Ends at Renewal","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.2.4.2#when-eligibility-ends-at-renewal","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.2 Medical Assistance for People Receiving Services at the Center for Victims of Torture > 2.5.2.4 Post-Eligibility > 2.5.2.4.2 Renewals > When Eligibility Ends at Renewal","text":"## When Eligibility Ends at Renewal\n\nChanges reported during an enrollee’s renewal may affect an MA enrollee's basis of eligibility. Enrollees who lose eligibility under one basis must be redetermined for all health care programs they are potentially eligible for, without interruption in their coverage. See EPM [1.3.2.1 Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1) for more information."}]},{"id":"epm:2.5.3","number":"2.5.3","title":"Emergency Medical Assistance","parent":"2.5","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.3 Emergency Medical Assistance","summary":"Emergency Medical Assistance (EMA) covers emergency services for certain people who meet the financial and non-financial eligibility requirements for Medical Assistance (MA), but are not eligible due to their immigration status.","effective_date":"2021-11-01","last_modified":"2026-10-03T03:51:59.785796+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_3.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.139","Code of Federal Regulations, title 42, section 435.350","Code of Federal Regulations, title 42, section 440.255","Minnesota Statutes, section 256B.06, subdivision 4"],"chunks":[{"chunk_id":"epm:2.5.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.3","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.3 Emergency Medical Assistance","text":"Emergency Medical Assistance (EMA) covers emergency services for certain people who meet the financial and non-financial eligibility requirements for Medical Assistance (MA), but are not eligible due to their immigration status.\n\nThe following people may qualify for EMA:\n- Noncitizens who do not have a lawfully present immigration status for MA eligibility, including noncitizens granted Deferred Action for Childhood Arrivals (DACA) status\n- Noncitizens age 21 and older with a lawfully present immigration status who are not eligible for MA because they do not have an MA qualified immigration status or who have not resided in the United States in a qualified status for five or more years\n- Sponsored noncitizens who are not eligible for MA because of their sponsors' income or assets\n- Sponsored noncitizens whose sponsor is not cooperating\n\nPeople enrolled in MA for people receiving services from the [Center for Victims of Torture](https://bot-corpus.mn-dhs.online/s/epm/2.5.2) (MA-CVT) may also be eligible for EMA if they have a medical emergency. This allows the Minnesota Department of Human Services (DHS) to claim federal reimbursement for the emergency medical costs.\n\nChildren with disabilities who are ineligible for MA due to immigration status may be eligible for EMA under the TEFRA option.\n\nTo qualify for EMA, a person must have a basis of eligibility for MA and must meet all the eligibility requirements for that basis of eligibility, with the exception of immigration status. A person's basis of eligibility determines the non-financial criteria and financial methodology used to determine EMA eligibility.\n- [MA for Families With Children and Adults (MA-FCA) Basis of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1)\n- [MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) Basis of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.2.1)\n\nPeople may request retroactive eligibility for EMA up to three months before the month of application.\n\nThis subchapter includes policies that apply to EMA and links to policies that apply to all MA programs and all Minnesota Health Care Programs (MHCP) programs.\n1. [EMA General Requirements](https://bot-corpus.mn-dhs.online/s/epm/2.5.3)\n  1. [MHCP Applications](https://bot-corpus.mn-dhs.online/s/epm/1.2)\n  2. [EMA Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/2.5.3.1.1)\n  3. [MA Responsibilities](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2)\n  4. [MHCP Retroactive Eligibility](https://bot-corpus.mn-dhs.online/s/epm/1.2.5)\n  5. [MHCP Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1)\n2. [EMA Non-Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.3.2)\n  1. [MA-ABD Bases of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.2.1)\n  2. [MA-ABD Non-Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.2)\n  3. [MA-ABD Certification of Disability](https://bot-corpus.mn-dhs.online/s/epm/2.3.2.2)\n  4. [MA-FCA Bases of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1)\n  5. [MA-FCA Non-Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.2.2)\n  6. [MA County Residency](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.3)\n  7. [MA Living Arrangement](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.4)\n  8. [MHCP State Residency](https://bot-corpus.mn-dhs.online/s/epm/1.4)\n  9. [MA-FCA Renewals](https://hcopub.dhs.state.mn.us/epm/2_2_4_2ar5.htm)\n  10. [MA-ABD Renewals](https://hcopub.dhs.state.mn.us/epm/2_3_4_2ar4.htm)\n3. [EMA Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.3.3)\n  1. [MA-ABD Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.3)\n  2. [MA-FCA Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.2.3)\n  3. [MA under the TEFRA Option](https://bot-corpus.mn-dhs.online/s/epm/2.3.6)\n4. [EMA Post-Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.3.4)\n  1. [MA Begin and End Dates](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.1)\n  2. [MA Benefit Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1)\n  3. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n  4. [MA Cooperation](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.2)\n  5. [MA Cost Sharing](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.3)\n  6. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n  7. [EMA Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/2.5.3.4.1)\n  8. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n  9. [MA Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4)\n  10. [MA-ABD Renewals](https://hcopub.dhs.state.mn.us/epm/2_3_4_2ar4.htm)\n  11. [MA-FCA Renewals](https://hcopub.dhs.state.mn.us/epm/2_2_4_2ar5.htm)"}]},{"id":"epm:2.5.3.1","number":"2.5.3.1","title":"General Requirements","parent":"2.5.3","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.3 Emergency Medical Assistance > 2.5.3.1 General Requirements","summary":"This subchapter provides general policy information that applies to Emergency Medical Assistance (EMA).","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:59.785796+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.3.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.3.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_3_1.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.5.3.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.3.1","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.3 Emergency Medical Assistance > 2.5.3.1 General Requirements","text":"This subchapter provides general policy information that applies to Emergency Medical Assistance (EMA).\n\nThis subchapter includes policies that apply to EMA and links to policies that apply to all Medical Assistance (MA) programs and all Minnesota Health Care Programs (MHCP).\n\nTopics covered in this subchapter are:\n1. [MHCP Applications](https://bot-corpus.mn-dhs.online/s/epm/1.2)\n2. [EMA Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/2.5.3.1.1)\n3. [MA Responsibilities](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2)\n4. [MHCP Retroactive Eligibility](https://bot-corpus.mn-dhs.online/s/epm/1.2.5)\n5. [MHCP Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1)"}]},{"id":"epm:2.5.3.1.1","number":"2.5.3.1.1","title":"Mandatory Verifications","parent":"2.5.3.1","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.3 Emergency Medical Assistance > 2.5.3.1 General Requirements > 2.5.3.1.1 Mandatory Verifications","summary":"Mandatory verifications must be verified through electronic data sources or by paper proof, if electronic data sources are unsuccessful or unavailable. Self-attestation of certain eligibility factors may be accepted if electronic data sources are unsuccessful or unavailable and paper proof does not exist or is not available.","effective_date":"2022-09-01","last_modified":"2026-10-03T04:46:27.667608+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.3.1.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.3.1.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_3_1_1.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.139","Code of Federal Regulations, title 42, section 435.350","Code of Federal Regulations, title 42, section 440.255","Minnesota Statutes, section 256B.06, subdivision 4"],"chunks":[{"chunk_id":"epm:2.5.3.1.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.3.1.1","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.3 Emergency Medical Assistance > 2.5.3.1 General Requirements > 2.5.3.1.1 Mandatory Verifications","text":"Mandatory verifications must be verified through electronic data sources or by paper proof, if electronic data sources are unsuccessful or unavailable. Self-attestation of certain eligibility factors may be accepted if electronic data sources are unsuccessful or unavailable and paper proof does not exist or is not available."},{"chunk_id":"epm:2.5.3.1.1#emergency-medical-assistance-ema-for-families-with-children-and-adults","heading":"Emergency Medical Assistance (EMA) for Families with Children and Adults","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.3.1.1#emergency-medical-assistance-ema-for-families-with-children-and-adults","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.3 Emergency Medical Assistance > 2.5.3.1 General Requirements > 2.5.3.1.1 Mandatory Verifications > Emergency Medical Assistance (EMA) for Families with Children and Adults","text":"## Emergency Medical Assistance (EMA) for Families with Children and Adults\n\nPeople using a basis of eligibility under Medical Assistance for Families with Children and Adults (MA-FCA) must verify current income."},{"chunk_id":"epm:2.5.3.1.1#ema-for-people-who-are-age-65-or-older-or-people-who-are-blind-or-have-a-disability","heading":"EMA for People Who Are Age 65 or Older or People Who Are Blind or Have a Disability","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.3.1.1#ema-for-people-who-are-age-65-or-older-or-people-who-are-blind-or-have-a-disability","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.3 Emergency Medical Assistance > 2.5.3.1 General Requirements > 2.5.3.1.1 Mandatory Verifications > EMA for People Who Are Age 65 or Older or People Who Are Blind or Have a Disability","text":"## EMA for People Who Are Age 65 or Older or People Who Are Blind or Have a Disability\n\nPeople using a basis of eligibility under Medical Assistance for People Who Are Age 65 or Older or People Who Are Blind or Have a Disability (MA-ABD) must verify:\n- Assets\n- Certification of Disability through Social Security Administration (SSA) or State Medical Review Team (SMRT) for people claiming a blind or disabled basis of eligibility\n- Current income"},{"chunk_id":"epm:2.5.3.1.1#ema-with-a-spenddown","heading":"EMA with a Spenddown","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.3.1.1#ema-with-a-spenddown","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.3 Emergency Medical Assistance > 2.5.3.1 General Requirements > 2.5.3.1.1 Mandatory Verifications > EMA with a Spenddown","text":"## EMA with a Spenddown\n\nPeople who qualify for EMA with a spenddown must also verify:\n- Assets The asset policy depends on the person's basis of eligibility. Refer to Sections [2.2.1.2 Medical Assistance for Families with Children and Adults (MA-FCA) Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/2.2.1.2) and [2.3.1.1 MA-ABD Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/2.3.1.1) for more information about asset policies for bases of eligibility under MA-FCA and MA-ABD, respectively.\n- \n  - Verification of assets is required at application and when a new asset is reported. If an asset is determined to be excluded it does not need to be verified again at renewal.\n- Medical expenses to meet a spenddown"},{"chunk_id":"epm:2.5.3.1.1#verifications-not-required","heading":"Verifications Not Required","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.3.1.1#verifications-not-required","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.3 Emergency Medical Assistance > 2.5.3.1 General Requirements > 2.5.3.1.1 Mandatory Verifications > Verifications Not Required","text":"## Verifications Not Required\n\nPeople applying for EMA are not required to verify:\n- Immigration Status\n- Medical Emergency\n- Social Security Number\n\nCounty, tribal and state servicing agencies must retain verification documentation in accordance with the County Human Service Records Retention Schedule ([DHS-6928](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-6928-ENG))."},{"chunk_id":"epm:2.5.3.1.1#self-attestation","heading":"Self-Attestation","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.3.1.1#self-attestation","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.3 Emergency Medical Assistance > 2.5.3.1 General Requirements > 2.5.3.1.1 Mandatory Verifications > Self-Attestation","text":"## Self-Attestation\n\nSelf-attestation, either verbal or in writing, of the following eligibility factors may be accepted if electronic data sources are unsuccessful or unavailable and paper proof does not exist or is not available:\n- Income\n- Assets\n- Medical expenses to meet a spenddown\n- Certification of Disability through Social Security Administration (SSA)\n\nPaper proof is considered not available if neither the applicant or enrollee, nor the agency can obtain it. The county, tribal and state servicing agency must make efforts to assist the applicant or enrollee in obtaining the requested paper proof, if it exists. This includes obtaining authorization from the applicant or enrollee to contact a third party on their behalf, if appropriate. Decisions to accept an applicant’s or enrollee’s self-attestation must be based on the individual case circumstances."}]},{"id":"epm:2.5.3.2","number":"2.5.3.2","title":"Non-Financial Eligibility","parent":"2.5.3","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.3 Emergency Medical Assistance > 2.5.3.2 Non-Financial Eligibility","summary":"This subchapter provides non-financial policy information that applies to Emergency Medical Assistance (EMA). Non-financial eligibility requirements are not related to a person’s income or assets.","effective_date":"2024-05-30","last_modified":"2026-10-03T03:51:59.785796+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.3.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.3.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_3_2.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.5.3.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.3.2","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.3 Emergency Medical Assistance > 2.5.3.2 Non-Financial Eligibility","text":"This subchapter provides non-financial policy information that applies to Emergency Medical Assistance (EMA). Non-financial eligibility requirements are not related to a person’s income or assets.\n\nA person must meet the non-financial eligibility requirements for their Medical Assistance (MA) basis of eligibility.\n- [MA for Families With Children and Adults Bases of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1)\n- [MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability Bases of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.2.1)"},{"chunk_id":"epm:2.5.3.2#ema-medical-emergency","heading":"EMA Medical Emergency","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.3.2#ema-medical-emergency","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.3 Emergency Medical Assistance > 2.5.3.2 Non-Financial Eligibility > EMA Medical Emergency","text":"## EMA Medical Emergency\n\nAt application, EMA applicants must attest to having a medical emergency. Verification of the medical emergency is not required."},{"chunk_id":"epm:2.5.3.2#ema-renewal","heading":"EMA Renewal","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.3.2#ema-renewal","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.3 Emergency Medical Assistance > 2.5.3.2 Non-Financial Eligibility > EMA Renewal","text":"## EMA Renewal\n\nEligibility for EMA must continue until renewal unless the enrollee requests voluntary termination or there is a change in circumstance that results in the loss of MA eligibility. A change in the status of the medical emergency is not considered a change in circumstance.\n\nIn order for EMA enrollees to remain eligible at renewal, they must continue to meet all non-financial eligibility requirements for their basis of eligibility, with the exception of immigration status. EMA enrollees do not need to have a medical emergency to qualify for EMA at renewal; however, coverage is limited to payment for medical emergencies or services approved through a Care Plan Certification."},{"chunk_id":"epm:2.5.3.2#ema-for-a-pregnant-person","heading":"EMA for a Pregnant Person","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.3.2#ema-for-a-pregnant-person","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.3 Emergency Medical Assistance > 2.5.3.2 Non-Financial Eligibility > EMA for a Pregnant Person","text":"## EMA for a Pregnant Person\n\nPregnant people may qualify for MA if they are lawfully present noncitizens, or CHIP-funded MA if they are not lawfully present noncitizens. EMA coverage for labor and delivery is available for certain pregnant people who are not lawfully present and who are ineligible for CHIP-funded MA because they have other health coverage or have excess income.\n\nThis subchapter includes links to the MA-ABD and MA-FCA bases of eligibility policies and links to policies that apply to all MA programs and all Minnesota Health Care Programs (MHCP).\n1. [MA-ABD Bases of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.2.1)\n2. [MA-ABD Non-Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.2)\n3. [MA-ABD Certification of Disability](https://bot-corpus.mn-dhs.online/s/epm/2.3.2.2)\n4. [MA-FCA Bases of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1)\n5. [MA-FCA Non-Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.2.2)\n6. [MA County Residency](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.3)\n7. [MA Living Arrangement](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.4)\n8. [MHCP State Residency](https://bot-corpus.mn-dhs.online/s/epm/1.4)\n9. [MA-FCA Renewals](https://hcopub.dhs.state.mn.us/epm/2_2_4_2ar5.htm)\n10. [MA-ABD Renewals](https://hcopub.dhs.state.mn.us/epm/2_3_4_2ar4.htm)"},{"chunk_id":"epm:2.5.3.2#the-following-ma-non-financial-eligibility-policies-do-not-apply-to-ema","heading":"The following MA non-financial eligibility policies do not apply to EMA:","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.3.2#the-following-ma-non-financial-eligibility-policies-do-not-apply-to-ema","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.3 Emergency Medical Assistance > 2.5.3.2 Non-Financial Eligibility > The following MA non-financial eligibility policies do not apply to EMA:","text":"## The following MA non-financial eligibility policies do not apply to EMA:\n- Verification of immigration status\n- Social Security number"}]},{"id":"epm:2.5.3.3","number":"2.5.3.3","title":"Financial Eligibility","parent":"2.5.3","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.3 Emergency Medical Assistance > 2.5.3.3 Financial Eligibility","summary":"This subchapter provides financial policy information that applies to Emergency Medical Assistance (EMA). This includes eligibility factors that involve a person’s income or assets.","effective_date":"2016-12-22","last_modified":"2026-10-03T03:51:59.785796+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.3.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.3.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_3_3.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.5.3.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.3.3","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.3 Emergency Medical Assistance > 2.5.3.3 Financial Eligibility","text":"This subchapter provides financial policy information that applies to Emergency Medical Assistance (EMA). This includes eligibility factors that involve a person’s income or assets.\n\nA person must meet the financial eligibility requirements for their Medical Assistance (MA) basis of eligibility at application and renewal. However, sponsor deeming does not apply to EMA.\n- [MA for Families With Children and Adults (MA-FCA) Bases of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1)\n- [MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) Bases of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.2.1)\n\nPeople who are not eligible for EMA because they are over the income limit for their basis of eligibility and who have medical expenses may be eligible for EMA with a spenddown.\n\nThis subchapter includes links to the MA-ABD and MA-FCA financial eligibility policies. Also included is a link to the TEFRA option for children who have a disability and household income above the income limit.\n1. [MA-FCA Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.2.3)\n2. [MA-ABD Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.3)\n3. [MA under the TEFRA Option](https://bot-corpus.mn-dhs.online/s/epm/2.3.6)"}]},{"id":"epm:2.5.3.4","number":"2.5.3.4","title":"Post-Eligibility","parent":"2.5.3","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.3 Emergency Medical Assistance > 2.5.3.4 Post-Eligibility","summary":"These policies apply to Emergency Medical Assistance (EMA) enrollees.","effective_date":"2016-12-22","last_modified":"2026-10-03T03:51:59.785796+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.3.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.3.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_3_4.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.5.3.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.3.4","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.3 Emergency Medical Assistance > 2.5.3.4 Post-Eligibility","text":"These policies apply to Emergency Medical Assistance (EMA) enrollees.\n\nA person must meet the post eligibility requirements for their Medical Assistance (MA) basis of eligibility, including at renewal.\n- MA for Families With Children and Adults (MA-FCA) Bases of Eligibility\n- MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) Bases of Eligibility\n\nThis subchapter includes policies that apply to EMA and links to policies that apply to MA-ABD, MA-FCA, all MA programs and all Minnesota Health Care Programs (MHCP) programs.\n1. [MA Begin and End Dates](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.1)\n2. [MA Benefit Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1)\n3. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n4. [MA Cooperation](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.2)\n5. [MA Cost Sharing](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.3)\n6. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n7. [EMA Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/2.5.3.4.1)\n8. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n9. [MA Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4)\n10. [MA-ABD Renewals](https://hcopub.dhs.state.mn.us/epm/2_3_4_2ar4.htm)\n11. [MA-FCA Renewals](https://hcopub.dhs.state.mn.us/epm/2_2_4_2ar5.htm)"}]},{"id":"epm:2.5.3.4.1","number":"2.5.3.4.1","title":"Health Care Delivery","parent":"2.5.3.4","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.3 Emergency Medical Assistance > 2.5.3.4 Post-Eligibility > 2.5.3.4.1 Health Care Delivery","summary":"Emergency Medical Assistance (EMA) enrollees must follow guidelines for receiving medically necessary services. People who receive EMA are excluded from managed care enrollment. EMA medical services are provided via fee for service.","effective_date":"2016-12-22","last_modified":"2026-10-03T03:51:59.785796+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.3.4.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.3.4.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_3_4_1.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.139","Code of Federal Regulations, title 42, section 435.350","Code of Federal Regulations, title 42, section 440.255","Minnesota Statutes, section 256B.06, subdivision 4","Minnesota Statutes, section 256B.0625, subdivision 4"],"chunks":[{"chunk_id":"epm:2.5.3.4.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.3.4.1","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.3 Emergency Medical Assistance > 2.5.3.4 Post-Eligibility > 2.5.3.4.1 Health Care Delivery","text":"Emergency Medical Assistance (EMA) enrollees must follow guidelines for receiving medically necessary services. People who receive EMA are excluded from managed care enrollment. EMA medical services are provided via fee for service."},{"chunk_id":"epm:2.5.3.4.1#fee-for-service","heading":"Fee for Service","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.3.4.1#fee-for-service","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.3 Emergency Medical Assistance > 2.5.3.4 Post-Eligibility > 2.5.3.4.1 Health Care Delivery > Fee for Service","text":"## Fee for Service\n\nFee-for-service is a method of payment where the medical provider bills the Minnesota Health Care Programs (MHCP) for specific, individual services. Enrollees must use a medical provider enrolled with MHCP, except in special circumstances. A [directory of enrolled providers](http://mhcpproviderdirectory.dhs.state.mn.us/) is available online."},{"chunk_id":"epm:2.5.3.4.1#covered-services","heading":"Covered Services","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.3.4.1#covered-services","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.3 Emergency Medical Assistance > 2.5.3.4 Post-Eligibility > 2.5.3.4.1 Health Care Delivery > Covered Services","text":"## Covered Services\n\nEMA covers the care and treatment of emergency medical conditions provided in an emergency department (ED) or in an inpatient hospital when the admission is the result of an ED admission. Emergency medical conditions include labor and delivery.\n\nIn certain situations, EMA may cover additional services when a health care provider determines additional services are needed to prevent serious jeopardy to the person's health, or bodily impairment or dysfunction. EMA will cover these services only if they are part of an approved Care Plan Certification (CPC) ([DHS-3642](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-3642-ENG)) request. The person's provider must initiate the CPC request.\n\nSee the [EMA section of the MHCP Provider Manual](http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=dhs16_157743) for more information on covered services."}]},{"id":"epm:2.5.4","number":"2.5.4","title":"Program for People Living in Institutions for Mental Diseases","parent":"2.5","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.4 Program for People Living in Institutions for Mental Diseases","summary":"Minnesota provides health care for people who meet Medical Assistance (MA) eligibility criteria while living in an Institution for Mental Diseases (IMD). This health care may be federally or state-funded. State-funded MA for people living in an IMD is also known as Program IM.","effective_date":"2021-10-01","last_modified":"2026-10-03T04:10:25.4789+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_4.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.1009","Code of Federal Regulations, title 42, section 438.6","Code of Federal Regulations, title 42, section 441.151","Minnesota Statues, section 256.055, subdivision 13"],"chunks":[{"chunk_id":"epm:2.5.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.4","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.4 Program for People Living in Institutions for Mental Diseases","text":"Minnesota provides health care for people who meet Medical Assistance (MA) eligibility criteria while living in an Institution for Mental Diseases (IMD). This health care may be federally or state-funded. State-funded MA for people living in an IMD is also known as Program IM.\n\nAn IMD is a hospital, nursing facility, or other institution of 17 beds or more that primarily provides diagnosis and treatment for people with mental illness or chemical dependency. See [Appendix E Institutions for Mental Diseases](https://bot-corpus.mn-dhs.online/s/epm/E) for more information.\n\nPeople must have an MA basis of eligibility and meet all of the MA eligibility requirements associated with their basis. People are in one of the following eligibility groups:\n- [MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability](https://bot-corpus.mn-dhs.online/s/epm/2.3) (MA-ABD)\n- [MA for Employed Persons with Disabilities](https://bot-corpus.mn-dhs.online/s/epm/2.3.5) (MA-EPD)\n- [MA for Families With Children and Adults](https://bot-corpus.mn-dhs.online/s/epm/2.2) (MA-FCA)\n\nWhen an MA enrollee moves into an IMD, they do not need to file a new application for health care.\n\nThe following people continue to be eligible for federally funded MA while living in an IMD:\n- People age 65 or older\n- Children younger than age 21 in an accredited, licensed inpatient psychiatric hospital\n- People residing in an IMD that is an accredited, licensed inpatient psychiatric hospital who received MA covered services prior to their 21st birthday. Enrollees who continue to receive these services in the same facility after age 21 are covered by MA until they turn age 22.\n- People residing in an IMD facility approved to participate in the 1115 Substance Use Disorder (SUD) System Reform Demonstration\n- People enrolled in Refugee Medical Assistance (RMA)\n- People ages 21 up to 65 enrolled in a managed care plan with a length of stay of no more than 15 days during the calendar month\n\nThis subchapter includes policies that apply to Program IM and links to policies that apply to all MA and all Minnesota Health Care Programs (MHCP) programs.\n1. [IMD General Requirements](https://bot-corpus.mn-dhs.online/s/epm/2.5.4.1)\n  1. [MA-ABD General Requirements](https://bot-corpus.mn-dhs.online/s/epm/2.3.1)\n  2. [MA-EPD General Requirements](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1)\n  3. [MA-FCA General Requirements](https://bot-corpus.mn-dhs.online/s/epm/2.2.1)\n2. [Program IM Non-Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.4.2)\n  1. [MA-ABD Bases of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.2.1)\n  2. [MA-ABD Certification of Disability](https://bot-corpus.mn-dhs.online/s/epm/2.3.2.2)\n  3. [MA-FCA Bases of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1)\n  4. [MA Citizenship and Immigration Status](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2)\n  5. [MA County Residency](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.3)\n  6. [MA Social Security Number](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5)\n  7. [MHCP State Residency](https://bot-corpus.mn-dhs.online/s/epm/1.4)\n3. [Program IM Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.4.3)\n  1. [MA-ABD Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.3)\n  2. [MA-EPD Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.3)\n  3. [MA-FCA Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.2.3)\n4. [Program IM Post-Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.4.4)\n  1. [MA Begin and End Dates](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.1)\n  2. [MA Benefit Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1)\n  3. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n  4. [MA Cooperation](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.2)\n  5. [Program IM Medicare](https://bot-corpus.mn-dhs.online/s/epm/2.5.4.4.1)\n  6. [MA Cost Sharing](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.3)\n  7. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n  8. [Program IM Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/2.5.4.4.2)\n  9. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n  10. [Program IM Leave Days](https://bot-corpus.mn-dhs.online/s/epm/2.5.4.4.3)\n  11. [MA-EPD Premiums and Cost Sharing](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.2)\n  12. [MA Qualifying Health Coverage](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.2)\n  13. [MA Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4)\n  14. [MA-ABD Renewals](https://hcopub.dhs.state.mn.us/epm/2_3_4_2ar4.htm)\n  15. [MA-FCA Renewals](https://hcopub.dhs.state.mn.us/epm/2_2_4_2ar5.htm)"}]},{"id":"epm:2.5.4.1","number":"2.5.4.1","title":"General Requirements","parent":"2.5.4","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.4 Program for People Living in Institutions for Mental Diseases > 2.5.4.1 General Requirements","summary":"This subchapter provides general policy information that applies to Program IM. The relevant general requirements depends on the person’s MA basis of eligibility. People are in one of the following eligibility groups:","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:59.785796+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.4.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.4.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_4_1.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.5.4.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.4.1","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.4 Program for People Living in Institutions for Mental Diseases > 2.5.4.1 General Requirements","text":"This subchapter provides general policy information that applies to Program IM. The relevant general requirements depends on the person’s MA basis of eligibility. People are in one of the following eligibility groups:\n- [MA for People Who Are Age 65 or Older and People Who are Blind or Have a Disability](https://bot-corpus.mn-dhs.online/s/epm/2.3) (MA-ABD)\n- [MA for Employed Persons with Disabilities](https://bot-corpus.mn-dhs.online/s/epm/2.3.5) (MA-EPD)\n- [MA for Families With Children and Adults](https://bot-corpus.mn-dhs.online/s/epm/2.2) (MA-FCA)\n\nThis subchapter links to general requirements that apply to the three eligibility groups\n1. [MA-ABD General Requirements](https://bot-corpus.mn-dhs.online/s/epm/2.3.1)\n2. [MA-EPD General Requirements](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1)\n3. [MA-FCA General Requirements](https://bot-corpus.mn-dhs.online/s/epm/2.2.1)"}]},{"id":"epm:2.5.4.2","number":"2.5.4.2","title":"Non-Financial Eligibility","parent":"2.5.4","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.4 Program for People Living in Institutions for Mental Diseases > 2.5.4.2 Non-Financial Eligibility","summary":"This subchapter provides non-financial policy information that applies to Program IM. Non-financial eligibility requirements are not related to a person’s income or assets.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:59.785796+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.4.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.4.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_4_2.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.5.4.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.4.2","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.4 Program for People Living in Institutions for Mental Diseases > 2.5.4.2 Non-Financial Eligibility","text":"This subchapter provides non-financial policy information that applies to Program IM. Non-financial eligibility requirements are not related to a person’s income or assets.\n\nA person must meet the non-financial eligibility requirements that match their basis of eligibility. People are in one of the following eligibility groups:\n- [MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability](https://bot-corpus.mn-dhs.online/s/epm/2.3) (MA-ABD)\n- [MA for Employed Persons with Disabilities](https://bot-corpus.mn-dhs.online/s/epm/2.3.5) (MA-EPD)\n- [MA for Families With Children and Adults](https://bot-corpus.mn-dhs.online/s/epm/2.2) (MA-FCA)\n\nThis subchapter includes links to the relevant MA-ABD and MA-FCA policies and links to policies that apply to all MA programs and all Minnesota Health Care Programs (MHCP).\n1. [MA-ABD Bases of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.2.1)\n2. [MA-ABD Certification of Disability](https://bot-corpus.mn-dhs.online/s/epm/2.3.2.2)\n3. [MA-FCA Bases of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1)\n4. [MA Citizenship and Immigration Status](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2)\n5. [MA County Residency](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.3)\n6. [MA Social Security Number](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5)\n7. [MHCP State Residency](https://bot-corpus.mn-dhs.online/s/epm/1.4)"}]},{"id":"epm:2.5.4.3","number":"2.5.4.3","title":"Financial Eligibility","parent":"2.5.4","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.4 Program for People Living in Institutions for Mental Diseases > 2.5.4.3 Financial Eligibility","summary":"This subchapter provides financial policy information that applies to Program IM. This includes eligibility factors that involve a person’s income or assets.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:59.785796+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.4.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.4.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_4_3.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.5.4.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.4.3","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.4 Program for People Living in Institutions for Mental Diseases > 2.5.4.3 Financial Eligibility","text":"This subchapter provides financial policy information that applies to Program IM. This includes eligibility factors that involve a person’s income or assets.\n\nA person must meet the financial eligibility requirements that match their basis of eligibility to be eligible for Program IM. People are in one of the following eligibility groups:\n- [Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability](https://bot-corpus.mn-dhs.online/s/epm/2.3) (MA-ABD)\n- [MA for Employed Persons with Disabilities](https://bot-corpus.mn-dhs.online/s/epm/2.3.5) (MA-EPD)\n- [MA for Families With Children and Adults](https://bot-corpus.mn-dhs.online/s/epm/2.2) (MA-FCA)\n\nThis subchapter includes a Program IM policy and links to the MA-FCA, MA-ABD and MA-EPD financial eligibility policies.\n1. [MA-ABD Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.3)\n  1. [MA-ABD Income](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3)\n  2. [MA-ABD Household Composition and Family Size](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.1)\n  3. [MA-ABD Assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2)\n  4. [MA-ABD Medical Spenddowns](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.4)\n2. [MA-EPD Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.3)\n  1. [MA-EPD Asset](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.3.1)\n  2. [MA-EPD Premiums and Cost Sharing](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.2)\n3. [MA-FCA Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.2.3)\n  1. [MA-FCA Asset Limits](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.1)\n  2. [MA-FCA Income Limit](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.3)\n  3. [MA-FCA Income Methodology](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.4)\n  4. [MA-FCA Household Composition and Family Size](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.2)\n  5. [MA-FCA Sponsor Deeming](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.2.1)\n  6. [MA-FCA Income Verification](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.5)\n  7. [MA-FCA Medical Spenddown](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.6)"}]},{"id":"epm:2.5.4.4","number":"2.5.4.4","title":"Post-Eligibility","parent":"2.5.4","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.4 Program for People Living in Institutions for Mental Diseases > 2.5.4.4 Post-Eligibility","summary":"These policies apply to Program IM enrollees.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:51:59.785796+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.4.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.4.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_4_4.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.5.4.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.4.4","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.4 Program for People Living in Institutions for Mental Diseases > 2.5.4.4 Post-Eligibility","text":"These policies apply to Program IM enrollees.\n\nA person must meet the post eligibility requirements that match their basis of eligibility. People are in one of the following eligibility groups:\n- [Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability](https://bot-corpus.mn-dhs.online/s/epm/2.3) (MA-ABD)\n- [MA for Employed Persons with Disabilities](https://bot-corpus.mn-dhs.online/s/epm/2.3.5) (MA-EPD)\n- [MA for Families With Children and Adults](https://bot-corpus.mn-dhs.online/s/epm/2.2) (MA-FCA)\n\nThis subchapter includes policies that apply to Program IM and links to policies that apply to MA-ABD, MA-FCA, MA-EPD, all MA programs and all Minnesota Health Care Programs (MHCP) programs.\n1. [MA Begin and End Dates](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.1)\n2. [MA Benefit Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1)\n3. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n4. [MA Cooperation](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.2)\n5. [Program IM Medicare](https://bot-corpus.mn-dhs.online/s/epm/2.5.4.4.1)\n6. [MA Cost Sharing](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.3)\n7. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n8. [Program IM Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/2.5.4.4.2)\n9. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n10. [Program IM Leave Days](https://bot-corpus.mn-dhs.online/s/epm/2.5.4.4.3)\n11. [MA-EPD Premiums and Cost Sharing](https://bot-corpus.mn-dhs.online/s/epm/2.3.5.1.2)\n12. [MA Qualifying Health Coverage](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.2)\n13. [MA Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4)\n14. [MA-ABD Renewals](https://hcopub.dhs.state.mn.us/epm/2_3_4_2ar4.htm)\n15. [MA-FCA Renewals](https://hcopub.dhs.state.mn.us/epm/2_2_4_2ar5.htm)"}]},{"id":"epm:2.5.4.4.1","number":"2.5.4.4.1","title":"Medicare","parent":"2.5.4.4","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.4 Program for People Living in Institutions for Mental Diseases > 2.5.4.4 Post-Eligibility > 2.5.4.4.1 Medicare","summary":"People who reside in an Institution for Mental Diseases (IMD) and who would otherwise qualify for Medical Assistance (MA) if they did not reside in an IMD must enroll in Medicare, if eligible, to be eligible for Program IM.","effective_date":"2024-04-17","last_modified":"2026-10-03T04:45:32.83864+00:00","version":3,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.4.4.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.4.4.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_4_4_1.htm","legal_citations":["Minnesota Rules, part 9505.0430","Minnesota Statutes, section 256B.0625, subdivision 15"],"chunks":[{"chunk_id":"epm:2.5.4.4.1#medicare-eligibility","heading":"Medicare Eligibility","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.4.4.1#medicare-eligibility","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.4 Program for People Living in Institutions for Mental Diseases > 2.5.4.4 Post-Eligibility > 2.5.4.4.1 Medicare > Medicare Eligibility","text":"## Medicare Eligibility\n\nPeople who reside in an Institution for Mental Diseases (IMD) and who would otherwise qualify for Medical Assistance (MA) if they did not reside in an IMD must enroll in Medicare, if eligible, to be eligible for Program IM.\n\nIf a person eligible for Medicare is not enrolled in the program at the time they are placed in an IMD, they must apply for Medicare during the next available general enrollment period (January through March of each year)."},{"chunk_id":"epm:2.5.4.4.1#medicare-reimbursement","heading":"Medicare Reimbursement","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.4.4.1#medicare-reimbursement","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.4 Program for People Living in Institutions for Mental Diseases > 2.5.4.4 Post-Eligibility > 2.5.4.4.1 Medicare > Medicare Reimbursement","text":"## Medicare Reimbursement\n\nPeople who are enrolled in federally funded MA who reside in an IMD may be eligible for Medicare Savings Programs (MSP). See EPM [2.5.4 Program for People Living in Institutions for Mental Diseases](https://bot-corpus.mn-dhs.online/s/epm/2.5.4) for more information. If an enrollee is eligible for an MSP, they must apply for Medicare immediately. They do not have to wait for the next general enrollment period.\n\nPeople who are enrolled in state-funded MA (Program IM) are not eligible to receive MSP benefits while living in an IMD. People who would receive MSP benefits if they did not reside in an IMD may be eligible to have their Medicare premiums manually reimbursed by their county or tribal servicing agency. See [EPM 1.7.2 MHCP Direct Reimbursement of Medicare Premiums](https://bot-corpus.mn-dhs.online/s/epm/1.7.2) for more information."}]},{"id":"epm:2.5.4.4.2","number":"2.5.4.4.2","title":"Health Care Delivery","parent":"2.5.4.4","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.4 Program for People Living in Institutions for Mental Diseases > 2.5.4.4 Post-Eligibility > 2.5.4.4.2 Health Care Delivery","summary":"Program IM enrollees must follow guidelines for receiving medically necessary services.","effective_date":"2018-06-01","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.4.4.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.4.4.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_4_4_2.htm","legal_citations":["Minnesota Rules, parts 9500.1450 to 9500.1464","Minnesota Rules, part 9505.0285"],"chunks":[{"chunk_id":"epm:2.5.4.4.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.4.4.2","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.4 Program for People Living in Institutions for Mental Diseases > 2.5.4.4 Post-Eligibility > 2.5.4.4.2 Health Care Delivery","text":"Program IM enrollees must follow guidelines for receiving medically necessary services."},{"chunk_id":"epm:2.5.4.4.2#fee-for-service","heading":"Fee for Service","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.4.4.2#fee-for-service","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.4 Program for People Living in Institutions for Mental Diseases > 2.5.4.4 Post-Eligibility > 2.5.4.4.2 Health Care Delivery > Fee for Service","text":"## Fee for Service\n\nFee-for-service is a method of payment where the medical provider bills MHCP for specific, individual services. Enrollees must use a medical provider enrolled with MHCP, except in special circumstances. A [directory of enrolled providers](http://mhcpproviderdirectory.dhs.state.mn.us/) is available online."},{"chunk_id":"epm:2.5.4.4.2#managed-care","heading":"Managed Care","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.4.4.2#managed-care","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.4 Program for People Living in Institutions for Mental Diseases > 2.5.4.4 Post-Eligibility > 2.5.4.4.2 Health Care Delivery > Managed Care","text":"## Managed Care\n\nMost MHCP enrollees receive services from a managed care health plan or network of providers. The health plan coordinates the services provided. The Minnesota Department of Human Services (DHS) pays a fixed rate in advance for each enrollee.\n\nPeople who are already enrolled in an MA managed care health plan when they enter an Institution for Mental Diseases (IMD) will remain enrolled in managed care.\n\nDetailed information on managed care and managed care exemptions is in the Prepaid Minnesota Health Care Programs (PMHCP) Manual."},{"chunk_id":"epm:2.5.4.4.2#covered-services","heading":"Covered Services","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.4.4.2#covered-services","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.4 Program for People Living in Institutions for Mental Diseases > 2.5.4.4 Post-Eligibility > 2.5.4.4.2 Health Care Delivery > Covered Services","text":"## Covered Services\n\nThe MHCP Summary of Coverage, Cost Sharing and Limits ([DHS-3860](https://www.google.com/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=1&ved=0CCAQFjAA&url=https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3860-ENG&ei=9WZrVPHVC5OnyASpgIKwBw&usg=AFQjCNFK_Yl9QXapcVWWYTJ5mQfMG7MSVw&bvm=bv.79908130,d.aWw)) explains covered services and cost-sharing requirements. People who reside or expect to reside for 30 days or more in a medical institution (including IMDs that are psychiatric hospitals and Rule 36 residential treatment programs) are exempt from co-payments."}]},{"id":"epm:2.5.4.4.3","number":"2.5.4.4.3","title":"Leave Days","parent":"2.5.4.4","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.4 Program for People Living in Institutions for Mental Diseases > 2.5.4.4 Post-Eligibility > 2.5.4.4.3 Leave Days","summary":"People on Program IM who are on a conditional release or convalescent leave from an Institution for Mental Diseases (IMD) are no longer considered living in an IMD.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.4.4.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.4.4.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_4_4_3.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.1009"],"chunks":[{"chunk_id":"epm:2.5.4.4.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.4.4.3","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.4 Program for People Living in Institutions for Mental Diseases > 2.5.4.4 Post-Eligibility > 2.5.4.4.3 Leave Days","text":"People on Program IM who are on a conditional release or convalescent leave from an Institution for Mental Diseases (IMD) are no longer considered living in an IMD.\n\nPeople are not eligible for Program IM while on a conditional release or convalescent leave. They may be enrolled in MA during their leave days if they meet all MA eligibility requirements.\n\nNo change in eligibility happens for people enrolled in MA while living in an IMD while on a leave. See [Institute for Mental Diseases](https://bot-corpus.mn-dhs.online/s/epm/2.5.4) for a list of people who maintain MA enrollment while living in an IMD."}]},{"id":"epm:2.5.5","number":"2.5.5","title":"Medical Assistance for People Who Are Incarcerated","parent":"2.5","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.5 Medical Assistance for People Who Are Incarcerated","summary":"A person who applies for or is enrolled in MA, and who is or becomes incarcerated in a state prison, county detention facility, or city jail is eligible for Medical Assistance (MA) if they meet all MA eligibility factors. All changes in circumstances and renewal policies apply to an MA enrollee who is incarcerated. When an MA applicant or enrollee is incarcerated, MA coverage is suspended, except ","effective_date":"2025-04-04","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.5","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.5","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_5.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.5.5#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.5","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.5 Medical Assistance for People Who Are Incarcerated","text":"A person who applies for or is enrolled in MA, and who is or becomes incarcerated in a state prison, county detention facility, or city jail is eligible for Medical Assistance (MA) if they meet all MA eligibility factors. All changes in circumstances and renewal policies apply to an MA enrollee who is incarcerated. When an MA applicant or enrollee is incarcerated, MA coverage is suspended, except for payment of inpatient hospital services."},{"chunk_id":"epm:2.5.5#ma-coverage-for-hospitalized-incarcerated-people","heading":"MA Coverage for Hospitalized Incarcerated People","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.5#ma-coverage-for-hospitalized-incarcerated-people","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.5 Medical Assistance for People Who Are Incarcerated > MA Coverage for Hospitalized Incarcerated People","text":"## MA Coverage for Hospitalized Incarcerated People\n\nA person who is incarcerated may be eligible for MA.\n\nWhen an MA applicant or enrollee is incarcerated, their MA coverage is limited to inpatient hospital services. Inpatient hospital services include professional and dental services associated with an inpatient hospital stay. When an MA applicant or enrollee is or becomes incarcerated, the person’s living arrangement must be correctly entered or updated in MMIS to ensure that MA only pays for inpatient hospital services.\n\nSee the [MA Living Arrangement](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.4) policy for further information.\n\nA person must meet the eligibility requirements that match their basis of eligibility. People are in one of the following eligibility groups:\n- [MA for Families With Children and Adults](https://bot-corpus.mn-dhs.online/s/epm/2.2) (MA-FCA)\n- [MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability](https://bot-corpus.mn-dhs.online/s/epm/2.3) (MA-ABD)\n- [MA for Long-Term Care Services](https://bot-corpus.mn-dhs.online/s/epm/2.4)\n\nThis subchapter includes policies that apply to MA for people who are incarcerated, including people who are or become hospitalized, with links to policies that apply to all MA programs and all Minnesota Health Care Programs (MHCP) programs.\n1. [MA for People Who Are Incarcerated General Requirements](https://hcopub.dhs.state.mn.us/epm/2_5_5_1ar1.htm)\n  1. [MA for People Who are Incarcerated Applications](https://bot-corpus.mn-dhs.online/s/epm/2.5.5.1.1)\n  2. [MA Responsibilities](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2)\n  3. [MHCP Retroactive Eligibility](https://bot-corpus.mn-dhs.online/s/epm/1.2.5)\n  4. [MHCP Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1)\n2. [MA for People Who Are Incarcerated Non-Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.5.2)\n  1. [MA-ABD Non-Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.3)\n  2. [MA-FCA Non-Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.2.2)\n  3. [MA-LTC](https://bot-corpus.mn-dhs.online/s/epm/2.4)\n3. [MA for People Who are Incarcerated Financial Eligibility](https://hcopub.dhs.state.mn.us/epm/2_5_5_3ar1.htm)\n  1. [MA-ABD Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.3)\n  2. [MA-FCA Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.2.3)\n  3. [MA-LTC](https://bot-corpus.mn-dhs.online/s/epm/2.4)\n4. [MA for People Who Are Incarcerated Post-Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.5.4)\n  1. [MA-HIP Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/2.5.4.4.2)\n  2. [MA-ABD Post Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.4)\n  3. [MA-FCA Post Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.2.4)\n  4. [MA-LTC](https://bot-corpus.mn-dhs.online/s/epm/2.4)"}]},{"id":"epm:2.5.5.1","number":"2.5.5.1","title":"General Requirements","parent":"2.5.5","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.5 Medical Assistance for People Who Are Incarcerated > 2.5.5.1 General Requirements","summary":"This subchapter provides general policy information that applies to Medical Assistance for people who are incarcerated.","effective_date":"2025-04-04","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.5.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.5.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_5_1.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.5.5.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.5.1","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.5 Medical Assistance for People Who Are Incarcerated > 2.5.5.1 General Requirements","text":"This subchapter provides general policy information that applies to Medical Assistance for people who are incarcerated.\n\nThis subchapter includes policies that apply to MA for those who are incarcerated and links to policies that apply to all MA programs and all Minnesota Health Care Programs (MHCP) programs.\n1. [MA for People Who Are Incarcerated Applications](https://bot-corpus.mn-dhs.online/s/epm/2.5.5.1.1)\n2. [MA Responsibilities](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2)\n3. [MHCP Retroactive Eligibility](https://bot-corpus.mn-dhs.online/s/epm/1.2.5)\n4. [MHCP Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1)"}]},{"id":"epm:2.5.5.1.1","number":"2.5.5.1.1","title":"Applications","parent":"2.5.5.1","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.5 Medical Assistance for People Who Are Incarcerated > 2.5.5.1 General Requirements > 2.5.5.1.1 Applications","summary":"People who are incarcerated may apply for Medical Assistance (MA) at any time. Agencies must determine eligibility according to regular MA application processing rules and timelines, regardless of a person’s anticipated release date. See EPM section 1.2.4 MHCP Processing Period for more information. The Individual Discharge Information Sheet (DHS-3443) is not required to be completed with the appl","effective_date":"2025-04-04","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.5.1.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.5.1.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_5_1_1.htm","legal_citations":["Minnesota Statute 256B.055, subdivision 14","Minnesota Statutes, section 256G.01, subdivision 4","Minnesota Statutes, section 256G.02, subdivision 4 and 6","Minnesota Statutes, section 256G.08, subdivision 2"],"chunks":[{"chunk_id":"epm:2.5.5.1.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.5.1.1","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.5 Medical Assistance for People Who Are Incarcerated > 2.5.5.1 General Requirements > 2.5.5.1.1 Applications","text":"People who are incarcerated may apply for Medical Assistance (MA) at any time. Agencies must determine eligibility according to regular MA application processing rules and timelines, regardless of a person’s anticipated release date. See EPM section [1.2.4 MHCP Processing Period](https://bot-corpus.mn-dhs.online/s/epm/1.2.4) for more information. The Individual Discharge Information Sheet ([DHS-3443](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3443-ENG)) is not required to be completed with the applicable Minnesota Health Care Programs (MHCP) application to be determined eligible for MA.\n\nPeople who are incarcerated and determined eligible for MA must have their coverage suspended, except for inpatient hospitalization services, until they are released."},{"chunk_id":"epm:2.5.5.1.1#health-care-application","heading":"Health Care Application","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.5.1.1#health-care-application","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.5 Medical Assistance for People Who Are Incarcerated > 2.5.5.1 General Requirements > 2.5.5.1.1 Applications > Health Care Application","text":"## Health Care Application\n\nThe demographics of a person who is incarcerated determine which paper application they must complete.\n\nIf the applicant is a current MA enrollee who becomes hospitalized while incarcerated, the Medical Assistance (MA) Inpatient Hospital Coverage for Incarcerated People ([DHS-6696G](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-6696G-ENG)) can be submitted without completing a new MHCP application.\n\nIf the individual who is incarcerated is not a current MA enrollee then the DHS-6696G must be submitted along with a MHCP application (either the MNsure application ([DHS-6696](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-6696-ENG)) or the MHCP Application for Certain Populations ([DHS-3876](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3876-ENG)).\n\nThe completed paper application and/or DHS-6696G must be submitted :\n- After the person is discharged from the hospital but no later than three calendar months after the month in which the person was admitted, or\n- If the person is hospitalized, or expected to be hospitalized, for more than three calendar months, then within three calendar months after the month the person was admitted to the hospital, or\n- After the preadmission screening (PAS) has been completed and the person has met institutional level-of-care (LOC) requirements for payment of long-term care.\n\nA correctional facility staff member must help the person complete the application process.\n\nThe correctional facility is responsible for notifying the hospital or long-term care facility (LTCF) of the person’s eligibility status and the person’s Person Master Index (PMI) number."},{"chunk_id":"epm:2.5.5.1.1#applications-for-incarcerated-people-preparing-for-release","heading":"Applications for Incarcerated People Preparing for Release","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.5.1.1#applications-for-incarcerated-people-preparing-for-release","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.5 Medical Assistance for People Who Are Incarcerated > 2.5.5.1 General Requirements > 2.5.5.1.1 Applications > Applications for Incarcerated People Preparing for Release","text":"## Applications for Incarcerated People Preparing for Release\n\nWhen a person who is incarcerated applies for MA prior to their release, the agency must verify both the incarceration and release dates. The release date may be verified by any of the following:\n- The actual date of release from the Facility Section on [DHS-5038](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-5038-ENG)\n- The actual date of release from the Facility Section on [DHS-3443](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3443-ENG)\n- Phone or fax contacts with the facility\n- Official correspondence from the facility with the release date listed\n- Official lists provided to the county agency by the facility containing the incarcerated individual’s name and release date\n- Department of Corrections website\n- Official jail roster\n\nFor a person who applies for MA while preparing for release, their MHCP application is submitted to the county or tribal servicing agency where the person lived immediately before entering the correctional facility. For a person whose MA was closed while they were incarcerated for less than a year, who is requesting MA be reopened, their DHS-5038 Request to Reopen MA is submitted to the county or tribal servicing agency where the person lived immediately before entering the correctional facility. If the previous county of residence is unknown or the person lived in another state immediately before being incarcerated, the completed forms are sent to the county or tribal servicing agency where the person plans to live after release.\n\nThe county of financial responsibility for an incarcerated person preparing for release is the agency in which the person resided immediately before entering the correctional facility. If the previous county of residence is unknown or the person lived in another state immediately before being incarcerated, the financially responsible agency is the county or tribe in which the facility is located."}]},{"id":"epm:2.5.5.2","number":"2.5.5.2","title":"Non-Financial Eligibility","parent":"2.5.5","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.5 Medical Assistance for People Who Are Incarcerated > 2.5.5.2 Non-Financial Eligibility","summary":"This subchapter provides non-financial policy information that applies to Medical Assistance (MA) for incarcerated people who are hospitalized. Non-financial eligibility requirements are not related to a person’s income or assets.","effective_date":"2025-04-04","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.5.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.5.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_5_2.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.5.5.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.5.2","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.5 Medical Assistance for People Who Are Incarcerated > 2.5.5.2 Non-Financial Eligibility","text":"This subchapter provides non-financial policy information that applies to Medical Assistance (MA) for incarcerated people who are hospitalized. Non-financial eligibility requirements are not related to a person’s income or assets.\n\nA person must meet the non-financial eligibility requirements that match their situation. People are in one of the following eligibility groups:\n- [MA for Families With Children and Adults](https://bot-corpus.mn-dhs.online/s/epm/2.2) (MA-FCA)\n- [MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability](https://bot-corpus.mn-dhs.online/s/epm/2.3) (MA-ABD)\n- [MA for Long-Term Care Services](https://bot-corpus.mn-dhs.online/s/epm/2.4) (MA-LTC)\n\nThis subchapter includes links to the Non-Financial Eligibility subchapters.\n1. [MA-ABD Non-Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.3)\n2. [MA-FCA Non-Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.2.2)\n3. [MA-LTC](https://bot-corpus.mn-dhs.online/s/epm/2.4)"}]},{"id":"epm:2.5.5.3","number":"2.5.5.3","title":"Financial Eligibility","parent":"2.5.5","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.5 Medical Assistance for People Who Are Incarcerated > 2.5.5.3 Financial Eligibility","summary":"This subchapter provides financial policy information that applies to Medical Assistance (MA) for hospitalized people who are incarcerated. This includes eligibility factors that involve a person’s income or assets.","effective_date":"2025-04-04","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.5.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.5.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_5_3.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.5.5.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.5.3","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.5 Medical Assistance for People Who Are Incarcerated > 2.5.5.3 Financial Eligibility","text":"This subchapter provides financial policy information that applies to Medical Assistance (MA) for hospitalized people who are incarcerated. This includes eligibility factors that involve a person’s income or assets.\n\nA person must meet the financial eligibility requirements that match their situation. People are in one of the following eligibility groups:\n- [MA for Families With Children and Adults](https://bot-corpus.mn-dhs.online/s/epm/2.2) (MA-FCA)\n- [MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability](https://bot-corpus.mn-dhs.online/s/epm/2.3) (MA-ABD)\n- [MA for Long-Term Care Services](https://bot-corpus.mn-dhs.online/s/epm/2.4) (MA-LTC)\n\nThis subchapter includes links to the financial eligibility policies.\n1. [MA-ABD Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.3)\n2. [MA-FCA Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.2.3)\n3. [MA-LTC](https://bot-corpus.mn-dhs.online/s/epm/2.4)"}]},{"id":"epm:2.5.5.4","number":"2.5.5.4","title":"Post-Eligibility","parent":"2.5.5","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.5 Medical Assistance for People Who Are Incarcerated > 2.5.5.4 Post-Eligibility","summary":"These policies apply to people who are incarcerated and enrolled in Medical Assistance (MA).","effective_date":"2025-04-04","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.5.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.5.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_5_4.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.5.5.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.5.4","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.5 Medical Assistance for People Who Are Incarcerated > 2.5.5.4 Post-Eligibility","text":"These policies apply to people who are incarcerated and enrolled in Medical Assistance (MA).\n\nA person must meet the post eligibility requirements that match their situation. People are in one of the following eligibility groups:\n- [MA for Families With Children and Adults](https://bot-corpus.mn-dhs.online/s/epm/2.2) (MA-FCA)\n- [MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability](https://bot-corpus.mn-dhs.online/s/epm/2.3) (MA-ABD)\n- [MA for Long-Term Care Services](https://bot-corpus.mn-dhs.online/s/epm/2.4) (MA-LTC)\n\nThis subchapter includes links to the post-eligibility policies.\n1. [MA-ABD Post-Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.3.4)\n2. [MA-FCA Post-Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.2.4)\n3. [MA-LTC](https://bot-corpus.mn-dhs.online/s/epm/2.4)\n\nThere is a unique Health Care Delivery policy for incarcerated people who are hospitalized and enrolled in Medical Assistance (MA). See EPM [2.5.5.4.1 MA for People Who Are Incarcerated Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/2.5.5.4.1) for People Who Are Hospitalized While Incarcerated for more information."}]},{"id":"epm:2.5.5.4.1","number":"2.5.5.4.1","title":"Health Care Delivery","parent":"2.5.5.4","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.5 Medical Assistance for People Who Are Incarcerated > 2.5.5.4 Post-Eligibility > 2.5.5.4.1 Health Care Delivery","summary":"Medical Assistance (MA) enrollees who are incarcerated are generally excluded from managed care enrollment. Medical services are provided via fee-for-service.","effective_date":"2025-04-04","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.5.4.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.5.4.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_5_4_1.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.1009","Code of Federal Regulations, title 42, section 435.1010","Minnesota Rules, part 9505.0050","Minnesota Statutes, section 256B.055, subdivision 14"],"chunks":[{"chunk_id":"epm:2.5.5.4.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.5.4.1","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.5 Medical Assistance for People Who Are Incarcerated > 2.5.5.4 Post-Eligibility > 2.5.5.4.1 Health Care Delivery","text":"Medical Assistance (MA) enrollees who are incarcerated are generally excluded from managed care enrollment. Medical services are provided via fee-for-service."},{"chunk_id":"epm:2.5.5.4.1#fee-for-service","heading":"Fee-for-Service","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.5.4.1#fee-for-service","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.5 Medical Assistance for People Who Are Incarcerated > 2.5.5.4 Post-Eligibility > 2.5.5.4.1 Health Care Delivery > Fee-for-Service","text":"## Fee-for-Service\n\nFee-for-service is a method of payment where the medical provider bills the Minnesota Health Care Programs (MHCP) for specific, individual services. Enrollees must use a medical provider enrolled with MHCP, except in special circumstances. A [directory of enrolled providers](http://mhcpproviderdirectory.dhs.state.mn.us/) is available online."},{"chunk_id":"epm:2.5.5.4.1#covered-services","heading":"Covered Services","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.5.4.1#covered-services","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.5 Medical Assistance for People Who Are Incarcerated > 2.5.5.4 Post-Eligibility > 2.5.5.4.1 Health Care Delivery > Covered Services","text":"## Covered Services\n\nMA only covers services received while the person who is incarcerated is in an inpatient in a hospital."}]},{"id":"epm:2.5.6","number":"2.5.6","title":"Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC)","parent":"2.5","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC)","summary":"All children who receive Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA) and children in foster care (FC) are eligible for Medical Assistance (MA).","effective_date":"2023-01-01","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.6","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_6.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.145","Code of Federal Regulations, title 42, section 435.227","Minnesota Statutes, section 256B.055","Minnesota Statutes, chapter 256N"],"chunks":[{"chunk_id":"epm:2.5.6#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC)","text":"All children who receive Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA) and children in foster care (FC) are eligible for Medical Assistance (MA).\n\nThis chapter includes MA eligibility policies that apply to:\n\n[MA Northstar Adoption Assistance](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1) (NAA)\n\n[MA Northstar Kinship Assistance](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2) (NKA)\n\n[MA for Children in Foster Care](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3) (FC)"}]},{"id":"epm:2.5.6.1","number":"2.5.6.1","title":"Medical Assistance Northstar Adoption Assistance","parent":"2.5.6","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.1 Medical Assistance Northstar Adoption Assistance","summary":"Children who receive Northstar Adoption Assistance are automatically eligible for Medical Assistance (MA) without a health care application. This includes children who are receiving Title IV-E or non-IV-E Adoption Assistance and children eligible for MA in Minnesota under the Interstate Compact on Adoption and Medical Assistance (ICAMA).","effective_date":"2019-06-01","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.6.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_6_1.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.5.6.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.1 Medical Assistance Northstar Adoption Assistance","text":"Children who receive Northstar Adoption Assistance are automatically eligible for Medical Assistance (MA) without a health care application. This includes children who are receiving Title IV-E or non-IV-E Adoption Assistance and children eligible for MA in Minnesota under the [Interstate Compact on Adoption and Medical Assistance (ICAMA)](https://bot-corpus.mn-dhs.online/s/epm/1.4.1).\n\nChildren who receive Title IV-E adoption assistance are automatically eligible for MA when they move to Minnesota.\n\nFor a child who receives non-Title IV-E adoption assistance to automatically receive MA under ICAMA, the adoption assistance agreement from the other state must include healthcare coverage. Not all states provide automatic MA for non-Title IV-E adoption assistance children, even if the state is a part of ICAMA. Those states which extend MA coverage to interstate agreements, through reciprocity under the Consolidated Omnibus Reconciliation Act of 1985 (COBRA) also known as COBRA-Reciprocity, will provide MA to non-Title IV-E adoption assistance children who move there from another state. See the [COBRA & COBRA-Reciprocity chart](https://aaicama.org/cms/index.php/medical-assistance/state-funded/cobra-cobra-reciprocity) on the Association of Administrators of the Interstate Compact on Adoption and Medical Assistance (AAICAMA) website for a state by state listing. See the MHCP Interstate Residency Agreements policy for more information.\n\nThis subchapter includes policies that apply to MA for children receiving Northstar Adoption Assistance and links to policies that apply to all MA programs and all Minnesota Health Care Programs (MHCP) programs.\n1. [MA Northstar Adoption Assistance (MA-NAA) General Requirements](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.1) [MA-NAA Non-Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.2) [MA-NAA Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.3) [MA-NAA Post Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.4)\n  1. [MA-NAA Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.1.1) [MA Benefit Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1) [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1) [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3) [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4) [MA Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4) [MHCP Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1)\n    1. [MA Third Party Liability](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.3) [MA Cost Effective Insurance](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.1) [MA Other Third Party Liability](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.3)\n  1. [MA-NAA Basis of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.2.1) [MA Citizenship and Immigration Status](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2) [MA County Residency](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.3) [MHCP State Residency for Adoption Assistance and Foster Care](https://bot-corpus.mn-dhs.online/s/epm/1.4.2)\n  1. MA-NAA has no financial eligibility requirements.\n  1. [MA Benefit Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1) [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1) [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3) [MA-NAA Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.4.1) [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4) [MA Northstar Title IV-E and Medicare](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.4.2) [MA Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4)"}]},{"id":"epm:2.5.6.1.1","number":"2.5.6.1.1","title":"General Requirements","parent":"2.5.6.1","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.1 Medical Assistance Northstar Adoption Assistance > 2.5.6.1.1 General Requirements","summary":"This subchapter provides general policy information that applies to Medical Assistance Northstar Adoption Assistance (MA-NAA).","effective_date":"2016-06-01","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.6.1.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_6_1_1.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.5.6.1.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.1","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.1 Medical Assistance Northstar Adoption Assistance > 2.5.6.1.1 General Requirements","text":"This subchapter provides general policy information that applies to Medical Assistance Northstar Adoption Assistance (MA-NAA).\n\nTopics covered in this subchapter are:\n1. [MA-NAA Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.1.1)\n2. [MA Benefit Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1)\n  1. [MA Third Party Liability](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3)\n  2. [MA Cost Effective Insurance](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.1)\n  3. [MA Other Third Party Liability](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.3)\n3. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n4. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n5. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n6. [MA Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4)\n7. [MHCP Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1)\n  1. [MHCP Appeals](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.1)\n  2. [MHCP Authorized Representative](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.2)\n  3. [MHCP Civil Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.3)\n  4. [MHCP Data Privacy](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.4)\n  5. [MHCP Notices](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.5)"}]},{"id":"epm:2.5.6.1.1.1","number":"2.5.6.1.1.1","title":"Mandatory Verifications","parent":"2.5.6.1.1","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.1 Medical Assistance Northstar Adoption Assistance > 2.5.6.1.1 General Requirements > 2.5.6.1.1.1 Mandatory Verifications","summary":"Mandatory verifications must be verified through an available electronic data source or by paper proof, if electronic data sources are unsuccessful or unavailable. Self-attestation alone is not acceptable for eligibility requirements with mandatory verifications.","effective_date":"2019-04-01","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.1.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.6.1.1.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_6_1_1_1.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.145","Code of Federal Regulations, title 42, section 435.227","Minnesota Statutes, section 256B.055"],"chunks":[{"chunk_id":"epm:2.5.6.1.1.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.1.1","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.1 Medical Assistance Northstar Adoption Assistance > 2.5.6.1.1 General Requirements > 2.5.6.1.1.1 Mandatory Verifications","text":"Mandatory verifications must be verified through an available electronic data source or by paper proof, if electronic data sources are unsuccessful or unavailable. Self-attestation alone is not acceptable for eligibility requirements with mandatory verifications.\n\nNorthstar Adoption Assistance must be verified to establish initial Medical Assistance (MA) eligibility or to extend MA eligibility beyond age 18.The following is acceptable proof:\n- Copy of the Adoption Assistance Agreement\n- Adoption Assistance Agreement Amendment indicating an Adoption Assistance extension beyond age 18. The amendment lists a new end date for adoption assistance.\n- The Interstate Compact on Adoption and Medical Assistance (ICAMA) Form 6.01 and Adoption Assistance Agreement for ICAMA children receiving Adoption Assistance. See [MHCP Interstate Residency Agreements](https://bot-corpus.mn-dhs.online/s/epm/1.4.1) policy for more information about ICAMA.\n- Report of Change in Child/Family Status (ICAMA Form 6.03) indicating an Adoption Assistance extension beyond age 18. The form lists a new end date for Adoption Assistance."},{"chunk_id":"epm:2.5.6.1.1.1#social-security-number","heading":"Social Security Number","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.1.1#social-security-number","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.1 Medical Assistance Northstar Adoption Assistance > 2.5.6.1.1 General Requirements > 2.5.6.1.1.1 Mandatory Verifications > Social Security Number","text":"## Social Security Number\n\nA Social Security Number is required for Non-Title IV-E Adoption Assistance. See [MA Social Security Number](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5) policy for more information.\n\nA Social Security Number is not required for children receiving:\n- Title IV-E Adoption Assistance\n- Title IV-E and Non-Title IV-E-funded ICAMA\n\nThe county, tribal or state servicing agency must assist people in obtaining verification.\n\nCounty, tribal and state servicing agencies must retain verification documentation in accordance with the County Human Service Records Retention Schedule ([DHS-6928](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-6928-ENG))."}]},{"id":"epm:2.5.6.1.2","number":"2.5.6.1.2","title":"Non-Financial Eligibility","parent":"2.5.6.1","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.1 Medical Assistance Northstar Adoption Assistance > 2.5.6.1.2 Non-Financial Eligibility","summary":"This subchapter provides non-financial policy information that applies to Medical Assistance Northstar Adoption Assistance (MA-NAA). Non-financial eligibility requirements are not related to a person’s income or assets.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.6.1.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_6_1_2.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.145","Code of Federal Regulations, title 42, section 435.227","Minnesota Statutes, section 256B.055"],"chunks":[{"chunk_id":"epm:2.5.6.1.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.2","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.1 Medical Assistance Northstar Adoption Assistance > 2.5.6.1.2 Non-Financial Eligibility","text":"This subchapter provides non-financial policy information that applies to Medical Assistance Northstar Adoption Assistance (MA-NAA). Non-financial eligibility requirements are not related to a person’s income or assets.\n\nThis subchapter includes links to an MA-NAA policy and links to policies that apply to all MA programs and all Minnesota Health Care Programs (MHCP).\n1. [MA-NAA Basis of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.2)\n2. [MA Citizenship and Immigration Status](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2)\n3. [MA County Residency](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.3)\n4. [MA Social Security Number](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5)\n5. [MHCP State Residency for Adoption Assistance and Foster Care](https://bot-corpus.mn-dhs.online/s/epm/1.4.2)"}]},{"id":"epm:2.5.6.1.2.1","number":"2.5.6.1.2.1","title":"Basis of Eligibility","parent":"2.5.6.1.2","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.1 Medical Assistance Northstar Adoption Assistance > 2.5.6.1.2 Non-Financial Eligibility > 2.5.6.1.2.1 Basis of Eligibility","summary":"Minnesota provides Medical Assistance (MA) to certain groups of people as allowed under law. These groups are referred to as a basis of eligibility. A person’s basis of eligibility determines the non-financial criteria and financial methodology used to determine MA eligibility.","effective_date":"2024-01-12","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.2.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.6.1.2.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_6_1_2_1.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.145","Code of Federal Regulations, title 42, section 435.227","Minnesota Statutes, section 256B.055"],"chunks":[{"chunk_id":"epm:2.5.6.1.2.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.2.1","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.1 Medical Assistance Northstar Adoption Assistance > 2.5.6.1.2 Non-Financial Eligibility > 2.5.6.1.2.1 Basis of Eligibility","text":"Minnesota provides Medical Assistance (MA) to certain groups of people as allowed under law. These groups are referred to as a basis of eligibility. A person’s basis of eligibility determines the non-financial criteria and financial methodology used to determine MA eligibility.\n\nThe MA for children receiving Northstar Adoption Assistance (MA-NAA) basis of eligibility includes children receiving:\n- Title IV-E and non-Title IV-E Adoption Assistance\n- Title IV-E and non-Title IV-E Adoption Assistance under the Interstate Compact on Adoption and Medical Assistance (ICAMA)\n\nChildren who also have a certified disability, receiving a home and community-based services waiver continue to use the Northstar Adoption Assistance basis of eligibility. They do not use the disabled basis of eligibility."},{"chunk_id":"epm:2.5.6.1.2.1#eligibility-begin-date","heading":"Eligibility Begin Date","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.2.1#eligibility-begin-date","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.1 Medical Assistance Northstar Adoption Assistance > 2.5.6.1.2 Non-Financial Eligibility > 2.5.6.1.2.1 Basis of Eligibility > Eligibility Begin Date","text":"## Eligibility Begin Date\n\nA child’s MA under the NAA basis begins the first day of the month the NAA benefit agreement goes into effect. When NAA benefits are approved to begin, the DHS Permanency Support Payment Specialist sends both the NAA payment commencement notice and a copy of the NAA benefit agreement to the health care eligibility worker in the child’s county of residence. The effective date of the NAA benefit agreement is included in the NAA payment commencement notice.\n\nFor a child who is transitioning from MA under the foster care basis (MA-FC) to MA-NAA, MA-FC must continue until MA-NAA is established for the child."},{"chunk_id":"epm:2.5.6.1.2.1#eligibility-end-date","heading":"Eligibility End Date","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.2.1#eligibility-end-date","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.1 Medical Assistance Northstar Adoption Assistance > 2.5.6.1.2 Non-Financial Eligibility > 2.5.6.1.2.1 Basis of Eligibility > Eligibility End Date","text":"## Eligibility End Date\n\nMA-NAA ends the last day of the month the child turns age 18, unless they receive an extension. Extensions to the benefit agreement may continue up to age 21. A child may have multiple extensions to the benefit agreement. Each extension will have a new end date.\n\nThe DHS Permanency Support Payment Specialist will notify the eligibility worker if there is a change to the benefit agreement end date."},{"chunk_id":"epm:2.5.6.1.2.1#change-in-circumstances","heading":"Change in Circumstances","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.2.1#change-in-circumstances","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.1 Medical Assistance Northstar Adoption Assistance > 2.5.6.1.2 Non-Financial Eligibility > 2.5.6.1.2.1 Basis of Eligibility > Change in Circumstances","text":"## Change in Circumstances\n\nA change in circumstances may affect an MA enrollee's basis of eligibility. Enrollees who lose eligibility under one basis must be redetermined under another basis without interruption in their coverage. If an enrollee is no longer eligible for MA under any basis, eligibility must be redetermined for MinnesotaCare, Advance Premium Tax Credits or a Qualified Health Plan. See [EPM 1.3.2.1 Change in Circumstance](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1) for more information."}]},{"id":"epm:2.5.6.1.3","number":"2.5.6.1.3","title":"Financial Eligibility","parent":"2.5.6.1","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.1 Medical Assistance Northstar Adoption Assistance > 2.5.6.1.3 Financial Eligibility","summary":"Financial eligibility requirements involve a person’s income or assets. Medical Assistance (MA) Northstar Adoption Assistance has no income or asset eligibility requirements.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.6.1.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_6_1_3.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.145","Code of Federal Regulations, title 42, section 435.227","Minnesota Statutes, section 256B.055, subdivision 1"],"chunks":[{"chunk_id":"epm:2.5.6.1.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.3","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.1 Medical Assistance Northstar Adoption Assistance > 2.5.6.1.3 Financial Eligibility","text":"Financial eligibility requirements involve a person’s income or assets. Medical Assistance (MA) Northstar Adoption Assistance has no income or asset eligibility requirements."}]},{"id":"epm:2.5.6.1.4","number":"2.5.6.1.4","title":"Post-Eligibility","parent":"2.5.6.1","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.1 Medical Assistance Northstar Adoption Assistance > 2.5.6.1.4 Post-Eligibility","summary":"These policies apply to Medical Assistance Northstar Adoption Assistance (MA-NAA) enrollees. This subchapter includes policies that apply to MA-NAA and links to policies that apply to all MA programs and all Minnesota Health Care Programs (MHCP) programs.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.6.1.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_6_1_4.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.5.6.1.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.4","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.1 Medical Assistance Northstar Adoption Assistance > 2.5.6.1.4 Post-Eligibility","text":"These policies apply to Medical Assistance Northstar Adoption Assistance (MA-NAA) enrollees. This subchapter includes policies that apply to MA-NAA and links to policies that apply to all MA programs and all Minnesota Health Care Programs (MHCP) programs.\n\nTopics covered in this sub-chapter are:\n1. [MA Benefit Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1)\n2. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n3. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n4. [MA-NAA Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.4.1)\n5. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n6. [MA Northstar Title IV-E and Medicare](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.4.2)\n7. [MA Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4)"}]},{"id":"epm:2.5.6.1.4.1","number":"2.5.6.1.4.1","title":"Health Care Delivery","parent":"2.5.6.1.4","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.1 Medical Assistance Northstar Adoption Assistance > 2.5.6.1.4 Post-Eligibility > 2.5.6.1.4.1 Health Care Delivery","summary":"Medical Assistance Northstar Adoption Assistance enrollees must follow guidelines for receiving medically necessary services. There are guidelines for benefit sets, managed care plans, cost-sharing, and out-of-state services. See the Minnesota Health Care Programs (MHCP) Health Care Delivery policy for more information.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.4.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.6.1.4.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_6_1_4_1.htm","legal_citations":["Minnesota Statute 256B"],"chunks":[{"chunk_id":"epm:2.5.6.1.4.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.4.1","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.1 Medical Assistance Northstar Adoption Assistance > 2.5.6.1.4 Post-Eligibility > 2.5.6.1.4.1 Health Care Delivery","text":"Medical Assistance Northstar Adoption Assistance enrollees must follow guidelines for receiving medically necessary services. There are guidelines for benefit sets, managed care plans, cost-sharing, and out-of-state services. See the [Minnesota Health Care Programs (MHCP) Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/1.6) policy for more information.\n\nChildren who receive Northstar Adoption Assistance receive MA on a fee for service basis. They are excluded from managed care enrollment; however, they may enroll voluntarily in managed care.\n\nMinnesota retains responsibility for non-Title IV-E adoption assistance children who move to a state that does not have full reciprocity under ICAMA. See the [MHCP Interstate Residency Agreements](https://bot-corpus.mn-dhs.online/s/epm/1.4.1) policy for more information. As a result, a child who receives non-Title IV-E Adoption Assistance and moves to another state may remain eligible for Minnesota MA. Minnesota supplements the child’s health care benefits if the new state’s MA program does not include all Minnesota MA benefits."},{"chunk_id":"epm:2.5.6.1.4.1#fee-for-service","heading":"Fee for Service","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.4.1#fee-for-service","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.1 Medical Assistance Northstar Adoption Assistance > 2.5.6.1.4 Post-Eligibility > 2.5.6.1.4.1 Health Care Delivery > Fee for Service","text":"## Fee for Service\n\nFee-for-service is a method of payment where the medical provider bills MHCP for specific, individual services. Enrollees must use a medical provider enrolled with MHCP, except in special circumstances. A [directory of enrolled providers](http://mhcpproviderdirectory.dhs.state.mn.us/) is available online."},{"chunk_id":"epm:2.5.6.1.4.1#covered-services","heading":"Covered Services","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.4.1#covered-services","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.1 Medical Assistance Northstar Adoption Assistance > 2.5.6.1.4 Post-Eligibility > 2.5.6.1.4.1 Health Care Delivery > Covered Services","text":"## Covered Services\n\nThe MHCP Summary of Coverage, Cost Sharing and Limits ([DHS-3860](https://www.google.com/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=1&ved=0CCAQFjAA&url=https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3860-ENG&ei=9WZrVPHVC5OnyASpgIKwBw&usg=AFQjCNFK_Yl9QXapcVWWYTJ5mQfMG7MSVw&bvm=bv.79908130,d.aWw)) explains covered services."}]},{"id":"epm:2.5.6.1.4.2","number":"2.5.6.1.4.2","title":"Title IV-E and Medicare","parent":"2.5.6.1.4","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.1 Medical Assistance Northstar Adoption Assistance > 2.5.6.1.4 Post-Eligibility > 2.5.6.1.4.2 Title IV-E and Medicare","summary":"The Minnesota Department of Human Services (DHS) pays the monthly Medicare Part B premiums for Medicare eligible children with Title IV-E Adoption Assistance, Title IV-E Foster Care, or Title IV-E Kinship Assistance.","effective_date":"2023-01-01","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.4.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.6.1.4.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_6_1_4_2.htm","legal_citations":["United States Code, title 42, section 1395v"],"chunks":[{"chunk_id":"epm:2.5.6.1.4.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.4.2","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.1 Medical Assistance Northstar Adoption Assistance > 2.5.6.1.4 Post-Eligibility > 2.5.6.1.4.2 Title IV-E and Medicare","text":"The Minnesota Department of Human Services (DHS) pays the monthly Medicare Part B premiums for Medicare eligible children with Title IV-E Adoption Assistance, Title IV-E Foster Care, or Title IV-E Kinship Assistance."}]},{"id":"epm:2.5.6.1.4.3","number":"2.5.6.1.4.3","title":"Renewals","parent":"2.5.6.1.4","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.1 Medical Assistance Northstar Adoption Assistance > 2.5.6.1.4 Post-Eligibility > 2.5.6.1.4.3 Renewals","summary":"Medical Assistance for children who receive Northstar Adoption Assistance (MA-NAA) must be renewed every 12 months.","effective_date":"2024-01-12","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.4.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.6.1.4.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_6_1_4_3.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.916","Minnesota Statutes, section 256B.056, subdivision 7a"],"chunks":[{"chunk_id":"epm:2.5.6.1.4.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.4.3","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.1 Medical Assistance Northstar Adoption Assistance > 2.5.6.1.4 Post-Eligibility > 2.5.6.1.4.3 Renewals","text":"Medical Assistance for children who receive Northstar Adoption Assistance (MA-NAA) must be renewed every 12 months.\n\nChildren receiving the MA-NAA basis of eligibility who continue to meet all eligibility factors must have MA eligibility automatically renewed without having to complete a renewal form.\n\nContact information for the child and adoptive parent(s) must be confirmed at renewal to ensure ongoing MA eligibility for the child."},{"chunk_id":"epm:2.5.6.1.4.3#when-eligibility-ends-at-renewal","heading":"When Eligibility Ends at Renewal","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.4.3#when-eligibility-ends-at-renewal","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.1 Medical Assistance Northstar Adoption Assistance > 2.5.6.1.4 Post-Eligibility > 2.5.6.1.4.3 Renewals > When Eligibility Ends at Renewal","text":"## When Eligibility Ends at Renewal\n\nChanges reported during an enrollee’s renewal may affect an MA enrollee's basis of eligibility. Enrollees who lose eligibility under one basis must be redetermined for all health care programs they are potentially eligible for, without interruption in their coverage. See EPM [1.3.2.1 Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1) for more information."}]},{"id":"epm:2.5.6.2","number":"2.5.6.2","title":"Medical Assistance for Children Receiving Northstar Kinship Assistance (MA-NKA)","parent":"2.5.6","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.2 Medical Assistance for Children Receiving Northstar Kinship Assistance (MA-NKA)","summary":"Children who receive Minnesota Northstar Kinship Assistance are eligible for Medical Assistance (MA-NKA) without a health care application or financial eligibility requirements.","effective_date":"2025-12-05","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.6.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_6_2.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.145","Minnesota Statutes, section 256B.055","Minnesota Statutes, Chapter 256N"],"chunks":[{"chunk_id":"epm:2.5.6.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.2 Medical Assistance for Children Receiving Northstar Kinship Assistance (MA-NKA)","text":"Children who receive Minnesota Northstar Kinship Assistance are eligible for Medical Assistance (MA-NKA) without a health care application or financial eligibility requirements.\n\nChildren who receive Title IV-E Guardianship Assistance from another state and live in Minnesota are also eligible for MA-NKA without a health care application or financial eligibility requirements.\n\nChildren who receive non-Title IV-E Guardianship Assistance from another state and live in Minnesota are not eligible for MA-NKA, but may qualify for MA under other [MA-FCA](https://bot-corpus.mn-dhs.online/s/epm/2.2) or [MA-ABD](https://bot-corpus.mn-dhs.online/s/epm/2.3) bases of eligibility if they complete an application and meet program requirements."},{"chunk_id":"epm:2.5.6.2#overview-of-northstar-kinship-assistance","heading":"Overview of Northstar Kinship Assistance","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2#overview-of-northstar-kinship-assistance","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.2 Medical Assistance for Children Receiving Northstar Kinship Assistance (MA-NKA) > Overview of Northstar Kinship Assistance","text":"## Overview of Northstar Kinship Assistance\n\nNorthstar Kinship Assistance (NKA) is Minnesota’s Guardianship Assistance Program. NKA supports eligible children in foster care in Minnesota who find permanency with a relative through a transfer of permanent legal and physical custody (TPLPC). A TPLPC to a relative custodian provides a child in out-of-home care with a permanent home when efforts to reunite the child with his or her family have been unsuccessful and permanency through adoption is either not possible or not appropriate.\n\nIn addition to receiving MA-NKA without an application or financial eligibility requirements (such as an income limit ), the child receives other benefits under the NKA benefit agreement, including monthly payments and reimbursement for nonrecurring expenses associated with finalizing a TPLPC.\n\nNKA replaced Minnesota’s Relative Custody Assistance (RCA) program on January 1, 2015. NKA will gradually replace RCA as children age out. Children who receive RCA do not qualify for MA-NKA but may qualify for MA under other [MA-FCA](https://bot-corpus.mn-dhs.online/s/epm/2.2) or [MA-ABD](https://bot-corpus.mn-dhs.online/s/epm/2.3) bases of eligibility.\n\nThis chapter includes the following policies that apply to MA-NKA.\n1. [MA-NKA General Requirements](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.1)\n  1. [MA-NKA Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.1.1)\n  2. [MA-NKA Non-Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.2)\n  3. [MA-NKA Basis of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.2.1)\n  4. [MA-NKA Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.2)\n  5. [MA-NKA Post-Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.4)\n  6. [MA-NKA Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.4.1)\n  7. [MA-NKA Renewals](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.4.2)\n\n[MA County Residency](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.3)\n\n[MA Medical Support](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.2)\n\n[MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n\n[MA-NAA, MA-NKA, and MA-FC Title IV-E and Medicare](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.4.2)\n\n[MA Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4)"}]},{"id":"epm:2.5.6.2.1","number":"2.5.6.2.1","title":"General Requirements","parent":"2.5.6.2","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.2 Medical Assistance for Children Receiving Northstar Kinship Assistance (MA-NKA) > 2.5.6.2.1 General Requirements","summary":"This subchapter provides general policy information for MA for children who receive Northstar Kinship Assistance (MA-NKA), and where applicable, links to policies that apply to all Medical Assistance (MA) programs and all Minnesota Health Care Programs (MHCP).","effective_date":"2023-01-01","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.6.2.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_6_2_1.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.5.6.2.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.1","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.2 Medical Assistance for Children Receiving Northstar Kinship Assistance (MA-NKA) > 2.5.6.2.1 General Requirements","text":"This subchapter provides general policy information for MA for children who receive Northstar Kinship Assistance (MA-NKA), and where applicable, links to policies that apply to all Medical Assistance (MA) programs and all Minnesota Health Care Programs (MHCP).\n\nTopics covered in this subchapter are:\n1. [MA-NKA Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.1.1)\n2. [MA Benefit Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1)\n3. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n4. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n5. [MHCP Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1)\n  1. [MHCP Appeals](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.1)\n  2. [MHCP Authorized Representative](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.2)\n  3. [MHCP Civil Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.3)\n  4. [MHCP Data Privacy](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.4)\n  5. [MHCP Notices](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.5)"}]},{"id":"epm:2.5.6.2.1.1","number":"2.5.6.2.1.1","title":"Mandatory Verifications","parent":"2.5.6.2.1","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.2 Medical Assistance for Children Receiving Northstar Kinship Assistance (MA-NKA) > 2.5.6.2.1 General Requirements > 2.5.6.2.1.1 Mandatory Verifications","summary":"Mandatory verifications must be verified through an available electronic data source or by paper proof, if electronic data sources are unsuccessful or unavailable. Self-attestation alone is not acceptable for eligibility requirements with mandatory verifications.Self-attestation of certain eligibility factors may be accepted if electronic data sources are unsuccessful or unavailable and paper proo","effective_date":"2023-01-01","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.1.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.6.2.1.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_6_2_1_1.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.145","Minnesota Statutes, section 256N.22","Minnesota Statutes, section 256B.055"],"chunks":[{"chunk_id":"epm:2.5.6.2.1.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.1.1","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.2 Medical Assistance for Children Receiving Northstar Kinship Assistance (MA-NKA) > 2.5.6.2.1 General Requirements > 2.5.6.2.1.1 Mandatory Verifications","text":"Mandatory verifications must be verified through an available electronic data source or by paper proof, if electronic data sources are unsuccessful or unavailable. Self-attestation alone is not acceptable for eligibility requirements with mandatory verifications.Self-attestation of certain eligibility factors may be accepted if electronic data sources are unsuccessful or unavailable and paper proof does not exist or is not available. When determining MA eligibility for a child receiving Northstar Kinship Assistance (MA-NKA), the eligibility worker in the relative custodian’s county of residence or MA processing tribal agency is responsible for verifying the following information for the child:\n- Receiving NKA benefits\n- Social Security number (SSN)\n- U.S. Citizenship\n- Immigration Status"},{"chunk_id":"epm:2.5.6.2.1.1#proof-of-northstar-kinship-assistance-nka-benefits","heading":"Proof of Northstar Kinship Assistance (NKA) Benefits","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.1.1#proof-of-northstar-kinship-assistance-nka-benefits","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.2 Medical Assistance for Children Receiving Northstar Kinship Assistance (MA-NKA) > 2.5.6.2.1 General Requirements > 2.5.6.2.1.1 Mandatory Verifications > Proof of Northstar Kinship Assistance (NKA) Benefits","text":"## Proof of Northstar Kinship Assistance (NKA) Benefits\n\nA health care application is not required to determine MA for a child who receives NKA. However, proof the child is receiving NKA benefits is required prior to MA approval.\n\nAs proof of NKA benefits, the eligibility worker in the relative custodian’s county of residence or MA processing tribal agency will receive the NKA Payment Commencement Notice from the DHS permanency support payment specialist. DHS permanency support payment specialists are state employees who are responsible for initiation, issuance and maintenance of NKA benefits."},{"chunk_id":"epm:2.5.6.2.1.1#social-security-number","heading":"Social Security Number","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.1.1#social-security-number","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.2 Medical Assistance for Children Receiving Northstar Kinship Assistance (MA-NKA) > 2.5.6.2.1 General Requirements > 2.5.6.2.1.1 Mandatory Verifications > Social Security Number","text":"## Social Security Number\n\nA Social Security Number (SSN) is required for a child receiving NKA unless the child meets an exception. See EPM section [2.1.2.5 MA Social Security Number](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5) for more information.\n\nThe eligibility worker must assist the child’s relative custodian in obtaining a SSN for the child, if the child does not have one. In most cases, the child’s SSN was previously obtained while the child was in foster care, prior to NKA approval. MA eligibility must not be denied or delayed due to this requirement."},{"chunk_id":"epm:2.5.6.2.1.1#citizenship-and-immigration-status","heading":"Citizenship and Immigration Status","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.1.1#citizenship-and-immigration-status","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.2 Medical Assistance for Children Receiving Northstar Kinship Assistance (MA-NKA) > 2.5.6.2.1 General Requirements > 2.5.6.2.1.1 Mandatory Verifications > Citizenship and Immigration Status","text":"## Citizenship and Immigration Status\n\nChildren who receive NKA are U.S. citizens or lawfully present noncitizens. U.S. citizen and lawfully present noncitizen children are eligible for MA.\n\nVerification of U.S. citizenship and lawful presence was previously obtained while the child was in foster care as part of Title IV-E determination or the NKA eligibility determination and does not need to be re-verified."}]},{"id":"epm:2.5.6.2.2","number":"2.5.6.2.2","title":"Non-Financial Eligibility","parent":"2.5.6.2","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.2 Medical Assistance for Children Receiving Northstar Kinship Assistance (MA-NKA) > 2.5.6.2.2 Non-Financial Eligibility","summary":"This subchapter provides non-financial policy information that applies to Medical Assistance for children receicing Northstar Kinship Assistance (NKA). Non-financial eligibility requirements are not related to a person’s income or assets.","effective_date":"2023-01-01","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.6.2.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_6_2_2.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.145","Minnesota Statutes, section 256B.055"],"chunks":[{"chunk_id":"epm:2.5.6.2.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.2","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.2 Medical Assistance for Children Receiving Northstar Kinship Assistance (MA-NKA) > 2.5.6.2.2 Non-Financial Eligibility","text":"This subchapter provides non-financial policy information that applies to Medical Assistance for children receicing Northstar Kinship Assistance (NKA). Non-financial eligibility requirements are not related to a person’s income or assets.\n\nThis subchapter includes links to policies that apply to MA-NKA, and where applicable, policies that apply to all Minnesota Health Care Programs (MHCP).\n1. [MA-NKA Basis of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.2.1)\n2. [MA Citizenship and Immigration Status](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2)\n3. [MA County Residency](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.3)\n4. [MA Social Security Number](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5)"}]},{"id":"epm:2.5.6.2.2.1","number":"2.5.6.2.2.1","title":"Basis of Eligibility","parent":"2.5.6.2.2","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.2 Medical Assistance for Children Receiving Northstar Kinship Assistance (MA-NKA) > 2.5.6.2.2 Non-Financial Eligibility > 2.5.6.2.2.1 Basis of Eligibility","summary":"Minnesota provides Medical Assistance (MA) to certain groups of people as allowed under law. These groups are referred to as a basis of eligibility. A person’s basis of eligibility determines the non-financial criteria and financial methodology used to determine MA eligibility.","effective_date":"2025-12-05","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.2.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.6.2.2.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_6_2_2_1.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.145","Code of Federal Regulations, title 42, Section 435.916","Minnesota Statutes, section 256B.055, subdivision 2"],"chunks":[{"chunk_id":"epm:2.5.6.2.2.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.2.1","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.2 Medical Assistance for Children Receiving Northstar Kinship Assistance (MA-NKA) > 2.5.6.2.2 Non-Financial Eligibility > 2.5.6.2.2.1 Basis of Eligibility","text":"Minnesota provides Medical Assistance (MA) to certain groups of people as allowed under law. These groups are referred to as a basis of eligibility. A person’s basis of eligibility determines the non-financial criteria and financial methodology used to determine MA eligibility.\n\nThe MA for children receiving Northstar Kinship Assistance (MA-NKA) basis of eligibility is available to all children receiving NKA benefits, regardless of Title IV-E eligibility.\n\nFor children who are not receiving Minnesota NKA benefits, but live in Minnesota and receive Guardianship Assistance from another state, eligibility for MA-NKA depends on Title IV-E eligibility.\n- Children who receive Title IV-E Guardianship Assistance from another state are eligible for MA-NKA.\n- Children who receive non-Title IV-E Guardianship Assistance from another state are not eligible for MA-NKA, but may qualify for MA under other MA-FCA or MA-ABD bases of eligibility.\n\nChildren who are eligible for MA-NKA who have a certified disability and receive [home and community-based waiver services](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.3) are not required to use the disabled basis of eligibility and should continue to use the NKA basis of eligibility."},{"chunk_id":"epm:2.5.6.2.2.1#eligibility-begin-date","heading":"Eligibility Begin Date","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.2.1#eligibility-begin-date","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.2 Medical Assistance for Children Receiving Northstar Kinship Assistance (MA-NKA) > 2.5.6.2.2 Non-Financial Eligibility > 2.5.6.2.2.1 Basis of Eligibility > Eligibility Begin Date","text":"## Eligibility Begin Date\n\nA child’s MA-NKA basis of eligibility begins the first day of the month the NKA benefit agreement goes into effect. When NKA benefits are approved, the DHS permanency support specialist sends both the NKA payment commencement notice and a copy of the NKA benefit agreement to the health care eligibility worker in the child’s county of residence. The effective date of the NKA benefit agreement is included in the NKA payment commencement notice.\n\nFor a child who is transitioning from MA under the foster care basis (MA-FC) to MA-NKA, MA-FC eligibility must continue under the foster care basis until MA-NKA is approved for the child."},{"chunk_id":"epm:2.5.6.2.2.1#eligibility-end-date","heading":"Eligibility End Date","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.2.1#eligibility-end-date","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.2 Medical Assistance for Children Receiving Northstar Kinship Assistance (MA-NKA) > 2.5.6.2.2 Non-Financial Eligibility > 2.5.6.2.2.1 Basis of Eligibility > Eligibility End Date","text":"## Eligibility End Date\n\nA child's MA-NKA basis of eligibility ends the last day of the month the child turns age 18, unless they receive an extension. Extensions to the NKA benefit agreements may continue up to age 21. A child may have multiple extensions to the NKA benefit agreement. Each extension will have a new end date.\n\nThe DHS Permanency Support Specialist will notify the eligibility worker if there is a change to the NKA benefit agreement end date."},{"chunk_id":"epm:2.5.6.2.2.1#change-in-circumstances","heading":"Change in Circumstances","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.2.1#change-in-circumstances","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.2 Medical Assistance for Children Receiving Northstar Kinship Assistance (MA-NKA) > 2.5.6.2.2 Non-Financial Eligibility > 2.5.6.2.2.1 Basis of Eligibility > Change in Circumstances","text":"## Change in Circumstances\n\nA change in circumstances may affect an MA enrollee's basis of eligibility. A child whose MA-NKA basis of eligibility ends must be redetermined under another MA basis without interruption in their coverage. If the child is no longer eligible for MA under any basis, eligibility must be redetermined for MinnesotaCare, Advance Premium Tax Credits or a Qualified Health Plan. See [EPM 1.3.2.1 Change in Circumstance](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1) for more information."}]},{"id":"epm:2.5.6.2.3","number":"2.5.6.2.3","title":"Financial Eligibility","parent":"2.5.6.2","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.2 Medical Assistance for Children Receiving Northstar Kinship Assistance (MA-NKA) > 2.5.6.2.3 Financial Eligibility","summary":"This subchapter provides policy about financial eligibility. This includes eligibility factors that involve a person’s income or assets.","effective_date":"2023-01-01","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.6.2.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_6_2_3.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.145","Minnesota Statutes, section 256B.055, subdivision 2"],"chunks":[{"chunk_id":"epm:2.5.6.2.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.3","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.2 Medical Assistance for Children Receiving Northstar Kinship Assistance (MA-NKA) > 2.5.6.2.3 Financial Eligibility","text":"This subchapter provides policy about financial eligibility. This includes eligibility factors that involve a person’s income or assets.\n\nMedical Assistance for children receiving Northstar Kinship Assistance (MA-NKA) does not have an income or asset limit."}]},{"id":"epm:2.5.6.2.4","number":"2.5.6.2.4","title":"Post-Eligibility","parent":"2.5.6.2","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.2 Medical Assistance for Children Receiving Northstar Kinship Assistance (MA-NKA) > 2.5.6.2.4 Post-Eligibility","summary":"This subchapter includes policies that apply to Medical Assistance (MA) for children receiving Northstar Kinship Assistance (NKA) and links to policies that apply to all MA programs and all Minnesota Health Care Programs (MHCP).","effective_date":"2023-01-01","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.6.2.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_6_2_4.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.5.6.2.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.4","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.2 Medical Assistance for Children Receiving Northstar Kinship Assistance (MA-NKA) > 2.5.6.2.4 Post-Eligibility","text":"This subchapter includes policies that apply to Medical Assistance (MA) for children receiving Northstar Kinship Assistance (NKA) and links to policies that apply to all MA programs and all Minnesota Health Care Programs (MHCP).\n\nTopics covered in this sub-chapter are:\n1. [MA-NKA Basis of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.2.1)\n2. [MA Benefit Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1)\n3. \n  1. [MA Third Party Liability](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3)\n    1. Children who receive NKA are not required to cooperate with TPL requirements as a condition of eligibility for MA.\n  2. [MA Cost Effective Insurance](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.1)\n  3. [MA Medical Support](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.2)\n    1. A medical support referral is not required for children who receive NKA.\n4. [MA-NKA Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.4.1)\n5. [MA-NAA, MA-NKA, and MA-FC Title IV-E and Medicare](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.4.2)\n6. [MA Benefit Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1)\n7. [Ma Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4)\n8. \n  1. Children who receive NKA are not required to apply for other benefits as a condition of MA eligibility.\n9. [MA-NKA Renewals](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.4.2)\n10. \n  1. //<![CDATA[ if (typeof(TextPopupInit) != 'function') TextPopupInit = new Function(); TextPopupInit('a1', 'POPUP706945249'); //]]>"}]},{"id":"epm:2.5.6.2.4.1","number":"2.5.6.2.4.1","title":"Health Care Delivery","parent":"2.5.6.2.4","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.2 Medical Assistance for Children Receiving Northstar Kinship Assistance (MA-NKA) > 2.5.6.2.4 Post-Eligibility > 2.5.6.2.4.1 Health Care Delivery","summary":"All children who receive Northstar Kinship Assistance (NKA) receive Medical Assistance (MA) health care services through managed care plans unless they meet a reason for exclusion.","effective_date":"2023-01-01","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.4.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.6.2.4.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_6_2_4_1.htm","legal_citations":["Minnesota Rules, parts 9500.1450 to 9500.1464","Minnesota Rules, part 9505.0285","Minnesota Statutes, section 256B.69"],"chunks":[{"chunk_id":"epm:2.5.6.2.4.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.4.1","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.2 Medical Assistance for Children Receiving Northstar Kinship Assistance (MA-NKA) > 2.5.6.2.4 Post-Eligibility > 2.5.6.2.4.1 Health Care Delivery","text":"All children who receive Northstar Kinship Assistance (NKA) receive Medical Assistance (MA) health care services through managed care plans unless they meet a reason for exclusion.\n\nSee the [Prepaid Minnesota Health Care Programs Manual](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=dhs16_145398#excluded) for more information about managed care exclusions. For additional information on health care delivery and cost of services, refer to EPM [2.2.4.1 MA-FCA Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/2.2.4.1)."}]},{"id":"epm:2.5.6.2.4.2","number":"2.5.6.2.4.2","title":"Renewals","parent":"2.5.6.2.4","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.2 Medical Assistance for Children Receiving Northstar Kinship Assistance (MA-NKA) > 2.5.6.2.4 Post-Eligibility > 2.5.6.2.4.2 Renewals","summary":"Medical Assistance for children who receive Northstar Kinship Assistance (MA-NKA) must be renewed every 12 months.","effective_date":"2024-01-12","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.4.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.6.2.4.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_6_2_4_2.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.916","Minnesota Statutes, section 256B.056, subdivision 7a"],"chunks":[{"chunk_id":"epm:2.5.6.2.4.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.4.2","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.2 Medical Assistance for Children Receiving Northstar Kinship Assistance (MA-NKA) > 2.5.6.2.4 Post-Eligibility > 2.5.6.2.4.2 Renewals","text":"Medical Assistance for children who receive Northstar Kinship Assistance (MA-NKA) must be renewed every 12 months.\n\nChildren receiving the MA-NKA basis of eligibility who continue to meet all eligibility factors must have MA eligibility automatically renewed without having to complete a renewal form.\n\nContact information for the child and relative custodian must be confirmed at renewal to ensure ongoing MA eligibility for the child."},{"chunk_id":"epm:2.5.6.2.4.2#when-eligibility-ends-at-renewal","heading":"When Eligibility Ends at Renewal","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.2.4.2#when-eligibility-ends-at-renewal","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.2 Medical Assistance for Children Receiving Northstar Kinship Assistance (MA-NKA) > 2.5.6.2.4 Post-Eligibility > 2.5.6.2.4.2 Renewals > When Eligibility Ends at Renewal","text":"## When Eligibility Ends at Renewal\n\nChanges reported during an enrollee’s renewal may affect an MA enrollee's basis of eligibility. Enrollees who lose eligibility under one basis must be redetermined for all health care programs they are potentially eligible for, without interruption in their coverage. See [EPM 1.3.2.1 Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1) for more information."}]},{"id":"epm:2.5.6.3","number":"2.5.6.3","title":"Medical Assistance for Children in Foster Care (MA-FC)","parent":"2.5.6","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.3 Medical Assistance for Children in Foster Care (MA-FC)","summary":"Children in foster care are eligible for Medical Assistance (MA-FC) the month the child enters foster care, without a health care application or financial eligibility requirements.","effective_date":"2025-12-05","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.6.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_6_3.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.145","Minnesota Statues, section 256B.055"],"chunks":[{"chunk_id":"epm:2.5.6.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.3 Medical Assistance for Children in Foster Care (MA-FC)","text":"- MA for Children in Foster Care\n\nChildren in foster care are eligible for Medical Assistance (MA-FC) the month the child enters foster care, without a health care application or financial eligibility requirements.\n\nThis includes all children living in Minnesota who are placed in foster care by Minnesota agencies, regardless of Title IV-E status, and children living in Minnesota who are placed in foster care by other states who receive Title IV-E. Children living in Minnesota who are placed in foster care by other states who do not receive Title IV-E are not eligible for MA-FC, but may qualify for MA under a different basis or another Minnesota Health Care Program (MHCP) upon application if they are Minnesota residents and meet program requirements. See EPM [1.4.2 MHCP State Residency for Adoption Assistance, Kinship Assistance, and Foster Care](https://bot-corpus.mn-dhs.online/s/epm/1.4.2) for more information.g."},{"chunk_id":"epm:2.5.6.3#overview-of-foster-care","heading":"Overview of Foster Care","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3#overview-of-foster-care","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.3 Medical Assistance for Children in Foster Care (MA-FC) > Overview of Foster Care","text":"## Overview of Foster Care\n\nFoster care is temporary out-of-home care for children. Children who cannot safely remain with their family may be placed in a family foster home or group residential facility. In addition youth age 18 to 21 in extended foster care may live in a supervised independent living setting, such as a dorm or apartment.\n\nWhen a child enters foster care, the county or tribal social services agency is granted legal responsibility for the child. A social services case manager is assigned to the child to determine the need and appropriateness, authority, and funding for the child’s foster care placement. The case manager acts on the child’s behalf to ensure the child receives necessary services and benefits, including Medical Assistance (MA) eligibility, while in placement. The case manager collaborates with the health care eligibility worker to obtain information needed to approve MA immediately upon placement in foster care and to maintain MA eligibility for the child throughout placement.\n\nThe foster care placement begins the date the child is removed from their home by the authority of a 72-hour law enforcement emergency protective hold, court order, or voluntary placement agreement.\n\nChildren enter foster care in a variety of ways, such as:\n- Child is court ordered into placement, under the placement responsibility of the county or tribal social service agency, through the juvenile court or tribal court as a child protection matter.\n- Child's removal is initiated by a delinquency court action and\n- the county or tribal social service agency was given placement responsibility through a court action or by the signing of a Voluntary Placement Agreement, or\n- the county/community corrections department has placement responsibility and there is a Title IV-E Agreement in place between the social service agency and corrections department making them a designee of the social service agency, or\n- the social service agency and corrections department are considered an umbrella agency (Umbrella Counties are Dakota, Nobles and Olmsted County).\n- Child is removed under the authority of a 72-hour law enforcement emergency protective hold.\n- Voluntary placement through an agreement between the parent and the county or tribal social service agency.\n- Voluntary placement agreement between a youth, age 18 to 21 who is remaining in or re-entering extended foster care, and county or tribal social service agency."},{"chunk_id":"epm:2.5.6.3#trial-home-visits","heading":"Trial Home Visits","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3#trial-home-visits","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.3 Medical Assistance for Children in Foster Care (MA-FC) > Trial Home Visits","text":"## Trial Home Visits\n\nA child who returns home on a trial home visit (THV) remains in foster care and eligible for MA under the foster care basis of eligibility. Children on a THV are considered to be in foster care because the county or tribal social service agency has care and placement responsibility for the child during the THV."},{"chunk_id":"epm:2.5.6.3#72-hour-law-enforcement-emergency-protective-hold","heading":"72-Hour Law Enforcement Emergency Protective Hold","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3#72-hour-law-enforcement-emergency-protective-hold","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.3 Medical Assistance for Children in Foster Care (MA-FC) > 72-Hour Law Enforcement Emergency Protective Hold","text":"## 72-Hour Law Enforcement Emergency Protective Hold\n\nA child who is removed under the authority of a 72-hour law endorcement emergency protective hold is in foster care and is eligible for MA under the foster care basis of eligibility, regardless of whether a court order has been issued to transfer placement and care responsibility to the county or tribe.\n\nThis chapter includes policies that apply to MA for children in foster care.\n1. [MA-FC General Requirements](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3.1)\n2. [MA-FC Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3.1.1)\n3. [MA-FC Non-Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3.2)\n4. [MA-FC Basis of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3.2.1)\n5. [MA County Residency](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.3)\n6. [MA-FC Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3.3)\n7. [MA-FC Post-Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3.4)\n8. [MA Medical Support](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.2)\n9. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n10. [MA-FC Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3.4.1)\n11. [MA-NAA, MA-NKA, and MA-FC Title IV-E and Medicare](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.4.2)\n12. [MA Referral for Other Benefi](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4)[ts](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4)\n13. Children in foster care are not required to apply for other benefits as a condition of MA eligibility.\n14. [MA-FC Renewals](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3.4.2)\n15. \n16. \n17."}]},{"id":"epm:2.5.6.3.1","number":"2.5.6.3.1","title":"General Requirements","parent":"2.5.6.3","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.3 Medical Assistance for Children in Foster Care (MA-FC) > 2.5.6.3.1 General Requirements","summary":"This subchapter provides general policy information that applies to Medical Assistance for children in foster care (MA-FC), and where applicable, links to policies that apply to all MA programs and all Minnesota Health Care Programs (MHCP).","effective_date":"2023-01-01","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.6.3.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_6_3_1.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.5.6.3.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3.1","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.3 Medical Assistance for Children in Foster Care (MA-FC) > 2.5.6.3.1 General Requirements","text":"This subchapter provides general policy information that applies to Medical Assistance for children in foster care (MA-FC), and where applicable, links to policies that apply to all MA programs and all Minnesota Health Care Programs (MHCP).\n\nTopics covered in this subchapter are:\n\n[MA-FC Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3.1.1)\n\n[MA Benefit Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1)\n\n[MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n\n[MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n\n[MHCP Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1)\n\n[MHCP Appeals](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.1)\n\n[MHCP Authorized Representative](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.2)\n\n[MHCP Civil Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.3)\n\n[MHCP Data Privacy](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.4)\n\n[MHCP Notices](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.5)"}]},{"id":"epm:2.5.6.3.1.1","number":"2.5.6.3.1.1","title":"Mandatory Verifications","parent":"2.5.6.3.1","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.3 Medical Assistance for Children in Foster Care (MA-FC) > 2.5.6.3.1 General Requirements > 2.5.6.3.1.1 Mandatory Verifications","summary":"Mandatory verifications must be verified through an available electronic data source or by paper proof, if electronic data sources are unsuccessful or unavailable. Self-attestation of certain eligibility factors may be accepted if electronic data sources are unsuccessful or unavailable and paper proof does not exist or is not available. See EPM section 2.2.1.2 MA-FCA Mandatory Verifications for mo","effective_date":"2023-01-01","last_modified":"2026-10-03T03:52:16.196617+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3.1.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.6.3.1.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_6_3_1_1.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.145","Minnesota Statutes, section 256B.055"],"chunks":[{"chunk_id":"epm:2.5.6.3.1.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3.1.1","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.3 Medical Assistance for Children in Foster Care (MA-FC) > 2.5.6.3.1 General Requirements > 2.5.6.3.1.1 Mandatory Verifications","text":"Mandatory verifications must be verified through an available electronic data source or by paper proof, if electronic data sources are unsuccessful or unavailable. Self-attestation of certain eligibility factors may be accepted if electronic data sources are unsuccessful or unavailable and paper proof does not exist or is not available. See EPM section [2.2.1.2 MA-FCA Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/2.2.1.2) for more information.\n\nThe following mandatory verifications are required for MA for children in foster care (MA-FC):\n- Foster care placement begin date\n- Social Security number (SSN)\n- U.S. Citizenship\n- Immigration Status\n\nThe child’s social services case manager will obtain mandatory verifications on the child’s behalf. The child remains eligible for MA while the case manager obtains mandatory verifications."},{"chunk_id":"epm:2.5.6.3.1.1#foster-care-placement-begin-date","heading":"Foster Care Placement Begin Date","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3.1.1#foster-care-placement-begin-date","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.3 Medical Assistance for Children in Foster Care (MA-FC) > 2.5.6.3.1 General Requirements > 2.5.6.3.1.1 Mandatory Verifications > Foster Care Placement Begin Date","text":"## Foster Care Placement Begin Date\n\nThe foster care placement begin date must be received from the case manager (via a system interface or from the case manager directly) before approving MA-FC for the child."},{"chunk_id":"epm:2.5.6.3.1.1#social-security-number","heading":"Social Security Number","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3.1.1#social-security-number","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.3 Medical Assistance for Children in Foster Care (MA-FC) > 2.5.6.3.1 General Requirements > 2.5.6.3.1.1 Mandatory Verifications > Social Security Number","text":"## Social Security Number\n\nA SSN is required unless the child meets an exception. See [EPM 2.1.2.5 MA Social Security Number](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5) for more information.\n\nSome children may not have a SSN when first placed in foster care. The child’s case manager will assist the child with obtaining a SSN or to apply for a SSN if they do not have one and are eligible to receive a SSN. The child remains eligible for MA if they are eligible to receive a SSN and the case manager is assisting the child with obtaining it."},{"chunk_id":"epm:2.5.6.3.1.1#citizenship-and-immigration-status","heading":"Citizenship and Immigration Status","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3.1.1#citizenship-and-immigration-status","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.3 Medical Assistance for Children in Foster Care (MA-FC) > 2.5.6.3.1 General Requirements > 2.5.6.3.1.1 Mandatory Verifications > Citizenship and Immigration Status","text":"## Citizenship and Immigration Status\n\nTo receive MA, children in foster care must be U.S. citizens, U.S. nationals or lawfully present noncitizens.\n\nUndocumented children in foster care who are not eligible for MA because they do not have a valid immigration status may be eligible for Emergency Medical Assistance (EMA).\n\nMost undocumented children in foster care qualify for a path to lawful permanent residence (green card) through Special Immigrant Juvenile (SIJ) classification. Case managers assist undocumented children in foster care with obtaining information about and applying for SIJ classification. Once an application for SIJ has been accepted by the United States Citizenship and Immigration Services (USCIS), an undocumented child is considered lawfully present for the purpose of MA eligibility.\n\nThe process for applying for SIJ classification is lengthy and can take several months.\n\nSee EPM sections [2.1.2.2.1 MA Citizenship](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2.1) and [2.1.2.2.2 MA Immigration Status](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2.2) for more information."}]},{"id":"epm:2.5.6.3.2","number":"2.5.6.3.2","title":"Non-Financial Eligibility","parent":"2.5.6.3","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.3 Medical Assistance for Children in Foster Care (MA-FC) > 2.5.6.3.2 Non-Financial Eligibility","summary":"This subchapter provides non-financial eligibility policy that applies to Medical Assistance for children in foster care (MA-FC). Non-financial eligibility requirements are not related to a person’s income or assets.","effective_date":"2023-01-01","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.6.3.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_6_3_2.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.145","Minnesota Statutes, section 256B.055"],"chunks":[{"chunk_id":"epm:2.5.6.3.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3.2","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.3 Medical Assistance for Children in Foster Care (MA-FC) > 2.5.6.3.2 Non-Financial Eligibility","text":"This subchapter provides non-financial eligibility policy that applies to Medical Assistance for children in foster care (MA-FC). Non-financial eligibility requirements are not related to a person’s income or assets.\n\nThis subchapter includes links to policies that apply to Medical Assistance for children in foster care (MA-FC), and where applicable, policies that apply to all MA programs and all Minnesota Health Care Programs (MHCP).\n\n[MA-FC Basis of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3.2.1)\n\n[MA Citizenship and Immigration Status](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2)\n\n[MA County Residency](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.3)\n\n[MA Social Security Number](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5)\n\n[MHCP State Residency for Northstar Adoption Assistance and Foster Care](https://bot-corpus.mn-dhs.online/s/epm/1.4.2)"}]},{"id":"epm:2.5.6.3.2.1","number":"2.5.6.3.2.1","title":"Basis of Eligibility","parent":"2.5.6.3.2","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.3 Medical Assistance for Children in Foster Care (MA-FC) > 2.5.6.3.2 Non-Financial Eligibility > 2.5.6.3.2.1 Basis of Eligibility","summary":"Minnesota provides Medical Assistance (MA) to certain groups of people as allowed under law. These groups are referred to as a basis of eligibility. A person’s basis of eligibility determines the non-financial criteria and financial methodology used to determine MA eligibility.","effective_date":"2025-12-05","last_modified":"2026-10-03T03:52:16.366337+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3.2.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.6.3.2.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_6_3_2_1.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.145","Code of Federal Regulations, title 42, section 435.916","Code of Federal Regulations, title 42, section 435.150","Minnesota Statutes, section 256B.055, subdivision 2"],"chunks":[{"chunk_id":"epm:2.5.6.3.2.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3.2.1","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.3 Medical Assistance for Children in Foster Care (MA-FC) > 2.5.6.3.2 Non-Financial Eligibility > 2.5.6.3.2.1 Basis of Eligibility","text":"Minnesota provides Medical Assistance (MA) to certain groups of people as allowed under law. These groups are referred to as a basis of eligibility. A person’s basis of eligibility determines the non-financial criteria and financial methodology used to determine MA eligibility.\n\nThe MA for children in foster care (MA-FC) basis of eligibility is available to children in foster care in Minnesota who:\n- Were placed by Minnesota, regardless of Title IV-E eligibility, or\n- Were placed by another state, and are Title IV-E eligible.\n\nA child who was placed in Minnesota by another state, and who is not Title IV-E eligible cannot qualify for MA under the foster care basis of eligibility. An application must be submitted to make an eligibility determination for a child in this circumstance. The child may qualify for MA under a different basis of eligibility or may be eligible for another Minnesota Health Care Program (MHCP), if they are a Minnesota resident and they meet all other program requirements. See [EPM 1.4.2 MHCP State Residency for Adoption Assistance, Kinship Assistance, and Foster Care](https://bot-corpus.mn-dhs.online/s/epm/1.4.2) for more information.\n\nChildren in foster care who have a certified disability and receive [home and community-based waiver services](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.3 community based service services&rhsearch=home and community based services) should continue to use the MA-FC basis of eligibility. They do not need to use the disabled basis of eligibility."},{"chunk_id":"epm:2.5.6.3.2.1#ma-fc-basis-of-eligibility-begin-date","heading":"MA-FC Basis of Eligibility Begin Date","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3.2.1#ma-fc-basis-of-eligibility-begin-date","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.3 Medical Assistance for Children in Foster Care (MA-FC) > 2.5.6.3.2 Non-Financial Eligibility > 2.5.6.3.2.1 Basis of Eligibility > MA-FC Basis of Eligibility Begin Date","text":"## MA-FC Basis of Eligibility Begin Date\n\nA child’s MA-FC basis of eligibility begins the first day of the month the foster care placement begins.\n\nThe foster care placement begins the date the child is removed from their home by the authority of a 72-hour law enforcement emergency protective hold (i.e. 72-hour hold), court order, or voluntary placement agreement."},{"chunk_id":"epm:2.5.6.3.2.1#ma-fc-basis-of-eligibility-end-date","heading":"MA-FC Basis of Eligibility End Date","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3.2.1#ma-fc-basis-of-eligibility-end-date","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.3 Medical Assistance for Children in Foster Care (MA-FC) > 2.5.6.3.2 Non-Financial Eligibility > 2.5.6.3.2.1 Basis of Eligibility > MA-FC Basis of Eligibility End Date","text":"## MA-FC Basis of Eligibility End Date\n\nA child whose foster care placement ends must be redetermined for all health care programs they are potentially eligible for, without interruption in their coverage. See [EPM 1.3.2.1 Change in Circumstance](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1) for more information. A new application is not required.\n\nFoster care placements end in the following circumstances, including, but not limited to:\n- A child under age 18:\n- returns home and is no longer under the placement and care responsibility of the agency,\n- has a Transfer of Permanent Legal and Physical Custody (TPLPC) to a relative and is approved for Northstar Kinship Assistance (NKA) benefits,\n- is adopted.\n\nA child who returns home on a Trial Home Visit (THV) is still considered to be in foster care and eligible for MA-FC.\n- A child under age 18 or older:\n- A child turns age 18, ages out of foster care and does not continue in extended foster care.\n- A youth ages 18,19, or 20 who has continued in or re-entered extended foster care chooses to leave extended foster care or turns age 21.\n\nYouth whose foster care placement ends at age 18 or older qualify for MA under the Former Foster Care Youth (FFY) basis until age 26, without regard to income, beginning the month after foster care ends. A new application is not required. See [MA-FCA Bases of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.2.2.1) for more information."}]},{"id":"epm:2.5.6.3.3","number":"2.5.6.3.3","title":"Financial Eligibility","parent":"2.5.6.3","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.3 Medical Assistance for Children in Foster Care (MA-FC) > 2.5.6.3.3 Financial Eligibility","summary":"This subchapter provides policy about financial eligibility. Financial eligibility requirements involve a person’s income or assets.","effective_date":"2023-01-01","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.6.3.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_6_3_3.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.145","Minnesota Statutes, section 256B.055, subdivision 2"],"chunks":[{"chunk_id":"epm:2.5.6.3.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3.3","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.3 Medical Assistance for Children in Foster Care (MA-FC) > 2.5.6.3.3 Financial Eligibility","text":"This subchapter provides policy about financial eligibility. Financial eligibility requirements involve a person’s income or assets.\n\nChildren in foster care do not have a Medical Assistance income or asset limit."}]},{"id":"epm:2.5.6.3.4","number":"2.5.6.3.4","title":"Post-Eligibility","parent":"2.5.6.3","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.3 Medical Assistance for Children in Foster Care (MA-FC) > 2.5.6.3.4 Post-Eligibility","summary":"This subchapter includes policies that apply to Medical Assistance for children in foster care (MA-FC) and when applicable, links to policies that apply to all MA programs and all Minnesota Health Care Programs (MHCP).","effective_date":"2023-01-01","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.6.3.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_6_3_4.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:2.5.6.3.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3.4","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.3 Medical Assistance for Children in Foster Care (MA-FC) > 2.5.6.3.4 Post-Eligibility","text":"This subchapter includes policies that apply to Medical Assistance for children in foster care (MA-FC) and when applicable, links to policies that apply to all MA programs and all Minnesota Health Care Programs (MHCP).\n\nTopics covered in this sub-chapter are:\n\n[MA-FC Basis of Eligibility](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3.2.1)\n\n[MA Benefit Recovery](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1)\n\n[MA Third Party Liability](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3)\n\nChildren in foster care are not required to cooperate with TPL requirements as a condition of eligibility for MA.\n\n[MA Cost Effective Insurance](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.1)\n\n[MA Medical Support](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.2)\n\nA medical support referral is not required for children in foster care.\n\n[MA-FC Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3.4.1)\n\n[MA-NAA, MA-NKA, and MA-FC Title IV-E and Medicare](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.1.4.2)\n\n[MA Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4)\n\nChildren in foster care are not required to apply for other benefits as a condition of MA eligibility.\n\n[MA-FC Renewals](https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3.4.2)"}]},{"id":"epm:2.5.6.3.4.1","number":"2.5.6.3.4.1","title":"Health Care Delivery","parent":"2.5.6.3.4","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.3 Medical Assistance for Children in Foster Care (MA-FC) > 2.5.6.3.4 Post-Eligibility > 2.5.6.3.4.1 Health Care Delivery","summary":"Children in foster care receive Medical Assistance (MA) health care services through managed care plans unless they meet a reason for exclusion. See Prepaid Minnesota Health Care Programs Manual for more information about managed care exclusions. For additional information on health care delivery and cost of services, refer to EPM 2.2.4.1 MA FCA Health Care Delivery.","effective_date":"2023-01-01","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3.4.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.6.3.4.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_6_3_4_1.htm","legal_citations":["Minnesota Rules, parts 9500.1450 to 9500.1464","Minnesota Rules, part 9505.0285","Minnesota Statutes, section 256B.69"],"chunks":[{"chunk_id":"epm:2.5.6.3.4.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3.4.1","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.3 Medical Assistance for Children in Foster Care (MA-FC) > 2.5.6.3.4 Post-Eligibility > 2.5.6.3.4.1 Health Care Delivery","text":"Children in foster care receive Medical Assistance (MA) health care services through managed care plans unless they meet a reason for exclusion. See [Prepaid Minnesota Health Care Programs Manual](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=dhs16_145398#excluded) for more information about managed care exclusions. For additional information on health care delivery and cost of services, refer to [EPM 2.2.4.1 MA FCA Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/2.2.4.1)."}]},{"id":"epm:2.5.6.3.4.2","number":"2.5.6.3.4.2","title":"Renewals","parent":"2.5.6.3.4","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.3 Medical Assistance for Children in Foster Care (MA-FC) > 2.5.6.3.4 Post-Eligibility > 2.5.6.3.4.2 Renewals","summary":"Medical Assistance for children in foster care (MA-FC) must be renewed every 12 months.","effective_date":"2024-01-12","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3.4.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.6.3.4.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_6_3_4_2.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.916","Minnesota Statutes, section 256B.056, subdivision 7a"],"chunks":[{"chunk_id":"epm:2.5.6.3.4.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3.4.2","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.3 Medical Assistance for Children in Foster Care (MA-FC) > 2.5.6.3.4 Post-Eligibility > 2.5.6.3.4.2 Renewals","text":"Medical Assistance for children in foster care (MA-FC) must be renewed every 12 months.\n\nA child’s eligibility for MA-FC must be renewed without requiring information or paperwork from the child or foster family. No renewal form or verifications are gathered.\n\nThe child's continued placement in foster care must be confirmed with the child's case manager as a condition of ongoing eligibility under this basis. Contact information for the child and case manager must also be confirmed at renewal to ensure ongoing MA eligibility for the child."},{"chunk_id":"epm:2.5.6.3.4.2#when-eligibility-ends-at-renewal","heading":"When Eligibility Ends at Renewal","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.6.3.4.2#when-eligibility-ends-at-renewal","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.6 Medical Assistance for Children Receiving Northstar Adoption Assistance (NAA), Northstar Kinship Assistance (NKA), and Children in Foster Care (FC) > 2.5.6.3 Medical Assistance for Children in Foster Care (MA-FC) > 2.5.6.3.4 Post-Eligibility > 2.5.6.3.4.2 Renewals > When Eligibility Ends at Renewal","text":"## When Eligibility Ends at Renewal\n\nChanges reported during an enrollee’s renewal may affect an MA enrollee's basis of eligibility. Enrollees who lose eligibility under one basis must be redetermined for all health care programs they are potentially eligible for, without interruption in their coverage. See [EPM 1.3.2.1 Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1) for more information."}]},{"id":"epm:2.5.7","number":"2.5.7","title":"Refugee Medical Assistance","parent":"2.5","breadcrumb":"2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.7 Refugee Medical Assistance","summary":"Refugee Medical Assistance (RMA) is a federally funded Office of Refugee Resettlement (ORR) program that provides health care coverage for the first eight months for certain noncitizens who are otherwise ineligible for Medical Assistance (MA).","effective_date":"2026-10-01","last_modified":"2026-10-03T03:52:00.221519+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.7","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/2.5.7","official_origin":"https://hcopub.dhs.state.mn.us/epm/2_5_7.htm","legal_citations":["Code of Federal Regulations, title 45, subtitle B, Chapter IV, Part 400, Subpart G","Code of Federal Regulations, title 42, Chapter IV, subchapter C, part 440"],"chunks":[{"chunk_id":"epm:2.5.7#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.7","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.7 Refugee Medical Assistance","text":"Refugee Medical Assistance (RMA) is a federally funded Office of Refugee Resettlement (ORR) program that provides health care coverage for the first eight months for certain noncitizens who are otherwise ineligible for Medical Assistance (MA).\n\nTo qualify for RMA, applicants must meet the following conditions:\n- Be ineligible for MA.\n- Have an ORR-eligible immigration status or classification.\n- Provide the name of their resettlement agency to the county human services agency, if applicable.\n- Meet RMA financial eligibility criteria.\n- Are not a full-time student in an institution of higher learning.\n- Be within the RMA 8-month eligibility period, or requesting coverage for medical bill accrued during that period.\n- Reside in Minnesota.\n\nAgencies must follow the step-by-step POLI TEMP procedures, “Refugee Medical Assistance,” when processing RMA determination and [ONEsource.](http://Agencies must follow the step-by-step POLI TEMP procedures, “Refugee Medical Assistance,” when processing RMA determination and ONEsource.)"},{"chunk_id":"epm:2.5.7#social-security-number","heading":"Social Security Number","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.7#social-security-number","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.7 Refugee Medical Assistance > Social Security Number","text":"## Social Security Number\n\nRMA applicants and enrollees are not required to apply for or provide SSNs."},{"chunk_id":"epm:2.5.7#non-financial-eligibility","heading":"Non-Financial Eligibility","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.7#non-financial-eligibility","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.7 Refugee Medical Assistance > Non-Financial Eligibility","text":"## Non-Financial Eligibility\n\n### Immigration Status\n\nNoncitizens with the following ORR-eligible immigration statuses or classifications are eligible for RMA if they meet all other eligibility factors:\n- Refugees\n- Asylees (people granted asylum)\n- Certified Victims of Human Trafficking\n- Iraqi and Afghan Special Immigrant Visa holders\n- Certain Amerasians from Vietnam\n- Cuban and Haitian Entrants\n- Certain Afghan Humanitarian Parolees\n- Certain Ukrainian Humanitarian Parolees\n\nPeople who adjusted to LPR or are an LPR upon gaining status from any of the above statuses or classifications, and meet the following criteria, may be eligible for RMA if they are not eligible for MA:\n- Still within the 8-month eligibility period, and\n- Meets all RMA program requirements\n\n### RMA 8-month Eligibility Period\n\nThe RMA 8-month period of eligibility is the maximum length of time a person can qualify for RMA.\n\nThe RMA 8-month period of eligibility begins the earlier of either:\n- the date the person enters the United States with ORR-eligible immigration status, or\n- the date the person is granted ORR-eligible immigration status or classification.\n\nThe RMA 8-month period of eligibility ends on the last day of the 8th month.\n\nThe RMA 8-month eligibility period runs consecutively through the eight months without pause, even if the person is not active on RMA. A change in state residency does not restart the eligibility period."},{"chunk_id":"epm:2.5.7#financial-eligibility","heading":"Financial Eligibility","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.7#financial-eligibility","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.7 Refugee Medical Assistance > Financial Eligibility","text":"## Financial Eligibility\n\n### Income Limit\n\nTo be eligible for RMA a person’s household income must be less than or equal to 200% of federal poverty guidelines (FPG).\n\nUse only actual income received at initial application. Do not average the income prospectively over the eligibility period. The actual income amount is used throughout the RMA eligibility period.\n\nWhen income increases after the initial RMA application is approved, the enrollee remains eligible for the remainder of the 8-month RMA period.\n\nWhen an MA enrollee loses MA due to an income increase and is still within the [RMA 8-month eligibility period,](https://hcopub.dhs.state.mn.us/epm/RMAPeroid) the enrollee must be determined for RMA without the income being considered for the remainder of the RMA 8-month period.\n\n**Asset Limit**\n\nThe asset limit for RMA is eligibility is:\n- $10,000 for a household of 1.\n- $20,000 for a household of 2 or more.\n\nRMA follows the same asset methodology as MA-FCA with a spenddown. See [EPM 2.2.3.6 MA-FCA Medical Spenddown](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.6) for more information.\n\nSponsor deeming does not apply to RMA enrollees. Noncitizens with ORR-eligible immigration statuses or classifications are exempt from Form I-864 Sponsorship, so they are not subject to sponsorship or sponsor deeming."},{"chunk_id":"epm:2.5.7#eligibility-begin-date","heading":"Eligibility Begin Date","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.7#eligibility-begin-date","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.7 Refugee Medical Assistance > Eligibility Begin Date","text":"## Eligibility Begin Date\n\nRMA eligibility begins on the date of application if the person meets all financial and non-financial eligibility factors.\n\nIf a person requests retroactive RMA coverage, it can go back up to 3 months from the date of the application, if there was a medical need during that timeframe. This retroactive coverage request cannot go back beyond the start of the [RMA 8-month eligibility period.](https://hcopub.dhs.state.mn.us/epm/RMAPeroid)\n\nFollow EPM 1.4 State Residency, Overlapping State Coverage, when the applicant has coverage in another state."},{"chunk_id":"epm:2.5.7#eligibility-end-date","heading":"Eligibility End Date","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.7#eligibility-end-date","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.7 Refugee Medical Assistance > Eligibility End Date","text":"## Eligibility End Date\n\nRMA eligibility must end on the last day of the eight-month RMA period. If RMA ends for reasons other than income, RMA must be closed on the last day of the month, allowing a 10-day adverse action notice.\n\nEligibility must be redetermined for other health care programs such as Medical Assistance, MinnesotaCare, Advanced Premium Tax Credits, or a Qualified Health Plan.\n\nAn enrollee must receive at least 10-day advance notice of any adverse change to their RMA eligibility. See [EPM 1.3.2.1 MHCP Change in Circumstance](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1) for more information."},{"chunk_id":"epm:2.5.7#health-care-delivery","heading":"Health Care Delivery","url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.7#health-care-delivery","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.7 Refugee Medical Assistance > Health Care Delivery","text":"## Health Care Delivery\n\nRMA enrollees receive their benefits via fee-for-service. Fee-for-service is a method of payment for health care services used for enrollees not in a managed care plan. See [MHCP Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/1.6) for more information."},{"chunk_id":"epm:2.5.7#part-7","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/2.5.7","context":"EPM > 2 Medical Assistance > 2.5 Medical Assistance for Certain Populations > 2.5.7 Refugee Medical Assistance","text":"## Legal Citations:"}]},{"id":"epm:3","number":"3","title":"MinnesotaCare","parent":null,"breadcrumb":"3 MinnesotaCare","summary":"MinnesotaCare is a publicly funded state health care program established in 1992. In 2015, MinnesotaCare became a Basic Health Plan authorized under the Affordable Care Act.","effective_date":"2025-06-16","last_modified":"2026-10-03T03:56:36.864408+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/3","official_origin":"https://hcopub.dhs.state.mn.us/epm/3.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/3","context":"EPM > 3 MinnesotaCare","text":"MinnesotaCare is a publicly funded state health care program established in 1992. In 2015, MinnesotaCare became a Basic Health Plan authorized under the Affordable Care Act.\n\nThis chapter provides policy information for MinnesotaCare and links to policies that apply to all Minnesota Health Care Programs (MHCP). The list below links to each subchapter and the topics covered under that subchapter.\n1. [MinnesotaCare General Requirements](https://bot-corpus.mn-dhs.online/s/epm/3.1)\n  1. [MHCP Applications](https://bot-corpus.mn-dhs.online/s/epm/1.2)\n  2. [MinnesotaCare Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/3.1.1)\n  3. [MinnesotaCare Responsibilities](https://bot-corpus.mn-dhs.online/s/epm/3.1.2)\n  4. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n  5. [MinnesotaCare Cooperation](https://bot-corpus.mn-dhs.online/s/epm/3.1.2.1)\n  6. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n  7. [MHCP Inconsistent information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n  8. [MHCP Overpayments](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.5)\n  9. [MinnesotaCare Premiums and Cost Sharing](https://bot-corpus.mn-dhs.online/s/epm/3.1.2.2)\n  10. [MHCP Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1)\n  11. [MHCP Appeals](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.1)\n  12. [MHCP Authorized Representative](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.2)\n  13. [MHCP Civil Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.3)\n  14. [MHCP Data Privacy](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.4)\n  15. [MHCP Notices](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.5)\n  16. [MinnesotaCare Periodic Data Matching](https://bot-corpus.mn-dhs.online/s/epm/3.1.2.3)\n2. [MinnesotaCare Non-Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/3.2)\n  1. [MinnesotaCare Citizenship and Lawful Presence](https://bot-corpus.mn-dhs.online/s/epm/3.2.1)\n    1. [MinnesotaCare Citizenship](https://bot-corpus.mn-dhs.online/s/epm/3.2.1.1)\n    2. [MinnesotaCare Lawful Presence](https://bot-corpus.mn-dhs.online/s/epm/3.2.1.2)\n  2. [MinnesotaCare Incarceration Status](https://bot-corpus.mn-dhs.online/s/epm/3.2.2)\n  3. [MinnesotaCare Insurance Barriers](https://bot-corpus.mn-dhs.online/s/epm/3.2.3)\n  4. [MHCP State Residency](https://bot-corpus.mn-dhs.online/s/epm/1.4)\n  5. [MinnesotaCare Social Security Number](https://bot-corpus.mn-dhs.online/s/epm/3.2.4)\n3. [MinnesotaCare Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/3.3)\n  1. [MinnesotaCare Household Composition and Family Size](https://bot-corpus.mn-dhs.online/s/epm/3.3.1)\n  2. [MinnesotaCare Income Limit](https://bot-corpus.mn-dhs.online/s/epm/3.3.2)\n  3. [MinnesotaCare Income Methodology](https://bot-corpus.mn-dhs.online/s/epm/3.3.3)\n  4. [MinnesotaCare Income Verification](https://bot-corpus.mn-dhs.online/s/epm/3.3.4)\n4. [MinnesotaCare Post-Eligibility](https://bot-corpus.mn-dhs.online/s/epm/3.4)\n  1. [MinnesotaCare Begin and End Dates](https://bot-corpus.mn-dhs.online/s/epm/3.4.1)\n  2. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n  3. [MinnesotaCare Cooperation](https://bot-corpus.mn-dhs.online/s/epm/3.1.2.1)\n  4. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n  5. [MHCP Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/1.6)\n  6. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n  7. [MHCP Overpayments](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.5)\n  8. [MinnesotaCare Premiums and Cost Sharing](https://bot-corpus.mn-dhs.online/s/epm/3.1.2.2)\n  9. [MinnesotaCare Qualifying Health Care Coverage](https://bot-corpus.mn-dhs.online/s/epm/3.4.2)\n  10. [MinnesotaCare Renewals](https://bot-corpus.mn-dhs.online/s/epm/3.4.3)"}]},{"id":"epm:3.1","number":"3.1","title":"General Requirements","parent":"3","breadcrumb":"3 MinnesotaCare > 3.1 General Requirements","summary":"This subchapter includes general policies that apply to MinnesotaCare and links to policies that apply to all Minnesota Health Care Programs (MHCP).","effective_date":"2025-06-16","last_modified":"2026-10-03T03:56:36.864408+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/3.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/3_1.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:3.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.1","context":"EPM > 3 MinnesotaCare > 3.1 General Requirements","text":"This subchapter includes general policies that apply to MinnesotaCare and links to policies that apply to all Minnesota Health Care Programs (MHCP).\n1. [MHCP Applications](https://bot-corpus.mn-dhs.online/s/epm/1.2)\n2. [MinnesotaCare Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/3.1.1)\n3. [MinnesotaCare Responsibilities](https://bot-corpus.mn-dhs.online/s/epm/3.1.2.1)\n  1. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n  2. [MinnesotaCare Cooperation](https://bot-corpus.mn-dhs.online/s/epm/3.1.2.1)\n  3. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n  4. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n  5. [MHCP Overpayments](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.5)\n  6. [MinnesotaCare Premiums and Cost Sharing](https://bot-corpus.mn-dhs.online/s/epm/3.1.2.2)\n  7. [MinnesotaCare Periodic Data Matching](https://bot-corpus.mn-dhs.online/s/epm/3.1.2.3)\n4. [Minnesota Health Care Programs Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1)\n  1. [MHCP Appeals](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.1)\n  2. [MHCP Authorized Representative](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.2)\n  3. [MHCP Civil Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.3)\n  4. [MHCP Data Privacy](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.4)\n  5. [MHCP Notices](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.5)"}]},{"id":"epm:3.1.1","number":"3.1.1","title":"Mandatory Verifications","parent":"3.1","breadcrumb":"3 MinnesotaCare > 3.1 General Requirements > 3.1.1 Mandatory Verifications","summary":"Mandatory verifications must be verified through an available electronic data source or by paper proof, if electronic data sources are unsuccessful or unavailable. MinnesotaCare has the following required verifications:","effective_date":"2020-03-04","last_modified":"2026-10-03T03:56:36.864408+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.1.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/3.1.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/3_1_1.htm","legal_citations":["Code of Federal Regulations, title 42, sections 435.940 to 435.956","Code of Federal Regulations, title 42, section 600.345","Code of Federal Regulations, title 45, sections 155.305 to 155.320","Minnesota Statutes, section 256L.04"],"chunks":[{"chunk_id":"epm:3.1.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.1.1","context":"EPM > 3 MinnesotaCare > 3.1 General Requirements > 3.1.1 Mandatory Verifications","text":"Mandatory verifications must be verified through an available electronic data source or by paper proof, if electronic data sources are unsuccessful or unavailable. MinnesotaCare has the following required verifications:\n- Lawful presence in the United States\n- Projected annual income (PAI). PAI is the Modified Adjusted Gross Income (MAGI) a person expects to have a for a calendar year. Refer to [MinnesotaCare Income Verification](https://bot-corpus.mn-dhs.online/s/epm/3.3.4) for information about how a person's PAI is verified for MinnesotaCare.\n- Social Security number\n- U.S. Citizenship"}]},{"id":"epm:3.1.2","number":"3.1.2","title":"Responsibilities","parent":"3.1","breadcrumb":"3 MinnesotaCare > 3.1 General Requirements > 3.1.2 Responsibilities","summary":"MinnesotaCare applicants and enrollees have rights and responsibilities under various laws. These policies apply to MinnesotaCare applicants and enrollees.","effective_date":"2025-06-16","last_modified":"2026-10-03T03:56:36.864408+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.1.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/3.1.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/3_1_2.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:3.1.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.1.2","context":"EPM > 3 MinnesotaCare > 3.1 General Requirements > 3.1.2 Responsibilities","text":"MinnesotaCare applicants and enrollees have rights and responsibilities under various laws. These policies apply to MinnesotaCare applicants and enrollees.\n\nInformation about rights and responsibilities is part of the online and paper applications, various forms, eligibility notices, and brochures. Such information is in plain language and accessible to people with limited English proficiency (LEP) and people with disabilities.\n\nThis subchapter includes policies that apply to MinnesotaCare and links to policies that apply to all Minnesota Health Care Programs (MHCP).\n1. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n2. [MinnesotaCare Cooperation](https://bot-corpus.mn-dhs.online/s/epm/3.1.2.1)\n3. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n4. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n5. [MinnesotaCare Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/3.1.1)\n6. [MHCP Overpayments](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.5)\n7. [MinnesotaCare Premiums and Cost Sharing](https://bot-corpus.mn-dhs.online/s/epm/3.1.2.2)\n8. [MinnesotaCare Periodic Data Matching](https://bot-corpus.mn-dhs.online/s/epm/3.1.2.3)"}]},{"id":"epm:3.1.2.1","number":"3.1.2.1","title":"Cooperation","parent":"3.1.2","breadcrumb":"3 MinnesotaCare > 3.1 General Requirements > 3.1.2 Responsibilities > 3.1.2.1 Cooperation","summary":"MinnesotaCare enrollees must comply with various eligibility requirements. Enrollees who fail to cooperate with requirements may have their health care coverage ended.","effective_date":"2025-06-16","last_modified":"2026-10-03T03:56:36.864408+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.1.2.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/3.1.2.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/3_1_2_1.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:3.1.2.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.1.2.1","context":"EPM > 3 MinnesotaCare > 3.1 General Requirements > 3.1.2 Responsibilities > 3.1.2.1 Cooperation","text":"MinnesotaCare enrollees must comply with various eligibility requirements. Enrollees who fail to cooperate with requirements may have their health care coverage ended.\n\nCooperation is required for the following eligibility requirements:\n1. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n2. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n3. [MinnesotaCare Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/3.1.1)\n4. [MinnesotaCare Premiums and Cost Sharing](https://bot-corpus.mn-dhs.online/s/epm/3.1.2.2)\n5. [MinnesotaCare Periodic Data Matching](https://bot-corpus.mn-dhs.online/s/epm/3.1.2.3)"}]},{"id":"epm:3.1.2.2","number":"3.1.2.2","title":"Premiums and Cost Sharing","parent":"3.1.2","breadcrumb":"3 MinnesotaCare > 3.1 General Requirements > 3.1.2 Responsibilities > 3.1.2.2 Premiums and Cost Sharing","summary":"Many MinnesotaCare enrollees must pay a monthly premium to establish and maintain coverage. The premium amount is based on household income and household size.","effective_date":null,"last_modified":"2026-10-03T03:56:36.864408+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.1.2.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/3.1.2.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/3_1_2_2.htm","legal_citations":["Code of Federal Regulations, title 42, section 600.505","Code of Federal Regulations, title 42, section 600.510","Code of Federal Regulations, title 42, section 600.525","Code of Federal Regulations, title 45, section 155.350","Minnesota Statutes, section 256L.03","Minnesota Statutes, section 256L.06","Minnesota Statutes, section 256L.15"],"chunks":[{"chunk_id":"epm:3.1.2.2#premiums","heading":"Premiums","url":"https://bot-corpus.mn-dhs.online/s/epm/3.1.2.2#premiums","context":"EPM > 3 MinnesotaCare > 3.1 General Requirements > 3.1.2 Responsibilities > 3.1.2.2 Premiums and Cost Sharing > Premiums","text":"## Premiums\n\nMany MinnesotaCare enrollees must pay a monthly premium to establish and maintain coverage. The premium amount is based on household income and household size.\n\nThe following enrollees have no premium:\n- Households that include one or more military members, enrolled in MinnesotaCare, who have completed a tour of active duty within 24 months of MinnesotaCare eligibility, are exempt from paying MinnesotaCare premiums for up to 12 months, which do not have to be consecutive\n- Households with one or more American Indians or Alaska Natives enrolled in MinnesotaCare\n- Households with projected annual income below 35% of the Federal Poverty Guidelines (FPG)\n- People younger than 21\n\nAmerican Indian and Alaska Native enrollees are not required to provide proof of status to be exempt from paying MinnesotaCare premiums.\n\nIf a person is added to an existing MinnesotaCare household that is required to pay a premium, or is newly determined eligible for MinnesotaCare as an existing household member, the effective date of the resulting premium change is as follows:\n- If adding the person to the MinnesotaCare household results in a premium decrease, the decrease is effective the first day of the month after the person was determined eligible.\n- If adding the person to the MinnesotaCare household results in an increase in the household's premium, the increase in the overall premium is effective at the next regular billing for the household.\n\nA household may become newly exempt from premiums when a returning military member, American Indian or Alaska Native is added to the household and is determined eligible for MinnesotaCare. A household may also become newly exempt when a person is added to the household, which causes the household to have income below 35% of the federal poverty guidelines. The effective date of the premium exemption is the first day of the month after eligibility for that person was determined.\n\nThe MinnesotaCare Premium Estimator Table ([DHS-4139A](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-4139A-ENG)) lists estimated premiums based on household income and household size. The premium listed on a bill is the official calculation and the amount an enrollee must pay.\n\nPeople who are required to pay a monthly premium must pay it to keep MinnesotaCare coverage. Ongoing MinnesotaCare premiums are due the 15th of the month, but can be paid through noon on the last working day of the month. Premiums should be paid on time to avoid a gap in coverage. There is no good cause exception for nonpayment of a MinnesotaCare premium.\n\nHouseholds may pay the premiums for coverage months that have not yet been billed. A MinnesotaCare premium is refunded only if, at the time the household requested a refund, the premium was for a future month of coverage for which the agency has not yet paid a health plan.\n\n### Grace Month\n\nMinnesotaCare enrollees who do not pay their premium before the coverage month, have a one-month grace period. An enrollee will remain covered during the grace month, regardless of whether the enrollee pays the premium for that month. Coverage stops at the end of the grace month if they fail to pay their past due premium for the grace month.\n\nA person must pay the grace month premium in full by noon on the last working day of the grace month to avoid a gap in coverage for enrollees who are required to pay a premium. People who are disenrolled from coverage because they did not pay a premium may have a gap in coverage of one month or more.\n\nTo restart coverage, the person must pay the past-due premium for the grace month, if it has not yet been forgiven, and the future month’s premium. Coverage begins the first day of the month after the month in which the person pays both these premiums in full.\n\nA person may have back-to-back grace months. If the person pays the grace month premium by noon on the last working of the grace month, but does not pay for a future month of coverage, the future month of coverage is a grace month.\n\nA person approved for retroactive Medical Assistance (MA) for a month in which the person had MinnesotaCare eligibility and was in a grace month must still pay the grace month premium, if it has not yet been forgiven, to re-enroll in coverage.\n\nThe MinnesotaCare grace month applies only to enrollees who are required to pay a MinnesotaCare premium. Household members who are not required to pay premiums, such as people under the age of 21, remain covered, regardless of whether other household members’ premiums are paid.\n\n### Grace Month and Renewals\n\nWhether a person is a MinnesotaCare enrollee who is in a grace month or was disenrolled for failure to pay premiums has no effect on his or her MinnesotaCare renewal process. The agency must process renewals for MinnesotaCare enrollees who have entered a grace month and people who are disenrolled for nonpayment, following the same process for MinnesotaCare enrollees who are not in a grace month. Disenrollment for nonpayment of a MinnesotaCare premium does not prevent or delay a person's renewal of MinnesotaCare eligibility.\n\nPeople who are subject to a premium must continue paying their premiums timely during the renewal process to maintain coverage.\n\nA person disenrolled for nonpayment whose eligibility is renewed with a different monthly premium must pay the new premium amount for a future month of coverage in addition to the past due premium for a grace month, if it has not yet been forgiven, to re-enroll in MinnesotaCare coverage.\n\nThe grace month and premium payment policies apply to enrolles who are required to complete a renewal form. MinnesotaCare enrollees have a January renewal month. January may be a grace month.\n\n### Premium Forgiveness\n\nAny full or partial unpaid grace month premium, whether it s unpaid because of lack of payment or insufficient funds, is forgiven before issuing the MinnesotaCare premium bill for the fourth month of coverage after disenrollment. Premiums are forgiven even though capitation was paid for the grace month After the grace month's premium is forgiven, a person is only required to pay a future month's premium to re-enroll in coverage.\n\nWhen a person is added to an existing MinnesotaCare case during a grace month, and, as a result of the person being added, the household is no longer required to pay a premium for coverage, the household is premium exempt effective the first day of the month after the change was reported. Any unpaid grace month premium for the household that is no longer required to pay a MinnesotaCare premium is forgiven once the person is added to the household and determined eligible for MinnesotaCare."},{"chunk_id":"epm:3.1.2.2#cost-sharing","heading":"Cost Sharing","url":"https://bot-corpus.mn-dhs.online/s/epm/3.1.2.2#cost-sharing","context":"EPM > 3 MinnesotaCare > 3.1 General Requirements > 3.1.2 Responsibilities > 3.1.2.2 Premiums and Cost Sharing > Cost Sharing","text":"## Cost Sharing\n\nCost sharing includes those costs a MinnesotaCare enrollee pays towards their health care. MinnesotaCare cost sharing includes deductibles, medical visit and prescription copays.\n\nAdults age 21 or older have a:\n- Monthly deductible\n- Copays for non-preventative visits\n- Copays for nonemergency ER visits\n- Copays for eyeglasses\n- Copays for prescription drugs\n\nThere is no cost sharing for mental health services.\n\nAmerican Indians and Alaska Natives enrolled in a federally recognized tribe are exempt from cost sharing. Verification of membership in a federally recognized tribe is required to be exempt from cost sharing. Acceptable verifications include a data match from an electronic data source or paper documentation.\n\nProviders must serve MinnesotaCare enrollees who are not able to pay a copay or deductible at the time of the visit, however, that provider does not have to serve an enrollee again if their cost sharing is still not paid."}]},{"id":"epm:3.1.2.3","number":"3.1.2.3","title":"Periodic Data Matching","parent":"3.1.2","breadcrumb":"3 MinnesotaCare > 3.1 General Requirements > 3.1.2 Responsibilities > 3.1.2.3 Periodic Data Matching","summary":"Periodic Data Matching (PDM) is a process that uses electronic data sources to identify MinnesotaCare enrollees who may no longer meet eligibility criteria for MinnesotaCare.","effective_date":"2019-11-01","last_modified":"2026-10-03T03:56:36.864408+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.1.2.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/3.1.2.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/3_1_2_3.htm","legal_citations":["Minnesota Statutes, section 256B.0561"],"chunks":[{"chunk_id":"epm:3.1.2.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.1.2.3","context":"EPM > 3 MinnesotaCare > 3.1 General Requirements > 3.1.2 Responsibilities > 3.1.2.3 Periodic Data Matching","text":"Periodic Data Matching (PDM) is a process that uses electronic data sources to identify MinnesotaCare enrollees who may no longer meet eligibility criteria for MinnesotaCare.\n\nEnrollees in MinnesotaCare are subject to data matching using electronic data sources at least once during an enrollee’s 12-month period of eligibility.\n\nThe electronic data sources used for periodic data matching provide information about an enrollee’s or household member’s income, Medicare Part A enrollment, or death."},{"chunk_id":"epm:3.1.2.3#notification-of-discrepant-information","heading":"Notification of Discrepant Information","url":"https://bot-corpus.mn-dhs.online/s/epm/3.1.2.3#notification-of-discrepant-information","context":"EPM > 3 MinnesotaCare > 3.1 General Requirements > 3.1.2 Responsibilities > 3.1.2.3 Periodic Data Matching > Notification of Discrepant Information","text":"## Notification of Discrepant Information\n\nDiscrepant information is electronic data that is not consistent with the case information attested to by the enrollee. An enrollee will receive a discrepancy notice only when the information received from an electronic data source indicates the enrollee may no longer qualify for the program in which he or she is currently enrolled.\n\nAn enrollee must respond to the discrepancy notice within 30 days from the date on the notice, by mail, in person, or by calling the agency. An enrollee may respond to the discrepancy notice by submitting a response form with confirmed or corrected information. An enrollee who confirms the information on the form is correct must not be required to provide paper verification to resolve the discrepancy."},{"chunk_id":"epm:3.1.2.3#extension-to-resolve-a-discrepancy","heading":"Extension to Resolve a Discrepancy","url":"https://bot-corpus.mn-dhs.online/s/epm/3.1.2.3#extension-to-resolve-a-discrepancy","context":"EPM > 3 MinnesotaCare > 3.1 General Requirements > 3.1.2 Responsibilities > 3.1.2.3 Periodic Data Matching > Extension to Resolve a Discrepancy","text":"## Extension to Resolve a Discrepancy\n\nAn extension of time beyond the 30-day period is available when an enrollee is cooperating with the agency but unable to provide the information needed to resolve a discrepancy before the date of closure. An extension may be granted only upon enrollee request. There is no limit to the number of extensions an enrollee may be granted, if the enrollee is cooperating with the PDM process."},{"chunk_id":"epm:3.1.2.3#resolving-a-pdm-discrepancy","heading":"Resolving a PDM discrepancy","url":"https://bot-corpus.mn-dhs.online/s/epm/3.1.2.3#resolving-a-pdm-discrepancy","context":"EPM > 3 MinnesotaCare > 3.1 General Requirements > 3.1.2 Responsibilities > 3.1.2.3 Periodic Data Matching > Resolving a PDM discrepancy","text":"## Resolving a PDM discrepancy\n- Income discrepancy An income-related PDM discrepancy is considered resolved when the agency receives an attestation of projected annual income for the household from the MinnesotaCare enrollee. No verification is required if the enrollee’s attested projected annual income is the same as the projected annual income listed on the discrepancy notice.\n- Medicare Part A discrepancy A Medicare Part A discrepancy is considered resolved when an enrollee confirms having Medicare Part A or attests that he or she does not have Medicare Part A. If an enrollee disputes having Medicare, the agency must check any other available data sources about Medicare enrollment, and if necessary, refer the enrollee to the Social Security Administration (SSA) to update his or her records. The agency cannot require an enrollee to contact SSA before resolving the discrepancy.\n- Death discrepancy A death discrepancy is considered resolved when the death is either confirmed or denied by the household. If an enrollee denies the death discrepancy, the agency must resolve the discrepancy and refer the enrollee to SSA to correct his or her records. The agency cannot require an enrollee to contact SSA before resolving the discrepancy.\n\nAn enrollee may report changes during the process of resolving their PDM discrepancies. See [MHCP Changes in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1) for more information."},{"chunk_id":"epm:3.1.2.3#failure-to-resolve-a-pdm-discrepancy","heading":"Failure to Resolve a PDM Discrepancy","url":"https://bot-corpus.mn-dhs.online/s/epm/3.1.2.3#failure-to-resolve-a-pdm-discrepancy","context":"EPM > 3 MinnesotaCare > 3.1 General Requirements > 3.1.2 Responsibilities > 3.1.2.3 Periodic Data Matching > Failure to Resolve a PDM Discrepancy","text":"## Failure to Resolve a PDM Discrepancy\n\nA MinnesotaCare enrollee must cooperate with the PDM process as a condition of eligibility. Enrollees who fail to resolve a PDM discrepancy or request an extension within 30 days of the notice are no longer eligible for their current program. The enrollee is not eligible for MinnesotaCare, MA, advanced premium tax credits (APTC) or cost-sharing reductions (CSR) until the enrollee resolves all outstanding discrepancies. An enrollee with an outstanding discrepancy may be eligible to purchase a qualified health plan without a subsidy if he or she meets the eligibility criteria.\n\nA MinnesotaCare enrollee whose eligibility ended due to failure to resolve a PDM discrepancy must resolve the outstanding discrepancy to qualify for MinnesotaCare again. Once the person resolves the outstanding discrepancy, the earliest the person can be eligible for MinnesotaCare is the first day of the month in which the person cooperated with the agency to resolve the PDM discrepancy or reapplied. MinnesotaCare coverage begins the first day of the month after the month in which eligibility is approved and a first premium payment is received, if the person is required to pay a premium. See MinnesotaCare Begin and End Dates for more information."}]},{"id":"epm:3.2","number":"3.2","title":"Non-Financial Eligibility","parent":"3","breadcrumb":"3 MinnesotaCare > 3.2 Non-Financial Eligibility","summary":"This subsection includes MinnesotaCare non-financial eligibility policies and links to policies that apply to all Minnesota Health Care Programs (MHCP). This covers eligibility requirements not related to a person’s income or assets.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:56:36.864408+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/3.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/3_2.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:3.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.2","context":"EPM > 3 MinnesotaCare > 3.2 Non-Financial Eligibility","text":"This subsection includes MinnesotaCare non-financial eligibility policies and links to policies that apply to all Minnesota Health Care Programs (MHCP). This covers eligibility requirements not related to a person’s income or assets.\n1. [MinnesotaCare Citizenship and Lawful Presence](https://bot-corpus.mn-dhs.online/s/epm/3.2.1)\n2. [MinnesotaCare Incarceration Status](https://bot-corpus.mn-dhs.online/s/epm/3.2.2)\n3. [MinnesotaCare Insurance Barriers](https://bot-corpus.mn-dhs.online/s/epm/3.2.3)\n4. [MHCP State Residency](https://bot-corpus.mn-dhs.online/s/epm/1.4)\n5. [MinnesotaCare Social Security Number](https://bot-corpus.mn-dhs.online/s/epm/3.2.4)"}]},{"id":"epm:3.2.1","number":"3.2.1","title":"Citizenship and Lawful Presence","parent":"3.2","breadcrumb":"3 MinnesotaCare > 3.2 Non-Financial Eligibility > 3.2.1 Citizenship and Lawful Presence","summary":"To be eligible for MinnesotaCare, a person must be one of the following and meet all other eligibility factors:","effective_date":"2026-06-03","last_modified":"2026-10-03T03:56:36.864408+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.2.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/3.2.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/3_2_1.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:3.2.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.2.1","context":"EPM > 3 MinnesotaCare > 3.2 Non-Financial Eligibility > 3.2.1 Citizenship and Lawful Presence","text":"To be eligible for MinnesotaCare, a person must be one of the following and meet all other eligibility factors:\n- a U.S. citizen or U.S. national,\n- a lawfully present noncitizen,\n- a Deferred Action for Childhood Arrivals (DACA) grantee, or\n- a child who is not lawfully present under age 18.\n\nThis section covers citizenship and lawful presence eligibility and verification policies. The following policies apply to MinnesotaCare.\n1. [MinnesotaCare Citizenship](https://bot-corpus.mn-dhs.online/s/epm/3.2.1.1)\n2. [MinnesotaCare Lawful Presence](https://bot-corpus.mn-dhs.online/s/epm/3.2.1.2)"}]},{"id":"epm:3.2.1.1","number":"3.2.1.1","title":"Citizenship","parent":"3.2.1","breadcrumb":"3 MinnesotaCare > 3.2 Non-Financial Eligibility > 3.2.1 Citizenship and Lawful Presence > 3.2.1.1 Citizenship","summary":"A person who is a U.S. citizen or a U.S. national is eligible for MinnesotaCare if they meet all other eligibility requirements.","effective_date":"2026-06-03","last_modified":"2026-10-03T03:56:36.864408+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.2.1.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/3.2.1.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/3_2_1_1.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.407","Code of Federal Regulations, title 42, section 600.305","Code of Federal Regulations, title 42, section 600.345","Code of Federal Regulations, title 45, section 155.315","Minnesota Statutes, section 256L.04, subdivision 10"],"chunks":[{"chunk_id":"epm:3.2.1.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.2.1.1","context":"EPM > 3 MinnesotaCare > 3.2 Non-Financial Eligibility > 3.2.1 Citizenship and Lawful Presence > 3.2.1.1 Citizenship","text":"A person who is a U.S. citizen or a U.S. national is eligible for MinnesotaCare if they meet all other eligibility requirements."},{"chunk_id":"epm:3.2.1.1#us-citizen","heading":"U.S. Citizen","url":"https://bot-corpus.mn-dhs.online/s/epm/3.2.1.1#us-citizen","context":"EPM > 3 MinnesotaCare > 3.2 Non-Financial Eligibility > 3.2.1 Citizenship and Lawful Presence > 3.2.1.1 Citizenship > U.S. Citizen","text":"## U.S. Citizen\n\nA U.S. citizen is someone who is born in the U.S. (including U.S. territories, except for American Samoa) or who was born outside the U.S. and who either:\n- Was naturalized as a U.S. citizen\n- Derived citizenship through the naturalization of his or her parent(s)\n- Derived citizenship through adoption by U.S. citizen parents, provided certain conditions are met\n- Acquired citizenship at birth because he or she was born to U.S. citizen parent(s)\n- Became a U.S. citizen by operation of law"},{"chunk_id":"epm:3.2.1.1#us-national","heading":"U.S. National","url":"https://bot-corpus.mn-dhs.online/s/epm/3.2.1.1#us-national","context":"EPM > 3 MinnesotaCare > 3.2 Non-Financial Eligibility > 3.2.1 Citizenship and Lawful Presence > 3.2.1.1 Citizenship > U.S. National","text":"## U.S. National\n\nA U.S. national is someone who is a U.S. citizen or owes permanent allegiance to the U.S. With extremely limited exceptions, all noncitizen U.S. nationals are people born in American Samoa or people born abroad with one or more American Samoan parents under certain conditions."},{"chunk_id":"epm:3.2.1.1#verification","heading":"Verification","url":"https://bot-corpus.mn-dhs.online/s/epm/3.2.1.1#verification","context":"EPM > 3 MinnesotaCare > 3.2 Non-Financial Eligibility > 3.2.1 Citizenship and Lawful Presence > 3.2.1.1 Citizenship > Verification","text":"## Verification\n\nCitizenship may be verified electronically at the time of application through a data match with the Federal Data Services Hub ( FDSH) or the Social Security Administration (SSA). This is the preferred method of verifying citizenship for MHCP applicants and enrollees. The county, tribal, or state agency must attempt and exhaust all trusted electronic sources prior to requiring paper documentation from the enrollee. Only applicants and enrollees whose U.S. citizenship or U.S. national status cannot be verified electronically must provide proofs.\n\nEligibility must be approved for applicants who meet all other eligibility criteria and attest to meeting the citizenship eligibility requirements. A person approved for MinnesotaCare whose citizenship cannot be electronically verified has a reasonable opportunity to work with the agency to resolve clerical discrepancies preventing electronic verification or to provide proof. A notice must be sent to the enrollee to indicate they have 90 days, plus 5 days for mailing, from the date of the notice to satisfy the request.\n\nThe 95-day reasonable opportunity period can be extended for MinnesotaCare enrollees who demonstrate a good faith effort to get and provide the necessary proof of their citizenship. Enrollees who need more time to obtain documents must receive a notice that tells them the new due date. There is no limit to the number of times the reasonable opportunity period can be extended for a MinnesotaCare enrollee to obtain proof of citizenship. Eligibility and coverage must end with a 10-day advance notice if the enrollee fails to provide verification or assist in the verification process by the end of the reasonable opportunity period or any extension.\n\nDuring the reasonable opportunity period, the county, tribal or state servicing agency must continue efforts to complete verification of an applicant’s citizenship. This includes correcting errant demographic data, re-running electronic sources and checking case records and files for prior instances of successful electronic verification or citizenship documentation received previously. The agency must document efforts to verify an applicant’s citizenship during the reasonable opportunity period in the case record. The agency must also help applicants and enrollees obtain required paper proofs.\n\nOnce citizenship is verified, county, tribal and state servicing agencies cannot request proof again, unless an agency possesses inconsistent information regarding a person’s citizenship status.\n\nA person who reapplies for health care coverage, whose citizenship was not previously verified, must be given a new reasonable opportunity period to provide proof of citizenship."},{"chunk_id":"epm:3.2.1.1#paper-proof-of-citizenship","heading":"Paper Proof of Citizenship","url":"https://bot-corpus.mn-dhs.online/s/epm/3.2.1.1#paper-proof-of-citizenship","context":"EPM > 3 MinnesotaCare > 3.2 Non-Financial Eligibility > 3.2.1 Citizenship and Lawful Presence > 3.2.1.1 Citizenship > Paper Proof of Citizenship","text":"## Paper Proof of Citizenship\n\nApplicants and enrollees who must provide proof because citizenship could not be electronically verified can submit a copy of one of the following to verify U.S. citizenship:\n- U.S. passport, including a U.S. Passport Card issued by the Department of State, without regard to any expiration date as long as such passport or card was issued without limitation\n- Certificate of Naturalization\n- Certificate of Citizenship\n- Valid Minnesota Enhanced Driver's License or Enhanced Identification Card\n- Documentary evidence issued by a federally recognized Native American Tribe which identifies the tribe that issued the document, identifies the individual by name, and confirms the individuals membership, enrollment or affiliation with the tribe. These documents include a tribal enrollment card, A Certificate for Degree of Indian Blood; a Tribal census document; or documents on tribal letterhead, issued under the appropriate tribal official.\n\nApplicants and enrollees can also verify citizenship by submitting a copy of one document from each of the following two lists:\n- List 1 An affidavit can be used in lieu of a List 1 proof, if citizenship cannot be verified electronically and the person does not have any List 1 documents\n  - U.S. public birth certificate or other birth document\n    - The birth record document may be issued by a State, Commonwealth, Territory, or local jurisdiction.\n    - For people born in Minnesota, birth records can only be obtained by sending the Minnesota Department of Health (MDH) the Minnesota Birth Record Application form. For people that were born in another state, birth records can be obtained directly from the state of birth.\n  - An electronic data match with a State vital statistics agency can substitute for a List 1 document. Electronic Verification of Vital Events (EVVE) is a web-based system that requests birth records for the purpose of verifying U.S. Citizenship for Minnesota and other participating states. Nineteen states are currently participating in the EVVE program. Note that EVVE does not verify identity; therefore, an item from List 2 must still be provided with the EVVE.\n  - A Certificate of Report of Birth, issued to U.S.. citizens born outside of the U.S.; or Report of Birth Abroad of a U.S. citizen\n  - Certification of Birth in the U.S.\n  - U.S. citizen ID card\n  - Northern Marianas Identification Card issued by the U.S. Department of Homeland Security\n  - American Indian card (I-872) from the U.S. Department of Homeland Security\n  - Final U.S. adoption papers that show the child's name and a U.S. place of birth, or if an adoption is not final, a Statement from a State-approved adoption agency that shows the child's name and U.S. place of birth\n  - Papers showing U.S. government employment before June 1,1976\n  - U.S. Military Record of Service showing U.S. place of birth\n  - Documentation that a child meets the requirements of section 101 of the Child Citizenship Act of 2000\n  - Medical records showing a U.S. place of birth\n  - Life, health or other insurance company record showing a U.S. place of birth\n  - Official religious record recorded in the U.S. showing that the birth occurred in the U.S.\n  - School records, including pre-school records, Head Start and daycare showing the child's name of U.S. place of birth\n  - Federal or state census record showing U.S. citizenship or U.S. place of birth\n- List 2 An affidavit can be used in lieu of List 2 proof, if citizenship cannot be verified electronically and the person does not have any List 2 documents.\n  - State driver’s license or state ID card\n  - Real ID driver's license or ID card\n  - School ID card\n  - U.S. military ID card or draft record\n  - Military Dependent's ID Card\n  - For a person under age 19:\n    - School records including pre-school or day care records\n    - Clinic, doctor or hospital records\n    - Two other documents containing consistent information that corroborates a person's identity.\n  - Finding of identity from a federal or State government agency"}]},{"id":"epm:3.2.1.2","number":"3.2.1.2","title":"Lawful Presence and DACA","parent":"3.2.1","breadcrumb":"3 MinnesotaCare > 3.2 Non-Financial Eligibility > 3.2.1 Citizenship and Lawful Presence > 3.2.1.2 Lawful Presence and DACA","summary":"To be eligible for MinnesotaCare, a person who is not a U.S. citizen or a U.S. national must be one of the following and meet all other eligibility factors:","effective_date":"2026-06-03","last_modified":"2026-10-03T04:10:19.820821+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.2.1.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/3.2.1.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/3_2_1_2.htm","legal_citations":["Code of Federal Regulations, title 42, section 600.305","Code of Federal Regulations, title 42, section 600.345","Code of Federal Regulations, title 42, section 600.5","Code of Federal Regulations, title 45, section 155.20","Code of Federal Regulations, title 45, section 155.315","Code of Federal Regulations, title 45, section 155.320","Minnesota Statutes, section 256L.04, subdivision 10"],"chunks":[{"chunk_id":"epm:3.2.1.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.2.1.2","context":"EPM > 3 MinnesotaCare > 3.2 Non-Financial Eligibility > 3.2.1 Citizenship and Lawful Presence > 3.2.1.2 Lawful Presence and DACA","text":"To be eligible for MinnesotaCare, a person who is not a U.S. citizen or a U.S. national must be one of the following and meet all other eligibility factors:\n- lawfully present, as defined in [Appendix H](https://bot-corpus.mn-dhs.online/s/epm/H)\n- a Deferred Action for Childhood Arrivals (DACA) grantee, or\n- a child who is not lawfully present and under age 18. A person who is not lawfully present and is age 18 or over is not eligible for MinnesotaCare.\n  - A person is treated as not lawfully present if they do not attest to a status that meets the definition of lawful presence in [Appendix H.](https://bot-corpus.mn-dhs.online/s/epm/H)\n  - A person is considered age 18 the first day of the month following the month of the person’s 18th birthday.\n\nRefer to the[Immigration Status and Minnesota Health Care Programs Eligibility chart](https://hcopub.dhs.state.mn.us/epm/assets/docs/Immigration_Chart.pdf)for a quick reference guide to MinnesotaCare eligibility for applicants and enrollees who are noncitizens."},{"chunk_id":"epm:3.2.1.2#verification","heading":"Verification","url":"https://bot-corpus.mn-dhs.online/s/epm/3.2.1.2#verification","context":"EPM > 3 MinnesotaCare > 3.2 Non-Financial Eligibility > 3.2.1 Citizenship and Lawful Presence > 3.2.1.2 Lawful Presence and DACA > Verification","text":"## Verification\n\nAn attestation that an applicant or enrollee is lawfully present or is a DACA grantee must be verified electronically:\n- At application\n- When a change in immigration status is reported by the enrollee after application\n- When a new non-citizen household member is added and requests coverage\n- When corrections are made about a person’s immigration status after application\n\nSee [1.3.2.1 MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1) for more information.\n\nAn attestation that an applicant or enrollee is not lawfully present does not require verification, either electronically or through paper documentation."},{"chunk_id":"epm:3.2.1.2#paper-documentation","heading":"Paper Documentation","url":"https://bot-corpus.mn-dhs.online/s/epm/3.2.1.2#paper-documentation","context":"EPM > 3 MinnesotaCare > 3.2 Non-Financial Eligibility > 3.2.1 Citizenship and Lawful Presence > 3.2.1.2 Lawful Presence and DACA > Paper Documentation","text":"## Paper Documentation\n\nLawful presence may be verified electronically at the time of application through a data match with the Federal Data Services Hub (FDSH). If unsuccessful the county, tribal, or state servicing agency must submit a request for verification through SAVE prior to requiring paper documentation from the enrollee.\n\nApplicants and enrollees whose lawful presence cannot be verified electronically must provide proofs, which must be validated using electronic sources such as SAVE. People who are DACA grantees must also provide proof that DACA has been approved if their status cannot be verified electronically.\n\nSee [Immigration documentation types](https://www.healthcare.gov/immigrants/documentation/) at [HealthCare.gov](https://www.healthcare.gov/) for information about immigration documentation."},{"chunk_id":"epm:3.2.1.2#reasonable-opportunity-period","heading":"Reasonable Opportunity Period","url":"https://bot-corpus.mn-dhs.online/s/epm/3.2.1.2#reasonable-opportunity-period","context":"EPM > 3 MinnesotaCare > 3.2 Non-Financial Eligibility > 3.2.1 Citizenship and Lawful Presence > 3.2.1.2 Lawful Presence and DACA > Reasonable Opportunity Period","text":"## Reasonable Opportunity Period\n\nEligibility is approved for applicants who meet all other eligibility criteria and attest to meeting the noncitizen eligibility requirements.\n\nA person approved for MinnesotaCare whose attestation of lawful presence or DACA grantee status cannot be verified electronically has a reasonable opportunity to work with the agency to resolve clerical discrepancies preventing electronic verification or to provide proof. A notice is sent to the enrollee to indicate they have 90 days, plus 5 days for mailing, from the date of the notice to satisfy the request.\n\nThe 95-day reasonable opportunity period can be extended for MInnesotaCare enrollees who demonstrate a good faith effort to get and provide proof of their lawful presence or DACA grantee status. Enrollees who need more time to obtain documents must receive a notice that tells them the new due date. There is no limit to the number of times the reasonable opportunity period can be extended for a MinnesotaCare enrollee to obtain proof of lawful presence or DACA grantee status. Eligibility and coverage must end with a 10-day advance notice if the enrollee fails to provide proof or assist in the verification process by the end of the reasonable opportunity period or any extension.\n\nDuring the reasonable opportunity period, the county, tribal or state servicing agency must continue efforts to verify an applicant’s lawful presence or DACA grantee status. This includes correcting errant demographic data, re-running electronic data sources and checking case records and files for prior instances of successful electronic verification or paper documentation received previously. The agency must document efforts to verify an applicant’s lawful presence or DACA grantee status in the case record. The agency must also help applicants and enrollees obtain required paper proofs.\n\nA person who reapplies for healthcare coverage, whose lawful presence or DACA grantee status was not previously verified, must be given a new reasonable opportunity period to provide proof of these eligibility factors."}]},{"id":"epm:3.2.2","number":"3.2.2","title":"Incarceration Status","parent":"3.2","breadcrumb":"3 MinnesotaCare > 3.2 Non-Financial Eligibility > 3.2.2 Incarceration Status","summary":"Applicants and enrollees residing in the community or most types of facilities are eligible for MinnesotaCare.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:56:36.864408+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.2.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/3.2.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/3_2_2.htm","legal_citations":["Code of Federal Regulations, title 42, section 600.305","Minnesota Statutes, section 256L.04, subdivision 12"],"chunks":[{"chunk_id":"epm:3.2.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.2.2","context":"EPM > 3 MinnesotaCare > 3.2 Non-Financial Eligibility > 3.2.2 Incarceration Status","text":"Applicants and enrollees residing in the community or most types of facilities are eligible for MinnesotaCare.\n\nIncarceration is the only living arrangement that is a barrier to MinnesotaCare. A person incarcerated in a state prison, county detention facility, or city jail is not eligible for MinnesotaCare. However, people awaiting the court’s determination of charges, also known as pending disposition of charges, are eligible for MinnesotaCare."}]},{"id":"epm:3.2.3","number":"3.2.3","title":"Insurance Barriers","parent":"3.2","breadcrumb":"3 MinnesotaCare > 3.2 Non-Financial Eligibility > 3.2.3 Insurance Barriers","summary":"Certain types of health care coverage may be a barrier to MinnesotaCare eligibility.","effective_date":"2018-01-01","last_modified":"2026-10-03T03:56:36.864408+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.2.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/3.2.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/3_2_3.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:3.2.3#other-health-coverage","heading":"Other Health Coverage","url":"https://bot-corpus.mn-dhs.online/s/epm/3.2.3#other-health-coverage","context":"EPM > 3 MinnesotaCare > 3.2 Non-Financial Eligibility > 3.2.3 Insurance Barriers > Other Health Coverage","text":"## Other Health Coverage\n\nCertain types of health care coverage may be a barrier to MinnesotaCare eligibility.\n- Access to some types of health coverage is always a barrier, even if the person is not enrolled.\n- Some types of health care coverage are a barrier to MinnesotaCare only if the person is enrolled in the coverage.\n- Some types of health care coverage are never a barrier to MinnesotaCare.\n\nThe following Sections in this chapter provide information on which types of health care coverage are a barrier to MinnesotaCare eligibility:\n\n[Minnesota Health Care Coverage Barriers](https://bot-corpus.mn-dhs.online/s/epm/3.2.3.1)\n\n[Minnesota Employer-Sponsored Coverage](https://bot-corpus.mn-dhs.online/s/epm/3.2.3.2)"}]},{"id":"epm:3.2.3.1","number":"3.2.3.1","title":"Health Care Coverage Barriers","parent":"3.2.3","breadcrumb":"3 MinnesotaCare > 3.2 Non-Financial Eligibility > 3.2.3 Insurance Barriers > 3.2.3.1 Health Care Coverage Barriers","summary":"This section provides policy on whether government-sponsored health care coverage and other types of health care coverage are barriers to MinnesotaCare eligibility. For information about employer-sponsored health care coverage, refer to MinnesotaCare Employer-Sponsored Health Care Coverage.","effective_date":"2018-09-01","last_modified":"2026-10-03T03:57:10.353422+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.2.3.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/3.2.3.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/3_2_3_1.htm","legal_citations":["Code of Federal Regulations, title 26, section 1.5000A-2","Code of Federal Regulations, title 42, section 600.305"],"chunks":[{"chunk_id":"epm:3.2.3.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.2.3.1","context":"EPM > 3 MinnesotaCare > 3.2 Non-Financial Eligibility > 3.2.3 Insurance Barriers > 3.2.3.1 Health Care Coverage Barriers","text":"This section provides policy on whether government-sponsored health care coverage and other types of health care coverage are barriers to MinnesotaCare eligibility. For information about employer-sponsored health care coverage, refer to MinnesotaCare Employer-Sponsored Health Care Coverage."},{"chunk_id":"epm:3.2.3.1#government-sponsored-health-care-coverage","heading":"Government-Sponsored Health Care Coverage","url":"https://bot-corpus.mn-dhs.online/s/epm/3.2.3.1#government-sponsored-health-care-coverage","context":"EPM > 3 MinnesotaCare > 3.2 Non-Financial Eligibility > 3.2.3 Insurance Barriers > 3.2.3.1 Health Care Coverage Barriers > Government-Sponsored Health Care Coverage","text":"## Government-Sponsored Health Care Coverage\n\nThis chart provides a list of government-sponsored health care coverage and their impact on MinnesotaCare eligibility.\n\nAccess means the person can get the coverage but is not currently enrolled.\n\nEnrollment means the person has the coverage.\n\n| Type of Coverage | Impact on MinnesotaCare Eligibility |\n| --- | --- |\n| Emergency Medical Assistance (EMA) | Not a barrier to MinnesotaCare |\n| Health Care for Peace Corp Volunteers | Enrollment is a barrier to MinnesotaCare |\n| Health insurance plans offered by AmeriCorps to its volunteers and their dependents, if recognized by CMS as MEC | Enrollment is a barrier to MinnesotaCare |\n| Health insurance plans offered by AmeriCorps to its volunteers and their dependents, not recognized by CMS as MEC | Not a barrier to MinnesotaCare |\n| Indian Health Services | Not a barrier to MinnesotaCare |\n| Medicaid in another state | Enrollment is a barrier to MinnesotaCare |\n| Medical Assistance, without a spenddown | Access or enrollment is always a barrier to MinnesotaCare |\n| Medical Assistance, with a spenddown | Not a barrier to MinnesotaCare |\n| Medicare Part A, if the person is **not** required to pay a premium | Access or enrollment is always a barrier to MinnesotaCare |\n| Medicare Part A, if the person is required to pay a premium | Enrollment is a barrier to MinnesotaCare |\n| Medicare Part B | Enrollment is a barrier to MinnesotaCare |\n| Medicare Supplement, unless the person also has access to Medicare Part A or is enrolled in Medicare Part A or Part B | Not a barrier to MinnesotaCare |\n| Non-Appropriated Fund Health Benefits Program (NAF) of the Department of Defense | Enrollment is a barrier to MinnesotaCare |\n| TRICARE Continued Health Care Beneift Program | Enrollment is a barrier to MinnesotaCare |\n| TRICARE for Life | Access or enrollment is always a barrier to MinnesotaCare |\n| TRICARE Prime | Access or enrollment is always a barrier to MinnesotaCare |\n| TRICARE Prime Overseas | Access or enrollment is always a barrier to MinnesotaCare |\n| TRICARE Prime Remote | Access or enrollment is always a barrier to MinnesotaCare |\n| TRICARE Reserve Select | Enrollment is a barrier to MinnesotaCare |\n| TRICARE Retired Reserve | Enrollment is a barrier to MinnesotaCare |\n| TRICARE Standard and Extra | Access or enrollment is always a barrier to MinnesotaCare |\n| TRICARE Standard Overseas | Access or enrollment is always a barrier to MinnesotaCare |\n| TRICARE Transitional Assistance Management Program | Access or enrollment is always a barrier to MinnesotaCare |\n| TRICARE US Family Health Plan | Access or enrollment is always a barrier to MinnesotaCare |\n| TRICARE Young Adult (Prime and Standard) | Enrollment is a barrier to MinnesotaCare |\n| Veterans Administration (VA) Civilians Health and Medical Program (CHAMPVA) | Enrollment is a barrier to MinnesotaCare |\n| VA Spina bifida health care benefits program | Enrollment is a barrier to MinnesotaCare |\n| VA Veterans health care plan | Enrollment is a barrier to MinnesotaCare |"},{"chunk_id":"epm:3.2.3.1#other-health-care-coverage","heading":"Other Health Care Coverage","url":"https://bot-corpus.mn-dhs.online/s/epm/3.2.3.1#other-health-care-coverage","context":"EPM > 3 MinnesotaCare > 3.2 Non-Financial Eligibility > 3.2.3 Insurance Barriers > 3.2.3.1 Health Care Coverage Barriers > Other Health Care Coverage","text":"## Other Health Care Coverage\n\nThe following chart provides a list of other health care coverage and their impact MinnesotaCare eligibility.\n\n| Type of Coverage | Impact on MinnesotaCare Eligibility |\n| --- | --- |\n| Accident insurance | Not a barrier to MinnesotaCare |\n| Automobile medical payment insurance | Not a barrier to MinnesotaCare |\n| Benefits for long-term care, nursing home care, home health or community care | Not a barrier to MinnesotaCare |\n| Cancer only | Not a barrier to MinnesotaCare |\n| Coverage for on-site medical clinics | Not a barrier to MinnesotaCare |\n| Coverage just for specific diseases or illnesses | Not a barrier to MinnesotaCare |\n| Coverage only for accident or disability | Not a barrier to MinnesotaCare |\n| Credit-only insurance | Not a barrier to MinnesotaCare |\n| Employer Sponsored COBRA | Enrollment is a barrier to MinnesotaCare. Refer to Section 3.2.3.2, MinnesotaCare Employer-Sponsored Coverage, for more information. |\n| Employer sponsored health insurance (ESI) that does not meet both affordability and minimum value standards. | Enrollment is a barrier to MinnesotaCare. Refer to [Section 3.2.3.2, MinnesotaCare Employer-Sponsored Coverage](https://bot-corpus.mn-dhs.online/s/epm/3.2.3.2), for more information. |\n| Employer sponsored health insurance (ESI) that meets both affordability and minimum value standards. | Access or enrollment is always a barrier to MinnesotaCare. Refer to [Section 3.2.3.2, MinnesotaCare Employer-Sponsored Coverage](https://bot-corpus.mn-dhs.online/s/epm/3.2.3.2), for more information. |\n| Employer Sponsored Retiree Health Coverage | Enrollment is a barrier to MinnesotaCare. Refer to [Section 3.2.3.2, MinnesotaCare Employer-Sponsored Coverage](https://bot-corpus.mn-dhs.online/s/epm/3.2.3.2), for more information. |\n| Family planning-only coverage | Not a barrier to MinnesotaCare |\n| Grandfathered employer sponsored health plan that does not meet both affordability and minimum value standards. | Enrollment is a barrier to MinnesotaCare |\n| Grandfathered employer sponsored health plan that meets both affordability and minimum value standards. | Access or enrollment is always a barrier to MinnesotaCare |\n| Health care coverage offered by foreign governments and organizations, if recognized by CMS as minimum essential coverage (MEC) | Enrollment is a barrier to MinnesotaCare |\n| Health care coverage offered by foreign governments and organizations, not recognized by CMS as MEC | Not a barrier to MinnesotaCare |\n| Hospital indemnity or fixed indemnity insurance | Not a barrier to MinnesotaCare |\n| Hospital only | Not a barrier to MinnesotaCare |\n| Liability insurance | Not a barrier to MinnesotaCare |\n| Limited scope dental or vision benefits | Not a barrier to MinnesotaCare |\n| Long term care insurance | Not a barrier to MinnesotaCare |\n| Other similar coverage that is secondary or incidental to other insurance benefits | Not a barrier to MinnesotaCare |\n| Pregnancy-only coverage | Not a barrier to MinnesotaCare |\n| Prescription drug only | Not a barrier to MinnesotaCare |\n| Private health insurance | Enrollment is a barrier to MinnesotaCare |\n| Qualified Health Plan – without subsidy | Enrollment is a barrier to MinnesotaCare |\n| Self-funded student health insurance plans offered by post-secondary institutions to students and their dependents, if recognized by CMS as MEC | Enrollment is a barrier to MinnesotaCare |\n| Self-funded student health insurance plans offered by post-secondary institutions to students and their dependents, **not** recognized by CMS as MEC | Not a barrier to MinnesotaCare |\n| Supplemental coverage with no comprehensive coverage | Not a barrier to MinnesotaCare |\n| Supplemental liability insurance coverage | Not a barrier to MinnesotaCare |\n| Tuberculosis-only coverage | Not a barrier to MinnesotaCare |\n| Vision only | Not a barrier to MinnesotaCare |\n| Worker’s Compensation | Not a barrier to MinnesotaCare |"}]},{"id":"epm:3.2.3.2","number":"3.2.3.2","title":"Employer-Sponsored Coverage","parent":"3.2.3","breadcrumb":"3 MinnesotaCare > 3.2 Non-Financial Eligibility > 3.2.3 Insurance Barriers > 3.2.3.2 Employer-Sponsored Coverage","summary":"Employer-sponsored coverage is a barrier to MinnesotaCare eligibility for an employee in the following circumstances:","effective_date":"2025-10-14","last_modified":"2026-10-03T03:56:36.864408+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.2.3.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/3.2.3.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/3_2_3_2.htm","legal_citations":["Code of Federal Regulations, title 26, section 1.36B-2","Code of Federal Regulations, title 26, section 1.5000A-2","Code of Federal Regulations, title 26, section 1.5000A-3","Code of Federal Regulations, title 42, section 600.305","Code of Federal Regulations, title 42, section 600.345","Code of Federal Regulations, title 45, section 155.320","Minnesota Statutes, section 256L.07"],"chunks":[{"chunk_id":"epm:3.2.3.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.2.3.2","context":"EPM > 3 MinnesotaCare > 3.2 Non-Financial Eligibility > 3.2.3 Insurance Barriers > 3.2.3.2 Employer-Sponsored Coverage","text":"Employer-sponsored coverage is a barrier to MinnesotaCare eligibility for an employee in the following circumstances:\n- The employee has access to coverage that meets both the minimum value and affordability standards.\n- The employee is enrolled in the coverage, regardless of whether it meets the minimum value or affordability standards.\n\nAccess to employer-sponsored coverage that meets both the minimum value and affordability standards is a barrier to MinnesotaCare eligibility for people when they do not enroll in the employer-sponsored coverage at the time of the employer’s open enrollment period or during a special enrollment period.\n\nWhen an employer offers open enrollment less often than annually for a plan that meets the minimum value and affordability standards, an employee is considered eligible for the employer-sponsored coverage during the first coverage year that follows each open enrollment period. The employee is not eligible for MinnesotaCare for the first coverage year after each open enrollment opportunity.\n\nWhen an employer offers open enrollment less often than annually for a plan that meets the minimum value and affordability standards and there was no open enrollment opportunity for the current coverage year an employee is not considered to be eligible for the employer-sponsored coverage until after the next open enrollment period. The employee may be eligible for MinnesotaCare, if the employee meets all other MinnesotaCare eligibility factors, until the employer-sponsored plan is offered again.\n\nA person does not have access to employer-sponsored coverage until the first day of the first full month it is available to the person.\n\n### Employer-Sponsored Coverage for a Spouse and Dependents\n\nEmployer-sponsored coverage is a barrier to MinnesotaCare eligibility for an employee’s spouse or dependents if they are enrolled in the coverage, regardless of whether the employer-sponsored coverage meets the minimum value and affordability standards.\n\nEmployer-sponsored coverage that meets both the minimum value and affordability standards is a barrier to MinnesotaCare eligibility for the following people if they have access to enroll in the coverage, regardless of whether they enroll:\n- People the employee expects to claim as a tax dependent\n- The employee’s spouse, if the employee and the spouse expect to file taxes jointly.\n\nEmployer-sponsored coverage is a barrier to eligibility for these people if they did not enroll in the employer-sponsored coverage at the time of the employer’s open enrollment period or during a special enrollment period.\n\n### Minimum Value Standard for Employer-Sponsored Coverage\n\nAn employer-sponsored health plan meets the minimum value standard if it covers at least 60 percent of the total allowed costs under the plan, and the plan's benefits include substantial coverage of inpatient hospital and physician services.\n\n### Affordability Standard for Employer-Sponsored Coverage\n\nEmployee-only Affordability Standard\n\nAn employer-sponsored health plan is affordable if the employee’s portion of the annual premiums for employee-only coverage does not exceed 9.96 percent of their annual household income for the tax year. The lowest-cost plan for employee-only coverage is used when determining affordability.\n\n### Family Affordability Standard\n\nAn employer-sponsored health plan is affordable for the employee’s spouse and dependents if the employee’s portion of the annual premiums for family coverage does not exceed 9.96 percent of their annual household income for the tax year.\n\n“Family coverage” means the lowest-cost plan offered by the employer that covers all members of the family, which may include any combination of the employee, the employee’s spouse if filing taxes jointly, and the employee’s tax dependents. The cost of family coverage is used when determining affordability for spouses and dependents.\n\nThe calculation used to determine employer-sponsored coverage affordability for the family is separate from the calculation used to determine affordability for the individual employee.\n- If the ESC premium is not affordable for the employee and also not affordable for the spouse and dependents, the entire household is eligible for MinnesotaCare if they meet all other eligibility criteria.\n- If the premium is affordable for the employee, but not affordable for the spouse and tax dependents, only the spouse and tax dependents may qualify for MinnesotaCare..\n\n### Change in Affordability for Employer-Sponsored Coverage\n\nIf a person’s employer-sponsored coverage is determined unaffordable at application, and becomes affordable at some point later in the employer-sponsored plan year, they remain eligible for MinnesotaCare for the remainder of the employer-sponsored plan year. Once the person is able to enroll in affordable employer-sponsored coverage through an open enrollment period, they are no longer eligible for MinnesotaCare.\n- If a person is determined eligible for MinnesotaCare because they provide incorrect information regarding the affordability of their employer-sponsored plan at application, they can be disenrolled following 10-day advance notice requirements.\n- If a person is determined eligible for MinnesotaCare because they did not update information regarding the affordability of their employer-sponsored plan at the time of their renewal, they can be disenrolled following 10-day advance notice requirements.\n\n### Voluntary Disenrollment from Employer-Sponsored Coverage\n\nPeople who are ineligible for MinnesotaCare because they are enrolled in employer-sponsored coverage may qualify for MinnesotaCare if the employer-sponsored coverage does not meet either the affordability or minimum value standard and they disenroll from the coverage. Eligibility begins the month after the employer-sponsored coverage ends.\n\n### Post-Employment Employer-Sponsored Coverage\n\nHealth insurance available to former employees and dependents of former employees, such as continuation coverage under COBRA or retiree insurance, is only a barrier to MinnesotaCare eligibility if a person is enrolled in the coverage."}]},{"id":"epm:3.2.4","number":"3.2.4","title":"Social Security Number","parent":"3.2","breadcrumb":"3 MinnesotaCare > 3.2 Non-Financial Eligibility > 3.2.4 Social Security Number","summary":"The Department of Human Services (DHS) uses Social Security numbers (SSNs) to identify applicants and enrollees and to administer MinnesotaCare. DHS matches SSNs against records in electronic data sources to identify and verify household income and household size based on the most recent tax return filed by the household tax filer.","effective_date":"2020-06-01","last_modified":"2026-10-03T03:56:36.864408+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.2.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/3.2.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/3_2_4.htm","legal_citations":["Code of Federal Regulations, title 45, section 155.305","Code of Federal Regulations, title 45, section 155.310","Code of Federal Regulations, title 45, section 155.315","Minnesota Statutes, section 256L.04"],"chunks":[{"chunk_id":"epm:3.2.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.2.4","context":"EPM > 3 MinnesotaCare > 3.2 Non-Financial Eligibility > 3.2.4 Social Security Number","text":"The Department of Human Services (DHS) uses Social Security numbers (SSNs) to identify applicants and enrollees and to administer MinnesotaCare. DHS matches SSNs against records in electronic data sources to identify and verify household income and household size based on the most recent tax return filed by the household tax filer.\n\nAll people seeking MinnesotaCare must provide an SSN if they have one.\n\nA person who is not applying for coverage cannot be required to provide an SSN."},{"chunk_id":"epm:3.2.4#verification","heading":"Verification","url":"https://bot-corpus.mn-dhs.online/s/epm/3.2.4#verification","context":"EPM > 3 MinnesotaCare > 3.2 Non-Financial Eligibility > 3.2.4 Social Security Number > Verification","text":"## Verification\n\nEach applicant’s SSN must be verified electronically with the Social Security Administration (SSA). If an applicant cannot recall his or her SSN, the county, tribal or state servicing agency must assist the applicant in:\n- Contacting the SSA to confirm the applicant’s SSN if one has already been issued, or\n- Resolving discrepancies in the case file that are preventing successful electronic verification.\n\nEligibility cannot be delayed for an otherwise eligible applicant pending the electronic verification of a SSN. A notice must be sent to the person to inform them that they have 95 days from the date of the notice to provide proof of their correct SSN or to resolve any clerical discrepancies preventing electronic verification.\n\nThe 95 day period can be extended if the MinnesotaCare enrollee is demonstrating a good faith effort to resolve the discrepancy preventing electronic verification. Enrollees who need more time to resolve the SSN discrepancy must receive a notice that tells them the new due date. There is no limit to the number of times the reasonable opportunity period can be extended for the MinnesotaCare enrollee to resolve the SSN discrepancy. MinnesotaCare eligibility and coverage must end with 10-day advance notice if the enrollee fails to resolve the SSN discrepancy by the end of the reasonable opportunity period or any extension.\n\nDuring the reasonable opportunity period, the county, tribal or state servicing agency must continue efforts to verify an applicant’s SSN. This includes correcting errant demographic data, re-running electronic sources and checking case records and files for prior instances of successful electronic verification. The agency must assist the applicant in resolving discrepancies in the case file that are preventing successful verification. The agency must document efforts to verify an applicant’s SSN during the reasonable opportunity period in the case record.\n\nA person who reapplies for health care coverage, whose SSN was not previously verified, must be given a new reasonable opportunity period to resolve the SSN discrepancy.\n\nA newly issued or corrected SSN must be electronically verified with the SSA. The agency must assist the applicant in resolving discrepancies in the case file that are preventing successful verification. Electronic verification is ultimately required to verify a person’s SSN."}]},{"id":"epm:3.2.5","number":"3.2.5","title":"Age","parent":"3.2","breadcrumb":"3 MinnesotaCare > 3.2 Non-Financial Eligibility > 3.2.5 Age","summary":"MinnesotaCare covers people of any age who meet the nonfinancial and financial eligibility requirements of the program. Most enrollees are people between the ages of 19 through 64, but children under age 19 and adults age 65 or older may also be eligible for the program.","effective_date":"2019-04-01","last_modified":"2026-10-03T03:56:36.864408+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.2.5","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/3.2.5","official_origin":"https://hcopub.dhs.state.mn.us/epm/3_2_5.htm","legal_citations":["Minnesota Statutes 256L.04"],"chunks":[{"chunk_id":"epm:3.2.5#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.2.5","context":"EPM > 3 MinnesotaCare > 3.2 Non-Financial Eligibility > 3.2.5 Age","text":"MinnesotaCare covers people of any age who meet the nonfinancial and financial eligibility requirements of the program. Most enrollees are people between the ages of 19 through 64, but children under age 19 and adults age 65 or older may also be eligible for the program.\n- Children under age 19 may be eligible for MinnesotaCare if they are not eligible for Medical Assistance (MA).\n- Adults who are age 65 or older may be eligible for MinnesotaCare if they are not eligible for MA and cannot get Medicare or must pay a premium for [Medicare Part A](https://bot-corpus.mn-dhs.online/s/epm/3.2.3.1). Adults who are age 65 or older who can enroll in Medicare Part A without paying a premium are not eligible for MinnesotaCare.\n- MinnesotaCare enrollees who become eligible for Medicare Part A without a premium when they turn 65 are eligible for MinnesotaCare until the last day of the month before the month of their 65th birthday."}]},{"id":"epm:3.3","number":"3.3","title":"Financial Eligibility","parent":"3","breadcrumb":"3 MinnesotaCare > 3.3 Financial Eligibility","summary":"This subchapter provides policy about financial eligibility. This includes eligibility factors that involve a person’s income. There are no asset requirements for MinnesotaCare.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:56:36.864408+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/3.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/3_3.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:3.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.3","context":"EPM > 3 MinnesotaCare > 3.3 Financial Eligibility","text":"This subchapter provides policy about financial eligibility. This includes eligibility factors that involve a person’s income. There are no asset requirements for MinnesotaCare.\n\nThis subchapter includes policies that apply to MinnesotaCare. This subchapter covers:\n1. [MinnesotaCare Household Composition and Family Size](https://bot-corpus.mn-dhs.online/s/epm/3.3.1)\n2. [MinnesotaCare Income Limit](https://bot-corpus.mn-dhs.online/s/epm/3.3.2)\n3. [MinnesotaCare Income Methodology](https://bot-corpus.mn-dhs.online/s/epm/3.3.3)\n4. [MinnesotaCare Income Verification](https://bot-corpus.mn-dhs.online/s/epm/3.3.4)"}]},{"id":"epm:3.3.1","number":"3.3.1","title":"Household Composition and Family Size","parent":"3.3","breadcrumb":"3 MinnesotaCare > 3.3 Financial Eligibility > 3.3.1 Household Composition and Family Size","summary":"Household composition means the people included in an applicant's or enrollee’s household. Household composition determines the family size. Household composition and family size are factors used to determine financial eligibility.","effective_date":"2018-01-01","last_modified":"2026-10-03T04:10:19.988438+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.3.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/3.3.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/3_3_1.htm","legal_citations":["Code of Federal Regulations, title 26, section 1.36B-1(d)","Code of Federal Regulations, title 42, section 600.5","Minnesota Statutes, section 256L.01, subdivision 3a"],"chunks":[{"chunk_id":"epm:3.3.1#overview","heading":"Overview","url":"https://bot-corpus.mn-dhs.online/s/epm/3.3.1#overview","context":"EPM > 3 MinnesotaCare > 3.3 Financial Eligibility > 3.3.1 Household Composition and Family Size > Overview","text":"## Overview\n\nHousehold composition means the people included in an applicant's or enrollee’s household. Household composition determines the family size. Household composition and family size are factors used to determine financial eligibility.\n\nHousehold composition and family size are determined for each person separately. Household composition and family size may be different for each person on an application or in a household."},{"chunk_id":"epm:3.3.1#tax-filing-status","heading":"Tax Filing Status","url":"https://bot-corpus.mn-dhs.online/s/epm/3.3.1#tax-filing-status","context":"EPM > 3 MinnesotaCare > 3.3 Financial Eligibility > 3.3.1 Household Composition and Family Size > Tax Filing Status","text":"## Tax Filing Status\n\nApplicants and enrollees do not need to file a federal income tax return or be claimed as tax dependents to be eligible for MinnesotaCare. Additionally, married couples do not need to file a joint federal income tax return to be eligible. Even if legally separated, a married couple is considered married until and unless they are legally divorced.\n\nThe household composition policy for tax filers, tax dependents and non-filers are outlined below. Whose income counts in determining financial eligibility is based on the household composition."},{"chunk_id":"epm:3.3.1#household-composition-and-family-size-for-tax-filers-and-joint-tax-filers","heading":"Household Composition and Family Size for Tax Filers and Joint Tax Filers","url":"https://bot-corpus.mn-dhs.online/s/epm/3.3.1#household-composition-and-family-size-for-tax-filers-and-joint-tax-filers","context":"EPM > 3 MinnesotaCare > 3.3 Financial Eligibility > 3.3.1 Household Composition and Family Size > Household Composition and Family Size for Tax Filers and Joint Tax Filers","text":"## Household Composition and Family Size for Tax Filers and Joint Tax Filers\n\nThe household composition for a person who expects to file taxes and who does not expect to be claimed as a tax dependent by someone else includes:\n- All of the people expected to be on the taxpayer’s federal income tax return including:\n  - Tax filer\n  - Joint tax filer\n  - Tax dependents\n- The taxpayer’s spouse, if living with the taxpayer and not filing jointly\n\nA person’s household composition may include a deceased person. Deceased people who are expected to be included on the federal income tax return continue to count in the household composition for the remainder of the tax year. A person’s household composition cannot include a deceased person beyond the tax year in which the person died.\n\nThe family size for a person who expects to file taxes and who does not expect to be claimed as a tax dependent by someone else includes:\n- All of the people in the person’s household composition\n\nMinnesotaCare household composition and family size do not include unborn children.\n\nPeople who expect to file taxes and expect to be claimed as a tax dependent by someone one else follow the policy for people who expect to be claimed as a dependent."},{"chunk_id":"epm:3.3.1#household-composition-and-family-size-for-tax-dependents","heading":"Household Composition and Family Size for Tax Dependents","url":"https://bot-corpus.mn-dhs.online/s/epm/3.3.1#household-composition-and-family-size-for-tax-dependents","context":"EPM > 3 MinnesotaCare > 3.3 Financial Eligibility > 3.3.1 Household Composition and Family Size > Household Composition and Family Size for Tax Dependents","text":"## Household Composition and Family Size for Tax Dependents\n\nThe household composition for a person who expects to be claimed as a tax dependent is based on the household composition of the tax filer who expects to claim them as a tax dependent. This is true even if the person also expects to file their own tax return.\n\nThe household composition of a tax dependent includes:\n- The tax dependent\n- Tax filer\n- Joint tax filer\n- All other tax dependents\n- The taxpayer’s spouse, if living with the taxpayer and not filing jointly\n- If the tax dependent is married, the spouse, if they live together\n\nA person’s household composition may include a deceased person. Deceased people who are expected to be included on the federal income tax return continue to count in household composition for the remainder of the tax year. A person’s household composition cannot include a deceased person beyond the tax year in which the person died.\n\nMinnesotaCare household composition and family size do not include unborn children.\n\nThe family size for a person who expects to be claimed as a tax dependent by someone else is the sum of:\n- All of the people in the person’s household composition\n\n### Whose Income Counts for Tax Filers and Tax Dependents?\n\nThe household income of a tax filer, joint tax filer or tax dependent consists of the person’s own income and the income of everyone in his or her household composition, unless specifically excluded.\n\n### Exclusions\n\nThe income of a child (regardless of age) who:\n- is included in the household of his or her biological, natural, adopted or step parent, and\n- is not expected to be required to file a tax return for the taxable year that MinnesotaCare is being determined.\n\nThe income of a tax dependent who:\n- is not the spouse or child of the tax filer or joint tax filer, and\n- is not expected to be required to file a tax return for the taxable year that MinnesotaCare is being determined\n\nIn [Appendix F Standards and Guidelines](https://bot-corpus.mn-dhs.online/s/epm/F), refer to the table of Tax Filing Income Thresholds for Children and Tax Dependents to assist in determining whether a child may be expected to be required to file a tax return.\n\nIncome that is not taxable (for example, non-taxable social security benefits) is not considered when determining if the child or tax dependent is expected to be required to file a federal tax return. However, if the child or tax dependent is expected to be required to file a federal tax return, all of the child's or tax dependent's projected annual income (including both taxable and non-taxable Social Security benefits) is counted in the household projected annual income. See the [MA-FCA Income Methodology](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.4) policy for more information."},{"chunk_id":"epm:3.3.1#household-composition-and-family-size-for-non-tax-filers-and-non-tax-dependents","heading":"Household Composition and Family Size for Non Tax Filers and Non Tax Dependents","url":"https://bot-corpus.mn-dhs.online/s/epm/3.3.1#household-composition-and-family-size-for-non-tax-filers-and-non-tax-dependents","context":"EPM > 3 MinnesotaCare > 3.3 Financial Eligibility > 3.3.1 Household Composition and Family Size > Household Composition and Family Size for Non Tax Filers and Non Tax Dependents","text":"## Household Composition and Family Size for Non Tax Filers and Non Tax Dependents\n\nNon-filers are people who do not expect to file taxes and do not expect to be claimed as a tax dependent. The following people living with the person are included in their household composition:\n- The person\n- The person’s spouse\n- The person’s biological, natural, adopted and step children younger than age 19\n- If the person is under age 19, the following are also included:\n  - Biological, natural, adopted and step parents\n  - Biological, natural, adopted and step siblings, under age 19\n\nMinnesotaCare household composition and family size do not include unborn children.\n\nThe family size for a person who expects to be claimed as a tax dependent by someone else is the sum of:\n- All of the people in the person’s household composition\n\n### Whose Income Counts for Non Tax Filers and Non Tax Dependents?\n\nThe household income of non-filers and non-tax dependents consists of the person’s own income and the income of everyone in his or her household composition, unless specifically excluded.\n\n### Exclusions\n\nThe income of a child (regardless of age) who:\n- is included in the household of his or her biological, natural, adopted or step parent, and\n- is not expected to be required to file a tax return for the taxable year that MinnesotaCare is being determined.\n\nIn [Appendix F Standards and Guidelines](https://bot-corpus.mn-dhs.online/s/epm/F), refer to the table of Tax Filing Income Thresholds for Children and Tax Dependents to assist in determining whether a child may be expected to be required to file a tax return.\n\nIncome that is not taxable (for example, non-taxable social security benefits) is not considered when determining if the child is expected to be required to file a federal tax return. However, if the child is expected to be required to file a federal tax return, all of the child's projected annual income (both taxable and non-taxable Social Security benefits) is counted in the household projected annual income. See the [MA-FCA Income Methodology](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.4) policy for more information."}]},{"id":"epm:3.3.2","number":"3.3.2","title":"Income Limit","parent":"3.3","breadcrumb":"3 MinnesotaCare > 3.3 Financial Eligibility > 3.3.2 Income Limit","summary":"Minnesota Health Care Programs (MHCP) considers income in determining eligibility. Income limits and calculations vary by program. Income limits are based on federal poverty guidelines issued by the U.S. Department of Health and Human Services (HHS). The MHCP Income and Asset Guidelines (DHS-3461A) lists income limits for all MHCPs.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:56:36.864408+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.3.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/3.3.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/3_3_2.htm","legal_citations":["Code of Federal Regulations, title 42, section 600.305","Minnesota Statutes, section 256L.04"],"chunks":[{"chunk_id":"epm:3.3.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.3.2","context":"EPM > 3 MinnesotaCare > 3.3 Financial Eligibility > 3.3.2 Income Limit","text":"Minnesota Health Care Programs (MHCP) considers income in determining eligibility. Income limits and calculations vary by program. Income limits are based on federal poverty guidelines issued by the U.S. Department of Health and Human Services (HHS). The MHCP Income and Asset Guidelines ([DHS-3461A](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3461A-ENG)) lists income limits for all MHCPs."},{"chunk_id":"epm:3.3.2#minnesotacare-income-limit","heading":"MinnesotaCare Income Limit","url":"https://bot-corpus.mn-dhs.online/s/epm/3.3.2#minnesotacare-income-limit","context":"EPM > 3 MinnesotaCare > 3.3 Financial Eligibility > 3.3.2 Income Limit > MinnesotaCare Income Limit","text":"## MinnesotaCare Income Limit\n\nTo be eligible for MinnesotaCare, a person must have income equal to or less than 200% federal poverty guidelines (FPG) and be ineligible for MA."}]},{"id":"epm:3.3.3","number":"3.3.3","title":"Income Methodology","parent":"3.3","breadcrumb":"3 MinnesotaCare > 3.3 Financial Eligibility > 3.3.3 Income Methodology","summary":"Income eligibility for MinnesotaCare is based on projected annual income (PAI). PAI is the Modified Adjusted Gross Income (MAGI) that a person expects to have for a calendar year. PAI includes the MAGI a person has already received for the year as well as the MAGI the person expects to receive for the remaining months of the year. PAI also includes temporary income the person receives or expects t","effective_date":"2021-06-01","last_modified":"2026-10-03T03:56:36.864408+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.3.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/3.3.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/3_3_3.htm","legal_citations":["Code of Federal Regulations, title 26, section 1.36B-1","26 United States Code, section 36B(d)(2)(B)","Code of Federal Regulations, title 42, section 600.5","Code of Federal Regulations, title 42, section 600.330(b)","Code of Federal Regulations, title 42, section 435.603(e)","Minnesota Statues, section 256L.01"],"chunks":[{"chunk_id":"epm:3.3.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.3.3","context":"EPM > 3 MinnesotaCare > 3.3 Financial Eligibility > 3.3.3 Income Methodology","text":"Income eligibility for MinnesotaCare is based on projected annual income (PAI). PAI is the Modified Adjusted Gross Income (MAGI) that a person expects to have for a calendar year. PAI includes the MAGI a person has already received for the year as well as the MAGI the person expects to receive for the remaining months of the year. PAI also includes temporary income the person receives or expects to receive within the entire calendar year. When a person is requesting coverage for a future calendar year, PAI consists of the MAGI a person expects to receive for that future year.\n\nAn applicant or enrollee may attest to a PAI that is different from his or her current income. When a person reports a change in PAI, current income and adjustments may also change There may be inconsistent information when the PAI a person reports conflicts with other information or documentation provided by the person or in the case file.\n\nMAGI includes:\n- The types of income included in Federal taxable income, including losses, minus Federal income tax adjustments\n- Nontaxable foreign earned income and housing cost of citizens or residents of the United States living abroad\n- Nontaxable interest income\n- Nontaxable Social Security and tier one railroad retirement benefits\n\nRefer to the [MAGI Fact Sheet](https://hcopub.dhs.state.mn.us/epm/assets/docs/MAGI Fact Sheet.pdf) for a quick reference guide for MAGI."},{"chunk_id":"epm:3.3.3#federal-taxable-income","heading":"Federal Taxable Income","url":"https://bot-corpus.mn-dhs.online/s/epm/3.3.3#federal-taxable-income","context":"EPM > 3 MinnesotaCare > 3.3 Financial Eligibility > 3.3.3 Income Methodology > Federal Taxable Income","text":"## Federal Taxable Income\n\nFederal taxable income are the different types of income that appear in the Income section of the Internal Revenue Service (IRS) form 1040, IRS form 1040-A or IRS form 1040-EZ. Only the taxable portions of these types of income are included in the adjusted gross income. The types of losses that would be reported on income tax returns can offset income. See the appropriate [IRS](http://www.irs.gov) form instructions for examples of federal taxable income. The general types of taxable income include the following:\n- Wages, salary and tips\n  - Payroll or pre-tax deductions for childcare, health insurance, retirement plans, transportation assistance and other employee benefits are not taxable and are not included in a person's adjusted gross income.\n  - Medicaid waiver payments received by a person who provides [Home and Community-Based Services (HCBS) waiver services](https://bot-corpus.mn-dhs.online/s/epm/2.4.2.3), such as personal care services, habilitation services, and other services, to an eligible person living with them are not taxable and not included in a person's adjusted gross income. See [Internal Revenue Bulletin #2014-4](https://www.irs.gov/irb/2014-04_IRB) more information. If the eligible person does not live with the person providing HCBS waiver services, the Medicaid waiver payments are taxable and are included in the person's adjusted gross income.\n- Interest\n- Dividends\n- Taxable refunds, credits or offsets of state and local income taxes\n- Alimony received (spousal maintenance) based on a divorce decree or separation agreement executed before January 1, 2019.\n  - Alimony received based on a divorce decree or separation agreement dated on or after January 1, 2019, is not taxable income to the recipient. It does not need to be reported and is not countable income under the MAGI methodology.\n  - If the divorce decree or separation agreement is modified on or after January 1, 2019, and the modification expressly provides that the alimony tax law changes apply, then the alimony received on or after the date of modification is not considered countable income under the MAGI methodology.\n  - Applicants and enrollees must determine whether the alimony payments they receive are based on a divorce decree or separation agreement executed or modified on or after January 1, 2019, and report accordingly.\n  - Verification of the date of a divorce decree or separation agreement, or a modification to these, is not required.\n- Business income or loss\n- Capital gains or losses\n- Other gains or losses\n- Individual retirement account (IRA) distributions\n- Pension and annuity payments\n- Income or loss from rental real estate, royalties, partnerships, S corporations, trusts, etc.\n- Farm income or loss\n- Unemployment compensation\n- Social Security benefits\n- Other income or loss Generally, money a person receives through a fundraising or donation event is considered a personal gift if the money was given directly or indirectly without the expectation of receiving anything in return. Personal gifts are not included in a person's adjusted gross income.\n- Net operating loss, including carry forward loss"},{"chunk_id":"epm:3.3.3#federal-income-tax-adjustments","heading":"Federal Income Tax Adjustments","url":"https://bot-corpus.mn-dhs.online/s/epm/3.3.3#federal-income-tax-adjustments","context":"EPM > 3 MinnesotaCare > 3.3 Financial Eligibility > 3.3.3 Income Methodology > Federal Income Tax Adjustments","text":"## Federal Income Tax Adjustments\n\nThe types of adjustments that would be listed in the Adjusted Gross Income section of the 1040 or 1040-A are subtracted from gross income to calculate the adjusted gross income. Only specific types of adjustments are allowed. See the appropriate [IRS](http://www.irs.gov) form instructions for specific information about the types of adjustments.\n\nThe types of tax adjustments include:\n- Educator expenses\n- Certain business expenses of reservists, performing artists and fee-basis government officials\n- Health savings account\n- Moving expenses\n  - Through December 31, 2025, moving expenses are permitted only for households that include active duty members of the military who move because of a military order and a permanent change in station.\n- Deductible portion of self-employment tax\n- Self-employed Simplified Employee Pension (SEP), Savings Incentive Match Plan for Employees (SIMPLE) and qualified plans\n- Self-employed health insurance\n- Penalty on early withdrawal of savings\n- Alimony paid (spousal support) based on a divorce decree or separation agreement executed before January 1, 2019.\n  - Alimony paid based on a divorce decree or separation agreement executed on or after January 1, 2019, is not an allowable adjustment to income. It should not be reported as an adjustment to income and is not permitted as an adjustment under the MAGI methodology.\n  - \n    - If the divorce decree or separation agreement is modified on or after January 1, 2019, and the modification expressly provides that the alimony tax law changes apply, then the alimony paid on and after the date of modification is not an allowable adjustment under the MAGI methodology.\n    - \n      - Applicants and enrollees must determine whether the alimony they pay is based on a divorce decree or separation agreement executed or modified before January 1, 2019, and report accordingly.\n      - \n        - Verification of the date of a divorce decree or separation agreement, or a modification to these, is not required.\n- IRA deduction\n- Student loan interest"}]},{"id":"epm:3.3.4","number":"3.3.4","title":"Income Verification","parent":"3.3","breadcrumb":"3 MinnesotaCare > 3.3 Financial Eligibility > 3.3.4 Income Verification","summary":"MinnesotaCare requires verification of a person’s attested Projected Annual Income (PAI). PAI must be verified through an available electronic data source or by paper proof, if electronic data sources are unsuccessful or unavailable.","effective_date":"2019-06-01","last_modified":"2026-10-03T03:56:36.864408+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.3.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/3.3.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/3_3_4.htm","legal_citations":["Code of Federal Regulations, title 42, section 600.345","Code of Federal Regulations, title 45, section 155.315","Code of Federal Regulations, title 45, section 155.320","Minnesota Statutes, section 256L.05, subdivision 2"],"chunks":[{"chunk_id":"epm:3.3.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.3.4","context":"EPM > 3 MinnesotaCare > 3.3 Financial Eligibility > 3.3.4 Income Verification","text":"MinnesotaCare requires verification of a person’s attested Projected Annual Income (PAI). PAI must be verified through an available electronic data source or by paper proof, if electronic data sources are unsuccessful or unavailable.\n\nThe PAI is determined using the [MinnesotaCare Income Methodology](https://bot-corpus.mn-dhs.online/s/epm/3.3.3) policy.\n\nHousehold PAI includes the PAI of everyone in the household composition whose income counts. See the [MinnesotaCare Household Composition and Family Size](https://bot-corpus.mn-dhs.online/s/epm/3.3.1) policy for more information.\n\nEligibility is approved for applicants who meet all other eligibility criteria who attest to PAI within the MinnesotaCare limit. If verification of PAI is required, the person or people whose MinnesotaCare eligibility depends on the verification are given a reasonable opportunity period of 90 days to provide appropriate proof of PAI. The 90 days begins on the date the notice is mailed informing the household of the requirement to verify.\n\nthe 90 day reasonable opportunity period can be extended for MinnesotaCare enrollees if the household is demonstrating a good faith effort to get and provide the necessary proof of their PAI. Enrollees who are given more time to obtain documents must receive a notice that tells them the new due date. There is no limit to the number of times the reasonable opportunity period can be extended for a MinnesotaCare enrollee to provide proof of PAI. Eligibility and coverage must end with the 10-day advance notice when PAI is not verified using electronic or paper verification as stated below by the end of the reasonable opportunity period or any extension.\n\nA person who reapplies for healthcare coverage, whose PAI was not previously verified, must be given a new reasonable opportunity period to provide proof of PAI.\n\nIf someone appears to be newly eligible for MinnesotaCare after reporting a change in circumstances, verification of PAI must be provided prior to the approval of MinnesotaCare eligibility. See [EPM 1.3.2.1 MHCP Change in Circumstance](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1) for full policy.\n\nAn individual who reports having no income is not required to provide verification or an explanation, unless electronic sources or other information the agency has indicate there is inconsistent information. See [EPM 1.3.2.4 MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4) for full policy."},{"chunk_id":"epm:3.3.4#electronic-verification","heading":"Electronic Verification","url":"https://bot-corpus.mn-dhs.online/s/epm/3.3.4#electronic-verification","context":"EPM > 3 MinnesotaCare > 3.3 Financial Eligibility > 3.3.4 Income Verification > Electronic Verification","text":"## Electronic Verification\n\nElectronic sources verify PAI when:\n1. The attested household PAI is at or below the MinnesotaCare income limit and electronic sources indicate the household PAI is at or below the limit.\n2. The attested household PAI is at or below the MinnesotaCare income limit and electronic sources indicates the household PAI is above the limit but is reasonably compatible."},{"chunk_id":"epm:3.3.4#paper-verification","heading":"Paper Verification","url":"https://bot-corpus.mn-dhs.online/s/epm/3.3.4#paper-verification","context":"EPM > 3 MinnesotaCare > 3.3 Financial Eligibility > 3.3.4 Income Verification > Paper Verification","text":"## Paper Verification\n\nWhen self-attestation of PAI is below the MinnesotaCare income limit and electronic sources indicate the person’s household PAI is above the limit, and the amounts are not reasonably compatible, the person must provide paper proof to verify PAI. Paper proof is also required when electronic sources are unavailable.\n\nThe person must provide a complete copy of their most recently filed federal tax return if they have filed a federal tax return in the last three years. This includes people who currently do not expect to file a tax return for the next tax year. A complete federal tax return includes all forms and schedules. If a person expects their PAI will be different from what their most recently filed tax return shows, the person must explain why and include proof. Examples of types of proofs for income and income tax adjustments are located in the [Medical Assistance for Families With Children and Adults Income Verification](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.5) policy.\n\nThe county, tribal or state servicing agency must review the federal tax return and proofs to confirm that the person has reported all sources of income listed on the tax return or has explained why an income source has ended.\n\n### Federal Tax Return Only\n\nWhen the person submits a federal tax return as the only proof of PAI and:\n- The modified adjusted gross income derived from the tax return is less than or equal to the PAI attested on the application or renewal, the attested PAI is verified.\n- The modified adjusted gross income derived from the tax return is more than the PAI attested on the application or renewal, the new amount is the PAI used to determine health care eligibility.\n\n### Federal Tax Return and Other Paper Proof\n\nWhen the person submits a federal tax return and other paper proof, the modified adjusted gross income derived from the tax return information and paper proof of any changes, the new amount is the PAI used to determine health care eligibility.\n\n### Other Paper Proof\n\nWhen the person has not filed a federal tax return within the last three years, and modified adjusted gross income is derived from other paper proof, the new amount is the PAI used to determine health care eligibility.\n\n### Partial or No Other Paper Proof\n\nA signed Yearly Income Statement ([DHS-7117](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-7117-ENG)) can verify PAI for a person who is unable to provide other proof. The Yearly Income Statement can be used on its own, or it may be used in conjunction with other paper proof if the person is able to provide only partial proof of PAI. The person must provide a copy of their most recently filed federal tax return if they have filed a federal tax return in the last three years. The Yearly Income Statement must indicate the total amount of PAI, even if paper proof exists for some of the PAI amount. The Yearly Income Statement verifies PAI only if a person has no other proof.\n\nA person can also submit a signed affidavit to the county, tribal or state servicing agency including any partial proof and a copy of their most recently filed federal tax return if they have filed a federal tax return in the last three years."}]},{"id":"epm:3.4","number":"3.4","title":"Post-Eligibility","parent":"3","breadcrumb":"3 MinnesotaCare > 3.4 Post-Eligibility","summary":"These policies apply to MinnesotaCare enrollees. This subchapter includes policies that apply to MinnesotaCare and links to policies that apply to all Minnesota Health Care Programs (MHCP).","effective_date":"2016-06-01","last_modified":"2026-10-03T03:56:36.864408+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/3.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/3_4.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:3.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.4","context":"EPM > 3 MinnesotaCare > 3.4 Post-Eligibility","text":"These policies apply to MinnesotaCare enrollees. This subchapter includes policies that apply to MinnesotaCare and links to policies that apply to all Minnesota Health Care Programs (MHCP).\n1. [MinnesotaCare Begin and End Dates](https://bot-corpus.mn-dhs.online/s/epm/3.4.1)\n2. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n3. [MinnesotaCare Cooperation](https://bot-corpus.mn-dhs.online/s/epm/3.1.2.1)\n4. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n5. [MHCP Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/1.6)\n6. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n7. [MHCP Overpayments](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.5)\n8. [MinnesotaCare Premiums and Cost Sharing](https://bot-corpus.mn-dhs.online/s/epm/3.1.2.2)\n9. [MinnesotaCare Qualifying Health Coverage](https://bot-corpus.mn-dhs.online/s/epm/3.4.2)\n10. [MinnesotaCare Renewals](https://bot-corpus.mn-dhs.online/s/epm/3.4.3)"}]},{"id":"epm:3.4.1","number":"3.4.1","title":"Begin and End Dates","parent":"3.4","breadcrumb":"3 MinnesotaCare > 3.4 Post-Eligibility > 3.4.1 Begin and End Dates","summary":"Eligibility and coverage are separate concepts for MinnesotaCare:","effective_date":"2016-12-22","last_modified":"2026-10-03T03:56:36.864408+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.4.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/3.4.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/3_4_1.htm","legal_citations":["Minnesota Statutes, section 256L.05","Minnesota Statutes, section 256L.15"],"chunks":[{"chunk_id":"epm:3.4.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.4.1","context":"EPM > 3 MinnesotaCare > 3.4 Post-Eligibility > 3.4.1 Begin and End Dates","text":"Eligibility and coverage are separate concepts for MinnesotaCare:\n- Eligibility refers to when a person meets the MinnesotaCare eligibility rules.\n- Coverage refers to when a person can receive MinnesotaCare benefits.\n\nMinnesotaCare eligibility and coverage begin dates can be different dates. When a person is determined eligible for MinnesotaCare, coverage can begin no earlier than the first of the month following the determination. Once a person has been determined eligible for MinnesotaCare, that person remains eligible for MinnesotaCare for the rest of the certification period, unless a change in circumstances makes the person ineligible during the certification period. A person may still be eligible for MinnesotaCare even if they fail to pay a premium. A person required to pay a premium has coverage for only those months for which a premium is paid, subject to the grace month policy.\n\nSee [MinnesotaCare Premiums and Cost Sharing](https://bot-corpus.mn-dhs.online/s/epm/3.1.2.2) for more information.\n\nMinnesotaCare eligibility and coverage end dates can be different dates as well. For example, a person can remain eligible for MinnesotaCare but have coverage end due to nonpayment of their premium.\n\nWhen a MinnesotaCare enrollee received coverage for a month they were not eligible for MinnesotaCare, an overpayment may exist. See the MHCP Overpayment policy for more information."},{"chunk_id":"epm:3.4.1#eligibility-begin-date","heading":"Eligibility Begin Date","url":"https://bot-corpus.mn-dhs.online/s/epm/3.4.1#eligibility-begin-date","context":"EPM > 3 MinnesotaCare > 3.4 Post-Eligibility > 3.4.1 Begin and End Dates > Eligibility Begin Date","text":"## Eligibility Begin Date\n\nMinnesotaCare eligibility begins the first day of the month that a person meets the eligibility requirements. Eligibility can begin no earlier than the first day of the month of application. If a request for an eligibility determination does not require a new application, the eligibility begin date can begin no earlier than the first day of the month the request for coverage is received.\n\nGenerally, people who meet all eligibility requirements at any time during a month are eligible for the entire month. The eligibility begin date exceptions are:\n- When a person is born, eligibility can begin no earlier than the date the person was born.\n- When a person moves to Minnesota, eligibility can begin no earlier than the date the person became a Minnesota resident."},{"chunk_id":"epm:3.4.1#coverage-begin-date","heading":"Coverage Begin Date","url":"https://bot-corpus.mn-dhs.online/s/epm/3.4.1#coverage-begin-date","context":"EPM > 3 MinnesotaCare > 3.4 Post-Eligibility > 3.4.1 Begin and End Dates > Coverage Begin Date","text":"## Coverage Begin Date\n\nThe coverage begin date for a person newly eligible for MinnesotaCare is the first day of the month after the month in which eligibility is approved and a first premium payment is received, if the person is required to pay a premium.\n\nThe coverage begin date for a person who is not required to pay a premium is the first day of the month after eligibility is approved. This is true even if the person is a member of a household with others who are required to pay a premium.\n\nThe coverage begin date for a person who is newly eligible for MinnesotaCare in a household with existing MinnesotaCare enrollees who are subject to premium payments and have coverage, is the month after the determination of eligibility.\n\nThe effective date of coverage for a person who is required to pay a premium and is added to an existing MinnesotaCare household whose members are exempt from paying a premium, or is newly determined eligible for MinnesotaCare as an existing member of a household whose other members are exempt from paying a premium, is the first day of the month after the month in which the premium is received.\n\nThere is no individual activation of MinnesotaCare coverage for premium-paying members within a household. A household must pay the entire premium due to start coverage for those members required to pay a premium."},{"chunk_id":"epm:3.4.1#eligibility-end-date","heading":"Eligibility End Date","url":"https://bot-corpus.mn-dhs.online/s/epm/3.4.1#eligibility-end-date","context":"EPM > 3 MinnesotaCare > 3.4 Post-Eligibility > 3.4.1 Begin and End Dates > Eligibility End Date","text":"## Eligibility End Date\n\nWhen a MinnesotaCare enrollee no longer meets the MinnesotaCare eligibility requirements, eligibility generally ends on the last day of the month in which the change occurred. The exceptions are:\n- When a MinnesotaCare enrollee dies, eligibility ends the date the person died.\n- When the change occurred too late in the month to send a 10-day advance notice, MinnesotaCare eligibility ends the last day of the month following the month in which the change occurred.\n- When a MinnesotaCare enrollee becomes newly eligible for MA, MinnesotaCare eligibility ends the day before MA eligibility begins."},{"chunk_id":"epm:3.4.1#coverage-end-date","heading":"Coverage End Date","url":"https://bot-corpus.mn-dhs.online/s/epm/3.4.1#coverage-end-date","context":"EPM > 3 MinnesotaCare > 3.4 Post-Eligibility > 3.4.1 Begin and End Dates > Coverage End Date","text":"## Coverage End Date\n\nMinnesotaCare coverage ends if a MinnesotaCare enrollee no longer meets the eligibility requirements or fails to pay the MinnesotaCare premium.\n\n### Coverage End Date due to Ineligibility\n\nWhen a MinnesotaCare enrollee no longer meets the MinnesotaCare eligibility requirements, MinnesotaCare coverage ends the last day of the month for which 10-day advance notice can be given.\n\nGenerally, 10-day advance notice is needed to end MinnesotaCare coverage. See the MHCP Notices policy for specific situations that require less than 10-day advance notice.\n\n### Coverage End Date due to Non-Payment of Premium\n\nThe monthly household premium must be paid to maintain coverage for a MinnesotaCare enrollee. See the MinnesotaCare Cost Sharing and Premiums policy for more information about the coverage end date due to nonpayment of premiums.\n\nHouseholds that are exempt from premiums and household members who are not required to pay premiums remain covered regardless of whether premiums are paid."}]},{"id":"epm:3.4.2","number":"3.4.2","title":"Qualifying Health Care Coverage","parent":"3.4","breadcrumb":"3 MinnesotaCare > 3.4 Post-Eligibility > 3.4.2 Qualifying Health Care Coverage","summary":"As of January 2014, people must have qualifying health care coverage, qualify for a coverage exemption, or make an individual shared responsibility payment upon filing a federal income tax return. The Individual Health Coverage Mandate is a provision of the Affordable Care Act.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:56:36.864408+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.4.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/3.4.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/3_4_2.htm","legal_citations":["United States Code, title 26, section 6055"],"chunks":[{"chunk_id":"epm:3.4.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.4.2","context":"EPM > 3 MinnesotaCare > 3.4 Post-Eligibility > 3.4.2 Qualifying Health Care Coverage","text":"As of January 2014, people must have qualifying health care coverage, qualify for a coverage exemption, or make an individual shared responsibility payment upon filing a federal income tax return. The Individual Health Coverage Mandate is a provision of the [Affordable Care Act](http://www.hhs.gov/healthcare/rights/index.html).\n\nMinnesotaCare is qualifying health care coverage and meets the federal individual responsibility requirement. Qualifying health care coverage is also called minimum essential coverage.\n\nMinnesotaCare enrollees receive a [Form 1095-B](http://www.irs.gov/pub/irs-pdf/f1095b.pdf) from the Minnesota Department of Human Services (DHS). Form 1095-B verifies health care coverage and is used to report individual health coverage to taxpayers and the IRS. An individual who maintains continuous health care coverage throughout the year is not liable for the individual shared responsibility payment.\n\nMore information regarding the individual responsibility mandate is located at [MNsure](http://www.mnsure.org/individual-family/mandate/)."}]},{"id":"epm:3.4.3","number":"3.4.3","title":"Renewals","parent":"3.4","breadcrumb":"3 MinnesotaCare > 3.4 Post-Eligibility > 3.4.3 Renewals","summary":"MinnesotaCare enrollees must have their eligibility renewed annually.","effective_date":"2025-05-30","last_modified":"2026-10-03T03:56:36.864408+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.4.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/3.4.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/3_4_3.htm","legal_citations":["Code of Federal Regulations, title 42, section 600.340","Minnesota Statutes, section 256L.05"],"chunks":[{"chunk_id":"epm:3.4.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/3.4.3","context":"EPM > 3 MinnesotaCare > 3.4 Post-Eligibility > 3.4.3 Renewals","text":"MinnesotaCare enrollees must have their eligibility renewed annually."},{"chunk_id":"epm:3.4.3#renewal-month","heading":"Renewal Month","url":"https://bot-corpus.mn-dhs.online/s/epm/3.4.3#renewal-month","context":"EPM > 3 MinnesotaCare > 3.4 Post-Eligibility > 3.4.3 Renewals > Renewal Month","text":"## Renewal Month\n\nAn enrollee’s renewal month is the month for which eligibility is redetermined when a renewal is conducted. The annual renewal month is January. The certification period is January 1 through December 31, regardless of when an enrollee is determined eligible. If an enrollee remains eligible after renewal, the new MinnesotaCare certification period is January 1 through December 31.\n\nA renewal is conducted individually for each enrollee in a household. If there are multiple enrollees due for renewal within a household, a renewal must not be delayed if all required information is available to determine the enrollee’s eligibility, even if additional information or proof is needed for other enrollees in the household."},{"chunk_id":"epm:3.4.3#ex-parte-renewals","heading":"Ex Parte Renewals","url":"https://bot-corpus.mn-dhs.online/s/epm/3.4.3#ex-parte-renewals","context":"EPM > 3 MinnesotaCare > 3.4 Post-Eligibility > 3.4.3 Renewals > Ex Parte Renewals","text":"## Ex Parte Renewals\n\nWhen it is time for an enrollee’s annual renewal, the agency must attempt to confirm eligibility using information in the case file and from trusted electronic data sources before sending a renewal form and requesting information from the enrollee. This is called an auto or ex parte renewal. When the enrollee’s eligibility cannot be auto renewed, the renewal must be completed using a prepopulated renewal form.\n\nIf eligibility for a MinnesotaCare enrollee is automatically renewed, the enrollee must receive a notice that includes their renewal outcome, and a summary of the information used to renew their eligibility. If all the information is correct, the enrollee does not need to do anything. If any of the information for the enrollee is inaccurate, the enrollee must report all corrections or changes to their county, tribal or state servicing agency.\n\n### Prepopulated Renewal Form\n\nA MinnesotaCare enrollee whose eligibility cannot automatically be renewed must receive a prepopulated renewal form listing information the agency has about them. The enrollee must be given until the end of the certification period, but no less than 30 days from the issuance date on the renewal notice, to respond. The enrollee must review the form, make any changes or updates, sign and return the renewal form to their county, tribal or state servicing agency.\n\nThe county, tribal or state servicing agency must accept any renewal form returned by the enrollee in lieu of the prepopulated renewal and must accept renewal information by:\n- mail,\n- fax,\n- telephone,\n- document upload, and\n- in person\n\nWhen all required information has been gathered to redetermine eligibility for an enrollee, a renewal decision must not be delayed for that enrollee while additional information or proof is requested for other enrollees in the household.\n\n### Combined Renewal Results\n\nIn households with more than one enrollee due for a renewal, some enrollees may be automatically renewed while other enrollees will need to complete a renewal form. When this occurs, the household must receive a notice that indicates who was automatically renewed and who is required to return a renewal form. A prepopulated renewal form will be included with the notice."},{"chunk_id":"epm:3.4.3#changes-in-circumstances-at-renewal","heading":"Changes in Circumstances at Renewal","url":"https://bot-corpus.mn-dhs.online/s/epm/3.4.3#changes-in-circumstances-at-renewal","context":"EPM > 3 MinnesotaCare > 3.4 Post-Eligibility > 3.4.3 Renewals > Changes in Circumstances at Renewal","text":"## Changes in Circumstances at Renewal\n\nChanges in circumstances reported on the renewal form or collected in the renewal process may change an enrollee’s eligibility and the eligibility of previously renewed household members. When a renewal is processed, eligibility for all household members is redetermined.\n\nIf the enrollee is ineligible for MinnesotaCare, eligibility must be redetermined for other programs such as Advanced Premium Tax Credits or a Qualified Health Plan. Enrollees who lose MinnesotaCare eligibility due to changes must receive at least 10-day advance notice. Beneficial changes discovered during renewal may make an enrollee eligible for Medical Assistance (MA). See [EPM 1.3.2.1, MHCP Change in Circumstance](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1) for more information."},{"chunk_id":"epm:3.4.3#closure-for-failure-to-renew","heading":"Closure for Failure to Renew","url":"https://bot-corpus.mn-dhs.online/s/epm/3.4.3#closure-for-failure-to-renew","context":"EPM > 3 MinnesotaCare > 3.4 Post-Eligibility > 3.4.3 Renewals > Closure for Failure to Renew","text":"## Closure for Failure to Renew\n\nMinnesotaCare eligibility ends for an enrollee who does not complete their renewal or submit required proofs by the last day of the certification period, regardless of whether other enrollees in their household were renewed. The enrollee must receive 10-day advance notice of closure for failure to complete a renewal."}]},{"id":"epm:4","number":"4","title":"Other Health Care Programs","parent":null,"breadcrumb":"4 Other Health Care Programs","summary":"In addition to Medical Assistance (MA) and MinnesotaCare, Minnesota Health Care Programs (MHCP) include two limited benefit programs. Since state and federal Medicaid monies fund these programs, some MA policies apply and are linked from these chapters.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:58:38.571566+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4","official_origin":"https://hcopub.dhs.state.mn.us/epm/4.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/4","context":"EPM > 4 Other Health Care Programs","text":"In addition to Medical Assistance (MA) and MinnesotaCare, Minnesota Health Care Programs (MHCP) include two limited benefit programs. Since state and federal Medicaid monies fund these programs, some MA policies apply and are linked from these chapters."},{"chunk_id":"epm:4#minnesota-family-planning-programsepm41","heading":"[Minnesota Family Planning Program](/s/epm/4.1)","url":"https://bot-corpus.mn-dhs.online/s/epm/4#minnesota-family-planning-programsepm41","context":"EPM > 4 Other Health Care Programs > [Minnesota Family Planning Program](/s/epm/4.1)","text":"## [Minnesota Family Planning Program](https://bot-corpus.mn-dhs.online/s/epm/4.1)\n\nThe Minnesota Family Planning Program (MFPP) provides coverage of family planning and related health care services. The program increases access to pre-pregnancy family planning services for low-income Minnesotans and helps reduce the number of unintended pregnancies."},{"chunk_id":"epm:4#medicare-savings-programssepm42","heading":"[Medicare Savings Programs](/s/epm/4.2)","url":"https://bot-corpus.mn-dhs.online/s/epm/4#medicare-savings-programssepm42","context":"EPM > 4 Other Health Care Programs > [Medicare Savings Programs](/s/epm/4.2)","text":"## [Medicare Savings Programs](https://bot-corpus.mn-dhs.online/s/epm/4.2)\n\nPeople eligible for Medicare may also be eligible for a Medicare Savings Program (MSP). People may be eligible for these programs, which help with costs such as Medicare premiums, deductibles and coinsurance, instead of or in addition to MA. MSPs include Qualified Medicare Beneficiary (QMB), Service Limited Medicare Beneficiary (SLMB), Qualified Individual (QI) and Qualified Working Disabled (QWD)."}]},{"id":"epm:4.1","number":"4.1","title":"Minnesota Family Planning Program","parent":"4","breadcrumb":"4 Other Health Care Programs > 4.1 Minnesota Family Planning Program","summary":"The Minnesota Family Planning Program (MFPP) is a health care program that covers family planning services and related health care services for people not enrolled in Medical Assistance or MinnesotaCare.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:58:38.571566+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_1.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:4.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program","text":"The Minnesota Family Planning Program (MFPP) is a health care program that covers family planning services and related health care services for people not enrolled in Medical Assistance or MinnesotaCare.\n\nMFPP eligibility is determined using a variety of non-financial, financial and post-eligibility requirements. All Minnesota Health Care Programs (MHCP) policies and some Medical Assistance (MA) policies apply to MFPP. Other eligibility policies are specific to MFPP.\n\nThis subchapter includes policies that apply to MFPP and links to MHCP and MA policies that apply to the program.\n1. [MFPP General Requirements](https://bot-corpus.mn-dhs.online/s/epm/4.1.1) [MFPP Non-Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/4.1.2)\n  1. [MFPP Application](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.1)\n  2. [MFPP Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.2)\n  3. [MFPP Presumptive Eligibility](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.3)\n  4. [MFPP Responsibilities](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4)\n    1. [MFPP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4.1)\n    2. [MFPP Cooperation](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4.2)\n    3. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n    4. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n    5. [MFPP Medical Support](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4.3)\n    6. [MFPP Other Health Insurance](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4.4)\n    7. [MHCP Overpayments](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.5)\n  5. [MFPP Rights](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.5)\n    1. [MFPP Appeals](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.5.1)\n    2. [MHCP Authorized Representative](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.2)\n    3. [MHCP Civil Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.3)\n    4. [MHCP Data Privacy](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.4)\n    5. [MHCP Notices](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.5)\n  1. [MFPP Barriers](https://bot-corpus.mn-dhs.online/s/epm/4.1.2.1)\n  2. [MA Citizenship and Immigration Status](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2)\n  3. [MA Living Arrangement](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.4)\n  4. [MHCP State Residency](https://bot-corpus.mn-dhs.online/s/epm/1.4)\n  5. [MA Social Security Number](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5)\n2. [MFPP Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/4.1.3)\n  1. [MFPP Household Composition](https://bot-corpus.mn-dhs.online/s/epm/4.1.3.1)\n  2. [MFPP Income Limit](https://bot-corpus.mn-dhs.online/s/epm/4.1.3.2)\n  3. [MFPP Income Methodology](https://bot-corpus.mn-dhs.online/s/epm/4.1.3.3)\n3. [MFPP Post-Eligibility](https://bot-corpus.mn-dhs.online/s/epm/4.1.4)\n  1. [MA Begin and End Dates](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.1)\n  2. [MFPP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4.1)\n  3. [MFPP Cooperation](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4.2)\n  4. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n  5. [MFPP Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/4.1.4.1)\n  6. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n  7. [MFPP Medical Support](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4.3)\n  8. [MFPP Other Health Insurance](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4.4)\n  9. [MHCP Overpayments](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.5)\n  10. [MFPP Renewals](https://bot-corpus.mn-dhs.online/s/epm/4.1.4.2)"}]},{"id":"epm:4.1.1","number":"4.1.1","title":"General Requirements","parent":"4.1","breadcrumb":"4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements","summary":"This subchapter provides general policy information that applies to Minnesota Family Planning Program (MFPP).","effective_date":"2016-06-01","last_modified":"2026-10-03T03:58:38.571566+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.1.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_1_1.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:4.1.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements","text":"This subchapter provides general policy information that applies to Minnesota Family Planning Program (MFPP).\n\nThis subchapter includes policies that apply to MFPP and links to relevant Minnesota Health Care Programs (MHCP) policies.\n1. [MFPP Application](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.1)\n2. [MFPP Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.2)\n3. [MFPP Presumptive Eligibility](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.3)\n4. [MFPP Responsibilities](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4)\n  1. [MFPP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4.1)\n  2. [MFPP Cooperation](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4.2)\n  3. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n  4. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n  5. [MFPP Medical Support](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4.3)\n  6. [MFPP Other Health Insurance](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4.4)\n  7. [MHCP Overpayments](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.5)\n5. [MFPP Rights](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.5)\n  1. [MFPP Appeals](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.5.1)\n  2. [MHCP Authorized Representative](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.2)\n  3. [MHCP Civil Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.3)\n  4. [MHCP Data Privacy](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.4)\n  5. [MHCP Notices](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.5)"}]},{"id":"epm:4.1.1.1","number":"4.1.1.1","title":"Application","parent":"4.1.1","breadcrumb":"4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.1 Application","summary":"People may apply for Minnesota Family Planning Program ( MFPP) in the following ways.","effective_date":"2017-08-01","last_modified":"2026-10-03T03:58:38.571566+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.1.1.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_1_1_1.htm","legal_citations":["Minnesota Statues, section 144.343","Minnesota Statutes, section 256B.78"],"chunks":[{"chunk_id":"epm:4.1.1.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.1","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.1 Application","text":"People may apply for Minnesota Family Planning Program ( MFPP) in the following ways.\n\n### Minnesota Family Planning Program Application ([DHS-4740](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-4740-ENG))\n\nPeople seeking coverage under MFPP submit this form to Minnesota Department of Human Services (DHS).\n\n### Presumptive Eligibility with a Certified MFPP Provider\n\nThe applicant completes the first page and the signature page of the MFPP Application (DHS-4740) at the Certified MFPP Provider's office. The provider reviews the application and either approves or denies temporary eligibility. See the [MFPP Presumptive Eligibility](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.3) policy for more information."},{"chunk_id":"epm:4.1.1.1#application-submission","heading":"Application Submission","url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.1#application-submission","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.1 Application > Application Submission","text":"## Application Submission\n\nPeople of any age can apply for MFPP. Minors can apply for MFPP on their own. Minors do not require anyone’s consent to apply for MFPP."},{"chunk_id":"epm:4.1.1.1#signature-requirement","heading":"Signature Requirement","url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.1#signature-requirement","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.1 Application > Signature Requirement","text":"## Signature Requirement\n\nApplicants must sign the application. Minor applicants do not need the signature of a parent or guardian."},{"chunk_id":"epm:4.1.1.1#address","heading":"Address","url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.1#address","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.1 Application > Address","text":"## Address\n\nMFPP applicants and enrollees can designate an address other than their home address as their mailing address."},{"chunk_id":"epm:4.1.1.1#retroactive-eligibility","heading":"Retroactive Eligibility","url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.1#retroactive-eligibility","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.1 Application > Retroactive Eligibility","text":"## Retroactive Eligibility\n\nPeople may request retroactive eligibility for MFPP for up to three months prior to the month of application. A person may use the MFPP Application (DHS-4740) to apply for ongoing MFPP coverage, ongoing MFPP and retroactive coverage, or to apply only for months of retroactive MFPP coverage. Retroactive MFPP coverage is not available to people who apply only for presumptive eligibility.\n\nA person may be eligible for one, two, or three months of retroactive MFPP coverage. The person qualifies for retroactive coverage for each month they meet the MFPP eligibility requirements and has paid or unpaid medical expenses that would be covered by MFPP."}]},{"id":"epm:4.1.1.2","number":"4.1.1.2","title":"Mandatory Verifications","parent":"4.1.1","breadcrumb":"4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.2 Mandatory Verifications","summary":"Mandatory verifications must be verified through an available electronic data source or by paper proof, if electronic data sources are unsuccessful or unavailable. The following are mandatory verifications for Minnesota Family Planning Program (MFPP) eligibility:","effective_date":"2017-08-01","last_modified":"2026-10-03T03:58:38.571566+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.1.1.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_1_1_2.htm","legal_citations":["Minnesota Statutes, section 256B.056","Minnesota Statutes, section 256B.78"],"chunks":[{"chunk_id":"epm:4.1.1.2#full-eligibility","heading":"Full Eligibility","url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.2#full-eligibility","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.2 Mandatory Verifications > Full Eligibility","text":"## Full Eligibility\n\nMandatory verifications must be verified through an available electronic data source or by paper proof, if electronic data sources are unsuccessful or unavailable. The following are mandatory verifications for Minnesota Family Planning Program (MFPP) eligibility:\n- Current income\n- Immigration status\n- Social Security number\n- U.S. Citizenship"},{"chunk_id":"epm:4.1.1.2#presumptive-eligibility","heading":"Presumptive Eligibility","url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.2#presumptive-eligibility","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.2 Mandatory Verifications > Presumptive Eligibility","text":"## Presumptive Eligibility\n\nVerification is not required for [presumptive eligibility](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.3)."}]},{"id":"epm:4.1.1.3","number":"4.1.1.3","title":"Presumptive Eligibility","parent":"4.1.1","breadcrumb":"4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.3 Presumptive Eligibility","summary":"Presumptive eligibility (PE) is a temporary period of eligibility that is determined by a Certified MFPP Provider using preliminary information. A person is only eligible for PE once in a 12-month period.","effective_date":"2023-06-20","last_modified":"2026-10-03T04:46:26.17799+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.1.1.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_1_1_3.htm","legal_citations":["Centers for Medicare and Medicaid Services (CMS) State Medicaid Director Letter Re: Family Planning Services Option and New Benefit rules for Benchmark Plans (July 2, 2010)","Minnesota Statutes, section 256B.78","Patient Protection and Affordability Care Act, Public Law 111-148, section 2303","United States Code, title 42, section 1396r-1c"],"chunks":[{"chunk_id":"epm:4.1.1.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.3","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.3 Presumptive Eligibility","text":"Presumptive eligibility (PE) is a temporary period of eligibility that is determined by a Certified MFPP Provider using preliminary information. A person is only eligible for PE once in a 12-month period."},{"chunk_id":"epm:4.1.1.3#presumptive-eligibility-begin-and-end-dates","heading":"Presumptive Eligibility Begin and End Dates","url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.3#presumptive-eligibility-begin-and-end-dates","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.3 Presumptive Eligibility > Presumptive Eligibility Begin and End Dates","text":"## Presumptive Eligibility Begin and End Dates\n\nThe PE period begins the date the Certified MFPP Provider approves PE. The PE period ends:\n- The date ongoing MFPP eligibility is determined if the PE enrollee submits an application for MFPP by the last day of the month following the month PE eligibility is approved.\n- The last day of the month following the month PE eligibility is approved if the PE enrollee does not submit an application for MFPP by that date."},{"chunk_id":"epm:4.1.1.3#minnesota-residency","heading":"Minnesota Residency","url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.3#minnesota-residency","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.3 Presumptive Eligibility > Minnesota Residency","text":"## Minnesota Residency\n\nAn applicant must be a Minnesota resident to qualify for PE. An applicant must provide a Minnesota address, or if homeless, indicate they live in a Minnesota county, to be considered a Minnesota resident.\n\nAn applicant age 21 or older must also indicate they plan to make Minnesota their home to meet residency requirements.\n\nSee section [1.4 Minnesota Health Care Programs State Residency](https://bot-corpus.mn-dhs.online/s/epm/1.4) for more information about residency requirements."},{"chunk_id":"epm:4.1.1.3#income","heading":"Income","url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.3#income","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.3 Presumptive Eligibility > Income","text":"## Income\n\nPE is determined using attested household income, which is a person's reasonable estimate of household income. Certified MFPP Providers cannot request verification of income from an applicant for the purpose of determining PE eligibility.\n\nThe household income of applicants age 21 or older includes the attested income of all members of the applicants household composition.\n\nThe household income of applicants under age 21 includes only the applicant's attested income."},{"chunk_id":"epm:4.1.1.3#household-composition","heading":"Household Composition","url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.3#household-composition","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.3 Presumptive Eligibility > Household Composition","text":"## Household Composition\n\nRefer to [Section 4.1.3.1 MFPP Household Composition](https://bot-corpus.mn-dhs.online/s/epm/4.1.3.1) for information about household composition for presumptive eligibility.\n\nRefer to [Section 1.4.4 Minnesota Health Care Programs (MHCP) Temporary Absence](https://bot-corpus.mn-dhs.online/s/epm/1.4.4) for information about household members who are temporarily living apart."},{"chunk_id":"epm:4.1.1.3#notice","heading":"Notice","url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.3#notice","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.3 Presumptive Eligibility > Notice","text":"## Notice\n\nThe Certified MFPP Provider gives the applicant a MFPP Short-Term Approval Notice or a MFPP Short-Term Denial Notice. The provider then submits the application to the Department of Human Services (DHS) Health Care Eligibility Operations for a full eligibility determination."},{"chunk_id":"epm:4.1.1.3#appeals","heading":"Appeals","url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.3#appeals","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.3 Presumptive Eligibility > Appeals","text":"## Appeals\n\nApplicants cannot appeal a denial of MFPP presumptive eligibility. They may appeal a denial of a full eligibility determination following the [MHCP Appeals](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.1) policy."},{"chunk_id":"epm:4.1.1.3#certified-mfpp-providers","heading":"Certified MFPP Providers","url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.3#certified-mfpp-providers","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.3 Presumptive Eligibility > Certified MFPP Providers","text":"## Certified MFPP Providers\n\nPeople may search for a certified provider in the [Minnesota Health Care Program Provider Directory](http://mhcpproviderdirectory.dhs.state.mn.us/index.aspx) using the provider type “Family Planning Services” and sub type “Certified MFPP Provider.”\n\nGeneral information about MFPP is available in the Minnesota Family Planning Program brochure ([DHS-4750](http://edocs.dhs.state.mn.us/lfserver/public/DHS-4750-ENG))."}]},{"id":"epm:4.1.1.4","number":"4.1.1.4","title":"Responsibilities","parent":"4.1.1","breadcrumb":"4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.4 Responsibilities","summary":"All Minnesota Family Planning Program (MFPP) applicants and enrollees have rights and responsibilities under various laws. Application forms, notices, and brochures include information on client rights and responsibilities.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:58:38.571566+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.1.1.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_1_1_4.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:4.1.1.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.4 Responsibilities","text":"All Minnesota Family Planning Program (MFPP) applicants and enrollees have rights and responsibilities under various laws. Application forms, notices, and brochures include information on client rights and responsibilities.\n\nThis subchapter includes policies that apply to MFPP and links to policies that apply to all Minnesota Health Care Programs (MHCP).\n1. [MFPP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4.1)\n2. [MFPP Cooperation](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4.2)\n3. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n4. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n5. [MFPP Other Health Insurance](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4.4)\n6. [MHCP Overpayments](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.5)"}]},{"id":"epm:4.1.1.4.1","number":"4.1.1.4.1","title":"Change in Circumstances","parent":"4.1.1.4","breadcrumb":"4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.4 Responsibilities > 4.1.1.4.1 Change in Circumstances","summary":"Minnesota Family Planning Program (MFPP) enrollees must report changes that affect eligibility. Changes that people are required to report include, but are not limited to:","effective_date":null,"last_modified":"2026-10-03T04:46:26.362548+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.1.1.4.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_1_1_4_1.htm","legal_citations":["Code of Federal Regulations, title 42, section 431.211","Code of Federal Regulations, title 42, section 435.916","Code of Federal Regulations, title 45, section 155.330"],"chunks":[{"chunk_id":"epm:4.1.1.4.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4.1","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.4 Responsibilities > 4.1.1.4.1 Change in Circumstances","text":"Minnesota Family Planning Program (MFPP) enrollees must report changes that affect eligibility. Changes that people are required to report include, but are not limited to:\n- Household composition, including members moving in or out, births, deaths, and marriages\n- Household tax filing status and tax dependent status\n- Income\n- Immigration status\n- Losing Minnesota state residency\n- Moving into an intermediate care facility for mental disease (IMD) or state prison, county detention facility or city jail\n- Pregnancy"},{"chunk_id":"epm:4.1.1.4.1#reporting-changes","heading":"Reporting Changes","url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4.1#reporting-changes","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.4 Responsibilities > 4.1.1.4.1 Change in Circumstances > Reporting Changes","text":"## Reporting Changes\n\nApplicants and enrollees must report changes to DHS agency within 10 days. They may report changes via:\n- Phone\n- Mail\n- In person\n- Using a renewal form\n- Using the Change Report Form ([DHS-4796](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-4796-ENG))\n\nChanges are discovered in other ways, such as:\n- Changes reported by another person or agency\n- Changes reported by an enrollee to another program, such as Supplemental Nutrition Assistance Program (SNAP)\n- Information reported by electronic matches\n- Upcoming or potential changes that the agency has been tracking\n\nMFPP enrollees must reconcile inconsistent information with DHS."},{"chunk_id":"epm:4.1.1.4.1#eligibility-redetermination","heading":"Eligibility Redetermination","url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4.1#eligibility-redetermination","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.4 Responsibilities > 4.1.1.4.1 Change in Circumstances > Eligibility Redetermination","text":"## Eligibility Redetermination\n\nWhen an enrollee reports a change in circumstances, eligibility must be redetermined with the new information. If the change results in no change in eligibility, no action needs to be taken by the agency.\n\nIf the change results in ineligibility for MFPP, coverage ends the last day of the month for which advance notice can be given. Generally, 10-day advanced notice is required to close coverage for the enrollee. See [Section 1.3.1.5 Minnesota Health Care Programs (MHCP) Notices](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.5) for more information."}]},{"id":"epm:4.1.1.4.2","number":"4.1.1.4.2","title":"Cooperation","parent":"4.1.1.4","breadcrumb":"4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.4 Responsibilities > 4.1.1.4.2 Cooperation","summary":"Minnesota Family Planning Program (MFPP) enrollees must comply with various eligibility requirements. Enrollees who fail to cooperate with requirements may have their MFPP coverage ended.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:58:38.571566+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.1.1.4.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_1_1_4_2.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:4.1.1.4.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4.2","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.4 Responsibilities > 4.1.1.4.2 Cooperation","text":"Minnesota Family Planning Program (MFPP) enrollees must comply with various eligibility requirements. Enrollees who fail to cooperate with requirements may have their MFPP coverage ended.\n1. Cooperation is required for the following eligibility requirements:\n2. [MFPP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4.1)\n3. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n4. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n5. [MFPP Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.2)\n6. [MFPP Medical Support](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4.3)"}]},{"id":"epm:4.1.1.4.3","number":"4.1.1.4.3","title":"Medical Support","parent":"4.1.1.4","breadcrumb":"4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.4 Responsibilities > 4.1.1.4.3 Medical Support","summary":"Medical Support referrals are not required for parents or relative caretakers who are enrolled in Minnesota Family Planning Program ( MFPP), even if the parent or relative caretaker has a child under age 19 enrolled in Medical Assistance (MA).","effective_date":"2017-08-01","last_modified":"2026-10-03T04:46:26.602065+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.1.1.4.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_1_1_4_3.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:4.1.1.4.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4.3","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.4 Responsibilities > 4.1.1.4.3 Medical Support","text":"Medical Support referrals are not required for parents or relative caretakers who are enrolled in Minnesota Family Planning Program ( MFPP), even if the parent or relative caretaker has a child under age 19 enrolled in Medical Assistance (MA).\n\nHowever, MFPP is not available to a parent or relative caretaker who has been dis-enrolled from MA for non-cooperation with medical support requirements. If MA was closed for non-cooperation, the parent or relative caretaker is not eligible for MFPP until they cooperate with MA medical support requirements. If the parent or relative caretaker cooperates, MFPP eligibility may begin the first day of the month in which cooperation occurs. Refer to [Section 2.1.1.2.1.3.2 MA Medical Support](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.3.2) for more information."}]},{"id":"epm:4.1.1.4.4","number":"4.1.1.4.4","title":"Other Health Insurance","parent":"4.1.1.4","breadcrumb":"4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.4 Responsibilities > 4.1.1.4.4 Other Health Insurance","summary":"Minnesota Family Planning Program (MFPP) applicants and enrollees may opt out of providing information on other health insurance if they fear physical or emotional harm. Applicants or enrollees who provide incomplete information about other health insurance are considered to have opted out.","effective_date":"2017-08-01","last_modified":"2026-10-03T03:58:38.571566+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.1.1.4.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_1_1_4_4.htm","legal_citations":["Code of Federal Regulations, title 42, section 433.147","Minnesota Statutes, section 256B.056, subdivision 6"],"chunks":[{"chunk_id":"epm:4.1.1.4.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4.4","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.4 Responsibilities > 4.1.1.4.4 Other Health Insurance","text":"Minnesota Family Planning Program (MFPP) applicants and enrollees may opt out of providing information on other health insurance if they fear physical or emotional harm. Applicants or enrollees who provide incomplete information about other health insurance are considered to have opted out."},{"chunk_id":"epm:4.1.1.4.4#third-party-liability","heading":"Third Party Liability","url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4.4#third-party-liability","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.4 Responsibilities > 4.1.1.4.4 Other Health Insurance > Third Party Liability","text":"## Third Party Liability\n\nThe Minnesota Department of Human Services (DHS) may recover medical costs for applicants and enrollees who provide information about other health insurance. Third parties include other health insurance that are, or may be, liable to pay all or part of the medical costs provided to MFPP. MFPP is always the payer of last resort. This means enrollees with third party liability (TPL) will have medical costs paid by those sources before MA pays claims."},{"chunk_id":"epm:4.1.1.4.4#medicare","heading":"Medicare","url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4.4#medicare","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.4 Responsibilities > 4.1.1.4.4 Other Health Insurance > Medicare","text":"## Medicare\n\nMFPP will not pay for prescription drugs covered under the Medicare prescription drug benefit."}]},{"id":"epm:4.1.1.5","number":"4.1.1.5","title":"Rights","parent":"4.1.1","breadcrumb":"4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.5 Rights","summary":"All Minnesota Family Planning Program (MFPP) applicants and enrollees have rights under various laws. Application forms, notices, and brochures include information on rights and responsibilities.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:58:38.571566+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.5","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.1.1.5","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_1_1_5.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:4.1.1.5#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.5","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.5 Rights","text":"All Minnesota Family Planning Program (MFPP) applicants and enrollees have rights under various laws. Application forms, notices, and brochures include information on rights and responsibilities.\n\nThis subchapter includes policies that apply to MFPP and links to policies that apply to all Minnesota Health Care Programs (MHCP).\n1. [MFPP Appeals](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.5.1)\n2. [MHCP Authorized Representative](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.2)\n3. [MHCP Civil Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.3)\n4. [MHCP Data Privacy](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.4)\n5. [MHCP Notices](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.5)"}]},{"id":"epm:4.1.1.5.1","number":"4.1.1.5.1","title":"Eligibility Appeals","parent":"4.1.1.5","breadcrumb":"4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.5 Rights > 4.1.1.5.1 Eligibility Appeals","summary":"Minnesota Health Care Programs (MHCP) applicants and enrollees have the right to appeal different types of decisions. This policy is about appealing Minnesota Family Planning Program eligibility decisions.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:58:38.571566+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.5.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.1.1.5.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_1_1_5_1.htm","legal_citations":["Code of Federal Regulations, title 42, section 431.10","Code of Federal Regulations, title 42, sections 431.200 to 431.246","Minnesota Statutes, section 256.045","Minnesota Statutes, section 256.0451"],"chunks":[{"chunk_id":"epm:4.1.1.5.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.1.5.1","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.1 General Requirements > 4.1.1.5 Rights > 4.1.1.5.1 Eligibility Appeals","text":"Minnesota Health Care Programs (MHCP) applicants and enrollees have the right to appeal different types of decisions. This policy is about appealing Minnesota Family Planning Program eligibility decisions.\n\nApplicants cannot appeal a denial of [MFPP presumptive eligibility](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.3). They may appeal a denial of a full eligibility determination following the [Minnesota Health Care Programs (MHCP) Appeals](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.1) policy."}]},{"id":"epm:4.1.2","number":"4.1.2","title":"Non-Financial Eligibility","parent":"4.1","breadcrumb":"4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.2 Non-Financial Eligibility","summary":"This subsection includes non-financial eligibility policies. This covers eligibility factors not related to a person’s income or assets.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:58:38.571566+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.1.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_1_2.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:4.1.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.2","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.2 Non-Financial Eligibility","text":"This subsection includes non-financial eligibility policies. This covers eligibility factors not related to a person’s income or assets.\n\nThis subchapter includes policies that apply to the Minnesota Family Planning Program (MFPP) and links to relevant Medical Assistance (MA) policies.\n1. [MFPP Barriers](https://bot-corpus.mn-dhs.online/s/epm/4.1.2.1)\n2. [MA Citizenship and Immigration Status](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2)\n3. [MA Living Arrangement](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.4)\n4. [MHCP State Residency](https://bot-corpus.mn-dhs.online/s/epm/1.4)\n5. [MA Social Security Number](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5)"}]},{"id":"epm:4.1.2.1","number":"4.1.2.1","title":"Barriers","parent":"4.1.2","breadcrumb":"4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.2 Non-Financial Eligibility > 4.1.2.1 Barriers","summary":"A barrier is an eligibility requirement that prevents a person’s eligibility for the Minnesota Family Planning Program (MFPP), even when the person meets all other eligibility criteria. Barriers to MFPP eligibility include:","effective_date":"2017-08-01","last_modified":"2026-10-03T03:58:38.571566+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.2.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.1.2.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_1_2_1.htm","legal_citations":["Code of Federal Regulations, title 26, section 1.5000A","Code of Federal Regulations, title 42, section 600.305","Patient Protection and Affordable Care Act, Public Law 111-148, section 2303"],"chunks":[{"chunk_id":"epm:4.1.2.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.2.1","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.2 Non-Financial Eligibility > 4.1.2.1 Barriers","text":"A barrier is an eligibility requirement that prevents a person’s eligibility for the Minnesota Family Planning Program (MFPP), even when the person meets all other eligibility criteria. Barriers to MFPP eligibility include:\n- Medical Assistance (MA) enrollment\n- Pregnancy"}]},{"id":"epm:4.1.3","number":"4.1.3","title":"Financial Eligibility","parent":"4.1","breadcrumb":"4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.3 Financial Eligibility","summary":"This subchapter provides policy about financial eligibility for the Minnesota Family Planning Program (MFPP). This includes eligibility factors that involve a person’s income or assets. MFPP has no asset limit.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:58:38.571566+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.1.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_1_3.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:4.1.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.3","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.3 Financial Eligibility","text":"This subchapter provides policy about financial eligibility for the Minnesota Family Planning Program (MFPP). This includes eligibility factors that involve a person’s income or assets. MFPP has no asset limit.\n\nThis subchapter includes the following policies:\n1. [MFPP Household Composition](https://bot-corpus.mn-dhs.online/s/epm/4.1.3.1)\n2. [MFPP Income Limit](https://bot-corpus.mn-dhs.online/s/epm/4.1.3.2)\n3. [MFPP Income Methodology](https://bot-corpus.mn-dhs.online/s/epm/4.1.3.3)"}]},{"id":"epm:4.1.3.1","number":"4.1.3.1","title":"Household Composition","parent":"4.1.3","breadcrumb":"4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.3 Financial Eligibility > 4.1.3.1 Household Composition","summary":"Household composition means the people included in an applicant's or enrollee’s household. Household composition is used to determine household size, income and program eligibility.","effective_date":"2017-08-01","last_modified":"2026-10-03T04:46:26.779059+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.3.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.1.3.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_1_3_1.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.603"],"chunks":[{"chunk_id":"epm:4.1.3.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.3.1","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.3 Financial Eligibility > 4.1.3.1 Household Composition","text":"Household composition means the people included in an applicant's or enrollee’s household. Household composition is used to determine household size, income and program eligibility."},{"chunk_id":"epm:4.1.3.1#presumptive-eligibility","heading":"Presumptive Eligibility","url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.3.1#presumptive-eligibility","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.3 Financial Eligibility > 4.1.3.1 Household Composition > Presumptive Eligibility","text":"## Presumptive Eligibility\n\nFor Minnesota Family Planning Program (MFPP) Presumptive Eligibility (PE), an applicant's household composition includes the applicant and the following people if they are living with the applicant:\n- The applicant's spouse\n- The applicant's biological, natural, adoptive, and stepchildren younger than age 19\n- The household composition for applicants under age 19 also includes the following people if they are living with the applicant:\n  - Biological, natural, adopted and step parents\n  - Biological, natural, and adopted and step siblings who are under age 19\n\nAn applicant's family size is the number of people in their household composition.\n\nRefer to [Section 1.4.4 Minnesota Health Care Programs (MHCP) Temporary Absence](https://bot-corpus.mn-dhs.online/s/epm/1.4.4) for information about household members who are temporarily living apart."},{"chunk_id":"epm:4.1.3.1#ongoing-eligibility","heading":"Ongoing Eligibility","url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.3.1#ongoing-eligibility","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.3 Financial Eligibility > 4.1.3.1 Household Composition > Ongoing Eligibility","text":"## Ongoing Eligibility\n\nFor ongoing MFPP eligibility, household composition and family size depend on whether the person expects to be a tax filer, tax dependent, or non-tax filer for the current tax year. MFPP household composition and family size policies follow household composition and family size policies for Medical Assistance for Families with Children and Adults (MA-FCA). See [MA-FCA Household Composition and Family Size](https://bot-corpus.mn-dhs.online/s/epm/2.2.3.2) for more information about household composition and family size.\n\nA person is not required to file a federal income tax return or be claimed as a tax dependent to be eligible for MFPP. Additionally, married couples are not required to file a joint federal income tax return to be eligible."}]},{"id":"epm:4.1.3.2","number":"4.1.3.2","title":"Income Limit","parent":"4.1.3","breadcrumb":"4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.3 Financial Eligibility > 4.1.3.2 Income Limit","summary":"To be eligible for the Minnesota Family Planning Program (MFPP) a person’s household income must be less than or equal to 200% of federal poverty guidelines (FPG). See the Minnesota Health Care Programs Income and Asset Guidelines (DHS-3461A) for current limits by family size.","effective_date":"2017-08-01","last_modified":"2026-10-03T03:58:38.571566+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.3.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.1.3.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_1_3_2.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.214","Minnesota Statutes, section 256B.78"],"chunks":[{"chunk_id":"epm:4.1.3.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.3.2","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.3 Financial Eligibility > 4.1.3.2 Income Limit","text":"To be eligible for the Minnesota Family Planning Program (MFPP) a person’s household income must be less than or equal to 200% of federal poverty guidelines (FPG). See the Minnesota Health Care Programs Income and Asset Guidelines ([DHS-3461A](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3461A-ENG)) for current limits by family size."}]},{"id":"epm:4.1.3.3","number":"4.1.3.3","title":"Income Methodology","parent":"4.1.3","breadcrumb":"4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.3 Financial Eligibility > 4.1.3.3 Income Methodology","summary":"For Minnesota Family Planning (MFPP) presumptive eligibility (PE), certified providers determine income eligibility based on the person's reported family size and income.","effective_date":"2016-12-22","last_modified":"2026-10-03T03:58:38.571566+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.3.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.1.3.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_1_3_3.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.603","Minnesota Statutes, section 256B.78"],"chunks":[{"chunk_id":"epm:4.1.3.3#presumptive-eligibility","heading":"Presumptive Eligibility","url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.3.3#presumptive-eligibility","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.3 Financial Eligibility > 4.1.3.3 Income Methodology > Presumptive Eligibility","text":"## Presumptive Eligibility\n\nFor Minnesota Family Planning (MFPP) presumptive eligibility (PE), certified providers determine income eligibility based on the person's reported family size and income.\n\nFor a person age 21 or older, household income consists of the countable income of the person and everyone in their household.\n\nFor a person who is under age 21, only the person's income counts."},{"chunk_id":"epm:4.1.3.3#ongoing-eligibility","heading":"Ongoing Eligibility","url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.3.3#ongoing-eligibility","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.3 Financial Eligibility > 4.1.3.3 Income Methodology > Ongoing Eligibility","text":"## Ongoing Eligibility\n\nThe MFPP income methodology for ongoing eligibility follows the Medical Assistance for Families with Children and Adults (MA-FCA) income methodology. See MA-FCA Income Methodology for information about the types of income that count for MFPP.\n\nFor a person age 21 or older, household income consists of the person's own income and the income of everyone in their household composition, unless specifically excluded. See MFPP Household Composition for more information about household composition policy.\n\nFor a person who is under age of 21, only the person's own income counts in determining ongoing eligibility."},{"chunk_id":"epm:4.1.3.3#income-disregard","heading":"Income Disregard","url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.3.3#income-disregard","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.3 Financial Eligibility > 4.1.3.3 Income Methodology > Income Disregard","text":"## Income Disregard\n\nFor both presumptive and ongoing eligibility, when a person's household income is above the 200 percent income limit, a 5 percent income disregard is applied. If the person's household income, minus the disregard, is within the income limit, the person qualifies for MFPP. This disregard effectively raises the income limit by five percent."}]},{"id":"epm:4.1.4","number":"4.1.4","title":"Post-Eligibility","parent":"4.1","breadcrumb":"4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.4 Post-Eligibility","summary":"These policies apply to Minnesota Family Planning Program (MFPP) enrollees. This subchapter includes policies that apply to MFPP and links to Minnesota Health Care Programs (MHCP) and Medical Assistance (MA) policies that apply to the program.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:58:38.571566+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.1.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_1_4.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:4.1.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.4","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.4 Post-Eligibility","text":"These policies apply to Minnesota Family Planning Program (MFPP) enrollees. This subchapter includes policies that apply to MFPP and links to Minnesota Health Care Programs (MHCP) and Medical Assistance (MA) policies that apply to the program.\n1. [MA Begin and End Dates](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.1)\n2. [MFPP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4.1)\n3. [MFPP Cooperation](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4.2)\n4. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n5. [MFPP Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/4.1.4.1)\n6. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n7. [MFPP Medical Support](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4.3)\n8. [MFPP Other Health Insurance](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.4.4)\n9. [MHCP Overpayments](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.5)\n10. [MFPP Renewals](https://bot-corpus.mn-dhs.online/s/epm/4.1.4.2)"}]},{"id":"epm:4.1.4.1","number":"4.1.4.1","title":"Health Care Delivery","parent":"4.1.4","breadcrumb":"4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.4 Post-Eligibility > 4.1.4.1 Health Care Delivery","summary":"All Minnesota Family Planning Program (MFPP) services are provided through a fee-for-service delivery system.","effective_date":"2017-08-01","last_modified":"2026-10-03T04:45:28.062607+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.4.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.1.4.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_1_4_1.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.214","Patient Protection and Affordable Care Act, Public Law 111-148, section 2303","United States Code, title 42, section 1396r-1c"],"chunks":[{"chunk_id":"epm:4.1.4.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.4.1","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.4 Post-Eligibility > 4.1.4.1 Health Care Delivery","text":"All Minnesota Family Planning Program (MFPP) services are provided through a [fee-for-service](https://bot-corpus.mn-dhs.online/s/epm/1.6#fee-for-service) delivery system."},{"chunk_id":"epm:4.1.4.1#medicare","heading":"Medicare","url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.4.1#medicare","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.4 Post-Eligibility > 4.1.4.1 Health Care Delivery > Medicare","text":"## Medicare\n\nThe Minnesota Family Planning Program (MFPP) will not pay for prescription drugs covered under the Medicare prescription drug benefit."},{"chunk_id":"epm:4.1.4.1#covered-services","heading":"Covered Services","url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.4.1#covered-services","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.4 Post-Eligibility > 4.1.4.1 Health Care Delivery > Covered Services","text":"## Covered Services\n\nThe MFPP covers family planning services and supplies, including:\n- Family planning-related office visits\n- Birth control prescriptions, devices and supplies\n- Sterilizations\n- Diagnosis and treatment of some sexually transmitted diseases (STDs) found during a family planning visit\n- Diagnosis of HIV/AIDS found during a family planning visit\n- Transportation to and from a family planning provider\n\nThe MFPP does not cover:\n- Abortions\n- Infertility treatment\n- Family planning services provided in an inpatient setting\n- Treatment of HIV/AIDS\n- Immunizations and vaccines"}]},{"id":"epm:4.1.4.2","number":"4.1.4.2","title":"Renewals","parent":"4.1.4","breadcrumb":"4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.4 Post-Eligibility > 4.1.4.2 Renewals","summary":"The eligibility period for the Minnesota Family Planning Program (MFPP) is 12 months. If the applicant is not receiving presumptive eligibility, this period begins on the first day of the month of application. If the applicant is receiving presumptive eligibility, the eligibility period begins on the first day of the month in which ongoing eligibility is established. Eligibility continues through ","effective_date":"2024-12-20","last_modified":"2026-10-03T03:58:38.571566+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.4.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.1.4.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_1_4_2.htm","legal_citations":["Minnesota Statutes, section 256B.78","Code of Federal Regulations, title 42, section 435.916"],"chunks":[{"chunk_id":"epm:4.1.4.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.4.2","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.4 Post-Eligibility > 4.1.4.2 Renewals","text":"The eligibility period for the Minnesota Family Planning Program (MFPP) is 12 months. If the applicant is not receiving presumptive eligibility, this period begins on the first day of the month of application. If the applicant is receiving presumptive eligibility, the eligibility period begins on the first day of the month in which ongoing eligibility is established. Eligibility continues through the last day of the twelfth month.\n\nEnrollees must submit the Minnesota Family Planning Program (MFPP) Application and Renewal Form ([DHS-4740](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-4740-ENG)) and complete the renewal process before the end of the eligibility period. If the renewal form or other information needed to renew is not returned before the eligibility period ends, MFPP eligibility is closed."},{"chunk_id":"epm:4.1.4.2#reconsideration-period","heading":"Reconsideration Period","url":"https://bot-corpus.mn-dhs.online/s/epm/4.1.4.2#reconsideration-period","context":"EPM > 4 Other Health Care Programs > 4.1 Minnesota Family Planning Program > 4.1.4 Post-Eligibility > 4.1.4.2 Renewals > Reconsideration Period","text":"## Reconsideration Period\n\nThe reconsideration period is the four-month period after an enrollee’s MFPP eligibility terminated for failure to complete a renewal.\n\nA renewal is within the reconsideration period when either of the following is true:\n- the renewal form is received before by the last day of the fourth month following closure for failure to renew, or\n- any additional information or verifications proof that was were required for an incomplete renewal is received before by the last day of the fourth month following closure for failure to renew.\n\nRenewals that are not within the reconsideration period are treated as a new application to which all application policies apply. See [4.1.1.1 MFPP Application](https://bot-corpus.mn-dhs.online/s/epm/4.1.1.1) for more information."}]},{"id":"epm:4.2","number":"4.2","title":"Medicare Savings Programs","parent":"4","breadcrumb":"4 Other Health Care Programs > 4.2 Medicare Savings Programs","summary":"Medicare Savings Programs (MSP) are federal and state-funded programs that assist people on Medicare who have limited income and assets by paying some Medicare expenses, such as premiums, deductibles, and coinsurance. A person’s county, tribal or state servicing agency determines who is eligible for an MSP.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:58:38.571566+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_2.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:4.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.2","context":"EPM > 4 Other Health Care Programs > 4.2 Medicare Savings Programs","text":"Medicare Savings Programs (MSP) are federal and state-funded programs that assist people on Medicare who have limited income and assets by paying some Medicare expenses, such as premiums, deductibles, and coinsurance. A person’s county, tribal or state servicing agency determines who is eligible for an MSP.\n\nThere are four types of MSPs:\n- Qualified Medicare Beneficiary (QMB)\n- Service Limited Medicare Beneficiary (SLMB)\n- Qualified Individual (QI)\n- Qualified Working Disabled (QWD)\n\nAlthough the eligibility requirements and benefits are different, MSPs follow many of the same eligibility policies as Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD).\n\nThis chapter includes policies that apply to MSPs and links to relevant MA and Minnesota Health Care Programs (MHCP) policies.\n1. [MSP General Requirements](https://bot-corpus.mn-dhs.online/s/epm/4.2.1)\n  1. [MSP Applications](https://bot-corpus.mn-dhs.online/s/epm/4.2.1.1)\n  2. [MSP Cooperation](https://bot-corpus.mn-dhs.online/s/epm/4.2.1.2)\n  3. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n  4. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n  5. [MSP Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/4.2.1.3)\n  6. [MSP Medicare Overview](https://bot-corpus.mn-dhs.online/s/epm/4.2.1.4)\n  7. [MHCP Overpayments](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.5)\n  8. [MSP Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/4.2.1.5)\n  9. [MSP Retroactive Coverage](https://bot-corpus.mn-dhs.online/s/epm/4.2.1.6)\n  10. [MHCP Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1)\n    1. [MHCP Appeals](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.1)\n    2. [MHCP Authorized Representative](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.2)\n    3. [MHCP Civil Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.3)\n    4. [MHCP Data Privacy](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.4)\n    5. [MHCP Notices](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.5)\n  11. [MSP Types of Medicare Savings Programs](https://bot-corpus.mn-dhs.online/s/epm/4.2.1.7)\n2. [MSP Non-Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/4.2.2)\n  1. [MA Citizenship and Immigration](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2)\n  2. [MA County Residency](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.3)\n  3. [MA Social Security Number](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5) [MHCP State Residency](https://bot-corpus.mn-dhs.online/s/epm/1.4)\n\n[MSP Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/4.2.3)\n1. [MSP Assets](https://bot-corpus.mn-dhs.online/s/epm/4.2.3.1)\n2. [MSP Household Composition and Family Size](https://bot-corpus.mn-dhs.online/s/epm/4.2.3.2)\n3. [MSP Income](https://bot-corpus.mn-dhs.online/s/epm/4.2.3.3)\n\n[MSP Post-Eligibility](https://bot-corpus.mn-dhs.online/s/epm/4.2.4)\n1. [MA Begin and End Dates](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.1)\n2. [MA Benefit Recovery (MSP benefits before 1/1/2010)](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1)\n  1. [MA Estate Recovery (MSP benefits before 1/1/2010)](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.1)\n  2. [MA Liens (MSP benefits before 1/1/2010)](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.2)\n3. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n4. [MSP Cooperation](https://bot-corpus.mn-dhs.online/s/epm/4.2.1.2)\n5. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n6. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n7. [MSP Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/4.2.1.5)\n8. [MA-ABD Renewals](https://hcopub.dhs.state.mn.us/epm/2_3_4_2ar4.htm)"}]},{"id":"epm:4.2.1","number":"4.2.1","title":"General Requirements","parent":"4.2","breadcrumb":"4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.1 General Requirements","summary":"This subchapter provides general policy information that applies to Medicare Savings Programs (MSP). It includes policies that apply to MSPs and links to relevant Minnesota Health Care Programs (MHCP) policies.","effective_date":"2024-05-30","last_modified":"2026-10-03T03:58:38.571566+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.2.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_2_1.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:4.2.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.1","context":"EPM > 4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.1 General Requirements","text":"This subchapter provides general policy information that applies to Medicare Savings Programs (MSP). It includes policies that apply to MSPs and links to relevant Minnesota Health Care Programs (MHCP) policies.\n1. [MSP Applications](https://bot-corpus.mn-dhs.online/s/epm/4.2.1.1)\n2. [MSP Cooperation](https://bot-corpus.mn-dhs.online/s/epm/4.2.1.2)\n3. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n4. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n5. [MSP Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/4.2.1.3)\n6. [MA-ABD Asset Verification Service (AVS)](https://bot-corpus.mn-dhs.online/s/epm/2.3.1.2)\n7. [MA-ABD Authorization to Obtain Financial Information](https://bot-corpus.mn-dhs.online/s/epm/2.3.1.3)\n8. [MSP Medicare Overview](https://bot-corpus.mn-dhs.online/s/epm/4.2.1.4)\n9. [MHCP Overpayments](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.5)\n10. [MSP Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/4.2.1.5)\n11. [MSP Retroactive Eligibility](https://bot-corpus.mn-dhs.online/s/epm/4.2.1.6)\n12. [MHCP Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1)\n  1. [MHCP Appeals](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.1)\n  2. [MHCP Authorized Representative](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.2)\n  3. [MHCP Civil Rights](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.3)\n  4. [MHCP Data Privacy](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.4)\n  5. [MHCP Notices](https://bot-corpus.mn-dhs.online/s/epm/1.3.1.5)\n13. [MSP Types of Medicare Savings Programs](https://bot-corpus.mn-dhs.online/s/epm/4.2.1.7)"}]},{"id":"epm:4.2.1.1","number":"4.2.1.1","title":"Applications","parent":"4.2.1","breadcrumb":"4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.1 General Requirements > 4.2.1.1 Applications","summary":"The federal government administers the Medicare program and the Minnesota Department of Human Services (DHS) administers the Medicare Savings Programs (MSP). This section outlines the requirements for Medicare and MSP applications.","effective_date":"2024-12-31","last_modified":"2026-10-03T03:58:38.571566+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.1.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.2.1.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_2_1_1.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:4.2.1.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.1.1","context":"EPM > 4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.1 General Requirements > 4.2.1.1 Applications","text":"The federal government administers the Medicare program and the Minnesota Department of Human Services (DHS) administers the Medicare Savings Programs (MSP). This section outlines the requirements for Medicare and MSP applications."},{"chunk_id":"epm:4.2.1.1#medicare-application","heading":"Medicare Application","url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.1.1#medicare-application","context":"EPM > 4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.1 General Requirements > 4.2.1.1 Applications > Medicare Application","text":"## Medicare Application\n\nPeople must sign up for Medicare with the federal government. See [MSP Medicare Overview](https://bot-corpus.mn-dhs.online/s/epm/4.2.1.4) for more information.\n\n### Medicare Part D Extra Help\n\nSome Part D beneficiaries who have limited income and assets are eligible for premium and cost sharing subsidies. These subsidies are referred to as Extra Help or Low-Income Subsidy (LIS). The two types of Extra Help are full and partial subsidies. People enrolled in a MSP or Medical Assistance (MA) automatically qualify for Extra Help with Medicare Part D. DHS informs Medicare who these people are and Medicare sends the person information about which Medicare Part D plans have Extra Help or LIS."},{"chunk_id":"epm:4.2.1.1#medicare-savings-program-application","heading":"Medicare Savings Program Application","url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.1.1#medicare-savings-program-application","context":"EPM > 4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.1 General Requirements > 4.2.1.1 Applications > Medicare Savings Program Application","text":"## Medicare Savings Program Application\n\nIf Medicare thinks someone might be eligible for an MSP, then the Social Security Administration (SSA) sends them a letter called [“How to Get Help With Your Medicare Costs” SSA Publication Form L447](https://www.socialsecurity.gov/legislation/SSA-L447.pdf). A person does not need this letter to apply for an MSP. A person must submit an application form to their county, tribal or state servicing agency for an MSP eligibility determination.\n\n### Application Forms\n\nA person’s situation determines which application form to use to apply for an MSP.\n\nNew applicants living in the community who are applying for an MSP and Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) should use the MHCP Application for Certain Populations ([DHS-3876](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3876-ENG)) for the quickest eligibility determination.\n\nNew applicants living in a nursing facility or intermediate care facility and who are applying for MSP and MA long-term care facility services using a MA-ABD basis of eligibility should use the MHCP Application for Payment of Long-Term Care Services ([DHS-3531](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3531-ENG)) for the quickest eligibility determination.\n\nNew applicants living in the community who are seeking a home and community based services waiver to help stay in their home and who are applying for MSP and MA for long-term care services using a MA-ABD basis of eligibility should use the MHCP Application for Payment of Long-Term Care Services ([DHS-3531](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3531-ENG)) for the quickest eligibility determination.\n\nThe servicing agency must consider potential MSP eligibility and request further information if necessary, to make an MSP eligibility determination when the person is applying for MA, has a change in circumstance, has a renewal, or when the enrollee becomes newly eligible for Medicare. The servicing agency cannot require an MA applicant or enrollee to submit a separate application when applying for an MSP. The servicing agency cannot require new verifications for eligibility factors that have already been verified for MA.\n\nAn MSP enrollee is not required to submit a new application when applying for MA.\n\n### Application Requirements\n\nThe following MHCP application policies also apply to MSPs:\n1. [MHCP Application Submission](https://bot-corpus.mn-dhs.online/s/epm/1.2.2)\n2. [MHCP Date of Application](https://bot-corpus.mn-dhs.online/s/epm/1.2.3)\n3. [MHCP Processing Period](https://bot-corpus.mn-dhs.online/s/epm/1.2.4)\n4. [MHCP Signature](https://bot-corpus.mn-dhs.online/s/epm/1.2.6)"}]},{"id":"epm:4.2.1.2","number":"4.2.1.2","title":"Cooperation","parent":"4.2.1","breadcrumb":"4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.1 General Requirements > 4.2.1.2 Cooperation","summary":"Medicare Savings Program (MSP) enrollees must comply with various Minnesota Health Care Programs (MHCP) eligibility requirements or they may have their MSP coverage ended. These requirements include:","effective_date":"2016-06-01","last_modified":"2026-10-03T03:58:38.571566+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.1.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.2.1.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_2_1_2.htm","legal_citations":["Minnesota Rules, part 9505.0080"],"chunks":[{"chunk_id":"epm:4.2.1.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.1.2","context":"EPM > 4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.1 General Requirements > 4.2.1.2 Cooperation","text":"Medicare Savings Program (MSP) enrollees must comply with various Minnesota Health Care Programs (MHCP) eligibility requirements or they may have their MSP coverage ended. These requirements include:\n\n[MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n\n[MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n\n[MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n\n[Medicaid Eligibility Quality Control and Payment Error Rate Measurement](https://hcopub.dhs.state.mn.us/epm/#meqc_perm)\n\n[MSP Mandatory Verifications](https://bot-corpus.mn-dhs.online/s/epm/4.2.1.3)\n\n[MSP Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/4.2.1.5)"},{"chunk_id":"epm:4.2.1.2#medicaid-eligibility-quality-control-and-payment-error-rate-measurement-cooperation","heading":"Medicaid Eligibility Quality Control and Payment Error Rate Measurement Cooperation","url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.1.2#medicaid-eligibility-quality-control-and-payment-error-rate-measurement-cooperation","context":"EPM > 4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.1 General Requirements > 4.2.1.2 Cooperation > Medicaid Eligibility Quality Control and Payment Error Rate Measurement Cooperation","text":"## Medicaid Eligibility Quality Control and Payment Error Rate Measurement Cooperation\n\nDHS conducts Medicaid Eligibility Quality Control (MEQC) and Payment Error Rate Measurement Cooperation (PERM) eligibility reviews for MSP. Enrollees are encouraged to cooperate with these eligibility reviews, however, enrollees are not required to cooperate as a condition of their eligibility. The county, tribal or state servicing agency must:\n- Request verification from the enrollee when MEQC or PERM eligibility reviews provide information that is inconsistent with information or documentation on file\n- Redetermine eligibility when an MEQC or PERM review results in new information that affects eligibility"}]},{"id":"epm:4.2.1.3","number":"4.2.1.3","title":"Mandatory Verifications","parent":"4.2.1","breadcrumb":"4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.1 General Requirements > 4.2.1.3 Mandatory Verifications","summary":"Mandatory verifications must be verified through an available electronic data source or by paper proof, if electronic data sources are unsuccessful or unavailable. Self-attestation of certain eligibility factors may be accepted without paper proof if electronic data sources are unsuccessful or unavailable and paper proof does not exist or is not available. Medicare Savings Programs (MSP) have the ","effective_date":"2024-10-21","last_modified":"2026-10-03T04:46:26.94331+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.1.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.2.1.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_2_1_3.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.407","Code of Federal Regulations, title 42, section 435.920","Code of Federal Regulations, title 42, section 435.945","Code of Federal Regulations, title 42, section 435.948","Code of Federal Regulations, title 42, section 435.949","Code of Federal Regulations, title 42, section 435.952","Code of Federal Regulations, title 42, section 435.956"],"chunks":[{"chunk_id":"epm:4.2.1.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.1.3","context":"EPM > 4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.1 General Requirements > 4.2.1.3 Mandatory Verifications","text":"Mandatory verifications must be verified through an available electronic data source or by paper proof, if electronic data sources are unsuccessful or unavailable. Self-attestation of certain eligibility factors may be accepted without paper proof if electronic data sources are unsuccessful or unavailable and paper proof does not exist or is not available. Medicare Savings Programs (MSP) have the following mandatory verifications:\n- Assets\n  - Verification of assets is required at application and when a new asset is reported.\n    - At renewal, an excluded asset that was verified does not need to be verified again unless the asset has changed, to determine whether the change affects the exclusion.\n    - The Asset Verification Service (AVS) may provide verifications for certain types of assets at application and renewal. Additional verification of these assets is not required when the total countable assets are at or below the program asset limit. See[2.3.1.2 MA-ABD Asset Verification Service](https://bot-corpus.mn-dhs.online/s/epm/2.3.1.2).\n  - Verification of the following assets are not required at application or renewal:\n    - Homestead, if it qualifies for the real property homestead exclusion. Refer to [Section 2.3.3.2.7.4.1 MA-ABD Homestead Real Property](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.4.1) for more information.\n    - Vehicle, if only one is reported. Refer to [Section 2.3.3.2.7.7 MA ABD Automobiles and Other Vehicles Used for Transportation](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7.7) for more information.\n    - Household goods and personal effects\n- Enrollment or eligibility to enroll in Medicare Part A\n- Income\n  1. \n    - If a person is receiving Supplemental Security Income (SSI), only the SSI income is verified. Eligibility for SSI is accepted as verification of other income SSA considers in determining eligibility.\n    - Veteran's Administration (VA) Aid and Attendance benefits and VA unusual medical expense payments must be verified even if the person is receiving SSI.\n- Immigration status\n- Social Security Number"}]},{"id":"epm:4.2.1.4","number":"4.2.1.4","title":"Medicare Overview","parent":"4.2.1","breadcrumb":"4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.1 General Requirements > 4.2.1.4 Medicare Overview","summary":"Medicare is a federal health insurance program for most people age 65 or older, people who are certified disabled, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant). The Centers for Medicare and Medicaid Services (CMS) determines who is eligible for Medicare. Medicare eligibility usually begins the month a person turns age 65. People who h","effective_date":"2016-06-01","last_modified":"2026-10-03T03:58:38.571566+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.1.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.2.1.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_2_1_4.htm","legal_citations":["United States Code, title 42, section 1395c","United States Code, title 42, section 1395j","United States Code, title 42, section 1395w"],"chunks":[{"chunk_id":"epm:4.2.1.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.1.4","context":"EPM > 4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.1 General Requirements > 4.2.1.4 Medicare Overview","text":"Medicare is a federal health insurance program for most people age 65 or older, people who are certified disabled, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant). The Centers for Medicare and Medicaid Services (CMS) determines who is eligible for Medicare. Medicare eligibility usually begins the month a person turns age 65. People who have been certified disabled by the Social Security Administration (SSA) and are receiving Social Security Disability Insurance (SSDI) have a 24 month wait before Medicare coverage can start.\n\nMedicare has four parts:\n- Part A is hospitalization insurance. Most people are entitled to premium-free Medicare Part A if they or their spouse has the required work history. Adult children with a disability may be eligible based on their parent’s work history. People who do not have required work history can pay a premium for Medicare Part A.\n- Part B is medical insurance. Medicare Part B has a monthly premium.\n- Part C is Medicare Advantage. Most Medicare beneficiaries can choose to participate in Medicare Advantage plans, which combine Part A, Part B, and, sometimes, Part D coverage. Private insurance companies approved by CMS manage Medicare Advantage plans. Many Medicare Advantage plans only charge the monthly Part B premium, others have higher monthly premiums and offer additional benefits.\n- Part D is prescription drug coverage. Medicare Part D is available to people entitled to premium-free Medicare Part A or enrolled in Medicare Part B. Enrollment in Medicare Part D is voluntary, but premium penalties apply for late enrollment by people without other drug coverage. People have a wide variety of Medicare-approved plans from which to choose. Some Part D beneficiaries who have limited income and assets are eligible for premium and cost sharing subsidies. These subsidies are referred to as Extra Help or Low-Income Subsidy (LIS).\n\nA person can be on all, some, or one of the Medicare parts at a time.\n\nSee the [Types of MSP](https://bot-corpus.mn-dhs.online/s/epm/4.2.1.7) policy for information about how MSPs help people keep their Medicare coverage by paying some Medicare expenses."}]},{"id":"epm:4.2.1.5","number":"4.2.1.5","title":"Referral for Other Benefits","parent":"4.2.1","breadcrumb":"4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.1 General Requirements > 4.2.1.5 Referral for Other Benefits","summary":"Medicare Savings Programs (MSP) enrollees who appear to have eligibility for other programs are required to apply for those programs to continue MSP eligibility only if it would increase their income above the MSP income standard. Enrollees must apply within 30 days of when the county, tribal, or state servicing agency notifies them of their potential eligibility, unless they can show good cause f","effective_date":"2016-06-01","last_modified":"2026-10-03T03:58:38.571566+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.1.5","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.2.1.5","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_2_1_5.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.608"],"chunks":[{"chunk_id":"epm:4.2.1.5#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.1.5","context":"EPM > 4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.1 General Requirements > 4.2.1.5 Referral for Other Benefits","text":"Medicare Savings Programs (MSP) enrollees who appear to have eligibility for other programs are required to apply for those programs to continue MSP eligibility only if it would increase their income above the MSP income standard. Enrollees must apply within 30 days of when the county, tribal, or state servicing agency notifies them of their potential eligibility, unless they can show good cause for not doing so.\n\nPeople enrolled in Medical Assistance (MA) and a MSP may be required to apply for other benefits, even if the benefits do not exceed the MSP income standard. See [MA Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.4) for more information.\n\nMSP enrollees are not required to reapply for benefits that were previously denied unless there has been a change in circumstances or eligibility requirements of the benefit program."}]},{"id":"epm:4.2.1.6","number":"4.2.1.6","title":"Retroactive Eligibility","parent":"4.2.1","breadcrumb":"4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.1 General Requirements > 4.2.1.6 Retroactive Eligibility","summary":"Service Limited Medicare Beneficiary (SLMB), Qualified Individuals (QI) and Qualified Working Disabled (QWD) Medicare Savings Programs (MSP) are available for the three months before the month of application for people who meet all eligibility requirements. The Social Security Administration reimburses the person for the cost of Medicare Part B premiums they paid during the retroactive period.","effective_date":"2016-06-01","last_modified":"2026-10-03T03:58:38.571566+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.1.6","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.2.1.6","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_2_1_6.htm","legal_citations":["Code of Federal Regulations, title 42, section 435.915","United States Code, title 42, section 1396a(a)(10)(E)","United States Code, title 42, section 1396d"],"chunks":[{"chunk_id":"epm:4.2.1.6#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.1.6","context":"EPM > 4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.1 General Requirements > 4.2.1.6 Retroactive Eligibility","text":"Service Limited Medicare Beneficiary (SLMB), Qualified Individuals (QI) and Qualified Working Disabled (QWD) Medicare Savings Programs (MSP) are available for the three months before the month of application for people who meet all eligibility requirements. The Social Security Administration reimburses the person for the cost of Medicare Part B premiums they paid during the retroactive period.\n\nWhile Qualified Medicare Beneficiary (QMB) has no retroactive coverage, people eligible for QMB may receive SLMB for the three-month retroactive period and all processing months preceding the month QMB eligibility begins if all other eligibility requirements are met."}]},{"id":"epm:4.2.1.7","number":"4.2.1.7","title":"Types of Medicare Savings Programs","parent":"4.2.1","breadcrumb":"4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.1 General Requirements > 4.2.1.7 Types of Medicare Savings Programs","summary":"Medicare Savings Programs (MSP) are for people entitled to or enrolled in Medicare and who are within certain income and asset limits. Medicare recipients can choose to apply for an MSP only, or both an MSP and Medical Assistance (MA).","effective_date":"2026-03-26","last_modified":"2026-10-03T03:58:38.571566+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.1.7","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.2.1.7","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_2_1_7.htm","legal_citations":["Code of Federal Regulations, title 42, section 400.200","Minnesota Statutes, section 256B.057","United States Code, title 42, section 1396a(a)(10)(E)","United States Code, title 42, section 1396d(p)","United States Code, title 42, section 1396d(s)"],"chunks":[{"chunk_id":"epm:4.2.1.7#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.1.7","context":"EPM > 4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.1 General Requirements > 4.2.1.7 Types of Medicare Savings Programs","text":"Medicare Savings Programs (MSP) are for people entitled to or enrolled in Medicare and who are within certain income and asset limits. Medicare recipients can choose to apply for an MSP only, or both an MSP and Medical Assistance (MA).\n\nThere are four Medicare Savings Programs available to people eligible for Medicare who meet all other requirements:\n- Qualified Medicare Beneficiary (QMB),\n- Service Limited Medicare Beneficiary (SLMB),\n- Qualified Individuals (QI), and\n- Qualified Working Disabled (QWD) program is limited to people who are blind or have a disability.\n\nQMB, SLMB, and QI do not require a basis of eligibility (such as disabled or blind). Individuals receiving Medicare through the Extended Period of Medicare Coverage (EPMC) may still qualify for an MSP, even if they are no longer certified disabled by the Social Security Administration (SSA)."},{"chunk_id":"epm:4.2.1.7#qualified-medicare-beneficiary-qmb","heading":"Qualified Medicare Beneficiary (QMB)","url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.1.7#qualified-medicare-beneficiary-qmb","context":"EPM > 4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.1 General Requirements > 4.2.1.7 Types of Medicare Savings Programs > Qualified Medicare Beneficiary (QMB)","text":"## Qualified Medicare Beneficiary (QMB)\n\nPeople who are enrolled in or are eligible to enroll in Medicare Part A may receive help with Medicare premium costs through the QMB program. QMB pays Medicare Part A (for people required to pay a Part A premium) and Medicare Part B premiums. It also pays for both Medicare Part A and Part B deductibles, coinsurance and copayments.\n\nTo qualify for QMB, a person must be entitled to Medicare Part A, have monthly income at or below 100% FPG, and meet the asset limit. See the [MSP Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/4.2.3) subchapter for more information. People who meet QMB requirements may receive QMB only or may receive QMB in addition to MA.\n\nMA-ABD enrollees who are turning 65 and receive SSI are deemed eligible for QMB. DHS notifies these individuals 60 days before their 65th birthday to apply for Medicare.\n\nQMB enrollees automatically qualify for Extra Help paying for Medicare Part D prescription drug coverage.\n\n### QMB Begin and End Dates\n\nQMB eligibility begins the first day of the month after the month eligibility is determined unless there is an agency error and eligibility should have begun sooner. QMB eligibility cannot begin in or before the month of application."},{"chunk_id":"epm:4.2.1.7#service-limited-medicare-beneficiary-slmb","heading":"Service Limited Medicare Beneficiary (SLMB)","url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.1.7#service-limited-medicare-beneficiary-slmb","context":"EPM > 4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.1 General Requirements > 4.2.1.7 Types of Medicare Savings Programs > Service Limited Medicare Beneficiary (SLMB)","text":"## Service Limited Medicare Beneficiary (SLMB)\n\nPeople enrolled in or eligible to enroll in Medicare Part B may receive help with Medicare premium costs through the SLMB program. SLMB pays Medicare Part B premiums. Medicare calls SLMB the Specified Low-Income Medicare Beneficiary (SLMB) Program.\n\nTo qualify for the SLMB program, a person must be eligible for Medicare Part A have monthly income at or below 120% FPG and meet the asset limit. See the [MSP Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/4.2.3) subchapter for more information. People who meet SLMB requirements may receive SLMB only, or may receive SLMB in addition to MA.\n\nSLMB enrollees automatically qualify for Extra Help paying for Medicare Part D prescription drug coverage.\n\nSLMB also offers retroactive coverage. See [MSP Retroactive Eligibility](https://bot-corpus.mn-dhs.online/s/epm/4.2.1.6) for more information."},{"chunk_id":"epm:4.2.1.7#qualified-individuals-qi","heading":"Qualified Individuals (QI)","url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.1.7#qualified-individuals-qi","context":"EPM > 4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.1 General Requirements > 4.2.1.7 Types of Medicare Savings Programs > Qualified Individuals (QI)","text":"## Qualified Individuals (QI)\n\nPeople enrolled in or eligible to enroll in Medicare Part B may receive help with Medicare premium costs through the QI program. QI pays Medicare Part B premiums. A limited amount of money is available for the QI program, and benefits are available on a first-come, first-served basis. Medicare calls QI the Qualifying Individuals (QI) program.\n\nTo qualify for QI, a person must be eligible for Medicare Part A and have monthly income at or below 135% FPG and meet the asset limit. See the [MSP Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/4.2.3) subchapter for more information.\n\nQI enrollees automatically qualify for Extra Help paying for Medicare Part D prescription drug coverage. QI also offers retroactive coverage. See [MSP Retroactive Eligibility](https://bot-corpus.mn-dhs.online/s/epm/4.2.1.6) for more information.\n\n### QI and Medical Assistance\n\nGenerally, a person cannot be enrolled in QI and MA benefits. However, a person may have overlapping QI and MA coverage when:\n- a person enrolled in QI requests and is determined eligible for retroactive MA eligibility, or\n- an MA enrollee's coverage remains open when redetermining MA under another basis and is eligible for QI during that redetermination process.\n\nQI and MA coverage cannot overlap ongoing after the determination for retroactive MA or the redetermination under another basis is complete.\n\n### QI and MinnesotaCare Eligibility\n\nQI pays for Medicare Part B premiums, and enrollment in Medicare Part B is a barrier to MinnesotaCare. Therefore, a person cannot be eligible for both QI and MinnesotaCare. For more information, see EPM [3.2.3.1 MinnesotaCare Health Care Coverage Barriers](https://bot-corpus.mn-dhs.online/s/epm/3.2.3.1)."},{"chunk_id":"epm:4.2.1.7#qualified-working-disabled-qwd","heading":"Qualified Working Disabled (QWD)","url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.1.7#qualified-working-disabled-qwd","context":"EPM > 4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.1 General Requirements > 4.2.1.7 Types of Medicare Savings Programs > Qualified Working Disabled (QWD)","text":"## Qualified Working Disabled (QWD)\n\nSome employed people under age 65 with disabilities may lose their Retirement, Survivors, and Disability Insurance (RSDI) and premium-free Medicare benefits because their income exceeds Substantial Gainful Activity (SGA) limits. QWD may pay Medicare Part A premiums for these individuals. Medicare calls QWD the Qualified Disabled and Working Individuals (QDWI) program.\n\nTo qualify for QWD, a person must meet a blind or disabled basis and be eligible to enroll in Medicare Part A with a premium under the Qualified Working Disabled Adult provisions of the Social Security Act. The person must also have monthly income at or below 200% FPG, meet the asset limit, and not be otherwise eligible for MA. See the [MSP Financial Eligibility](https://bot-corpus.mn-dhs.online/s/epm/4.2.3) subchapter for more information. People cannot be enrolled in both QWD and MA.\n\nQWD also offers retroactive coverage. See [MSP Retroactive Eligibility](https://bot-corpus.mn-dhs.online/s/epm/4.2.1.6) for more information."}]},{"id":"epm:4.2.2","number":"4.2.2","title":"Non-Financial Eligibility","parent":"4.2","breadcrumb":"4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.2 Non-Financial Eligibility","summary":"This subchapter includes non-financial eligibility policies. This covers eligibility factors not related to a person’s income or assets. Medicare Savings Programs (MSP) follow many of the same non-financial eligibility policies as Medical Assistance (MA).","effective_date":"2016-06-01","last_modified":"2026-10-03T03:58:38.571566+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.2.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_2_2.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:4.2.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.2","context":"EPM > 4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.2 Non-Financial Eligibility","text":"This subchapter includes non-financial eligibility policies. This covers eligibility factors not related to a person’s income or assets. Medicare Savings Programs (MSP) follow many of the same non-financial eligibility policies as Medical Assistance (MA).\n\nThis subchapter includes links to policies that apply to MSPs and links relevant to MA policies. Topics covered in this subchapter are:\n1. [MA Citizenship and Immigration](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2)\n2. [MA County Residency](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.3)\n3. [MA Social Security Number](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.5)\n4. [MHCP State Residency](https://bot-corpus.mn-dhs.online/s/epm/1.4)"}]},{"id":"epm:4.2.3","number":"4.2.3","title":"Financial Eligibility","parent":"4.2","breadcrumb":"4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.3 Financial Eligibility","summary":"This subchapter provides policy about financial eligibility for the Medicare Savings Programs (MSP). This includes eligibility factors that involve a person’s income or assets. MSP follows many of the same financial eligibility policies as Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD). The policies listed below explain MSP policy and l","effective_date":"2016-06-01","last_modified":"2026-10-03T03:58:38.571566+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.2.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_2_3.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:4.2.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.3","context":"EPM > 4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.3 Financial Eligibility","text":"This subchapter provides policy about financial eligibility for the Medicare Savings Programs (MSP). This includes eligibility factors that involve a person’s income or assets. MSP follows many of the same financial eligibility policies as Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD). The policies listed below explain MSP policy and link to the relevant MA-ABD financial policies.\n\nTopics in this subchapter include:\n1. [MSP Assets](https://bot-corpus.mn-dhs.online/s/epm/4.2.3.1)\n2. [MSP Household Composition and Family Size](https://bot-corpus.mn-dhs.online/s/epm/4.2.3.2)\n3. [MSP Income](https://bot-corpus.mn-dhs.online/s/epm/4.2.3.3)"}]},{"id":"epm:4.2.3.1","number":"4.2.3.1","title":"Assets","parent":"4.2.3","breadcrumb":"4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.3 Financial Eligibility > 4.2.3.1 Assets","summary":"Assets are items of value that people own like bank accounts, stocks and bonds, cars, and real estate. Medicare Savings Programs (MSP) follow many of the same asset eligibility policies as Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD). Specific MSP asset policies and links to the relevant MA-ABD asset policies are included.","effective_date":"2016-09-01","last_modified":"2026-10-03T03:58:38.571566+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.3.1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.2.3.1","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_2_3_1.htm","legal_citations":["Minnesota Statutes, section 256B.057, subdivision 3","Minnesota Statutes, section 256B.057, subdivision 4","United States Code, title 42, section 1396d(p)","United States Code, title 42, section 1396d(s)"],"chunks":[{"chunk_id":"epm:4.2.3.1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.3.1","context":"EPM > 4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.3 Financial Eligibility > 4.2.3.1 Assets","text":"Assets are items of value that people own like bank accounts, stocks and bonds, cars, and real estate. Medicare Savings Programs (MSP) follow many of the same asset eligibility policies as Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD). Specific MSP asset policies and links to the relevant MA-ABD asset policies are included."},{"chunk_id":"epm:4.2.3.1#asset-limit","heading":"Asset Limit","url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.3.1#asset-limit","context":"EPM > 4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.3 Financial Eligibility > 4.2.3.1 Assets > Asset Limit","text":"## Asset Limit\n\nThe asset limit for an MSP is determined by household composition and family size. See [MSP Household Composition and Family Size](https://bot-corpus.mn-dhs.online/s/epm/4.2.3.2) policy for more information about determining household composition.\n\nThe asset limit for the MSPs are:\n- Qualified Medicare Beneficiary (QMB)\n  - $10,000 for a household of one\n  - $18,000 for a household of two or more\n- Service Limited Medicare Beneficiary (SLMB)\n  - $10,000 for a household of one\n  - $18,000 for a household of two or more\n- Qualified Individual (QI)\n  - $10,000 for a household of one\n  - $18,000 for a household of two or more\n- Qualified Working Disabled (QWD)\n  - $4,000 for a household of one\n  - $6,000 for a household of two or more"},{"chunk_id":"epm:4.2.3.1#asset-policies","heading":"Asset Policies","url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.3.1#asset-policies","context":"EPM > 4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.3 Financial Eligibility > 4.2.3.1 Assets > Asset Policies","text":"## Asset Policies\n\nAll other factors in asset eligibility follow MA-ABD. See the following policies for more information.\n1. [MA-ABD Assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2)\n2. [MA-ABD Asset Deeming](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.2)\n3. [MA-ABD Asset Evaluation](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.7)\n4. [MA-ABD Countable Assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.4)\n5. [MA-ABD Excess Assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.6)\n6. [MA-ABD Excluded Assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.3)\n7. [MA-ABD Unknown Assets](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.2.5)"}]},{"id":"epm:4.2.3.2","number":"4.2.3.2","title":"Household Composition and Family Size","parent":"4.2.3","breadcrumb":"4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.3 Financial Eligibility > 4.2.3.2 Household Composition and Family Size","summary":"Household composition means the people included in a person’s household. Household composition determines the family size. Household composition and family size are factors used to determine financial eligibility.","effective_date":"2016-09-01","last_modified":"2026-10-03T03:58:38.571566+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.3.2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.2.3.2","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_2_3_2.htm","legal_citations":["Minnesota Statutes, section 256B.057, subdivision 3","Minnesota Statutes, section 256B.057, subdivision 4"],"chunks":[{"chunk_id":"epm:4.2.3.2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.3.2","context":"EPM > 4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.3 Financial Eligibility > 4.2.3.2 Household Composition and Family Size","text":"Household composition means the people included in a person’s household. Household composition determines the family size. Household composition and family size are factors used to determine financial eligibility.\n\nHousehold composition and family size are determined for each person separately, and may be different for each person on an application or in a household."},{"chunk_id":"epm:4.2.3.2#medicare-savings-program-household-composition-and-family-size","heading":"Medicare Savings Program Household Composition and Family Size","url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.3.2#medicare-savings-program-household-composition-and-family-size","context":"EPM > 4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.3 Financial Eligibility > 4.2.3.2 Household Composition and Family Size > Medicare Savings Program Household Composition and Family Size","text":"## Medicare Savings Program Household Composition and Family Size\n\nThe Medicare Savings Programs (MSP) generally follow the standard [Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) Household Composition and Family Size](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.1) policy."},{"chunk_id":"epm:4.2.3.2#elderly-waiver-exception","heading":"Elderly Waiver Exception","url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.3.2#elderly-waiver-exception","context":"EPM > 4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.3 Financial Eligibility > 4.2.3.2 Household Composition and Family Size > Elderly Waiver Exception","text":"## Elderly Waiver Exception\n\nAn MSP applicant or enrollee receiving Elderly Waiver (EW) services is a household of one when determining MSP financial eligibility.\n\nA spouse receiving EW services is not counted in an MSP applicant or enrollee’s household composition, when the MSP applicant or enrollee is not on EW."}]},{"id":"epm:4.2.3.3","number":"4.2.3.3","title":"Income","parent":"4.2.3","breadcrumb":"4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.3 Financial Eligibility > 4.2.3.3 Income","summary":"Medicare Savings Programs (MSP) follow many of the same income eligibility policies as Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD). Specific MSP income policies and links to the relevant MA-ABD income policies are included.","effective_date":"2018-01-01","last_modified":"2026-10-03T03:58:38.571566+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.3.3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.2.3.3","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_2_3_3.htm","legal_citations":["Minnesota Statutes, section 256B.056, subdivision 1a","Minnesota Statutes, section 256B.056, subdivision 4","Minnesota Statutes, section 256B.056, subdivision 5","Minnesota Statutes, section 256B.057, subdivision 3","Minnesota Statutes, section 256B.057, subdivision 4","United States Code, title 42, section 1382a","United States Code, title 42, section 1396d(p)","United States Code, title 42, section 1396d(s)"],"chunks":[{"chunk_id":"epm:4.2.3.3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.3.3","context":"EPM > 4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.3 Financial Eligibility > 4.2.3.3 Income","text":"Medicare Savings Programs (MSP) follow many of the same income eligibility policies as Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD). Specific MSP income policies and links to the relevant MA-ABD income policies are included."},{"chunk_id":"epm:4.2.3.3#income-limit","heading":"Income Limit","url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.3.3#income-limit","context":"EPM > 4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.3 Financial Eligibility > 4.2.3.3 Income > Income Limit","text":"## Income Limit\n\nTo be eligible for a MSP a person’s income must be less than or equal to the applicable federal poverty guidelines income limit. The income limit for an MSP is determined by household composition and family size. See [MSP Household Composition and Family Size](https://bot-corpus.mn-dhs.online/s/epm/4.2.3.2) policy for more information about determining household composition. Income deeming rules determine whose income counts for a person. See the [MA-ABD Income Deeming](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1.1) policy for more information about whose income’s count.\n\nMSP income limits are:\n- 100% FPG Qualified Medicare Beneficiary (QMB)\n- 120% FPG Service Limited Medicare Beneficiary (SLMB)\n- 135% FPG Qualified Individual (QI)\n- 200% FPG Qualified Working Disabled (QWD)\n\nSee Minnesota Insurance Affordability Programs Income and Asset Guidelines ([DHS-3461A](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3461A-ENG)) for information about income limits based on the household size."},{"chunk_id":"epm:4.2.3.3#income-policies","heading":"Income Policies","url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.3.3#income-policies","context":"EPM > 4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.3 Financial Eligibility > 4.2.3.3 Income > Income Policies","text":"## Income Policies\n\nFor MSPs, all other factors in income eligibility follow MA-ABD except as follows:\n\n### MSP Disregards and Deductions\n\nDisregards and deductions for MSP income are applied different than for MA-ABD income.\n- Unearned income The following list are the disregards and deductions that are deducted from the specific unearned income:\n  - Unearned Lump Sum Income Disregard\n  - Child Support Disregard\n- The following disregards and deductions are then deducted in the specific order listed:\n  - Disabled Widow and Widower Disregard\n  - Widow and Widower Disregard\n  - Pickle Disregard\n  - Disabled Adult Child Disregard\n  - Retirement, Survivors, Disability Insurance (RSDI) Cost of Living Adjustment (COLA) disregard\n  - Plan to Achieve Self Support (PASS) Deduction\n  - Standard Deduction. This deduction subtracts $20 from the income used to determine MSP eligibility. The deduction is first applied to unearned income. When a person has less than $20 of unearned income, the remainder of the deduction is applied to earned income. An eligible household receives only one $20 exclusion per month.\n  - Community Spouse Allocation. This deduction is applied only for people receiving services in a Long Term Care (LTC) facility or on the Elderly Waiver( EW). The deduction is first applied to unearned income. the remainder, if any, is then applied to a person's earned income.\n  - Family Allocation. This deduction is applied only for people receiving services in an LTC facility or on EW. The deduction is first applied to unearned income. The remainder, if any, is then applied to a person's earned income.\n- Earned Income The Earned Lump Sum Income Disregard is applied to earned lump sum income. The following disregards and deductions are then deduction in the specific order listed:\n  - PASS Deduction\n  - Student Earned Income Exclusion\n  - Standard Deduction. Any remaining amount from Standard Deduction after applying it to unearned income is applied to a person's earned income.\n  - Earned Income Disregard\n  - Impairment Related Work Expense Deduction\n  - Remaining Earned Income Disregard\n  - Blind Work Expense Deduction\n  - Community Spouse Allocation. Any remaining amount from the Community Spouse Allocation after applying it to unearned income is applied to earned income for people receiving services in an LTC facility or on EW.\n  - Family Allocation. Any remaining amount from the Family Allocation after applying it to unearned income is applied to earned income for people receiving services in an LTC facility or on EW.\n\n### MSP Excluded Income\n\nAid and Attendance benefits and Allowances for Unusual Medical Expenses from the Veteran's Administration are excluded income.\n\nSee the following policies for more information.\n1. [MA-ABD Income Methodology](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2)\n2. [MA-ABD Countable Income](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1)\n3. [MA-ABD Income Deeming](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1.1)\n4. [MA-ABD Sponsor Income Deeming](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.1.2)\n5. [MA-ABD Excluded Income](https://bot-corpus.mn-dhs.online/s/epm/2.3.3.3.2.3)\n-"}]},{"id":"epm:4.2.4","number":"4.2.4","title":"Post-Eligibility","parent":"4.2","breadcrumb":"4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.4 Post-Eligibility","summary":"These policies apply to Medicare Savings Programs (MSP). In general, MSPs follow the same post-eligibility policies as Medical Assistance (MA). This subchapter includes policies that apply to MSPs and links to policies that apply to all MA programs, MA for People Who Are Age 65 and Older and People Who Are Blind or Have a Disability (MA-ABD), and all other Minnesota Health Care Programs (MHCP) pro","effective_date":"2016-06-01","last_modified":"2026-10-03T03:58:38.571566+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/4.2.4","official_origin":"https://hcopub.dhs.state.mn.us/epm/4_2_4.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:4.2.4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/4.2.4","context":"EPM > 4 Other Health Care Programs > 4.2 Medicare Savings Programs > 4.2.4 Post-Eligibility","text":"These policies apply to Medicare Savings Programs (MSP). In general, MSPs follow the same post-eligibility policies as Medical Assistance (MA). This subchapter includes policies that apply to MSPs and links to policies that apply to all MA programs, MA for People Who Are Age 65 and Older and People Who Are Blind or Have a Disability (MA-ABD), and all other Minnesota Health Care Programs (MHCP) programs.\n\nTopics covered in this sub-chapter are:\n1. [MA Begin and End Dates](https://bot-corpus.mn-dhs.online/s/epm/2.1.4.1)\n2. [MA Benefit Recovery (MSP benefits before 1/1/2010)](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1)\n  1. [MA Estate Recovery (MSP benefits before 1/1/2010)](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.1)\n  2. [MA Liens (MSP benefits before 1/1/2010)](https://bot-corpus.mn-dhs.online/s/epm/2.1.1.2.1.2)\n3. [MHCP Change in Circumstances](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.1)\n4. [MSP Cooperation](https://bot-corpus.mn-dhs.online/s/epm/4.2.1.2)\n5. [MHCP Fraud](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.3)\n6. [MHCP Inconsistent Information](https://bot-corpus.mn-dhs.online/s/epm/1.3.2.4)\n7. [MSP Referral for Other Benefits](https://bot-corpus.mn-dhs.online/s/epm/4.2.1.5)\n8. [MA-ABD Renewals](https://hcopub.dhs.state.mn.us/epm/2_3_4_2ar4.htm)"}]},{"id":"epm:appendices","number":"appendices","title":"Appendices","parent":null,"breadcrumb":"appendices Appendices","summary":"The Minnesota Health Care Programs (MHCP) Eligibility Policy Manual (EPM) includes the appendices listed on this page. These appendices provide helpful contextual information that support the policy provided in the EPM.","effective_date":"2016-06-01","last_modified":"2026-10-03T04:10:19.068661+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/appendices","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/appendices","official_origin":"https://hcopub.dhs.state.mn.us/epm/appendices.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:appendices#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/appendices","context":"EPM > appendices Appendices","text":"The Minnesota Health Care Programs (MHCP) Eligibility Policy Manual (EPM) includes the appendices listed on this page. These appendices provide helpful contextual information that support the policy provided in the EPM.\n1. [Appendix A Types of Assets](https://bot-corpus.mn-dhs.online/s/epm/A)\n2. [Appendix B Types of Income](https://bot-corpus.mn-dhs.online/s/epm/B)\n3. [Appendix C Types of Other Health Care Coverage](https://bot-corpus.mn-dhs.online/s/epm/C)\n4. [Appendix D Community Living Arrangements](https://bot-corpus.mn-dhs.online/s/epm/D)\n5. [Appendix E Institutions for Mental Diseases](https://bot-corpus.mn-dhs.online/s/epm/E)\n6. [Appendix F Standards and Guidelines](https://bot-corpus.mn-dhs.online/s/epm/F)\n7. [Appendix G Life Estates Mortality Table](https://bot-corpus.mn-dhs.online/s/epm/G)\n8. [Appendix H Lawfully Present Noncitizens](https://bot-corpus.mn-dhs.online/s/epm/H)\n9. [Appendix I Life Insurance Concepts](https://bot-corpus.mn-dhs.online/s/epm/I)"}]},{"id":"epm:A","number":"A","title":"Appendix A Types of Assets","parent":"appendices","breadcrumb":"A Appendix A Types of Assets","summary":"A retirement savings plan in which people contribute a portion of their earnings to a 401(k) account. Sometimes the person’s employer may match these contributions.","effective_date":"2026-06-03","last_modified":"2026-10-03T04:10:19.068661+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/A","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/A","official_origin":"https://hcopub.dhs.state.mn.us/epm/appendix_a.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:A#401k-plan","heading":"401(k) Plan","url":"https://bot-corpus.mn-dhs.online/s/epm/A#401k-plan","context":"EPM > A Appendix A Types of Assets > 401(k) Plan","text":"## 401(k) Plan\n\nA retirement savings plan in which people contribute a portion of their earnings to a 401(k) account. Sometimes the person’s employer may match these contributions."},{"chunk_id":"epm:A#403b-plan","heading":"403(b) Plan","url":"https://bot-corpus.mn-dhs.online/s/epm/A#403b-plan","context":"EPM > A Appendix A Types of Assets > 403(b) Plan","text":"## 403(b) Plan\n\nA tax-deferred retirement plan available to employees of educational institutions and certain nonprofit organizations. This plan is also referred to as a tax-sheltered annuity."},{"chunk_id":"epm:A#457-plan","heading":"457 Plan","url":"https://bot-corpus.mn-dhs.online/s/epm/A#457-plan","context":"EPM > A Appendix A Types of Assets > 457 Plan","text":"## 457 Plan\n\nA deferred-compensation program made available to employees of state and federal governments and agencies. A 457 plan is similar to a 401(k) plan."},{"chunk_id":"epm:A#academic-achievement-incentive-scholarships","heading":"Academic Achievement Incentive Scholarships","url":"https://bot-corpus.mn-dhs.online/s/epm/A#academic-achievement-incentive-scholarships","context":"EPM > A Appendix A Types of Assets > Academic Achievement Incentive Scholarships","text":"## Academic Achievement Incentive Scholarships\n\nA student financial aid program created by Title IV of the Higher Education Act of 1965."},{"chunk_id":"epm:A#academic-competitiveness-grants","heading":"Academic Competitiveness Grants","url":"https://bot-corpus.mn-dhs.online/s/epm/A#academic-competitiveness-grants","context":"EPM > A Appendix A Types of Assets > Academic Competitiveness Grants","text":"## Academic Competitiveness Grants\n\nA student financial aid program created by Title IV of the Higher Education Act of 1965."},{"chunk_id":"epm:A#achieving-a-better-life-experience-able-account","heading":"Achieving a Better Life Experience (ABLE) Account","url":"https://bot-corpus.mn-dhs.online/s/epm/A#achieving-a-better-life-experience-able-account","context":"EPM > A Appendix A Types of Assets > Achieving a Better Life Experience (ABLE) Account","text":"## Achieving a Better Life Experience (ABLE) Account\n\nTax-free savings account that allows people with disabilities to save and invest money without affecting their program eligibility."},{"chunk_id":"epm:A#adoption-assistance","heading":"Adoption assistance","url":"https://bot-corpus.mn-dhs.online/s/epm/A#adoption-assistance","context":"EPM > A Appendix A Types of Assets > Adoption assistance","text":"## Adoption assistance\n\nAn adoption assistance grant provided to adoptive parents. It is funded either federally through Title IV-E of the Social Security Act or by the state under Minnesota Statutes, section 259.67."},{"chunk_id":"epm:A#agent-orange-settlement-fund-payments","heading":"Agent Orange Settlement Fund payments","url":"https://bot-corpus.mn-dhs.online/s/epm/A#agent-orange-settlement-fund-payments","context":"EPM > A Appendix A Types of Assets > Agent Orange Settlement Fund payments","text":"## Agent Orange Settlement Fund payments\n\nPayments made in connection with the case of In re Agent Orange Product Liability Litigation. Qualifying survivors of deceased veterans received a single lump sum payment. The settlement fund is now closed as all funds have been distributed."},{"chunk_id":"epm:A#agricultural-homestead","heading":"Agricultural homestead","url":"https://bot-corpus.mn-dhs.online/s/epm/A#agricultural-homestead","context":"EPM > A Appendix A Types of Assets > Agricultural homestead","text":"## Agricultural homestead\n\nThe property located on agricultural land that meets the definition of home and includes the dwelling, the garage, if any, and one acre of land immediately surrounding the dwelling. This applies to the home equity limit."},{"chunk_id":"epm:A#alaska-native-claims-settlement-act-ancsa-payments","heading":"Alaska Native Claims Settlement Act (ANCSA) payments","url":"https://bot-corpus.mn-dhs.online/s/epm/A#alaska-native-claims-settlement-act-ancsa-payments","context":"EPM > A Appendix A Types of Assets > Alaska Native Claims Settlement Act (ANCSA) payments","text":"## Alaska Native Claims Settlement Act (ANCSA) payments\n\nDistributions received by Alaska natives and their descendants from Alaska Native Regional and Village Corporations (ANRVCs)."},{"chunk_id":"epm:A#annuities","heading":"Annuities","url":"https://bot-corpus.mn-dhs.online/s/epm/A#annuities","context":"EPM > A Appendix A Types of Assets > Annuities","text":"## Annuities\n\nA purchased contract in which one party (annuity issuer) agrees to pay the purchaser, or the person(s) the purchaser designates (the payee or payees), a return on money deposited with the annuity issuer (either in the form of a single lump sum or several payments deposited over several months or years) according to the terms of the annuity contract."},{"chunk_id":"epm:A#asset-conversion","heading":"Asset conversion","url":"https://bot-corpus.mn-dhs.online/s/epm/A#asset-conversion","context":"EPM > A Appendix A Types of Assets > Asset conversion","text":"## Asset conversion\n\nA change from one type of asset to another."},{"chunk_id":"epm:A#austrian-reparation-payments-also-called-austrian-social-insurance-payments","heading":"Austrian Reparation payments (also called Austrian Social Insurance payments)","url":"https://bot-corpus.mn-dhs.online/s/epm/A#austrian-reparation-payments-also-called-austrian-social-insurance-payments","context":"EPM > A Appendix A Types of Assets > Austrian Reparation payments (also called Austrian Social Insurance payments)","text":"## Austrian Reparation payments (also called Austrian Social Insurance payments)\n\nThe nationwide class action lawsuit, Bondy v. Sullivan, involved Austrian social insurance payments which were passed, in whole or in part, on wage credits granted under Paragraph 500–506 of the Austrian General Social Insurance Act. (GSIA). These paragraphs grant credits to individuals who suffered a loss (i.e., were imprisoned, unemployed, or forced to flee Austria) during the period from March 1933 to May 1945 for political, religious, or ethnic reasons."},{"chunk_id":"epm:A#blood-product-settlement-payments","heading":"Blood product settlement payments","url":"https://bot-corpus.mn-dhs.online/s/epm/A#blood-product-settlement-payments","context":"EPM > A Appendix A Types of Assets > Blood product settlement payments","text":"## Blood product settlement payments\n\nPayments made pursuant to the class settlement of Susan Walker v. Bayer Corp., et al, and to the release of any claims in that case that were entered into in lieu of class settlement."},{"chunk_id":"epm:A#bureau-of-indian-affairs-bia-student-financial-aid","heading":"Bureau of Indian Affairs (BIA) student financial aid","url":"https://bot-corpus.mn-dhs.online/s/epm/A#bureau-of-indian-affairs-bia-student-financial-aid","context":"EPM > A Appendix A Types of Assets > Bureau of Indian Affairs (BIA) student financial aid","text":"## Bureau of Indian Affairs (BIA) student financial aid\n\nBIA funded student financial aid to eligible individuals."},{"chunk_id":"epm:A#burial-assets","heading":"Burial Assets","url":"https://bot-corpus.mn-dhs.online/s/epm/A#burial-assets","context":"EPM > A Appendix A Types of Assets > Burial Assets","text":"## Burial Assets\n\nFunds paid or designated in advance for funeral expenses. Burial funds provide for preparation of the body, cremation, or burial services. The money is usually held in trust by a bank or other financial institution unless the agreement is funded by an insurance policy or annuity."},{"chunk_id":"epm:A#cash-surrender-value-csv","heading":"Cash Surrender Value (CSV)","url":"https://bot-corpus.mn-dhs.online/s/epm/A#cash-surrender-value-csv","context":"EPM > A Appendix A Types of Assets > Cash Surrender Value (CSV)","text":"## Cash Surrender Value (CSV)\n\nThe monetary or equity value that a life insurance policy or annuity acquires over time as the policy owner pays the premiums and dividend additions and interest are added to the policy. The CSV is the amount the life insurance policy or annuity owner would receive if the policy were cashed in. A loan against a life insurance policy reduces its CSV."},{"chunk_id":"epm:A#certificate-of-deposit-cds","heading":"Certificate of Deposit (CDs)","url":"https://bot-corpus.mn-dhs.online/s/epm/A#certificate-of-deposit-cds","context":"EPM > A Appendix A Types of Assets > Certificate of Deposit (CDs)","text":"## Certificate of Deposit (CDs)\n\nA promissory note issued by a bank entitling the bearer to receive interest. A CD is a time deposit that restricts holders from withdrawing funds on demand. Although it is still possible to withdraw money, this action will often incur a penalty."},{"chunk_id":"epm:A#child-tax-credit-payments","heading":"Child Tax Credit Payments","url":"https://bot-corpus.mn-dhs.online/s/epm/A#child-tax-credit-payments","context":"EPM > A Appendix A Types of Assets > Child Tax Credit Payments","text":"## Child Tax Credit Payments\n\nThe federal child tax credit (CTC) was expanded for the tax year 2021 by the American Rescue Plan Act of 2021 (ARPA). The ARPA increased the maximum CTC to $3,600 for each child under age 6 and $3,000 for each child between ages 6 and 17."},{"chunk_id":"epm:A#client-funded-trusts","heading":"Client Funded Trusts","url":"https://bot-corpus.mn-dhs.online/s/epm/A#client-funded-trusts","context":"EPM > A Appendix A Types of Assets > Client Funded Trusts","text":"## Client Funded Trusts\n\nTrusts funded with the income or assets of the client and/or the client’s spouse. The client and/or the client’s spouse (grantor(s)) fund the trust by transferring liquid or non-liquid property to the trustee(s) of a trust for the benefit of the grantee(s) or others."},{"chunk_id":"epm:A#clinical-trial-participation-payments","heading":"Clinical trial participation payments","url":"https://bot-corpus.mn-dhs.online/s/epm/A#clinical-trial-participation-payments","context":"EPM > A Appendix A Types of Assets > Clinical trial participation payments","text":"## Clinical trial participation payments\n\nCompensation for participation in a clinical trial that involves the research and testing of medical treatments for a rare disease or condition."},{"chunk_id":"epm:A#clothing-and-personal-needs-allowance-accumulation","heading":"Clothing and Personal Needs Allowance Accumulation","url":"https://bot-corpus.mn-dhs.online/s/epm/A#clothing-and-personal-needs-allowance-accumulation","context":"EPM > A Appendix A Types of Assets > Clothing and Personal Needs Allowance Accumulation","text":"## Clothing and Personal Needs Allowance Accumulation\n\nClothing and personal needs allowance of people in long-term care facilities retained between annual renewals."},{"chunk_id":"epm:A#cobell-v-salazar-class-action-settlement-also-known-as-claims-resolution-act-of-2010","heading":"Cobell v. Salazar Class Action Settlement (also known as Claims Resolution Act of 2010)","url":"https://bot-corpus.mn-dhs.online/s/epm/A#cobell-v-salazar-class-action-settlement-also-known-as-claims-resolution-act-of-2010","context":"EPM > A Appendix A Types of Assets > Cobell v. Salazar Class Action Settlement (also known as Claims Resolution Act of 2010)","text":"## Cobell v. Salazar Class Action Settlement (also known as Claims Resolution Act of 2010)\n\nFund reimbursing a large number of Individual Indian Money (IIM) account holders due to inadequate historical accounting of funds held in trust by the federal government."},{"chunk_id":"epm:A#college-assistance-migrant-program-camp","heading":"College Assistance Migrant Program (CAMP)","url":"https://bot-corpus.mn-dhs.online/s/epm/A#college-assistance-migrant-program-camp","context":"EPM > A Appendix A Types of Assets > College Assistance Migrant Program (CAMP)","text":"## College Assistance Migrant Program (CAMP)\n\nA student financial aid program created by Title IV of the Higher Education Act of 1965."},{"chunk_id":"epm:A#commercial-annuity","heading":"Commercial annuity","url":"https://bot-corpus.mn-dhs.online/s/epm/A#commercial-annuity","context":"EPM > A Appendix A Types of Assets > Commercial annuity","text":"## Commercial annuity\n\nAn annuity that is purchased and set up via an insurance company or financial institution licensed or regulated by the Minnesota Department of Commerce or a similar agency of another state."},{"chunk_id":"epm:A#continuing-care-retirement-community-ccrc-entrance-fee","heading":"Continuing Care Retirement Community (CCRC) Entrance Fee","url":"https://bot-corpus.mn-dhs.online/s/epm/A#continuing-care-retirement-community-ccrc-entrance-fee","context":"EPM > A Appendix A Types of Assets > Continuing Care Retirement Community (CCRC) Entrance Fee","text":"## Continuing Care Retirement Community (CCRC) Entrance Fee\n\nThe entrance fee charged to a person who enters into a written contract with the CCRC. The CCRC offers a range of continuing care services while allowing the person to remain in a familiar setting. A CCRC may also be referred to as a life care community."},{"chunk_id":"epm:A#contract-for-deed","heading":"Contract for deed","url":"https://bot-corpus.mn-dhs.online/s/epm/A#contract-for-deed","context":"EPM > A Appendix A Types of Assets > Contract for deed","text":"## Contract for deed\n\nA contract for deed is a conditional sales contract for the purchase of real property. It is similar to a mortgage."},{"chunk_id":"epm:A#consolidated-appropriations-act-caa-recovery-rebate-payments","heading":"Consolidated Appropriations Act (CAA) recovery rebate payments","url":"https://bot-corpus.mn-dhs.online/s/epm/A#consolidated-appropriations-act-caa-recovery-rebate-payments","context":"EPM > A Appendix A Types of Assets > Consolidated Appropriations Act (CAA) recovery rebate payments","text":"## Consolidated Appropriations Act (CAA) recovery rebate payments\n\nIn December 2020, Congress passed a new coronavirus stimulus and relief package as part of the CAA. In 2021, recovery rebate payments were provided under the CAA authorized by an amendment to the CARES Act. Payments were up to $600 for individuals, $1,200 for married couples, and $600 per dependent child under 17."},{"chunk_id":"epm:A#coronavirus-aid-relief-and-economic-security-cares-act-payments","heading":"Coronavirus Aid, Relief, and Economic Security (CARES) Act payments","url":"https://bot-corpus.mn-dhs.online/s/epm/A#coronavirus-aid-relief-and-economic-security-cares-act-payments","context":"EPM > A Appendix A Types of Assets > Coronavirus Aid, Relief, and Economic Security (CARES) Act payments","text":"## Coronavirus Aid, Relief, and Economic Security (CARES) Act payments\n\nIn 2020, the CARES Act provided financial help to individuals and families, in the form of one-time payments. The IRS issued these Federal CARES Act payments of up to $1,200 for individuals, $2,400 for married couples, and $500 per dependent child under 17. These payments are also known as economic impact payments and recovery rebates."},{"chunk_id":"epm:A#corporation-for-national-and-community-service-cncs-payments","heading":"Corporation for National and Community Service (CNCS) payments","url":"https://bot-corpus.mn-dhs.online/s/epm/A#corporation-for-national-and-community-service-cncs-payments","context":"EPM > A Appendix A Types of Assets > Corporation for National and Community Service (CNCS) payments","text":"## Corporation for National and Community Service (CNCS) payments\n\nEstablished by the National and Community Service Trust Act of 1993 (NCSTA) by combining two formerly independent agencies: the Commission on National Service and ACTION. CNCS funds payments to volunteers in programs authorized under the Domestic Volunteer Services Act, including:\n- AmeriCorps\n- Urban Crime Prevention Program\n- Special volunteer programs under Title I\n- Demonstration programs under Title II\n- Senior Corps\n  - Retired Senior Volunteer Program (RSVP)\n  - Foster Grandparent Program\n  - Senior Companions"},{"chunk_id":"epm:A#coverdell-education-savings-account-esa-also-referred-to-as-a-section-530-plan-and-formerly-known-as-an-educational-individual-retirement-account","heading":"Coverdell Education Savings Account (ESA) (also referred to as a Section 530 Plan and formerly known as an Educational Individual Retirement Account)","url":"https://bot-corpus.mn-dhs.online/s/epm/A#coverdell-education-savings-account-esa-also-referred-to-as-a-section-530-plan-and-formerly-known-as-an-educational-individual-retirement-account","context":"EPM > A Appendix A Types of Assets > Coverdell Education Savings Account (ESA) (also referred to as a Section 530 Plan and formerly known as an Educational Individual Retirement Account)","text":"## Coverdell Education Savings Account (ESA) (also referred to as a Section 530 Plan and formerly known as an Educational Individual Retirement Account)\n\nAn account established to pay the educational expenses (elementary, secondary, and postsecondary school) of an individual who is the designated beneficiary and is under age 18 or a person with special needs."},{"chunk_id":"epm:A#covid-19-relief-payments","heading":"COVID-19 Relief Payments","url":"https://bot-corpus.mn-dhs.online/s/epm/A#covid-19-relief-payments","context":"EPM > A Appendix A Types of Assets > COVID-19 Relief Payments","text":"## COVID-19 Relief Payments\n\nOn April 24, 2020, Governor Walz issued Emergency Executive Order 20-42 that stated payments received by Minnesotans from state, local and tribal governments to relieve the adverse economic impact of the COVID-19 pandemic must not be counted as income and assets when determining eligibility for DHS programs during the COVID-19 peacetime emergency."},{"chunk_id":"epm:A#crime-victim-payments","heading":"Crime victim payments","url":"https://bot-corpus.mn-dhs.online/s/epm/A#crime-victim-payments","context":"EPM > A Appendix A Types of Assets > Crime victim payments","text":"## Crime victim payments\n\nPayments made to compensate crime victims for losses resulting from the crime."},{"chunk_id":"epm:A#deemed-individual-retirement-account-ira","heading":"Deemed Individual Retirement Account (IRA)","url":"https://bot-corpus.mn-dhs.online/s/epm/A#deemed-individual-retirement-account-ira","context":"EPM > A Appendix A Types of Assets > Deemed Individual Retirement Account (IRA)","text":"## Deemed Individual Retirement Account (IRA)\n\nAn employer sponsored retirement plan that offers the features of an IRA. The plan maintains a separate account or annuity to receive voluntary employee contributions to facilitate employee retirement savings."},{"chunk_id":"epm:A#deferred-annuity","heading":"Deferred annuity","url":"https://bot-corpus.mn-dhs.online/s/epm/A#deferred-annuity","context":"EPM > A Appendix A Types of Assets > Deferred annuity","text":"## Deferred annuity\n\nAn annuity contract under which periodic payments will begin sometime in the future. A deferred annuity contract provides the purchaser with the opportunity to accumulate savings over an extended period before the contract enters its payout phase."},{"chunk_id":"epm:A#disability-insurance","heading":"Disability insurance","url":"https://bot-corpus.mn-dhs.online/s/epm/A#disability-insurance","context":"EPM > A Appendix A Types of Assets > Disability insurance","text":"## Disability insurance\n\nA policy that pays a fixed amount of income to a person who becomes disabled under the terms of the policy. Disability insurance is intended as an income replacement and is not health insurance."},{"chunk_id":"epm:A#disaster-assistance-federal-declaration","heading":"Disaster Assistance, federal declaration","url":"https://bot-corpus.mn-dhs.online/s/epm/A#disaster-assistance-federal-declaration","context":"EPM > A Appendix A Types of Assets > Disaster Assistance, federal declaration","text":"## Disaster Assistance, federal declaration\n\nPayments issued pursuant to a presidential declaration of disaster or emergency. These payments may be made by the federal government (including, but not limited to, grants from the Federal Emergency Management Agency (FEMA), states, local governments, and disaster relief organizations such as the Red Cross and Salvation Army)."},{"chunk_id":"epm:A#disaster-assistance-state-declaration","heading":"Disaster Assistance, state declaration","url":"https://bot-corpus.mn-dhs.online/s/epm/A#disaster-assistance-state-declaration","context":"EPM > A Appendix A Types of Assets > Disaster Assistance, state declaration","text":"## Disaster Assistance, state declaration\n\nPayments issued pursuant to a state declaration of disaster or emergency. These payments may be made by the state government (including, local governments, and disaster relief organizations such as the Red Cross and Salvation Army)."},{"chunk_id":"epm:A#employee-stock-ownership-plans-esops","heading":"Employee Stock Ownership Plans (ESOPs)","url":"https://bot-corpus.mn-dhs.online/s/epm/A#employee-stock-ownership-plans-esops","context":"EPM > A Appendix A Types of Assets > Employee Stock Ownership Plans (ESOPs)","text":"## Employee Stock Ownership Plans (ESOPs)\n\nA form of defined contribution plan in which the investments are primarily in employer stock."},{"chunk_id":"epm:A#employer-sponsored-individual-retirement-account-ira","heading":"Employer-sponsored Individual Retirement Account (IRA)","url":"https://bot-corpus.mn-dhs.online/s/epm/A#employer-sponsored-individual-retirement-account-ira","context":"EPM > A Appendix A Types of Assets > Employer-sponsored Individual Retirement Account (IRA)","text":"## Employer-sponsored Individual Retirement Account (IRA)\n\nAn IRA which an employer establishes for an employee. Examples of Employer Based IRAs include:\n- Simplified Employee Pension (SEP) IRAs are available to employees and self-employed individuals\n- Savings Incentive Match Plans for Employees (SIMPLE) IRAs are available to employees and self-employed individuals\n- Deemed IRAs\n- Payroll Deduction IRAs"},{"chunk_id":"epm:A#escrow","heading":"Escrow","url":"https://bot-corpus.mn-dhs.online/s/epm/A#escrow","context":"EPM > A Appendix A Types of Assets > Escrow","text":"## Escrow\n\nA deed, bond, money, or piece of property held in trust by a third party to be turned over to the grantee only on fulfillment of a condition."},{"chunk_id":"epm:A#face-value-fv","heading":"Face Value (FV)","url":"https://bot-corpus.mn-dhs.online/s/epm/A#face-value-fv","context":"EPM > A Appendix A Types of Assets > Face Value (FV)","text":"## Face Value (FV)\n\nThe amount that is contracted for at the time the life insurance policy is purchased – it is the amount to be paid out when the insured dies."},{"chunk_id":"epm:A#federal-family-education-loan-ffel","heading":"Federal Family Education Loan (FFEL)","url":"https://bot-corpus.mn-dhs.online/s/epm/A#federal-family-education-loan-ffel","context":"EPM > A Appendix A Types of Assets > Federal Family Education Loan (FFEL)","text":"## Federal Family Education Loan (FFEL)\n\nA student financial aid created by Title IV of the Higher Education Act of 1965. FFEL includes four components:\n- Stafford loans (formerly Guaranteed student loans)\n- Unsubsidized Stafford loans\n- Federal PLUS loans\n- Federal Consolidation loans"},{"chunk_id":"epm:A#federal-pandemic-unemployment-compensation-fpuc-payments","heading":"Federal Pandemic Unemployment Compensation (FPUC) payments","url":"https://bot-corpus.mn-dhs.online/s/epm/A#federal-pandemic-unemployment-compensation-fpuc-payments","context":"EPM > A Appendix A Types of Assets > Federal Pandemic Unemployment Compensation (FPUC) payments","text":"## Federal Pandemic Unemployment Compensation (FPUC) payments\n\nThe CARES Act provides financial aid to individuals and families impacted by the COVID-19 pandemic by temporarily supplementing unemployment insurance (UI) benefit amounts and extending the duration of those benefits. From March 27, 2020 through July 31, 2020, UI claimants received their usual calculated benefit plus an additional $600 per week in FPUC."},{"chunk_id":"epm:A#federal-supplemental-educational-opportunity-grant-fseog-program","heading":"Federal Supplemental Educational Opportunity Grant (FSEOG) Program","url":"https://bot-corpus.mn-dhs.online/s/epm/A#federal-supplemental-educational-opportunity-grant-fseog-program","context":"EPM > A Appendix A Types of Assets > Federal Supplemental Educational Opportunity Grant (FSEOG) Program","text":"## Federal Supplemental Educational Opportunity Grant (FSEOG) Program\n\nA student financial aid program created by Title IV of the Higher Education Act of 1965."},{"chunk_id":"epm:A#federal-work-study-fws-program","heading":"Federal Work-Study (FWS) program","url":"https://bot-corpus.mn-dhs.online/s/epm/A#federal-work-study-fws-program","context":"EPM > A Appendix A Types of Assets > Federal Work-Study (FWS) program","text":"## Federal Work-Study (FWS) program\n\nA student financial aid program created by Title IV of the Higher Education Act of 1965."},{"chunk_id":"epm:A#filipino-veterans-equity-compensation-fvec-fund-payments","heading":"Filipino Veterans Equity Compensation (FVEC) fund payments","url":"https://bot-corpus.mn-dhs.online/s/epm/A#filipino-veterans-equity-compensation-fvec-fund-payments","context":"EPM > A Appendix A Types of Assets > Filipino Veterans Equity Compensation (FVEC) fund payments","text":"## Filipino Veterans Equity Compensation (FVEC) fund payments\n\nSection 1002 of the American Recovery and Reinvestment Act of 2009 (ARRA) established the FVECF to issue one-time payments to eligible Filipino veterans who aided American troops during World War II."},{"chunk_id":"epm:A#fixed-annuity","heading":"Fixed annuity","url":"https://bot-corpus.mn-dhs.online/s/epm/A#fixed-annuity","context":"EPM > A Appendix A Types of Assets > Fixed annuity","text":"## Fixed annuity\n\nA type of annuity in which benefits have guaranteed or fixed dollar amounts."},{"chunk_id":"epm:A#flexible-spending-accountsarrangement-fsa","heading":"Flexible spending accounts/arrangement (FSA)","url":"https://bot-corpus.mn-dhs.online/s/epm/A#flexible-spending-accountsarrangement-fsa","context":"EPM > A Appendix A Types of Assets > Flexible spending accounts/arrangement (FSA)","text":"## Flexible spending accounts/arrangement (FSA)\n\nEmployer-established benefit plan that allows employees to be reimbursed for out-of-pocket medical, dependent-care, or transportation expenses. These may be offered in conjunction with other employer-provided benefits. FSAs are usually funded through voluntary salary reduction agreements with an employer. Both employees and employers may contribute to the FSA. Self-employed individuals are not eligible for FSAs."},{"chunk_id":"epm:A#foster-care-payments","heading":"Foster care payments","url":"https://bot-corpus.mn-dhs.online/s/epm/A#foster-care-payments","context":"EPM > A Appendix A Types of Assets > Foster care payments","text":"## Foster care payments\n\nA payment made to the foster care provider for the purpose of meeting the needs of the individual in care. Payments include:\n- Federally funded foster care IV-E payments\n- State funded, non-IV-E, foster care payments\n- Adult foster care payments\n- Other payments for the care of foster children or adults who live in the household"},{"chunk_id":"epm:A#gear-up-gaining-early-awareness-and-readiness-for-undergraduate-programs","heading":"Gear Up (Gaining Early Awareness and Readiness for Undergraduate Programs)","url":"https://bot-corpus.mn-dhs.online/s/epm/A#gear-up-gaining-early-awareness-and-readiness-for-undergraduate-programs","context":"EPM > A Appendix A Types of Assets > Gear Up (Gaining Early Awareness and Readiness for Undergraduate Programs)","text":"## Gear Up (Gaining Early Awareness and Readiness for Undergraduate Programs)\n\nA student financial aid program created by Title IV of the Higher Education Act of 1965."},{"chunk_id":"epm:A#gifts-to-children-with-life-threatening-conditions","heading":"Gifts to children with life threatening conditions","url":"https://bot-corpus.mn-dhs.online/s/epm/A#gifts-to-children-with-life-threatening-conditions","context":"EPM > A Appendix A Types of Assets > Gifts to children with life threatening conditions","text":"## Gifts to children with life threatening conditions\n\nPayments made by tax-exempt organizations to or for the benefit of children under age 18 with life-threatening conditions. These gifts include gifts to the child's parents for the child's benefit and indirect benefits to other family members, such as payment to accompany the child on a trip. Such gifts can also include in-kind gifts, which is any food, shelter, or other item donated to the child or another individual on the child’s behalf."},{"chunk_id":"epm:A#guardianship-account","heading":"Guardianship account","url":"https://bot-corpus.mn-dhs.online/s/epm/A#guardianship-account","context":"EPM > A Appendix A Types of Assets > Guardianship account","text":"## Guardianship account\n\nAn account established at a financial institution held by a guardian who acts on behalf of and administers the funds for the benefit of a minor under age 18 or a person who is incapacitated or otherwise unable to handle financial transactions."},{"chunk_id":"epm:A#health-reimbursement-arrangementaccount-hra","heading":"Health Reimbursement Arrangement/Account (HRA)","url":"https://bot-corpus.mn-dhs.online/s/epm/A#health-reimbursement-arrangementaccount-hra","context":"EPM > A Appendix A Types of Assets > Health Reimbursement Arrangement/Account (HRA)","text":"## Health Reimbursement Arrangement/Account (HRA)\n\nAn employer-established benefit plan where employees are reimbursed tax free for qualified medical expenses. These may be offered in conjunction with other employer-provided health benefits. Employees may not contribute and the contribution cannot be paid through a voluntary salary reduction agreement. Only employers may contribute to the HRA. Self-employed individuals are not eligible for HRAs. HRAs include state and local government Health Care Savings Plans (HCSP)."},{"chunk_id":"epm:A#health-savings-account-hsa","heading":"Health Savings Account (HSA)","url":"https://bot-corpus.mn-dhs.online/s/epm/A#health-savings-account-hsa","context":"EPM > A Appendix A Types of Assets > Health Savings Account (HSA)","text":"## Health Savings Account (HSA)\n\nA tax-exempt trust or custodial account (an account managed for eligible employees by a custodian) that an individual sets up with a qualified HSA trustee to pay or reimburse certain medical expenses. To qualify for an HSA an individual must have a high deductible health plan. An HSA trustee can be a bank, an insurance company, or anyone already approved by the IRS to be a trustee of Individual Retirement Arrangements (IRAs) or Archer MSAs. An employer may also contribute to an employee’s HSA."},{"chunk_id":"epm:A#high-school-equivalency-program-hep","heading":"High School Equivalency Program (HEP)","url":"https://bot-corpus.mn-dhs.online/s/epm/A#high-school-equivalency-program-hep","context":"EPM > A Appendix A Types of Assets > High School Equivalency Program (HEP)","text":"## High School Equivalency Program (HEP)\n\nA student financial aid program created by Title IV of the Higher Education Act of 1965."},{"chunk_id":"epm:A#higher-education-act-of-1965-hea","heading":"Higher Education Act of 1965 (HEA)","url":"https://bot-corpus.mn-dhs.online/s/epm/A#higher-education-act-of-1965-hea","context":"EPM > A Appendix A Types of Assets > Higher Education Act of 1965 (HEA)","text":"## Higher Education Act of 1965 (HEA)\n\nA student financial aid program created by Title IV of the Higher Education Act of 1965."},{"chunk_id":"epm:A#home-equity","heading":"Home equity","url":"https://bot-corpus.mn-dhs.online/s/epm/A#home-equity","context":"EPM > A Appendix A Types of Assets > Home equity","text":"## Home equity\n\nThe market value of the home subtracted by any encumbrances on the home."},{"chunk_id":"epm:A#homestead-property","heading":"Homestead property","url":"https://bot-corpus.mn-dhs.online/s/epm/A#homestead-property","context":"EPM > A Appendix A Types of Assets > Homestead property","text":"## Homestead property\n\nA homestead is any property in which a person or a person’s spouse has an ownership interest and which serves as the person’s principal place of residence. It includes the surrounding land and buildings on that land, provided the land is not separated by any property owned by others. It may be fixed or mobile and located on land or water."},{"chunk_id":"epm:A#household-goods-and-personal-effects","heading":"Household goods and personal effects","url":"https://bot-corpus.mn-dhs.online/s/epm/A#household-goods-and-personal-effects","context":"EPM > A Appendix A Types of Assets > Household goods and personal effects","text":"## Household goods and personal effects\n\nItems of personal property found in or near a home that are used on a regular basis; items needed by the household for maintenance, use and occupancy of the premises as a home. Also includes personal property ordinarily worn or carried by the person, and articles having sentimental value to the person."},{"chunk_id":"epm:A#i-35w-bridge-collapse-payment","heading":"I-35W Bridge Collapse payment","url":"https://bot-corpus.mn-dhs.online/s/epm/A#i-35w-bridge-collapse-payment","context":"EPM > A Appendix A Types of Assets > I-35W Bridge Collapse payment","text":"## I-35W Bridge Collapse payment\n\nPayments made to survivors of the I-35W Bridge Collapse under the I-35W Emergency Hardship Relief Fund and The Catastrophic Survivor Compensation Fund."},{"chunk_id":"epm:A#immediate-annuity","heading":"Immediate annuity","url":"https://bot-corpus.mn-dhs.online/s/epm/A#immediate-annuity","context":"EPM > A Appendix A Types of Assets > Immediate annuity","text":"## Immediate annuity\n\nAn annuity contract under which the periodic payments will begin following the payment of the annuity premium, rather than being deferred."},{"chunk_id":"epm:A#individual-development-accounts-ida","heading":"Individual Development Accounts (IDA)","url":"https://bot-corpus.mn-dhs.online/s/epm/A#individual-development-accounts-ida","context":"EPM > A Appendix A Types of Assets > Individual Development Accounts (IDA)","text":"## Individual Development Accounts (IDA)\n\nA special bank account established under the Family Assets for Independence in Minnesota (FAIM) program that helps a person save for education, purchase of a first home, or to start a business. Eligible people must have earned income and have low income and assets."},{"chunk_id":"epm:A#individual-retirement-arrangement-ira","heading":"Individual Retirement Arrangement (IRA)","url":"https://bot-corpus.mn-dhs.online/s/epm/A#individual-retirement-arrangement-ira","context":"EPM > A Appendix A Types of Assets > Individual Retirement Arrangement (IRA)","text":"## Individual Retirement Arrangement (IRA)\n\nAn umbrella term used to describe a personal savings plan that provides the owner tax advantages for setting aside money for retirement. IRAs can be in the form of a trust, an account, or an annuity."},{"chunk_id":"epm:A#interest","heading":"Interest","url":"https://bot-corpus.mn-dhs.online/s/epm/A#interest","context":"EPM > A Appendix A Types of Assets > Interest","text":"## Interest\n\nMoney earned from a bank account, loan, or other investment. Earned interest may be credited to the account or paid directly to the owner."},{"chunk_id":"epm:A#interest-income-from-indian-trust-land-or-restricted-lands","heading":"Interest income from Indian trust land or restricted lands","url":"https://bot-corpus.mn-dhs.online/s/epm/A#interest-income-from-indian-trust-land-or-restricted-lands","context":"EPM > A Appendix A Types of Assets > Interest income from Indian trust land or restricted lands","text":"## Interest income from Indian trust land or restricted lands\n\nIncome from interests in restricted land allotted to an individual who is of Indian descent from a federally recognized Indian tribe."},{"chunk_id":"epm:A#irrevocable-trust","heading":"Irrevocable trust","url":"https://bot-corpus.mn-dhs.online/s/epm/A#irrevocable-trust","context":"EPM > A Appendix A Types of Assets > Irrevocable trust","text":"## Irrevocable trust\n\nA trust that cannot be modified or terminated after its creation by the grantor or the grantor’s representative."},{"chunk_id":"epm:A#james-zadroga-911-health-and-compensation-act-of-2010","heading":"James Zadroga 9/11 Health and Compensation Act of 2010.","url":"https://bot-corpus.mn-dhs.online/s/epm/A#james-zadroga-911-health-and-compensation-act-of-2010","context":"EPM > A Appendix A Types of Assets > James Zadroga 9/11 Health and Compensation Act of 2010.","text":"## James Zadroga 9/11 Health and Compensation Act of 2010.\n\nPayments made to a worker or volunteer, or if deceased, his or her heir, under the World Trade Center (WTC) Litigation Settlement or distributed by the WTC Captive Insurance Company. These payments are considered disaster assistance."},{"chunk_id":"epm:A#japanese-american-and-aleutian-restitution-payments","heading":"Japanese-American and Aleutian restitution payments","url":"https://bot-corpus.mn-dhs.online/s/epm/A#japanese-american-and-aleutian-restitution-payments","context":"EPM > A Appendix A Types of Assets > Japanese-American and Aleutian restitution payments","text":"## Japanese-American and Aleutian restitution payments\n\nReparation payments to certain United States citizens of Japanese ancestry and resident Japanese noncitizens and certain eligible Aleuts who were interned or relocated during World War II."},{"chunk_id":"epm:A#jensen-settlement-agreement-payment","heading":"Jensen Settlement Agreement payment","url":"https://bot-corpus.mn-dhs.online/s/epm/A#jensen-settlement-agreement-payment","context":"EPM > A Appendix A Types of Assets > Jensen Settlement Agreement payment","text":"## Jensen Settlement Agreement payment\n\nA fund resulting from settlement the lawsuit Jensen et al v. Minnesota Department of Human Services, et al. in which residents of the former Minnesota Extended Treatment Options (METO) program alleged they were unlawfully and unconstitutionally secluded and restrained."},{"chunk_id":"epm:A#keogh-plan","heading":"Keogh plan","url":"https://bot-corpus.mn-dhs.online/s/epm/A#keogh-plan","context":"EPM > A Appendix A Types of Assets > Keogh plan","text":"## Keogh plan\n\nA tax deferred pension plan available to self-employed individuals or unincorporated businesses for retirement purposes. A Keogh plan can be set up as either a defined-benefit or defined-contribution plan, although most plans are defined-contribution plans."},{"chunk_id":"epm:A#legal-instrument-or-device-similar-to-a-trust","heading":"Legal instrument or device similar to a trust","url":"https://bot-corpus.mn-dhs.online/s/epm/A#legal-instrument-or-device-similar-to-a-trust","context":"EPM > A Appendix A Types of Assets > Legal instrument or device similar to a trust","text":"## Legal instrument or device similar to a trust\n\nAny instrument that exhibits the general characteristics of a trust, but is not called a trust. This can include, but is not limited to, escrow accounts, investment accounts, pension funds and other similar devices managed by an individual or entity with fiduciary obligations."},{"chunk_id":"epm:A#leveraging-educational-assistance-partnership-leap-student-financial-aid-formerly-state-student-incentive-grants-ssig","heading":"Leveraging Educational Assistance Partnership (LEAP) student financial aid (formerly State Student Incentive Grants (SSIG))","url":"https://bot-corpus.mn-dhs.online/s/epm/A#leveraging-educational-assistance-partnership-leap-student-financial-aid-formerly-state-student-incentive-grants-ssig","context":"EPM > A Appendix A Types of Assets > Leveraging Educational Assistance Partnership (LEAP) student financial aid (formerly State Student Incentive Grants (SSIG))","text":"## Leveraging Educational Assistance Partnership (LEAP) student financial aid (formerly State Student Incentive Grants (SSIG))\n\nA student financial aid program created by Title IV of the Higher Education Act of 1965."},{"chunk_id":"epm:A#life-annuity-payments","heading":"Life annuity payments","url":"https://bot-corpus.mn-dhs.online/s/epm/A#life-annuity-payments","context":"EPM > A Appendix A Types of Assets > Life annuity payments","text":"## Life annuity payments\n\nAnnuity payments that continue for the life of the annuitant."},{"chunk_id":"epm:A#life-estate","heading":"Life estate","url":"https://bot-corpus.mn-dhs.online/s/epm/A#life-estate","context":"EPM > A Appendix A Types of Assets > Life estate","text":"## Life estate\n\nA life estate is a form of legal ownership that is usually created through a deed, will, or by operation of law. It is an interest in real property held only for the duration of a specified person’s life, or some other condition specified in the life estate agreement. The person who is transferring ownership is referred to a life tenant or a life estate owner. The person who is receiving the property following the specified condition is referred to as a remainderman."},{"chunk_id":"epm:A#life-insurance","heading":"Life insurance","url":"https://bot-corpus.mn-dhs.online/s/epm/A#life-insurance","context":"EPM > A Appendix A Types of Assets > Life insurance","text":"## Life insurance\n\nA type of policy that pays a beneficiary a designated sum upon the death of the insured person. There are two basic forms of life insurance policies: term and non-term."},{"chunk_id":"epm:A#liquid-assets","heading":"Liquid assets","url":"https://bot-corpus.mn-dhs.online/s/epm/A#liquid-assets","context":"EPM > A Appendix A Types of Assets > Liquid assets","text":"## Liquid assets\n\nCash or other types of assets that can be easily converted to cash, such as bank accounts, stocks, bonds, certificates of deposit, some retirement accounts and money market accounts."},{"chunk_id":"epm:A#low-income-home-energy-assistance-program-liheap-payments","heading":"Low Income Home Energy Assistance Program (LIHEAP) payments","url":"https://bot-corpus.mn-dhs.online/s/epm/A#low-income-home-energy-assistance-program-liheap-payments","context":"EPM > A Appendix A Types of Assets > Low Income Home Energy Assistance Program (LIHEAP) payments","text":"## Low Income Home Energy Assistance Program (LIHEAP) payments\n\nFederal block grant for energy assistance payments to low income households. The LIHEAP in Minnesota is the Energy Assistance Program (EAP)."},{"chunk_id":"epm:A#lump-sum-income","heading":"Lump sum income","url":"https://bot-corpus.mn-dhs.online/s/epm/A#lump-sum-income","context":"EPM > A Appendix A Types of Assets > Lump sum income","text":"## Lump sum income\n\nOne-time income that is not predictable. Periodic reoccurring income is not lump sum income. Examples of lump sum income include, but are not limited to:\n- Winnings (lottery, gambling)\n- Insurance settlements\n- Worker’s Compensation settlements\n- Inheritances\n- Retroactive Retirements, Survivors and Disability Insurance (RSDI); Supplemental Security Income (SSI); Veterans Administration (VA) and unemployment insurance benefits"},{"chunk_id":"epm:A#medicaid-qualifying-trust-mqt","heading":"Medicaid Qualifying Trust (MQT)","url":"https://bot-corpus.mn-dhs.online/s/epm/A#medicaid-qualifying-trust-mqt","context":"EPM > A Appendix A Types of Assets > Medicaid Qualifying Trust (MQT)","text":"## Medicaid Qualifying Trust (MQT)\n\nA trust or similar legal device established (other than by a will) by an individual (or spouse) under which the individual may be the beneficiary of all or part of the payments from the trust."},{"chunk_id":"epm:A#medical-savings-account-msa","heading":"Medical Savings Account (MSA)","url":"https://bot-corpus.mn-dhs.online/s/epm/A#medical-savings-account-msa","context":"EPM > A Appendix A Types of Assets > Medical Savings Account (MSA)","text":"## Medical Savings Account (MSA)\n\nA tax-deferred savings account that can be offered by employers as part of a benefits package. Medical savings accounts are designed to help participants pay for medical and health care expenses by allowing them to save for those expenses in a tax-sheltered environment. This is an example of a Health Savings Account (HSA)."},{"chunk_id":"epm:A#minnesota-housing-finance-agency-mhfa-home-improvement-loan","heading":"Minnesota Housing Finance Agency (MHFA) home improvement loan","url":"https://bot-corpus.mn-dhs.online/s/epm/A#minnesota-housing-finance-agency-mhfa-home-improvement-loan","context":"EPM > A Appendix A Types of Assets > Minnesota Housing Finance Agency (MHFA) home improvement loan","text":"## Minnesota Housing Finance Agency (MHFA) home improvement loan\n\nHome improvement loans through the MHFA to help homeowners live in safe, accessible, and energy efficient homes."},{"chunk_id":"epm:A#money-market-account","heading":"Money market account","url":"https://bot-corpus.mn-dhs.online/s/epm/A#money-market-account","context":"EPM > A Appendix A Types of Assets > Money market account","text":"## Money market account\n\nType of savings account offered by banks and credit unions just like regular savings accounts. The difference is that they usually pay higher interest and have higher minimum balance requirements."},{"chunk_id":"epm:A#mutual-fund-share","heading":"Mutual fund share","url":"https://bot-corpus.mn-dhs.online/s/epm/A#mutual-fund-share","context":"EPM > A Appendix A Types of Assets > Mutual fund share","text":"## Mutual fund share\n\nA mutual fund is an investment vehicle that is made up of a pool of funds collected from many investors for the purpose of investing in securities such as stocks, bonds, money market instruments and similar assets."},{"chunk_id":"epm:A#national-science-and-mathematics-access-to-retain-talent-smart-grants","heading":"National Science and Mathematics Access to Retain Talent (SMART) Grants","url":"https://bot-corpus.mn-dhs.online/s/epm/A#national-science-and-mathematics-access-to-retain-talent-smart-grants","context":"EPM > A Appendix A Types of Assets > National Science and Mathematics Access to Retain Talent (SMART) Grants","text":"## National Science and Mathematics Access to Retain Talent (SMART) Grants\n\nA student financial aid program created by Title IV of the Higher Education Act of 1965."},{"chunk_id":"epm:A#nazi-persecution-payment","heading":"Nazi Persecution payment","url":"https://bot-corpus.mn-dhs.online/s/epm/A#nazi-persecution-payment","context":"EPM > A Appendix A Types of Assets > Nazi Persecution payment","text":"## Nazi Persecution payment\n\nBenefits provided by countries to victims of Nazi persecution. These include:\n- Austrian Reparation payments\n- German Reparation payments\n- Netherlands WUV payments\n- Other payments received as a result of being a victim of Nazi persecution"},{"chunk_id":"epm:A#netherlands-act-wuv-payments-to-victims-of-japanese-persecution","heading":"Netherlands Act (WUV) payments to victims of Japanese persecution","url":"https://bot-corpus.mn-dhs.online/s/epm/A#netherlands-act-wuv-payments-to-victims-of-japanese-persecution","context":"EPM > A Appendix A Types of Assets > Netherlands Act (WUV) payments to victims of Japanese persecution","text":"## Netherlands Act (WUV) payments to victims of Japanese persecution\n\nThe Dutch government makes payments under the Netherlands' Act on Benefits for Victims of Persecution 1940-1945. Payments are for both Dutch and non-Dutch people who, during the Japanese occupation of the Netherlands East Indies (now the Republic of Indonesia) in World War II, were victims of persecution."},{"chunk_id":"epm:A#netherlands-act-wuv-payments-to-victims-of-nazi-persecution","heading":"Netherlands Act (WUV) payments to victims of Nazi persecution","url":"https://bot-corpus.mn-dhs.online/s/epm/A#netherlands-act-wuv-payments-to-victims-of-nazi-persecution","context":"EPM > A Appendix A Types of Assets > Netherlands Act (WUV) payments to victims of Nazi persecution","text":"## Netherlands Act (WUV) payments to victims of Nazi persecution\n\nThe Dutch government makes payments under the Netherlands' Act on Benefits for Victims of Persecution 1940-1945. Payments are for both Dutch and non-Dutch people who, during the German occupation of the Netherlands and Netherlands in World War II, were victims of persecution."},{"chunk_id":"epm:A#non-homestead-real-property","heading":"Non-homestead Real Property","url":"https://bot-corpus.mn-dhs.online/s/epm/A#non-homestead-real-property","context":"EPM > A Appendix A Types of Assets > Non-homestead Real Property","text":"## Non-homestead Real Property\n\nLand and buildings or immovable objects attached permanently to the land but is not the person’s principal place of residence."},{"chunk_id":"epm:A#non-term-life-insurance-policy","heading":"Non-term life insurance policy","url":"https://bot-corpus.mn-dhs.online/s/epm/A#non-term-life-insurance-policy","context":"EPM > A Appendix A Types of Assets > Non-term life insurance policy","text":"## Non-term life insurance policy\n\nOften referred to as whole life or universal life policies, non-term life insurance policies have both face value (FV) and cash surrender value (CSV). These types of policies also generate dividends. Generally, the person can borrow against the cash surrender value or the policy can be cashed in for the CSV."},{"chunk_id":"epm:A#non-title-iv-of-higher-education-act-and-non-bureau-of-indian-affairs-student-financial-aid","heading":"Non-Title IV of Higher Education Act and non-Bureau of Indian Affairs student financial aid","url":"https://bot-corpus.mn-dhs.online/s/epm/A#non-title-iv-of-higher-education-act-and-non-bureau-of-indian-affairs-student-financial-aid","context":"EPM > A Appendix A Types of Assets > Non-Title IV of Higher Education Act and non-Bureau of Indian Affairs student financial aid","text":"## Non-Title IV of Higher Education Act and non-Bureau of Indian Affairs student financial aid\n\nSuch aid includes grants, scholarships, gifts and so on."},{"chunk_id":"epm:A#operating-assets","heading":"Operating assets","url":"https://bot-corpus.mn-dhs.online/s/epm/A#operating-assets","context":"EPM > A Appendix A Types of Assets > Operating assets","text":"## Operating assets\n\nAssets used in a trade or business such as bank accounts, stocks, bonds, mutual funds, certificates of deposit, trusts or property agreements."},{"chunk_id":"epm:A#payroll-deduction-individual-retirement-account-ira","heading":"Payroll Deduction Individual Retirement Account (IRA)","url":"https://bot-corpus.mn-dhs.online/s/epm/A#payroll-deduction-individual-retirement-account-ira","context":"EPM > A Appendix A Types of Assets > Payroll Deduction Individual Retirement Account (IRA)","text":"## Payroll Deduction Individual Retirement Account (IRA)\n\nA retirement savings plan in which an employer sets up a payroll deduction to fund an IRA program with a financial institution, such as a bank, mutual fund or insurance company."},{"chunk_id":"epm:A#pell-grants","heading":"Pell grants","url":"https://bot-corpus.mn-dhs.online/s/epm/A#pell-grants","context":"EPM > A Appendix A Types of Assets > Pell grants","text":"## Pell grants\n\nA student financial aid program created by Title IV of the Higher Education Act of 1965."},{"chunk_id":"epm:A#pension-payments","heading":"Pension payments","url":"https://bot-corpus.mn-dhs.online/s/epm/A#pension-payments","context":"EPM > A Appendix A Types of Assets > Pension payments","text":"## Pension payments\n\nA fixed sum paid regularly to retired people or their dependents."},{"chunk_id":"epm:A#perkins-loan","heading":"Perkins loan","url":"https://bot-corpus.mn-dhs.online/s/epm/A#perkins-loan","context":"EPM > A Appendix A Types of Assets > Perkins loan","text":"## Perkins loan\n\nA student financial aid program created by Title IV of the Higher Education Act of 1965."},{"chunk_id":"epm:A#personal-property","heading":"Personal property","url":"https://bot-corpus.mn-dhs.online/s/epm/A#personal-property","context":"EPM > A Appendix A Types of Assets > Personal property","text":"## Personal property\n\nProperty that is not considered real property."},{"chunk_id":"epm:A#plan-to-achieve-self-support-pass-financial-aid","heading":"Plan to Achieve Self Support (PASS) financial aid","url":"https://bot-corpus.mn-dhs.online/s/epm/A#plan-to-achieve-self-support-pass-financial-aid","context":"EPM > A Appendix A Types of Assets > Plan to Achieve Self Support (PASS) financial aid","text":"## Plan to Achieve Self Support (PASS) financial aid\n\nA plan approved by the Social Security Administration that allows certain assets or income of the person to be excluded in determining benefits for some assistance programs."},{"chunk_id":"epm:A#pooled-trusts","heading":"Pooled trusts","url":"https://bot-corpus.mn-dhs.online/s/epm/A#pooled-trusts","context":"EPM > A Appendix A Types of Assets > Pooled trusts","text":"## Pooled trusts\n\nA trust established for the sole benefit of a person of any age with a certified disability and that contains a separate account for two or more persons who also have a certified disability for the purpose of investment and management of funds in the accounts. It is administered by a non-profit organization."},{"chunk_id":"epm:A#presidential-access-scholarships","heading":"Presidential Access scholarships","url":"https://bot-corpus.mn-dhs.online/s/epm/A#presidential-access-scholarships","context":"EPM > A Appendix A Types of Assets > Presidential Access scholarships","text":"## Presidential Access scholarships\n\nA student financial aid program created by Title IV of the Higher Education Act of 1965."},{"chunk_id":"epm:A#private-annuity","heading":"Private annuity","url":"https://bot-corpus.mn-dhs.online/s/epm/A#private-annuity","context":"EPM > A Appendix A Types of Assets > Private annuity","text":"## Private annuity\n\nAn annuity that is set up by a person who is not an employee of an insurance company or financial institution."},{"chunk_id":"epm:A#profit-sharing-plan","heading":"Profit Sharing Plan","url":"https://bot-corpus.mn-dhs.online/s/epm/A#profit-sharing-plan","context":"EPM > A Appendix A Types of Assets > Profit Sharing Plan","text":"## Profit Sharing Plan\n\nA plan that gives employees a share in the profits of the company. Each employee receives a percentage of those profits based on the company’s earnings. Also known as a deferred profit-sharing plan (DPSP)."},{"chunk_id":"epm:A#promissory-notes","heading":"Promissory notes","url":"https://bot-corpus.mn-dhs.online/s/epm/A#promissory-notes","context":"EPM > A Appendix A Types of Assets > Promissory notes","text":"## Promissory notes\n\nA written, unconditional agreement whereby one party promises to pay a specified sum of money at a specified time (or on demand) to another party. It may be given in return of goods, money loaned, or services rendered."},{"chunk_id":"epm:A#property-agreements","heading":"Property agreements","url":"https://bot-corpus.mn-dhs.online/s/epm/A#property-agreements","context":"EPM > A Appendix A Types of Assets > Property agreements","text":"## Property agreements\n\nA pledge or security of particular property for the payment of a debt or the performance of some other obligation within a specified period."},{"chunk_id":"epm:A#public-assistance-appeal-payments","heading":"Public assistance appeal payments","url":"https://bot-corpus.mn-dhs.online/s/epm/A#public-assistance-appeal-payments","context":"EPM > A Appendix A Types of Assets > Public assistance appeal payments","text":"## Public assistance appeal payments\n\nPayments resulting from an appeal of public assistance benefits."},{"chunk_id":"epm:A#qualified-tuition-program-qtp-also-referred-to-as-a-section-529-plan","heading":"Qualified Tuition Program (QTP), also referred to as a Section 529 Plan","url":"https://bot-corpus.mn-dhs.online/s/epm/A#qualified-tuition-program-qtp-also-referred-to-as-a-section-529-plan","context":"EPM > A Appendix A Types of Assets > Qualified Tuition Program (QTP), also referred to as a Section 529 Plan","text":"## Qualified Tuition Program (QTP), also referred to as a Section 529 Plan\n\nAllows individuals to prepay or contribute to an account established for paying a designated beneficiary’s education expenses beyond high school at an eligible educational institution. QTPs can be established and maintained by states, agencies, instrumentalities of states, and eligible educational institutions. Individuals may contribute to a QTP regardless of the amount of their income."},{"chunk_id":"epm:A#radiation-exposure-compensation-act-payments","heading":"Radiation Exposure Compensation Act payments","url":"https://bot-corpus.mn-dhs.online/s/epm/A#radiation-exposure-compensation-act-payments","context":"EPM > A Appendix A Types of Assets > Radiation Exposure Compensation Act payments","text":"## Radiation Exposure Compensation Act payments\n\nPayments made by the federal government to certain individuals (or their survivors) who were exposed to radiation from government nuclear testing and uranium mining."},{"chunk_id":"epm:A#real-property","heading":"Real property","url":"https://bot-corpus.mn-dhs.online/s/epm/A#real-property","context":"EPM > A Appendix A Types of Assets > Real property","text":"## Real property\n\nLand, all buildings, structures, improvements, or other fixtures on it belonging or pertaining to the land, including mobile or manufactured homes attached to a permanent foundation on land owned by the client, all mines, minerals, fossils, and trees on or under it, and life estate and remainder interests."},{"chunk_id":"epm:A#relocation-assistance-payments-federal","heading":"Relocation Assistance payments, federal","url":"https://bot-corpus.mn-dhs.online/s/epm/A#relocation-assistance-payments-federal","context":"EPM > A Appendix A Types of Assets > Relocation Assistance payments, federal","text":"## Relocation Assistance payments, federal\n\nRelocation assistance for displaced persons under Title II of the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, the Housing and Redevelopment Act of 1965, or the Housing Act of 1965. This assistance is paid when the government requires an individual to move."},{"chunk_id":"epm:A#relocation-assistance-payments-state-and-local","heading":"Relocation Assistance payments, state and local","url":"https://bot-corpus.mn-dhs.online/s/epm/A#relocation-assistance-payments-state-and-local","context":"EPM > A Appendix A Types of Assets > Relocation Assistance payments, state and local","text":"## Relocation Assistance payments, state and local\n\nRelocation assistance for displaced persons funded by state and local governments. This assistance is paid when the government requires an individual to move."},{"chunk_id":"epm:A#renthelp-mn-assistance","heading":"RentHelp MN Assistance","url":"https://bot-corpus.mn-dhs.online/s/epm/A#renthelp-mn-assistance","context":"EPM > A Appendix A Types of Assets > RentHelp MN Assistance","text":"## RentHelp MN Assistance\n\nEmergency Rental Assistance program established by the Consolidated Appropriations Act, 2021 (CAA). In Minnesota, the program is known as RentHelpMN COVID-19 Emergency Rental Assistance (RentHelpMN). RentHelpMN may pay a person’s past due rent, upcoming rent, past due utilities or other housing-related costs."},{"chunk_id":"epm:A#representative-payee-misuse-payments","heading":"Representative payee misuse payments","url":"https://bot-corpus.mn-dhs.online/s/epm/A#representative-payee-misuse-payments","context":"EPM > A Appendix A Types of Assets > Representative payee misuse payments","text":"## Representative payee misuse payments\n\nRestitution payments of SSI, RSDI, and Special Veterans Benefits for the Elderly due to representative payee misuse."},{"chunk_id":"epm:A#retirement-plans","heading":"Retirement plans","url":"https://bot-corpus.mn-dhs.online/s/epm/A#retirement-plans","context":"EPM > A Appendix A Types of Assets > Retirement plans","text":"## Retirement plans\n\nAn arrangement to provide individuals and their spouses with income during retirement. Employers, insurance companies, the government or other institutions such as employer associations or trade unions may set up retirement plans."},{"chunk_id":"epm:A#reverse-mortgages","heading":"Reverse mortgages","url":"https://bot-corpus.mn-dhs.online/s/epm/A#reverse-mortgages","context":"EPM > A Appendix A Types of Assets > Reverse mortgages","text":"## Reverse mortgages\n\nA special type of home equity loan for people age 62 or older. Reverse mortgages allow owners to convert some of the equity in their home to cash. The loan does not usually have to be repaid during the homeowner’s lifetime."},{"chunk_id":"epm:A#revocable-trust","heading":"Revocable trust","url":"https://bot-corpus.mn-dhs.online/s/epm/A#revocable-trust","context":"EPM > A Appendix A Types of Assets > Revocable trust","text":"## Revocable trust\n\nA trust in which the grantor(s) reserve the right to revoke, reclaim or take back the assets deposited in the trust."},{"chunk_id":"epm:A#ricky-ray-hemophilia-relief-act-payments","heading":"Ricky Ray Hemophilia Relief Act payments","url":"https://bot-corpus.mn-dhs.online/s/epm/A#ricky-ray-hemophilia-relief-act-payments","context":"EPM > A Appendix A Types of Assets > Ricky Ray Hemophilia Relief Act payments","text":"## Ricky Ray Hemophilia Relief Act payments\n\nSettlements to people with blood-clotting disorders who may have contracted an HIV infection from a blood transfusion. The current and former spouses of these people as well as their children who also contracted HIV are also eligible for the settlement payment."},{"chunk_id":"epm:A#robert-c-byrd-honors-scholarship-program-also-known-as-byrd-honors-scholarships","heading":"Robert C. Byrd Honors Scholarship Program (also known as Byrd Honors Scholarships)","url":"https://bot-corpus.mn-dhs.online/s/epm/A#robert-c-byrd-honors-scholarship-program-also-known-as-byrd-honors-scholarships","context":"EPM > A Appendix A Types of Assets > Robert C. Byrd Honors Scholarship Program (also known as Byrd Honors Scholarships)","text":"## Robert C. Byrd Honors Scholarship Program (also known as Byrd Honors Scholarships)\n\nA student financial aid program created by Title IV of the Higher Education Act of 1965."},{"chunk_id":"epm:A#roth-401k-plan","heading":"Roth 401(k) Plan","url":"https://bot-corpus.mn-dhs.online/s/epm/A#roth-401k-plan","context":"EPM > A Appendix A Types of Assets > Roth 401(k) Plan","text":"## Roth 401(k) Plan\n\nA retirement savings plan option for employers to offer their employees. A Roth 401(k) is a hybrid that combines features of a Roth Individual Retirement Account and a traditional 401(k)."},{"chunk_id":"epm:A#roth-individual-retirement-account-ira","heading":"Roth Individual Retirement Account (IRA)","url":"https://bot-corpus.mn-dhs.online/s/epm/A#roth-individual-retirement-account-ira","context":"EPM > A Appendix A Types of Assets > Roth Individual Retirement Account (IRA)","text":"## Roth Individual Retirement Account (IRA)\n\nAn IRA allowing a person to set aside after-tax income up to a specified amount each year."},{"chunk_id":"epm:A#savings-incentive-match-plans-for-employees-simple-individual-retirement-account-ira","heading":"Savings Incentive Match Plans for Employees (SIMPLE) Individual Retirement Account (IRA)","url":"https://bot-corpus.mn-dhs.online/s/epm/A#savings-incentive-match-plans-for-employees-simple-individual-retirement-account-ira","context":"EPM > A Appendix A Types of Assets > Savings Incentive Match Plans for Employees (SIMPLE) Individual Retirement Account (IRA)","text":"## Savings Incentive Match Plans for Employees (SIMPLE) Individual Retirement Account (IRA)\n\nAn IRA-based retirement savings plan designed specifically to make it easier for small employers to establish a retirement plan for employees. A Simple IRA is a salary-reduction plan that allows employees to divert some compensation into retirement savings. Contributions to a Simple IRA are deposited into a separate account for each participating employee."},{"chunk_id":"epm:A#section-529-plan-also-known-as-qualified-tuition-program-qtp","heading":"Section 529 Plan (also known as Qualified Tuition Program (QTP))","url":"https://bot-corpus.mn-dhs.online/s/epm/A#section-529-plan-also-known-as-qualified-tuition-program-qtp","context":"EPM > A Appendix A Types of Assets > Section 529 Plan (also known as Qualified Tuition Program (QTP))","text":"## Section 529 Plan (also known as Qualified Tuition Program (QTP))\n\nSee Qualified Tuition Program."},{"chunk_id":"epm:A#self-employment-assets","heading":"Self-employment assets","url":"https://bot-corpus.mn-dhs.online/s/epm/A#self-employment-assets","context":"EPM > A Appendix A Types of Assets > Self-employment assets","text":"## Self-employment assets\n\nProperty used in a trade or business, including vehicles, tools, machinery, farm implements, unsold inventory, business checking accounts, non-homestead real property, rental property, etc."},{"chunk_id":"epm:A#settlement-agreement","heading":"Settlement agreement","url":"https://bot-corpus.mn-dhs.online/s/epm/A#settlement-agreement","context":"EPM > A Appendix A Types of Assets > Settlement agreement","text":"## Settlement agreement\n\nA resolution between disputing parties in a lawsuit, reached either before or after court action begins."},{"chunk_id":"epm:A#simplified-employee-pension-sep-individual-retirement-account-ira","heading":"Simplified Employee Pension (SEP) Individual Retirement Account (IRA)","url":"https://bot-corpus.mn-dhs.online/s/epm/A#simplified-employee-pension-sep-individual-retirement-account-ira","context":"EPM > A Appendix A Types of Assets > Simplified Employee Pension (SEP) Individual Retirement Account (IRA)","text":"## Simplified Employee Pension (SEP) Individual Retirement Account (IRA)\n\nA special type of IRA that can be established by a small-business employer or by self-employed people. Under a SEP IRA, each participant has his or her own Traditional IRA to which the employer contributes. The contributions are excluded from the employee’s pay and are not taxable until distributed from the plan."},{"chunk_id":"epm:A#social-welfare-fund","heading":"Social Welfare Fund","url":"https://bot-corpus.mn-dhs.online/s/epm/A#social-welfare-fund","context":"EPM > A Appendix A Types of Assets > Social Welfare Fund","text":"## Social Welfare Fund\n\nAn account or trust account held by the county of financial responsibility for the purposes of providing maintenance and support to the person. The person's earned or unearned income may be deposited into this account and disbursed by the county, for the person's benefit."},{"chunk_id":"epm:A#special-leveraging-educational-assistance-partnership-sleap-program","heading":"Special Leveraging Educational Assistance Partnership (SLEAP) Program","url":"https://bot-corpus.mn-dhs.online/s/epm/A#special-leveraging-educational-assistance-partnership-sleap-program","context":"EPM > A Appendix A Types of Assets > Special Leveraging Educational Assistance Partnership (SLEAP) Program","text":"## Special Leveraging Educational Assistance Partnership (SLEAP) Program\n\nA student financial aid program created by Title IV of the Higher Education Act of 1965."},{"chunk_id":"epm:A#special-needs-trusts","heading":"Special Needs Trusts","url":"https://bot-corpus.mn-dhs.online/s/epm/A#special-needs-trusts","context":"EPM > A Appendix A Types of Assets > Special Needs Trusts","text":"## Special Needs Trusts\n\nA trust established for the sole benefit of a person who is certified disabled."},{"chunk_id":"epm:A#spousal-individual-retirement-account-ira","heading":"Spousal Individual Retirement Account (IRA)","url":"https://bot-corpus.mn-dhs.online/s/epm/A#spousal-individual-retirement-account-ira","context":"EPM > A Appendix A Types of Assets > Spousal Individual Retirement Account (IRA)","text":"## Spousal Individual Retirement Account (IRA)\n\nAn IRA set up by an employed spouse to contribute for a non-working spouse or for a spouse who has little or no income."},{"chunk_id":"epm:A#state-annuities-for-certain-veterans","heading":"State annuities for certain veterans","url":"https://bot-corpus.mn-dhs.online/s/epm/A#state-annuities-for-certain-veterans","context":"EPM > A Appendix A Types of Assets > State annuities for certain veterans","text":"## State annuities for certain veterans\n\nAn annuity paid by a state, to a person, and/or a person’s spouse, on the basis of the state’s determination that the person is a veteran and is over age 65, is blind, or has a disability."},{"chunk_id":"epm:A#state-student-incentive-grant-program-also-known-as-the-leveraging-educational-assistance-partnership-leap-program","heading":"State Student Incentive Grant Program (also known as the Leveraging Educational Assistance Partnership (LEAP) program)","url":"https://bot-corpus.mn-dhs.online/s/epm/A#state-student-incentive-grant-program-also-known-as-the-leveraging-educational-assistance-partnership-leap-program","context":"EPM > A Appendix A Types of Assets > State Student Incentive Grant Program (also known as the Leveraging Educational Assistance Partnership (LEAP) program)","text":"## State Student Incentive Grant Program (also known as the Leveraging Educational Assistance Partnership (LEAP) program)\n\nA student financial aid program created by Title IV of the Higher Education Act of 1965."},{"chunk_id":"epm:A#stocks","heading":"Stocks","url":"https://bot-corpus.mn-dhs.online/s/epm/A#stocks","context":"EPM > A Appendix A Types of Assets > Stocks","text":"## Stocks\n\nShares of stock represent ownership in a business corporation."},{"chunk_id":"epm:A#student-financial-aid","heading":"Student financial aid","url":"https://bot-corpus.mn-dhs.online/s/epm/A#student-financial-aid","context":"EPM > A Appendix A Types of Assets > Student financial aid","text":"## Student financial aid\n\nLoans, grants, scholarships, fellowships, internships, some training expenses, gifts and work study funds provided to a person enrolled in and attending an educational institution."},{"chunk_id":"epm:A#supplemental-education-opportunity-grants-seog-program","heading":"Supplemental Education Opportunity Grants (SEOG) Program","url":"https://bot-corpus.mn-dhs.online/s/epm/A#supplemental-education-opportunity-grants-seog-program","context":"EPM > A Appendix A Types of Assets > Supplemental Education Opportunity Grants (SEOG) Program","text":"## Supplemental Education Opportunity Grants (SEOG) Program\n\nA student financial aid program created by Title IV of the Higher Education Act of 1965."},{"chunk_id":"epm:A#supplemental-needs-trusts","heading":"Supplemental Needs Trusts","url":"https://bot-corpus.mn-dhs.online/s/epm/A#supplemental-needs-trusts","context":"EPM > A Appendix A Types of Assets > Supplemental Needs Trusts","text":"## Supplemental Needs Trusts\n\nTrust established and funded by a third party to provide for the reasonable living expenses and other basic needs of a person with a disability when benefits from publicly funded benefit programs are not sufficient to provide adequately for those needs."},{"chunk_id":"epm:A#supplemental-security-income-ssi-dedicated-child-accounts","heading":"Supplemental Security Income (SSI) Dedicated Child Accounts","url":"https://bot-corpus.mn-dhs.online/s/epm/A#supplemental-security-income-ssi-dedicated-child-accounts","context":"EPM > A Appendix A Types of Assets > Supplemental Security Income (SSI) Dedicated Child Accounts","text":"## Supplemental Security Income (SSI) Dedicated Child Accounts\n\nThis account is set up by the representative payee of a child under the age of 18 with past due monthly benefits. The account continues to be excluded after the child has reached age 18."},{"chunk_id":"epm:A#tax-credits","heading":"Tax credits","url":"https://bot-corpus.mn-dhs.online/s/epm/A#tax-credits","context":"EPM > A Appendix A Types of Assets > Tax credits","text":"## Tax credits\n\nAn amount of money that can be offset against a tax liability."},{"chunk_id":"epm:A#tax-refund","heading":"Tax refund","url":"https://bot-corpus.mn-dhs.online/s/epm/A#tax-refund","context":"EPM > A Appendix A Types of Assets > Tax refund","text":"## Tax refund\n\nA state or federal refund of the difference between the taxes paid and taxes owed."},{"chunk_id":"epm:A#teacher-education-assistance-for-college-and-higher-education-teach-grants","heading":"Teacher Education Assistance for College and Higher Education (TEACH) grants","url":"https://bot-corpus.mn-dhs.online/s/epm/A#teacher-education-assistance-for-college-and-higher-education-teach-grants","context":"EPM > A Appendix A Types of Assets > Teacher Education Assistance for College and Higher Education (TEACH) grants","text":"## Teacher Education Assistance for College and Higher Education (TEACH) grants\n\nA student financial aid program created by Title IV of the Higher Education Act of 1965."},{"chunk_id":"epm:A#term-certain-annuity","heading":"Term certain annuity","url":"https://bot-corpus.mn-dhs.online/s/epm/A#term-certain-annuity","context":"EPM > A Appendix A Types of Assets > Term certain annuity","text":"## Term certain annuity\n\nAn annuity under which payments are scheduled to continue for a specified period, such as for 10 years. The payments will be paid out to the annuitant’s beneficiaries or estate if the annuitant dies before the payment term ends."},{"chunk_id":"epm:A#term-life-insurance","heading":"Term life insurance","url":"https://bot-corpus.mn-dhs.online/s/epm/A#term-life-insurance","context":"EPM > A Appendix A Types of Assets > Term life insurance","text":"## Term life insurance\n\nInsurance policies that have Face Value (FV) but do not have a Cash Surrender Value (CSV) or pay dividends. The insured can cancel the policy but there is no cash value to receive. The death benefit is only available upon the insured’s death."},{"chunk_id":"epm:A#third-party-trusts","heading":"Third Party Trusts","url":"https://bot-corpus.mn-dhs.online/s/epm/A#third-party-trusts","context":"EPM > A Appendix A Types of Assets > Third Party Trusts","text":"## Third Party Trusts\n\nA trust established and funded by a person (third party grantor) during his or her lifetime or through a will for the benefit of another person."},{"chunk_id":"epm:A#thrift-savings-plans-tsps","heading":"Thrift Savings Plans (TSPs)","url":"https://bot-corpus.mn-dhs.online/s/epm/A#thrift-savings-plans-tsps","context":"EPM > A Appendix A Types of Assets > Thrift Savings Plans (TSPs)","text":"## Thrift Savings Plans (TSPs)\n\nA federal government sponsored retirement defined contribution plan for federal employees. Contributions are held in individual accounts rather than in a trust fund."},{"chunk_id":"epm:A#time-deposits","heading":"Time deposits","url":"https://bot-corpus.mn-dhs.online/s/epm/A#time-deposits","context":"EPM > A Appendix A Types of Assets > Time deposits","text":"## Time deposits\n\nAnother term for a savings account or certificate of deposit (CD) held in a financial institution."},{"chunk_id":"epm:A#title-iv-of-the-higher-education-act-of-1965-hea-student-financial-aid","heading":"Title IV of the Higher Education Act of 1965 (HEA) student financial aid","url":"https://bot-corpus.mn-dhs.online/s/epm/A#title-iv-of-the-higher-education-act-of-1965-hea-student-financial-aid","context":"EPM > A Appendix A Types of Assets > Title IV of the Higher Education Act of 1965 (HEA) student financial aid","text":"## Title IV of the Higher Education Act of 1965 (HEA) student financial aid\n\nA federal law that authorizes programs that provide student financial aid. These programs include, but are not limited to:\n- Pell grants\n- Academic Competitiveness Grants\n- National Science and Mathematics Access to Retain Talent (SMART) grants\n- Federal Family Education Loan (FFEL) Program. FFEL includes four components:\n  - Stafford Loans\n  - Unsubsidized Stafford Loans\n  - Federal PLUS Loans\n  - Federal Consolidation Loans\n- Perkins Loans\n- Federal Supplemental Education Opportunity Grant (SEOG) Program\n- Supplemental Education Opportunity Grants (SEOG) Program\n- Work Study Program\n- Teacher Education Assistance for College and Higher Education (TEACH) Grants\n- Direct Loan Program. Direct Loans include four components:\n  - Direct Subsidized Loans\n  - Direct Unsubsidized Loans\n  - Direct PLUS Loans\n  - Direct Consolidation Loans\n- Leveraging Educational Assistance Partnership (LEAP) Program\n- Special Leveraging Educational Assistance Partnership (SLEAP) Program\n- Robert C. Byrd Honors Scholarship Program (also known as Byrd Honors Scholarships)\n- TRIO Program\n- Academic Achievement Incentive Scholarships\n- Gear Up\n- High School Equivalency Program (HEP)\n- College Assistance Migrant Program (CAMP)\n- State Student Incentive Grant Program\n- Presidential Access Scholarships"},{"chunk_id":"epm:A#tort-settlement","heading":"Tort settlement","url":"https://bot-corpus.mn-dhs.online/s/epm/A#tort-settlement","context":"EPM > A Appendix A Types of Assets > Tort settlement","text":"## Tort settlement\n\nRights, obligations, and remedies applied by courts in civil proceedings to provide relief for persons who have suffered harm from the wrongful acts of others."},{"chunk_id":"epm:A#trade-or-business-asset","heading":"Trade or business asset","url":"https://bot-corpus.mn-dhs.online/s/epm/A#trade-or-business-asset","context":"EPM > A Appendix A Types of Assets > Trade or business asset","text":"## Trade or business asset\n\nProperty used in a trade or business, including vehicles, tools, machinery, farm implements, unsold inventory, business checking accounts, non-homestead real property, rental property, etc."},{"chunk_id":"epm:A#traditional-individual-retirement-account-ira","heading":"Traditional Individual Retirement Account (IRA)","url":"https://bot-corpus.mn-dhs.online/s/epm/A#traditional-individual-retirement-account-ira","context":"EPM > A Appendix A Types of Assets > Traditional Individual Retirement Account (IRA)","text":"## Traditional Individual Retirement Account (IRA)\n\nAn IRA that allows individuals to direct pretax income, up to specific annual limits, toward investments that can grow tax-deferred (no capital gains or dividend income is taxed)."},{"chunk_id":"epm:A#treasury-bill","heading":"Treasury bill","url":"https://bot-corpus.mn-dhs.online/s/epm/A#treasury-bill","context":"EPM > A Appendix A Types of Assets > Treasury bill","text":"## Treasury bill\n\nA short-term debt obligation backed by the U.S. government with a maturity of less than one year."},{"chunk_id":"epm:A#tribal-land-settlements-or-judgements","heading":"Tribal Land Settlements or Judgements","url":"https://bot-corpus.mn-dhs.online/s/epm/A#tribal-land-settlements-or-judgements","context":"EPM > A Appendix A Types of Assets > Tribal Land Settlements or Judgements","text":"## Tribal Land Settlements or Judgements\n\nFunds held in trust by the Secretary of the Interior or distributed per capita pursuant to a plan prepared by the Secretary of the Interior. Including:\n- Judgment funds distributed per capita under P.L. 99-377 to the Mississippi Band Chippewa Indians of White Earth, Leech Lake, and Mille Lacs reservations.\n- Distributions of claims settlement funds under P.L. 99-264, P.L. 100-153, and P.L. 100-212 to members of the White Earth Band of Chippewa Indians from the White Earth Reservation Land Settlement Act of 1985 (WELSA).\n- Per capita payments made under 25 USC § 1407 to members of the Bois Forte Band of Chippewa Indians pursuant to the agreement to restrict tribal rights to hunt and fish in ceded territories.\n- Per capita payments made under P.L. 85-794 to members of the Red Lake Band of Chippewa Indians from the proceeds of the sale of timber and lumber on the Red Lake Reservation.\n- Receipts derived from trust lands and distributed under P.L. 94-114 to the White Earth Band of Chippewa Indians regarding submarginal land held in trust by the United States.\n- Judgment funds distributed under P.L. 98-123 § 3 to the Red Lake Band of Chippewa Indians.\n- Per capita and dividend payment distributions of judgment funds made under P.L. 99-130 to members of the Prairie Island Sioux, Lower Sioux, and Shakopee Mdewakanton Sioux Communities of Minnesota.\n- Funds distributed per capita under P.L. 99-146 to members of the Chippewa of Lake Superior and the Chippewa of the Mississippi."},{"chunk_id":"epm:A#trio-programs-trio","heading":"TRIO Programs (TRIO)","url":"https://bot-corpus.mn-dhs.online/s/epm/A#trio-programs-trio","context":"EPM > A Appendix A Types of Assets > TRIO Programs (TRIO)","text":"## TRIO Programs (TRIO)\n\nStudent financial aid programs created by Title IV of the Higher Education Act of 1965. TRIO includes eight programs targeted to serve and assist low-income individuals, first-generation college students, and people with disabilities:\n- Educational Opportunity Centers\n- Ronald E. McNair Post-baccalaureate Achievement\n- Student Support Services\n- Talent Search\n- Training Program for Federal TRIO Programs Staff\n- Upward Bound\n- Upward Bound Math-Science\n- Veterans Upward Bound"},{"chunk_id":"epm:A#trust","heading":"Trust","url":"https://bot-corpus.mn-dhs.online/s/epm/A#trust","context":"EPM > A Appendix A Types of Assets > Trust","text":"## Trust\n\nAny arrangement, in which a grantor transfers money or property to a trustee with the intention that it be held, managed or administered by the trustee for the benefit of certain designated persons."},{"chunk_id":"epm:A#uniform-gift-to-minors-act-ugmauniform-transfer-to-minors-act-utma","heading":"Uniform Gift to Minors Act (UGMA)/Uniform Transfer to Minors Act (UTMA)","url":"https://bot-corpus.mn-dhs.online/s/epm/A#uniform-gift-to-minors-act-ugmauniform-transfer-to-minors-act-utma","context":"EPM > A Appendix A Types of Assets > Uniform Gift to Minors Act (UGMA)/Uniform Transfer to Minors Act (UTMA)","text":"## Uniform Gift to Minors Act (UGMA)/Uniform Transfer to Minors Act (UTMA)\n\nThe Uniform Gift to Minors Act (UGMA) established a way for a minor to own securities without requiring the services of an attorney to prepare trust documents or the court appointment of a trustee. The terms of this trust are established by a state statute instead of a trust document. The Uniform Transfer to Minors Act (UTMA) is similar, but also allows minors to own other types of property, such as real estate, fine art, patents and royalties, and for the transfers to occur through inheritance."},{"chunk_id":"epm:A#united-states-savings-bond","heading":"United States savings bond","url":"https://bot-corpus.mn-dhs.online/s/epm/A#united-states-savings-bond","context":"EPM > A Appendix A Types of Assets > United States savings bond","text":"## United States savings bond\n\nA bond issued by the government and sold to the general public."},{"chunk_id":"epm:A#universal-life-insurance","heading":"Universal Life Insurance","url":"https://bot-corpus.mn-dhs.online/s/epm/A#universal-life-insurance","context":"EPM > A Appendix A Types of Assets > Universal Life Insurance","text":"## Universal Life Insurance\n\nProvides insurance over a specified period, and builds cash value for policy owners over time. There are several types of universal life policies, including variable universal and equity indexed universal life. All universal life policies include a cash account in addition to the standard death benefit."},{"chunk_id":"epm:A#variable-annuity","heading":"Variable annuity","url":"https://bot-corpus.mn-dhs.online/s/epm/A#variable-annuity","context":"EPM > A Appendix A Types of Assets > Variable annuity","text":"## Variable annuity\n\nA type of annuity in which periodic payments vary according to income generated by assets in an underlying investment portfolio. Payment amounts may fluctuate because the annuity payments vary based upon the performance of the market."},{"chunk_id":"epm:A#vehicles","heading":"Vehicles","url":"https://bot-corpus.mn-dhs.online/s/epm/A#vehicles","context":"EPM > A Appendix A Types of Assets > Vehicles","text":"## Vehicles\n\nMay be any registered or unregistered conveyance used on air, land, or water, including, but not limited to cars, trucks, motorcycles, boats, snowmobiles, animal-drawn vehicles, and animals."},{"chunk_id":"epm:A#veterans-benefits-for-educational-assistance","heading":"Veterans Benefits for educational assistance","url":"https://bot-corpus.mn-dhs.online/s/epm/A#veterans-benefits-for-educational-assistance","context":"EPM > A Appendix A Types of Assets > Veterans Benefits for educational assistance","text":"## Veterans Benefits for educational assistance\n\nThe Department of Veterans Affairs (VA) provides educational assistance through different programs, including vocational rehabilitation."},{"chunk_id":"epm:A#veterans-children-with-certain-birth-defects-payments","heading":"Veterans’ Children with Certain Birth Defects payments","url":"https://bot-corpus.mn-dhs.online/s/epm/A#veterans-children-with-certain-birth-defects-payments","context":"EPM > A Appendix A Types of Assets > Veterans’ Children with Certain Birth Defects payments","text":"## Veterans’ Children with Certain Birth Defects payments\n\nPayments made to children of Vietnam or Korean veterans born with spina bifida, or payments made to the children of women Vietnam veterans if they have certain birth defects."},{"chunk_id":"epm:A#vietnamese-commando-compensation-act-payments","heading":"Vietnamese Commando Compensation Act Payments","url":"https://bot-corpus.mn-dhs.online/s/epm/A#vietnamese-commando-compensation-act-payments","context":"EPM > A Appendix A Types of Assets > Vietnamese Commando Compensation Act Payments","text":"## Vietnamese Commando Compensation Act Payments\n\nPayments made to an individual who was captured and interned by the Democratic Republic of North Vietnam as a result of that person's participation in certain military operations (known as OPLAN 34A or its predecessor, or OPLAN 35)."},{"chunk_id":"epm:A#voluntary-employees-beneficiary-association-veba-payments","heading":"Voluntary Employees' Beneficiary Association (VEBA) payments","url":"https://bot-corpus.mn-dhs.online/s/epm/A#voluntary-employees-beneficiary-association-veba-payments","context":"EPM > A Appendix A Types of Assets > Voluntary Employees' Beneficiary Association (VEBA) payments","text":"## Voluntary Employees' Beneficiary Association (VEBA) payments\n\nBenefits paid to members of the mutual association or their beneficiaries."},{"chunk_id":"epm:A#whole-life-insurance","heading":"Whole Life Insurance","url":"https://bot-corpus.mn-dhs.online/s/epm/A#whole-life-insurance","context":"EPM > A Appendix A Types of Assets > Whole Life Insurance","text":"## Whole Life Insurance\n\nA form of life insurance that applies part of the premium payments to build an investment or savings value for the policy owner. The investment or savings value is the cash surrender value (CSV) of the policy. A modified whole life policy charges smaller premiums for a specified length of time after which the premiums increase for the remainder of the policy."},{"chunk_id":"epm:A#women-infant-and-children-wic-vouchers","heading":"Women, Infant and Children (WIC) vouchers","url":"https://bot-corpus.mn-dhs.online/s/epm/A#women-infant-and-children-wic-vouchers","context":"EPM > A Appendix A Types of Assets > Women, Infant and Children (WIC) vouchers","text":"## Women, Infant and Children (WIC) vouchers\n\nA federal program authorized by the Child Nutrition Act of 1966 to provide nutritious food and nutrition education to low-income pregnant and postpartum women and their children."},{"chunk_id":"epm:A#workers-compensation-settlement","heading":"Workers’ compensation settlement","url":"https://bot-corpus.mn-dhs.online/s/epm/A#workers-compensation-settlement","context":"EPM > A Appendix A Types of Assets > Workers’ compensation settlement","text":"## Workers’ compensation settlement\n\nAn agreement between a worker injured on the job and an employer-paid insurance program providing benefits in the form of medical expenses and lost wages. If a worker dies due to an injury on the job, the worker’s beneficiaries are eligible to receive benefits on the worker’s behalf, known as death benefits."}]},{"id":"epm:B","number":"B","title":"Appendix B Types of Income","parent":"appendices","breadcrumb":"B Appendix B Types of Income","summary":"A student financial aid program created by Title IV of the Higher Education Act of 1965.","effective_date":"2020-06-01","last_modified":"2026-10-03T04:10:19.068661+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/B","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/B","official_origin":"https://hcopub.dhs.state.mn.us/epm/appendix_b.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:B#academic-achievement-incentive-scholarships","heading":"Academic Achievement Incentive Scholarships","url":"https://bot-corpus.mn-dhs.online/s/epm/B#academic-achievement-incentive-scholarships","context":"EPM > B Appendix B Types of Income > Academic Achievement Incentive Scholarships","text":"## Academic Achievement Incentive Scholarships\n\nA student financial aid program created by Title IV of the Higher Education Act of 1965."},{"chunk_id":"epm:B#academic-competitiveness-grants","heading":"Academic Competitiveness Grants","url":"https://bot-corpus.mn-dhs.online/s/epm/B#academic-competitiveness-grants","context":"EPM > B Appendix B Types of Income > Academic Competitiveness Grants","text":"## Academic Competitiveness Grants\n\nA student financial aid program created by Title IV of the Higher Education Act of 1965."},{"chunk_id":"epm:B#accelerated-life-insurance-payments","heading":"Accelerated life insurance payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#accelerated-life-insurance-payments","context":"EPM > B Appendix B Types of Income > Accelerated life insurance payments","text":"## Accelerated life insurance payments\n\nSome life insurance policies, in certain circumstances, allow the policy owner to receive some or all of the proceeds of the life insurance policy in the form of accelerated life insurance payments prior to the death of the insured."},{"chunk_id":"epm:B#adoption-assistance","heading":"Adoption assistance","url":"https://bot-corpus.mn-dhs.online/s/epm/B#adoption-assistance","context":"EPM > B Appendix B Types of Income > Adoption assistance","text":"## Adoption assistance\n\nAn adoption assistance grant provided to adoptive parents. It is funded either federally through Title IV-E of the Social Security Act or by the state under Minnesota Statutes, section 259.67."},{"chunk_id":"epm:B#americorps-national-civilian-community-corps-americorps-nccc-living-allowances-and-other-payments","heading":"AmeriCorps-National Civilian Community Corps (AmeriCorps NCCC) living allowances and other payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#americorps-national-civilian-community-corps-americorps-nccc-living-allowances-and-other-payments","context":"EPM > B Appendix B Types of Income > AmeriCorps-National Civilian Community Corps (AmeriCorps NCCC) living allowances and other payments","text":"## AmeriCorps-National Civilian Community Corps (AmeriCorps NCCC) living allowances and other payments\n\nA residential service program for young adults between the ages of 18 and 24 in which participants provide work teams for a variety of community service projects. Participants of AmeriCorps NCCC receive a stipend or living allowance generally based on minimum wage requirements. Participants are eligible to receive an educational award made upon completion of a specified term of service."},{"chunk_id":"epm:B#americorps-state-and-national-living-allowances-and-other-payments","heading":"AmeriCorps State and National living allowances and other payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#americorps-state-and-national-living-allowances-and-other-payments","context":"EPM > B Appendix B Types of Income > AmeriCorps State and National living allowances and other payments","text":"## AmeriCorps State and National living allowances and other payments\n\nA national service program authorized by the National and Community Service Act of 1990. The program provides grants to States, Indian tribes, private and public nonprofit organizations and Institutes of Higher Education for community service projects, such as educational programs, environmental activities, and disaster relief. Participants of AmeriCorps State and National receive a stipend or living allowance generally based on minimum wage requirements. Participants are eligible to receive an educational award made upon completion of a specified term of service."},{"chunk_id":"epm:B#americorps-vista-payments","heading":"AmeriCorps VISTA payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#americorps-vista-payments","context":"EPM > B Appendix B Types of Income > AmeriCorps VISTA payments","text":"## AmeriCorps VISTA payments\n\nThis program provides full-time AmeriCorps VISTA members to community organizations and public agencies to create and expand community service programs. Participants of AmeriCorps VISTA receive a stipend or living allowance generally based on minimum wage requirements. Participants are eligible to receive an educational award made upon completion of a specified term of service."},{"chunk_id":"epm:B#annuity-payments","heading":"Annuity payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#annuity-payments","context":"EPM > B Appendix B Types of Income > Annuity payments","text":"## Annuity payments\n\nPayments from an annuitized contract either in the form of a single lump sum or several payments over several months or years according to the terms chosen when the contract was annuitized."},{"chunk_id":"epm:B#austrian-reparation-payments-also-called-austrian-social-insurance-payments","heading":"Austrian Reparation payments (also called Austrian Social Insurance payments)","url":"https://bot-corpus.mn-dhs.online/s/epm/B#austrian-reparation-payments-also-called-austrian-social-insurance-payments","context":"EPM > B Appendix B Types of Income > Austrian Reparation payments (also called Austrian Social Insurance payments)","text":"## Austrian Reparation payments (also called Austrian Social Insurance payments)\n\nThe nationwide class action lawsuit, Bondy v. Sullivan, involved Austrian social insurance payments which were passed, in whole or in part, on wage credits granted under Paragraph 500–506 of the Austrian General Social Insurance Act. (GSIA). These paragraphs grant credits to individuals who suffered a loss (i.e., were imprisoned, unemployed, or forced to flee Austria) during the period from March 1933 to May 1945 for political, religious, or ethnic reasons."},{"chunk_id":"epm:B#awards","heading":"Awards","url":"https://bot-corpus.mn-dhs.online/s/epm/B#awards","context":"EPM > B Appendix B Types of Income > Awards","text":"## Awards\n\nCash, merchandise, or products received primarily in recognition of employment, religious, charitable, scientific, educational, artistic, literary or civic achievement."},{"chunk_id":"epm:B#blood-and-blood-plasma-sales","heading":"Blood and blood plasma sales","url":"https://bot-corpus.mn-dhs.online/s/epm/B#blood-and-blood-plasma-sales","context":"EPM > B Appendix B Types of Income > Blood and blood plasma sales","text":"## Blood and blood plasma sales\n\nCompensation received for blood or blood plasma donations."},{"chunk_id":"epm:B#blood-product-settlement-payments","heading":"Blood product settlement payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#blood-product-settlement-payments","context":"EPM > B Appendix B Types of Income > Blood product settlement payments","text":"## Blood product settlement payments\n\nPayments made pursuant to the class settlement of Susan Walker v. Bayer Corp., et al, and to the release of any claims in that case that were entered into in lieu of class settlement."},{"chunk_id":"epm:B#bureau-of-indian-affairs-bia-student-assistance","heading":"Bureau of Indian Affairs (BIA) student assistance","url":"https://bot-corpus.mn-dhs.online/s/epm/B#bureau-of-indian-affairs-bia-student-assistance","context":"EPM > B Appendix B Types of Income > Bureau of Indian Affairs (BIA) student assistance","text":"## Bureau of Indian Affairs (BIA) student assistance\n\nBIA funded student financial aid to eligible individuals."},{"chunk_id":"epm:B#cash-assistance-programs","heading":"Cash assistance programs","url":"https://bot-corpus.mn-dhs.online/s/epm/B#cash-assistance-programs","context":"EPM > B Appendix B Types of Income > Cash assistance programs","text":"## Cash assistance programs\n\nPublic programs established to provide for people’s basic living expenses, including General Assistance (GA), Housing Support (HS), Minnesota Family Investment Program (MFIP), Minnesota Supplemental Aid (MSA), Refugee Cash Assistance (RCA), and emergency cash programs."},{"chunk_id":"epm:B#child-care-assistance-program-ccap","heading":"Child Care Assistance Program (CCAP)","url":"https://bot-corpus.mn-dhs.online/s/epm/B#child-care-assistance-program-ccap","context":"EPM > B Appendix B Types of Income > Child Care Assistance Program (CCAP)","text":"## Child Care Assistance Program (CCAP)\n\nPublic program available to help low- and moderate-income families pursue employment or education leading to economic self-sufficiency by subsidizing their childcare."},{"chunk_id":"epm:B#child-care-and-development-block-grant-act-ccdbga-payments","heading":"Child Care and Development Block Grant Act (CCDBGA) payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#child-care-and-development-block-grant-act-ccdbga-payments","context":"EPM > B Appendix B Types of Income > Child Care and Development Block Grant Act (CCDBGA) payments","text":"## Child Care and Development Block Grant Act (CCDBGA) payments\n\nFederally funded child care assistance payments for low income families and children with special needs. These payments are administered by the Child Care and Development Fund (CCDF)."},{"chunk_id":"epm:B#child-support","heading":"Child support","url":"https://bot-corpus.mn-dhs.online/s/epm/B#child-support","context":"EPM > B Appendix B Types of Income > Child support","text":"## Child support\n\nA voluntary or court-ordered payment by non-custodial parents for the support of their children."},{"chunk_id":"epm:B#clergy-housing-in-kind","heading":"Clergy housing, in-kind","url":"https://bot-corpus.mn-dhs.online/s/epm/B#clergy-housing-in-kind","context":"EPM > B Appendix B Types of Income > Clergy housing, in-kind","text":"## Clergy housing, in-kind\n\nHousing provided to clergy in exchange for work or services. Cash is not provided in lieu of the housing."},{"chunk_id":"epm:B#clergy-housing-cash-payment","heading":"Clergy housing, cash payment","url":"https://bot-corpus.mn-dhs.online/s/epm/B#clergy-housing-cash-payment","context":"EPM > B Appendix B Types of Income > Clergy housing, cash payment","text":"## Clergy housing, cash payment\n\nHousing allowances paid in cash to members of the clergy as compensation for employment."},{"chunk_id":"epm:B#clinical-trial-participation-payments","heading":"Clinical trial participation payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#clinical-trial-participation-payments","context":"EPM > B Appendix B Types of Income > Clinical trial participation payments","text":"## Clinical trial participation payments\n\nCompensation for participation in a clinical trial that involves the research and testing of medical treatments for a rare disease or condition."},{"chunk_id":"epm:B#cobell-v-salazar-class-action-settlement-also-known-as-claims-resolution-act-of-2010","heading":"Cobell v. Salazar Class Action Settlement (also known as Claims Resolution Act of 2010)","url":"https://bot-corpus.mn-dhs.online/s/epm/B#cobell-v-salazar-class-action-settlement-also-known-as-claims-resolution-act-of-2010","context":"EPM > B Appendix B Types of Income > Cobell v. Salazar Class Action Settlement (also known as Claims Resolution Act of 2010)","text":"## Cobell v. Salazar Class Action Settlement (also known as Claims Resolution Act of 2010)\n\nFund reimbursing a large number of Individual Indian Money (IIM) account holders due to inadequate historical accounting of funds held in trust by the federal government."},{"chunk_id":"epm:B#college-assistance-migrant-program-camp","heading":"College Assistance Migrant Program (CAMP)","url":"https://bot-corpus.mn-dhs.online/s/epm/B#college-assistance-migrant-program-camp","context":"EPM > B Appendix B Types of Income > College Assistance Migrant Program (CAMP)","text":"## College Assistance Migrant Program (CAMP)\n\nA student financial aid program created by Title IV of the Higher Education Act of 1965."},{"chunk_id":"epm:B#commissions","heading":"Commissions","url":"https://bot-corpus.mn-dhs.online/s/epm/B#commissions","context":"EPM > B Appendix B Types of Income > Commissions","text":"## Commissions\n\nFees paid to a person for performing a service. (e.g., a percentage of sales)."},{"chunk_id":"epm:B#community-service-employment-program-title-v-of-the-older-americans-act","heading":"Community Service Employment Program (Title V of the Older Americans Act)","url":"https://bot-corpus.mn-dhs.online/s/epm/B#community-service-employment-program-title-v-of-the-older-americans-act","context":"EPM > B Appendix B Types of Income > Community Service Employment Program (Title V of the Older Americans Act)","text":"## Community Service Employment Program (Title V of the Older Americans Act)\n\nFederally funded payments for supportive services or reimbursement for out-of-pocket expenses to employees performing services in such programs as the Experience Works program and the Senior Aides program."},{"chunk_id":"epm:B#conservation-and-youth-service-corps-payments","heading":"Conservation and Youth Service Corps payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#conservation-and-youth-service-corps-payments","context":"EPM > B Appendix B Types of Income > Conservation and Youth Service Corps payments","text":"## Conservation and Youth Service Corps payments\n\nPaid service work under the National and Community Service Act of 1990 under Title I."},{"chunk_id":"epm:B#consumer-support-grant-csg-program","heading":"Consumer Support Grant (CSG) program","url":"https://bot-corpus.mn-dhs.online/s/epm/B#consumer-support-grant-csg-program","context":"EPM > B Appendix B Types of Income > Consumer Support Grant (CSG) program","text":"## Consumer Support Grant (CSG) program\n\nA state-funded program providing funds to help people with functional limitations and their families purchase and secure supports that people need to live safely and independently in the community. CSG allows a person to convert the state portion of medical assistance payments for specific home care services into a cash grant. Eligible participants receive monthly cash grants to replace fee-for-service home care services payments."},{"chunk_id":"epm:B#corporation-for-national-and-community-service-cncs-payments","heading":"Corporation for National and Community Service (CNCS) payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#corporation-for-national-and-community-service-cncs-payments","context":"EPM > B Appendix B Types of Income > Corporation for National and Community Service (CNCS) payments","text":"## Corporation for National and Community Service (CNCS) payments\n\nEstablished by the National and Community Service Trust Act of 1993 (NCSTA) by combining two formerly independent agencies: the Commission on National Service and ACTION. CNCS funds payments to volunteers in programs authorized under the Domestic Volunteer Services Act, including:\n- AmeriCorps\n- Urban Crime Prevention Program\n- Special volunteer programs under Title I\n- Demonstration programs under Title II\n- Senior Corps:\n  - Retired Senior Volunteer Program (RSVP)\n  - Foster Grandparent Program\n  - Senior Companions"},{"chunk_id":"epm:B#coverdell-education-savings-account-esa-also-referred-to-as-a-section-530-plan-and-formerly-known-as-an-educational-individual-retirement-account","heading":"Coverdell Education Savings Account (ESA) (also referred to as a Section 530 Plan and formerly known as an Educational Individual Retirement Account)","url":"https://bot-corpus.mn-dhs.online/s/epm/B#coverdell-education-savings-account-esa-also-referred-to-as-a-section-530-plan-and-formerly-known-as-an-educational-individual-retirement-account","context":"EPM > B Appendix B Types of Income > Coverdell Education Savings Account (ESA) (also referred to as a Section 530 Plan and formerly known as an Educational Individual Retirement Account)","text":"## Coverdell Education Savings Account (ESA) (also referred to as a Section 530 Plan and formerly known as an Educational Individual Retirement Account)\n\nAn account established to pay the educational expenses (elementary, secondary, and postsecondary school) of an individual who is the designated beneficiary and is under age 18 or a person with special needs."},{"chunk_id":"epm:B#credit-disability-insurance-payments","heading":"Credit disability insurance payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#credit-disability-insurance-payments","context":"EPM > B Appendix B Types of Income > Credit disability insurance payments","text":"## Credit disability insurance payments\n\nPayments issued to, or on behalf of, borrowers on loans, mortgages, etc. in the event of disability. These insurance payments are made directly to the loan or mortgage companies, etc., and are not available to the person."},{"chunk_id":"epm:B#credit-life-insurance-payments","heading":"Credit life insurance payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#credit-life-insurance-payments","context":"EPM > B Appendix B Types of Income > Credit life insurance payments","text":"## Credit life insurance payments\n\nPayments issued to, or on behalf of, borrowers on loans, mortgages, etc. in the event of death. These insurance payments are made directly to the loan or mortgage companies, etc., and are not available to the person."},{"chunk_id":"epm:B#crime-victim-payments","heading":"Crime victim payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#crime-victim-payments","context":"EPM > B Appendix B Types of Income > Crime victim payments","text":"## Crime victim payments\n\nPayments made to compensate crime victims for losses resulting from a crime."},{"chunk_id":"epm:B#direct-loan-program-payments","heading":"Direct Loan Program payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#direct-loan-program-payments","context":"EPM > B Appendix B Types of Income > Direct Loan Program payments","text":"## Direct Loan Program payments\n\nProgram in the Title IV of the Higher Education Act of 1965 that provides student financial aid in:\n- Direct subsidized loans\n- Direct unsubsidized Loans\n- Direct PLUS loans\n- Direct Consolidation loans"},{"chunk_id":"epm:B#disability-payments-that-are-part-of-the-employers-benefit-package","heading":"Disability payments that are part of the employer’s benefit package","url":"https://bot-corpus.mn-dhs.online/s/epm/B#disability-payments-that-are-part-of-the-employers-benefit-package","context":"EPM > B Appendix B Types of Income > Disability payments that are part of the employer’s benefit package","text":"## Disability payments that are part of the employer’s benefit package\n\nAn employer’s policy or practice that provides salary continuation or other payments to workers during periods of disability."},{"chunk_id":"epm:B#disaster-assistance-federal-declaration","heading":"Disaster Assistance, federal declaration","url":"https://bot-corpus.mn-dhs.online/s/epm/B#disaster-assistance-federal-declaration","context":"EPM > B Appendix B Types of Income > Disaster Assistance, federal declaration","text":"## Disaster Assistance, federal declaration\n\nPayments issued pursuant to a presidential declaration of disaster or emergency. These payments may be made by the federal government (including, but not limited to, grants from the Federal Emergency Management Agency (FEMA), states, local governments, and disaster relief organizations such as the Red Cross and Salvation Army)."},{"chunk_id":"epm:B#disaster-assistance-state-declaration","heading":"Disaster Assistance, state declaration","url":"https://bot-corpus.mn-dhs.online/s/epm/B#disaster-assistance-state-declaration","context":"EPM > B Appendix B Types of Income > Disaster Assistance, state declaration","text":"## Disaster Assistance, state declaration\n\nPayments issued pursuant to a state declaration of disaster or emergency. These payments may be made by the state government (including, local governments, and disaster relief organizations such as the Red Cross and Salvation Army)."},{"chunk_id":"epm:B#diversionary-work-program-dwp-payment","heading":"Diversionary Work Program (DWP) payment","url":"https://bot-corpus.mn-dhs.online/s/epm/B#diversionary-work-program-dwp-payment","context":"EPM > B Appendix B Types of Income > Diversionary Work Program (DWP) payment","text":"## Diversionary Work Program (DWP) payment\n\nA short-term, work focused program for families applying for cash benefits. It provides a maximum of four consecutive months in a 12-month period of necessary services and supports to families that will lead to a subsidized employment, increased economic stability and reduced risk of needing longer term assistance under Minnesota Family Investment Program. (MFIP)."},{"chunk_id":"epm:B#dividend-payment","heading":"Dividend payment","url":"https://bot-corpus.mn-dhs.online/s/epm/B#dividend-payment","context":"EPM > B Appendix B Types of Income > Dividend payment","text":"## Dividend payment\n\nThe amount of the profit distribution a shareholder receives or the amount of the surplus distribution a policyholder of a participating insurance policy receives."},{"chunk_id":"epm:B#dividend-accumulation","heading":"Dividend accumulation","url":"https://bot-corpus.mn-dhs.online/s/epm/B#dividend-accumulation","context":"EPM > B Appendix B Types of Income > Dividend accumulation","text":"## Dividend accumulation\n\nDividends that the policy holder has left in the custody of the insurer to accumulate interest."},{"chunk_id":"epm:B#dividend-addition","heading":"Dividend addition","url":"https://bot-corpus.mn-dhs.online/s/epm/B#dividend-addition","context":"EPM > B Appendix B Types of Income > Dividend addition","text":"## Dividend addition\n\nAmounts of additional life insurance purchased with dividends."},{"chunk_id":"epm:B#domestic-volunteer-service-act-payments","heading":"Domestic Volunteer Service Act payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#domestic-volunteer-service-act-payments","context":"EPM > B Appendix B Types of Income > Domestic Volunteer Service Act payments","text":"## Domestic Volunteer Service Act payments\n\nEstablished to provide funding and regulations for federally administered volunteer activity programs. Volunteers in such programs may receive payments in the form of a minimal stipend, payment for supportive services (such as housing, supplies, equipment), and expense allowance, and/or reimbursement of out-of-pocket expenses."},{"chunk_id":"epm:B#earned-income","heading":"Earned income","url":"https://bot-corpus.mn-dhs.online/s/epm/B#earned-income","context":"EPM > B Appendix B Types of Income > Earned income","text":"## Earned income\n\nMoney received from employment or self-employment. This includes but is not limited to salaries, wages, tips, commissions, vacation and sick pay."},{"chunk_id":"epm:B#emergency-general-assistance-ega-payments","heading":"Emergency General Assistance (EGA) payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#emergency-general-assistance-ega-payments","context":"EPM > B Appendix B Types of Income > Emergency General Assistance (EGA) payments","text":"## Emergency General Assistance (EGA) payments\n\nProvides payments to adults without children and to families to meet emergency needs such as shelter and utility payments."},{"chunk_id":"epm:B#employment-and-training-reimbursements-and-allowances","heading":"Employment and Training Reimbursements and Allowances","url":"https://bot-corpus.mn-dhs.online/s/epm/B#employment-and-training-reimbursements-and-allowances","context":"EPM > B Appendix B Types of Income > Employment and Training Reimbursements and Allowances","text":"## Employment and Training Reimbursements and Allowances\n\nThese include employment and training reimbursements and allowances received from local social services programs and the Workforce Investment Act (WIA) program."},{"chunk_id":"epm:B#energy-assistance-program-payments","heading":"Energy Assistance Program payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#energy-assistance-program-payments","context":"EPM > B Appendix B Types of Income > Energy Assistance Program payments","text":"## Energy Assistance Program payments\n\nFederally funded block grant for energy assistance payments to low income households."},{"chunk_id":"epm:B#experience-works-wages","heading":"Experience Works wages","url":"https://bot-corpus.mn-dhs.online/s/epm/B#experience-works-wages","context":"EPM > B Appendix B Types of Income > Experience Works wages","text":"## Experience Works wages\n\nWages paid to participants in programs carried out under the Community Service Employment Program, Title V of the Older Americans Act."},{"chunk_id":"epm:B#family-support-grants","heading":"Family Support Grants","url":"https://bot-corpus.mn-dhs.online/s/epm/B#family-support-grants","context":"EPM > B Appendix B Types of Income > Family Support Grants","text":"## Family Support Grants\n\nA state-funded program that provides funds to help families provide home care for dependents with developmental disabilities. Includes both cash and non-cash payments provided under this program."},{"chunk_id":"epm:B#farm-income","heading":"Farm income","url":"https://bot-corpus.mn-dhs.online/s/epm/B#farm-income","context":"EPM > B Appendix B Types of Income > Farm income","text":"## Farm income\n\nCommon types of farm income that are considered self-employment income include:\n- Proceeds from sale of crops, livestock, or products\n- Soil conservation payments, such as Conservation Reserve Payments (CRP)\n- Proceeds from machine rental, including wages to the farmer/operator\n- Capital gains or capital losses"},{"chunk_id":"epm:B#federal-family-education-loans-ffel","heading":"Federal Family Education Loans (FFEL)","url":"https://bot-corpus.mn-dhs.online/s/epm/B#federal-family-education-loans-ffel","context":"EPM > B Appendix B Types of Income > Federal Family Education Loans (FFEL)","text":"## Federal Family Education Loans (FFEL)\n\nA student financial aid created by Title IV of the Higher Education Act of 1965. FFEL includes four components:\n- Stafford loans (formerly Guaranteed student loans)\n- Unsubsidized Stafford loans\n- Federal PLUS loans\n- Federal Consolidation loans"},{"chunk_id":"epm:B#federal-supplemental-opportunity-grant-fseog","heading":"Federal Supplemental Opportunity Grant (FSEOG)","url":"https://bot-corpus.mn-dhs.online/s/epm/B#federal-supplemental-opportunity-grant-fseog","context":"EPM > B Appendix B Types of Income > Federal Supplemental Opportunity Grant (FSEOG)","text":"## Federal Supplemental Opportunity Grant (FSEOG)\n\nA student financial aid program created by Title IV of the Higher Education Act of 1965."},{"chunk_id":"epm:B#federal-work-study-fws-program","heading":"Federal Work-Study (FWS) program","url":"https://bot-corpus.mn-dhs.online/s/epm/B#federal-work-study-fws-program","context":"EPM > B Appendix B Types of Income > Federal Work-Study (FWS) program","text":"## Federal Work-Study (FWS) program\n\nA student financial aid program created by Title IV of the Higher Education Act of 1965."},{"chunk_id":"epm:B#fellowships","heading":"Fellowships","url":"https://bot-corpus.mn-dhs.online/s/epm/B#fellowships","context":"EPM > B Appendix B Types of Income > Fellowships","text":"## Fellowships\n\nAmounts paid to enable qualified individuals to further their education and training by scholastic or research work, etc."},{"chunk_id":"epm:B#filipino-veterans-equity-compensation-fvec-fund-payments","heading":"Filipino Veterans Equity Compensation (FVEC) fund payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#filipino-veterans-equity-compensation-fvec-fund-payments","context":"EPM > B Appendix B Types of Income > Filipino Veterans Equity Compensation (FVEC) fund payments","text":"## Filipino Veterans Equity Compensation (FVEC) fund payments\n\nSection 1002 of the American Recovery and Reinvestment Act of 2009 (ARRA) established the FVECF to issue one-time payments to eligible Filipino veterans who aided American troops during World War II."},{"chunk_id":"epm:B#food-support-program","heading":"Food Support Program","url":"https://bot-corpus.mn-dhs.online/s/epm/B#food-support-program","context":"EPM > B Appendix B Types of Income > Food Support Program","text":"## Food Support Program\n\nFormer name of the Federal Supplemental Nutrition Assistance Program (SNAP)."},{"chunk_id":"epm:B#foster-care-payments","heading":"Foster Care payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#foster-care-payments","context":"EPM > B Appendix B Types of Income > Foster Care payments","text":"## Foster Care payments\n\nA payment made to the foster care provider for the purpose of meeting the needs of the individual in care. Payments include:\n- Federally funded foster care IV-E payments\n- State funded, non-IV-E, foster care payments\n- Adult foster care payments\n- Other payments for the care of foster children or adults who live in the household"},{"chunk_id":"epm:B#foster-grandparent-program-payments","heading":"Foster Grandparent Program payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#foster-grandparent-program-payments","context":"EPM > B Appendix B Types of Income > Foster Grandparent Program payments","text":"## Foster Grandparent Program payments\n\nA program funded by the Corporation for National and Community Service (CNCS) providing the opportunity for volunteers age 55 and older to work with children. Part of the Senior Corps Program."},{"chunk_id":"epm:B#fundraiser-income","heading":"Fundraiser income","url":"https://bot-corpus.mn-dhs.online/s/epm/B#fundraiser-income","context":"EPM > B Appendix B Types of Income > Fundraiser income","text":"## Fundraiser income\n\nFunds raised by a community group or organization."},{"chunk_id":"epm:B#gambling-winnings","heading":"Gambling winnings","url":"https://bot-corpus.mn-dhs.online/s/epm/B#gambling-winnings","context":"EPM > B Appendix B Types of Income > Gambling winnings","text":"## Gambling winnings\n\nCash or other items won in a game of chance, lottery, or contest."},{"chunk_id":"epm:B#gear-up-gaining-early-awareness-and-readiness-for-undergraduate-programs-scholarships","heading":"Gear Up (Gaining Early Awareness and Readiness for Undergraduate Programs) scholarships","url":"https://bot-corpus.mn-dhs.online/s/epm/B#gear-up-gaining-early-awareness-and-readiness-for-undergraduate-programs-scholarships","context":"EPM > B Appendix B Types of Income > Gear Up (Gaining Early Awareness and Readiness for Undergraduate Programs) scholarships","text":"## Gear Up (Gaining Early Awareness and Readiness for Undergraduate Programs) scholarships\n\nA student financial aid program created by Title IV of the Higher Education Act of 1965."},{"chunk_id":"epm:B#general-assistance-ga-benefits","heading":"General Assistance (GA) benefits","url":"https://bot-corpus.mn-dhs.online/s/epm/B#general-assistance-ga-benefits","context":"EPM > B Appendix B Types of Income > General Assistance (GA) benefits","text":"## General Assistance (GA) benefits\n\nA program authorized under Minnesota Statutes 256D to provide cash assistance to needy individuals and couples without children."},{"chunk_id":"epm:B#german-reparation-payments","heading":"German reparation payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#german-reparation-payments","context":"EPM > B Appendix B Types of Income > German reparation payments","text":"## German reparation payments\n\nPassed in 1956 to provide for reparations payments to certain survivors of the Holocaust."},{"chunk_id":"epm:B#gift-income","heading":"Gift income","url":"https://bot-corpus.mn-dhs.online/s/epm/B#gift-income","context":"EPM > B Appendix B Types of Income > Gift income","text":"## Gift income\n\nSomething a person receives which is not repayment for goods or services the person provided and is not given because of a legal obligation on the giver’s part. Gift income can be cash or in-kind. To be a gift, something must be given irrevocably. (i.e., the donor relinquishes all control)."},{"chunk_id":"epm:B#gifts-to-children-with-life-threatening-conditions","heading":"Gifts to children with life-threatening conditions","url":"https://bot-corpus.mn-dhs.online/s/epm/B#gifts-to-children-with-life-threatening-conditions","context":"EPM > B Appendix B Types of Income > Gifts to children with life-threatening conditions","text":"## Gifts to children with life-threatening conditions\n\nPayments made by tax-exempt organizations (e.g. Make a Wish) to or for the benefit of children younger than age 18 with life-threatening conditions. These gifts include gifts to the child's parents for the child's benefit and indirect benefits to other family members, such as payment to accompany the child on a trip. Such gifts can also include in-kind gifts, which is any food, shelter, or other item donated to the child or another individual on the child’s behalf."},{"chunk_id":"epm:B#grants","heading":"Grants","url":"https://bot-corpus.mn-dhs.online/s/epm/B#grants","context":"EPM > B Appendix B Types of Income > Grants","text":"## Grants\n\nAmounts paid to enable qualified individuals to further their education and training by scholastic or research work, etc."},{"chunk_id":"epm:B#gross-income","heading":"Gross income","url":"https://bot-corpus.mn-dhs.online/s/epm/B#gross-income","context":"EPM > B Appendix B Types of Income > Gross income","text":"## Gross income\n\nTotal earned and unearned income before any deductions or disregards are applied."},{"chunk_id":"epm:B#gross-social-security-administration-ssa-retirement-survivors-disability-insurance-rsdi-benefits","heading":"Gross Social Security Administration (SSA) Retirement, Survivors, Disability Insurance (RSDI) benefits","url":"https://bot-corpus.mn-dhs.online/s/epm/B#gross-social-security-administration-ssa-retirement-survivors-disability-insurance-rsdi-benefits","context":"EPM > B Appendix B Types of Income > Gross Social Security Administration (SSA) Retirement, Survivors, Disability Insurance (RSDI) benefits","text":"## Gross Social Security Administration (SSA) Retirement, Survivors, Disability Insurance (RSDI) benefits\n\nThe RSDI benefit amount before deducting a Medicare premium and other withholdings."},{"chunk_id":"epm:B#high-school-equivalency-program-hep-financial-aid","heading":"High School Equivalency Program (HEP) financial aid","url":"https://bot-corpus.mn-dhs.online/s/epm/B#high-school-equivalency-program-hep-financial-aid","context":"EPM > B Appendix B Types of Income > High School Equivalency Program (HEP) financial aid","text":"## High School Equivalency Program (HEP) financial aid\n\nA student financial aid program created by Title IV of the Higher Education Act of 1965."},{"chunk_id":"epm:B#honoraria","heading":"Honoraria","url":"https://bot-corpus.mn-dhs.online/s/epm/B#honoraria","context":"EPM > B Appendix B Types of Income > Honoraria","text":"## Honoraria\n\nHonorary or free gifts, rewards, or donations usually provided gratuitously for services rendered (e.g., a guest speaker), for which no compensation can be collected by law. An honorarium may include a free gift of lodging, or payment of an individual’s expenses."},{"chunk_id":"epm:B#hostile-fire-imminent-danger-and-combat-pay","heading":"Hostile fire, imminent danger and combat pay","url":"https://bot-corpus.mn-dhs.online/s/epm/B#hostile-fire-imminent-danger-and-combat-pay","context":"EPM > B Appendix B Types of Income > Hostile fire, imminent danger and combat pay","text":"## Hostile fire, imminent danger and combat pay\n\nTypes of special pay to a service member."},{"chunk_id":"epm:B#housing-allowances","heading":"Housing allowances","url":"https://bot-corpus.mn-dhs.online/s/epm/B#housing-allowances","context":"EPM > B Appendix B Types of Income > Housing allowances","text":"## Housing allowances\n\nHousing allowances paid in cash as compensation for employment."},{"chunk_id":"epm:B#housing-assistance-federal","heading":"Housing assistance, federal","url":"https://bot-corpus.mn-dhs.online/s/epm/B#housing-assistance-federal","context":"EPM > B Appendix B Types of Income > Housing assistance, federal","text":"## Housing assistance, federal\n\nThe Federal Government through the Office of Housing and Urban Development (HUD) and the U.S. Department of Agriculture’s Rural Housing Service (RHS), formerly called the Farmers Home Administration, provides many forms of housing assistance, including: subsidized housing (e.g., public housing, reduced rent, cash towards utilities, etc.); loans for renovations; loans for construction, improvement, or replacement of farm homes and other buildings; mortgage or investment insurance; guaranteed loans and mortgages. This assistance may be provided directly by the federal government or through other entities such as local housing authorities, nonprofit organizations, etc."},{"chunk_id":"epm:B#housing-and-urban-development-hud-subsidies","heading":"Housing and Urban Development (HUD) subsidies","url":"https://bot-corpus.mn-dhs.online/s/epm/B#housing-and-urban-development-hud-subsidies","context":"EPM > B Appendix B Types of Income > Housing and Urban Development (HUD) subsidies","text":"## Housing and Urban Development (HUD) subsidies\n\nRental payments made directly to a landlord through the Housing and Urban Development (HUD) agency, including Section 8 payments made through the Housing and Redevelopment Authority and refunds or rebates from HUD for excess rents charged."},{"chunk_id":"epm:B#housing-support-hs-payments","heading":"Housing Support (HS) payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#housing-support-hs-payments","context":"EPM > B Appendix B Types of Income > Housing Support (HS) payments","text":"## Housing Support (HS) payments\n\nA program paying for room and board for low income seniors and adults with disabilities."},{"chunk_id":"epm:B#individual-development-account-ida","heading":"Individual Development Account (IDA)","url":"https://bot-corpus.mn-dhs.online/s/epm/B#individual-development-account-ida","context":"EPM > B Appendix B Types of Income > Individual Development Account (IDA)","text":"## Individual Development Account (IDA)\n\nA special bank account established under the Family Assets for Independence in Minnesota (FAIM) program that helps a person save for education, purchase of a first home, or to start a business. Eligible people must have earned income and have low income and assets."},{"chunk_id":"epm:B#infrequent-income","heading":"Infrequent income","url":"https://bot-corpus.mn-dhs.online/s/epm/B#infrequent-income","context":"EPM > B Appendix B Types of Income > Infrequent income","text":"## Infrequent income\n\nIncome is infrequent if a person receives it only once during a calendar quarter from a single source and did not receive it in the month immediately preceding that month or in the month immediately after that month, regardless of whether or not these payments occur in different calendar quarters."},{"chunk_id":"epm:B#inheritance","heading":"Inheritance","url":"https://bot-corpus.mn-dhs.online/s/epm/B#inheritance","context":"EPM > B Appendix B Types of Income > Inheritance","text":"## Inheritance\n\nCash, a right, or noncash items received as the result of someone’s death."},{"chunk_id":"epm:B#in-home-day-care-payment","heading":"In-home day care payment","url":"https://bot-corpus.mn-dhs.online/s/epm/B#in-home-day-care-payment","context":"EPM > B Appendix B Types of Income > In-home day care payment","text":"## In-home day care payment\n\nA form of self-employment in which a person provides day care services in their home."},{"chunk_id":"epm:B#in-kind-income","heading":"In-kind income","url":"https://bot-corpus.mn-dhs.online/s/epm/B#in-kind-income","context":"EPM > B Appendix B Types of Income > In-kind income","text":"## In-kind income\n\nPayment for a service in a form other than money, or receipt of non-cash gifts or non-cash contributions such as food or clothing."},{"chunk_id":"epm:B#insurance-benefit-or-settlement","heading":"Insurance benefit or settlement","url":"https://bot-corpus.mn-dhs.online/s/epm/B#insurance-benefit-or-settlement","context":"EPM > B Appendix B Types of Income > Insurance benefit or settlement","text":"## Insurance benefit or settlement\n\nIncome paid by an insurance company to the insured or their beneficiary to settle an insurance claim within the guidelines of the insurance policy."},{"chunk_id":"epm:B#interest","heading":"Interest","url":"https://bot-corpus.mn-dhs.online/s/epm/B#interest","context":"EPM > B Appendix B Types of Income > Interest","text":"## Interest\n\nMoney earned from of a bank account, loan, or other investment. Earned interest may be credited to the account or paid directly to the owner."},{"chunk_id":"epm:B#interest-income-from-indian-trust-land-or-restricted-lands","heading":"Interest income from Indian trust land or restricted lands","url":"https://bot-corpus.mn-dhs.online/s/epm/B#interest-income-from-indian-trust-land-or-restricted-lands","context":"EPM > B Appendix B Types of Income > Interest income from Indian trust land or restricted lands","text":"## Interest income from Indian trust land or restricted lands\n\nIncome from interests in restricted land allotted to an individual who is of Indian descent from a federally recognized Indian tribe."},{"chunk_id":"epm:B#irregular-income","heading":"Irregular income","url":"https://bot-corpus.mn-dhs.online/s/epm/B#irregular-income","context":"EPM > B Appendix B Types of Income > Irregular income","text":"## Irregular income\n\nIncome that a person cannot reasonably expect to receive."},{"chunk_id":"epm:B#iv-e-adoption-assistance","heading":"IV-E Adoption Assistance","url":"https://bot-corpus.mn-dhs.online/s/epm/B#iv-e-adoption-assistance","context":"EPM > B Appendix B Types of Income > IV-E Adoption Assistance","text":"## IV-E Adoption Assistance\n\nAdoption assistance placements funded under Title IV-E of the Social Security Act."},{"chunk_id":"epm:B#iv-e-foster-care","heading":"IV-E Foster Care","url":"https://bot-corpus.mn-dhs.online/s/epm/B#iv-e-foster-care","context":"EPM > B Appendix B Types of Income > IV-E Foster Care","text":"## IV-E Foster Care\n\nFoster care placements funded under Title IV-E of the Social Security Act."},{"chunk_id":"epm:B#iv-e-kinship-assistance","heading":"IV-E Kinship Assistance","url":"https://bot-corpus.mn-dhs.online/s/epm/B#iv-e-kinship-assistance","context":"EPM > B Appendix B Types of Income > IV-E Kinship Assistance","text":"## IV-E Kinship Assistance\n\nAssistance payments funded under Title IV-E of the Social Security Act."},{"chunk_id":"epm:B#james-zadroga-911-health-and-compensation-act-of-2010","heading":"James Zadroga 9/11 Health and Compensation Act of 2010","url":"https://bot-corpus.mn-dhs.online/s/epm/B#james-zadroga-911-health-and-compensation-act-of-2010","context":"EPM > B Appendix B Types of Income > James Zadroga 9/11 Health and Compensation Act of 2010","text":"## James Zadroga 9/11 Health and Compensation Act of 2010\n\nPayments made to a worker or volunteer, or if deceased, his or her heir, under the World Trade Center (WTC) Litigation Settlement or distributed by the WTC Captive Insurance Company. These payments are considered disaster assistance."},{"chunk_id":"epm:B#japanese-american-and-aleutian-restitution-payments","heading":"Japanese-American and Aleutian restitution payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#japanese-american-and-aleutian-restitution-payments","context":"EPM > B Appendix B Types of Income > Japanese-American and Aleutian restitution payments","text":"## Japanese-American and Aleutian restitution payments\n\nReparation payments to certain United States citizens of Japanese ancestry and resident Japanese noncitizens and certain eligible Aleuts who were interned or relocated during World War II."},{"chunk_id":"epm:B#jensen-settlement-agreement-payment","heading":"Jensen Settlement Agreement payment","url":"https://bot-corpus.mn-dhs.online/s/epm/B#jensen-settlement-agreement-payment","context":"EPM > B Appendix B Types of Income > Jensen Settlement Agreement payment","text":"## Jensen Settlement Agreement payment\n\nA fund resulting from settlement the lawsuit Jensen et al v. Minnesota Department of Human Services, et al. in which residents of the former Minnesota Extended Treatment Options (METO) program alleged they were unlawfully and unconstitutionally secluded and restrained."},{"chunk_id":"epm:B#jury-duty-pay","heading":"Jury duty, pay","url":"https://bot-corpus.mn-dhs.online/s/epm/B#jury-duty-pay","context":"EPM > B Appendix B Types of Income > Jury duty, pay","text":"## Jury duty, pay\n\nEmployer payments to employees while on jury duty."},{"chunk_id":"epm:B#jury-duty-compensation","heading":"Jury duty, compensation","url":"https://bot-corpus.mn-dhs.online/s/epm/B#jury-duty-compensation","context":"EPM > B Appendix B Types of Income > Jury duty, compensation","text":"## Jury duty, compensation\n\nCourt payments to help cover out-of-pocket expenses incurred while on jury duty."},{"chunk_id":"epm:B#kinship-assistance-payments","heading":"Kinship assistance payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#kinship-assistance-payments","context":"EPM > B Appendix B Types of Income > Kinship assistance payments","text":"## Kinship assistance payments\n\nAn assistance grant provided to grandparents and other relatives who have assumed legal guardianship of children for whom they have custody. It is funded either federally through Title IV-E of the Social Security Act or by the State under Minnesota Statutes, section 259.67."},{"chunk_id":"epm:B#leveraging-education-assistance-partnership-leap-student-financial-aid-formerly-state-student-incentive-grants-ssig","heading":"Leveraging Education Assistance Partnership (LEAP) student financial aid (formerly State Student Incentive Grants (SSIG))","url":"https://bot-corpus.mn-dhs.online/s/epm/B#leveraging-education-assistance-partnership-leap-student-financial-aid-formerly-state-student-incentive-grants-ssig","context":"EPM > B Appendix B Types of Income > Leveraging Education Assistance Partnership (LEAP) student financial aid (formerly State Student Incentive Grants (SSIG))","text":"## Leveraging Education Assistance Partnership (LEAP) student financial aid (formerly State Student Incentive Grants (SSIG))\n\nA student financial aid program created by Title IV of the Higher Education Act of 1965."},{"chunk_id":"epm:B#life-annuity-payments","heading":"Life annuity payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#life-annuity-payments","context":"EPM > B Appendix B Types of Income > Life annuity payments","text":"## Life annuity payments\n\nAnnuity payments that continue for the life of the annuitant."},{"chunk_id":"epm:B#lottery-winnings","heading":"Lottery winnings","url":"https://bot-corpus.mn-dhs.online/s/epm/B#lottery-winnings","context":"EPM > B Appendix B Types of Income > Lottery winnings","text":"## Lottery winnings\n\nCash or other items won in a game of chance, lottery, or contest."},{"chunk_id":"epm:B#low-income-home-energy-assistance-program-liheap-payments","heading":"Low Income Home Energy Assistance Program (LIHEAP) payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#low-income-home-energy-assistance-program-liheap-payments","context":"EPM > B Appendix B Types of Income > Low Income Home Energy Assistance Program (LIHEAP) payments","text":"## Low Income Home Energy Assistance Program (LIHEAP) payments\n\nFederal block grant for energy assistance payments to low income households. The LIHEAP in Minnesota is the Energy Assistance Program (EAP)."},{"chunk_id":"epm:B#lump-sum-income","heading":"Lump sum income","url":"https://bot-corpus.mn-dhs.online/s/epm/B#lump-sum-income","context":"EPM > B Appendix B Types of Income > Lump sum income","text":"## Lump sum income\n\nOne-time income that is not predictable. Periodic reoccurring income is not lump sum income. Examples of lump sum income include, but are not limited to:\n- Winnings (lottery, gambling)\n- Insurance settlements\n- Worker’s Compensation settlements\n- Inheritances\n- Retroactive Retirements, Survivors and Disability Insurance (RSDI); Supplemental Security Income (SSI); Veterans Administration (VA) and unemployment insurance benefits"},{"chunk_id":"epm:B#medical-support-payments","heading":"Medical support payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#medical-support-payments","context":"EPM > B Appendix B Types of Income > Medical support payments","text":"## Medical support payments\n\nHealth insurance coverage or cash payments that a parent provides or is court-ordered to provide to meet the medical needs of the parent's child."},{"chunk_id":"epm:B#medicare-part-b-reimbursements","heading":"Medicare Part B reimbursements","url":"https://bot-corpus.mn-dhs.online/s/epm/B#medicare-part-b-reimbursements","context":"EPM > B Appendix B Types of Income > Medicare Part B reimbursements","text":"## Medicare Part B reimbursements\n\nReimbursement of the Part B premium."},{"chunk_id":"epm:B#mille-lacs-band-of-ojibwa-elder-supplement-assistance-program-payments","heading":"Mille Lacs Band of Ojibwa Elder Supplement Assistance Program payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#mille-lacs-band-of-ojibwa-elder-supplement-assistance-program-payments","context":"EPM > B Appendix B Types of Income > Mille Lacs Band of Ojibwa Elder Supplement Assistance Program payments","text":"## Mille Lacs Band of Ojibwa Elder Supplement Assistance Program payments\n\nThis program makes payments to elderly tribal members who meet the program's income and asset limits."},{"chunk_id":"epm:B#minnesota-family-investment-program-mfip-payments","heading":"Minnesota Family Investment Program (MFIP) payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#minnesota-family-investment-program-mfip-payments","context":"EPM > B Appendix B Types of Income > Minnesota Family Investment Program (MFIP) payments","text":"## Minnesota Family Investment Program (MFIP) payments\n\nA program authorized under the federal Temporary Assistance to Needy Families (TANF) block grant and Minnesota Statutes 256J to provide cash assistance and employment support to needy families. MFIP replaced the Aid to Families with Dependent Children (AFDC) program."},{"chunk_id":"epm:B#minnesota-supplemental-aid-msa-benefits","heading":"Minnesota Supplemental Aid (MSA) benefits","url":"https://bot-corpus.mn-dhs.online/s/epm/B#minnesota-supplemental-aid-msa-benefits","context":"EPM > B Appendix B Types of Income > Minnesota Supplemental Aid (MSA) benefits","text":"## Minnesota Supplemental Aid (MSA) benefits\n\nA state-funded program that provides cash assistance to some SSI recipients and those who would be SSI eligible if not for other income."},{"chunk_id":"epm:B#national-science-and-mathematics-access-to-retain-talent-smart-grants","heading":"National Science and Mathematics Access to Retain Talent (SMART) grants","url":"https://bot-corpus.mn-dhs.online/s/epm/B#national-science-and-mathematics-access-to-retain-talent-smart-grants","context":"EPM > B Appendix B Types of Income > National Science and Mathematics Access to Retain Talent (SMART) grants","text":"## National Science and Mathematics Access to Retain Talent (SMART) grants\n\nA student financial aid program created by Title IV of the Higher Education Act of 1965."},{"chunk_id":"epm:B#nazi-persecution-payments","heading":"Nazi Persecution payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#nazi-persecution-payments","context":"EPM > B Appendix B Types of Income > Nazi Persecution payments","text":"## Nazi Persecution payments\n\nBenefits provided by countries to victims of Nazi persecution. These include:\n- Austrian Reparation payments\n- German Reparation payments\n- Netherlands WUV payments\n- Other payments received as a result of being a victim of Nazi persecution"},{"chunk_id":"epm:B#netherlands-act-wuv-payments-to-victims-of-japanese-persecution","heading":"Netherlands Act (WUV) payments to victims of Japanese persecution","url":"https://bot-corpus.mn-dhs.online/s/epm/B#netherlands-act-wuv-payments-to-victims-of-japanese-persecution","context":"EPM > B Appendix B Types of Income > Netherlands Act (WUV) payments to victims of Japanese persecution","text":"## Netherlands Act (WUV) payments to victims of Japanese persecution\n\nThe Dutch government makes payments under the Netherlands' Act on Benefits for Victims of Persecution 1940-1945. Payments are for both Dutch and non-Dutch people who, during the Japanese occupation of the Netherlands East Indies (now the Republic of Indonesia) in World War II, were victims of persecution."},{"chunk_id":"epm:B#netherlands-act-wuv-payments-to-victims-of-nazi-persecution","heading":"Netherlands Act (WUV) payments to victims of Nazi persecution","url":"https://bot-corpus.mn-dhs.online/s/epm/B#netherlands-act-wuv-payments-to-victims-of-nazi-persecution","context":"EPM > B Appendix B Types of Income > Netherlands Act (WUV) payments to victims of Nazi persecution","text":"## Netherlands Act (WUV) payments to victims of Nazi persecution\n\nThe Dutch government makes payments under the Netherlands' Act on Benefits for Victims of Persecution 1940-1945. Payments are for both Dutch and non-Dutch people who, during the German occupation of the Netherlands and Netherlands in World War II, were victims of persecution."},{"chunk_id":"epm:B#non-title-iv-of-higher-education-act-and-non-bureau-of-indian-affairs-student-financial-aid","heading":"Non-Title IV of Higher Education Act and non-Bureau of Indian Affairs student financial aid","url":"https://bot-corpus.mn-dhs.online/s/epm/B#non-title-iv-of-higher-education-act-and-non-bureau-of-indian-affairs-student-financial-aid","context":"EPM > B Appendix B Types of Income > Non-Title IV of Higher Education Act and non-Bureau of Indian Affairs student financial aid","text":"## Non-Title IV of Higher Education Act and non-Bureau of Indian Affairs student financial aid\n\nSuch aid includes grants, scholarships, gifts and so on."},{"chunk_id":"epm:B#paid-internships","heading":"Paid internships","url":"https://bot-corpus.mn-dhs.online/s/epm/B#paid-internships","context":"EPM > B Appendix B Types of Income > Paid internships","text":"## Paid internships\n\nStudent financial aid that requires work."},{"chunk_id":"epm:B#participation-incentive-payments","heading":"Participation incentive payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#participation-incentive-payments","context":"EPM > B Appendix B Types of Income > Participation incentive payments","text":"## Participation incentive payments\n\nIncentive payments or cash-like cards for participation in projects with grant agreements."},{"chunk_id":"epm:B#pell-grants","heading":"Pell grants","url":"https://bot-corpus.mn-dhs.online/s/epm/B#pell-grants","context":"EPM > B Appendix B Types of Income > Pell grants","text":"## Pell grants\n\nA student financial aid program created by Title IV of the Higher Education Act of 1965."},{"chunk_id":"epm:B#pension-payments","heading":"Pension payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#pension-payments","context":"EPM > B Appendix B Types of Income > Pension payments","text":"## Pension payments\n\nA fixed sum paid regularly to retired people or their dependents."},{"chunk_id":"epm:B#per-capita-distributions-of-all-funds-held-in-trust-by-the-secretary-of-the-interior-to-members-of-an-indian-tribe","heading":"Per capita distributions of all funds held in trust by the Secretary of the Interior to members of an Indian tribe","url":"https://bot-corpus.mn-dhs.online/s/epm/B#per-capita-distributions-of-all-funds-held-in-trust-by-the-secretary-of-the-interior-to-members-of-an-indian-tribe","context":"EPM > B Appendix B Types of Income > Per capita distributions of all funds held in trust by the Secretary of the Interior to members of an Indian tribe","text":"## Per capita distributions of all funds held in trust by the Secretary of the Interior to members of an Indian tribe\n\nPayments that are made according to the number of individuals in a tribe and in which each individual tribe member shares equally."},{"chunk_id":"epm:B#perkins-loan","heading":"Perkins loan","url":"https://bot-corpus.mn-dhs.online/s/epm/B#perkins-loan","context":"EPM > B Appendix B Types of Income > Perkins loan","text":"## Perkins loan\n\nA student financial aid program created by Title IV of the Higher Education Act of 1965."},{"chunk_id":"epm:B#picket-duty-pay","heading":"Picket duty pay","url":"https://bot-corpus.mn-dhs.online/s/epm/B#picket-duty-pay","context":"EPM > B Appendix B Types of Income > Picket duty pay","text":"## Picket duty pay\n\nStrike benefits paid by a union to its members."},{"chunk_id":"epm:B#plan-to-achieve-self-support-pass-financial-aid","heading":"Plan to Achieve Self Support (PASS) financial aid","url":"https://bot-corpus.mn-dhs.online/s/epm/B#plan-to-achieve-self-support-pass-financial-aid","context":"EPM > B Appendix B Types of Income > Plan to Achieve Self Support (PASS) financial aid","text":"## Plan to Achieve Self Support (PASS) financial aid\n\nA plan approved by the Social Security Administration that allows certain assets or income of the person to be excluded in determining benefits for some assistance programs."},{"chunk_id":"epm:B#presidential-access-scholarships","heading":"Presidential Access scholarships","url":"https://bot-corpus.mn-dhs.online/s/epm/B#presidential-access-scholarships","context":"EPM > B Appendix B Types of Income > Presidential Access scholarships","text":"## Presidential Access scholarships\n\nA student financial aid program created by Title IV of the Higher Education Act of 1965."},{"chunk_id":"epm:B#prizes","heading":"Prizes","url":"https://bot-corpus.mn-dhs.online/s/epm/B#prizes","context":"EPM > B Appendix B Types of Income > Prizes","text":"## Prizes\n\nCash or other items won in a game of chance, lottery, or contest."},{"chunk_id":"epm:B#public-assistance-appeal-payments","heading":"Public assistance appeal payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#public-assistance-appeal-payments","context":"EPM > B Appendix B Types of Income > Public assistance appeal payments","text":"## Public assistance appeal payments\n\nPayments resulting from an appeal of public assistance benefits."},{"chunk_id":"epm:B#public-assistance-payments","heading":"Public assistance payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#public-assistance-payments","context":"EPM > B Appendix B Types of Income > Public assistance payments","text":"## Public assistance payments\n\nBenefits paid through the local, county, tribal, state or federal government."},{"chunk_id":"epm:B#radiation-exposure-compensation-act-payments","heading":"Radiation Exposure Compensation Act payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#radiation-exposure-compensation-act-payments","context":"EPM > B Appendix B Types of Income > Radiation Exposure Compensation Act payments","text":"## Radiation Exposure Compensation Act payments\n\nPayments made by the federal government to certain individuals (or their survivors) who were exposed to radiation from government nuclear testing and uranium mining."},{"chunk_id":"epm:B#railroad-retirement-board-rrb-benefits","heading":"Railroad Retirement Board (RRB) benefits","url":"https://bot-corpus.mn-dhs.online/s/epm/B#railroad-retirement-board-rrb-benefits","context":"EPM > B Appendix B Types of Income > Railroad Retirement Board (RRB) benefits","text":"## Railroad Retirement Board (RRB) benefits\n\nThe RRB is an independent agency of the Federal Government. It administers benefits and Medicare for railroad workers and their families. Railroad workers and their families who meet certain service requirements are eligible for retiree, disability dependent or survivor benefits."},{"chunk_id":"epm:B#refugee-cash-assistance-rca","heading":"Refugee Cash Assistance (RCA)","url":"https://bot-corpus.mn-dhs.online/s/epm/B#refugee-cash-assistance-rca","context":"EPM > B Appendix B Types of Income > Refugee Cash Assistance (RCA)","text":"## Refugee Cash Assistance (RCA)\n\nA program that provides financial help to certain refugees."},{"chunk_id":"epm:B#refunds-for-rental-security-and-utility-deposits","heading":"Refunds for rental security and utility deposits","url":"https://bot-corpus.mn-dhs.online/s/epm/B#refunds-for-rental-security-and-utility-deposits","context":"EPM > B Appendix B Types of Income > Refunds for rental security and utility deposits","text":"## Refunds for rental security and utility deposits\n\nSecurity and utility deposit refunds, paid by the applicant or another party, including the Emergency Assistance (EA) or Emergency General Assistance (EGA) programs."},{"chunk_id":"epm:B#reimbursements-for-expenses","heading":"Reimbursements for expenses","url":"https://bot-corpus.mn-dhs.online/s/epm/B#reimbursements-for-expenses","context":"EPM > B Appendix B Types of Income > Reimbursements for expenses","text":"## Reimbursements for expenses\n\nReimbursements for out-of-pocket expenses incurred while performing volunteer services, jury duty or employment."},{"chunk_id":"epm:B#reimbursements-for-medical-expenses","heading":"Reimbursements for medical expenses","url":"https://bot-corpus.mn-dhs.online/s/epm/B#reimbursements-for-medical-expenses","context":"EPM > B Appendix B Types of Income > Reimbursements for medical expenses","text":"## Reimbursements for medical expenses\n\nReimbursements for out-of-pocket health care expenses."},{"chunk_id":"epm:B#reimbursements-for-property","heading":"Reimbursements for property","url":"https://bot-corpus.mn-dhs.online/s/epm/B#reimbursements-for-property","context":"EPM > B Appendix B Types of Income > Reimbursements for property","text":"## Reimbursements for property\n\nCash or in-kind payments to replace personal or real property made by public agencies, issued by insurance companies, awarded by a court, or issued through public appeal."},{"chunk_id":"epm:B#relative-custody-assistance-payments","heading":"Relative custody assistance payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#relative-custody-assistance-payments","context":"EPM > B Appendix B Types of Income > Relative custody assistance payments","text":"## Relative custody assistance payments\n\nMonthly financial assistance administered by Social Services for relatives who take permanent legal and physical custody of children with special needs upon a juvenile court determination that children are unable to return to their parent’s home."},{"chunk_id":"epm:B#relocation-assistance-payments-federal","heading":"Relocation assistance payments, federal","url":"https://bot-corpus.mn-dhs.online/s/epm/B#relocation-assistance-payments-federal","context":"EPM > B Appendix B Types of Income > Relocation assistance payments, federal","text":"## Relocation assistance payments, federal\n\nRelocation assistance for displaced persons under Title II of the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, the Housing and Redevelopment Act of 1965, or the Housing Act of 1965. This assistance is paid when the government requires an individual to move."},{"chunk_id":"epm:B#rental-income","heading":"Rental income","url":"https://bot-corpus.mn-dhs.online/s/epm/B#rental-income","context":"EPM > B Appendix B Types of Income > Rental income","text":"## Rental income\n\nPayments that an individual receives from another person for the use of real or personal property such as land, housing, or machinery."},{"chunk_id":"epm:B#retired-senior-volunteer-program-rsvp-reimbursements","heading":"Retired Senior Volunteer Program (RSVP) reimbursements","url":"https://bot-corpus.mn-dhs.online/s/epm/B#retired-senior-volunteer-program-rsvp-reimbursements","context":"EPM > B Appendix B Types of Income > Retired Senior Volunteer Program (RSVP) reimbursements","text":"## Retired Senior Volunteer Program (RSVP) reimbursements\n\nA program funded by the Corporation for National and Community Service (CNCS) providing reimbursements for costs incurred to people age 55 and over for volunteer services. Part of the Senior Corps program."},{"chunk_id":"epm:B#retirement-payments","heading":"Retirement payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#retirement-payments","context":"EPM > B Appendix B Types of Income > Retirement payments","text":"## Retirement payments\n\nCash and other assets paid from a private or public retirement fund."},{"chunk_id":"epm:B#retirement-survivors-and-disability-insurance-rsdi-payments","heading":"Retirement, Survivor’s and Disability Insurance (RSDI) payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#retirement-survivors-and-disability-insurance-rsdi-payments","context":"EPM > B Appendix B Types of Income > Retirement, Survivor’s and Disability Insurance (RSDI) payments","text":"## Retirement, Survivor’s and Disability Insurance (RSDI) payments\n\nMonthly income provided by the Social Security Administration to retired people, survivors or dependents of insured people and people with disabilities who have contributed to Federal Insurance Contributions Act (FICA). Payments made to people with disabilities are referred to as Social Security Disability Insurance (SSDI) benefits."},{"chunk_id":"epm:B#retroactive-payments","heading":"Retroactive payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#retroactive-payments","context":"EPM > B Appendix B Types of Income > Retroactive payments","text":"## Retroactive payments\n\nA one-time payment or payments in installments for benefits retroactive back to the date of eligibility."},{"chunk_id":"epm:B#ricky-ray-hemophilia-relief-act-payments","heading":"Ricky Ray Hemophilia Relief Act payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#ricky-ray-hemophilia-relief-act-payments","context":"EPM > B Appendix B Types of Income > Ricky Ray Hemophilia Relief Act payments","text":"## Ricky Ray Hemophilia Relief Act payments\n\nSettlements to people with blood-clotting disorders who may have contracted an HIV infection from a blood transfusion. The current and former spouses of these people as well as their children who also contracted HIV are also eligible for the settlement payment."},{"chunk_id":"epm:B#robert-c-byrd-honors-scholarship-program","heading":"Robert C. Byrd Honors Scholarship Program","url":"https://bot-corpus.mn-dhs.online/s/epm/B#robert-c-byrd-honors-scholarship-program","context":"EPM > B Appendix B Types of Income > Robert C. Byrd Honors Scholarship Program","text":"## Robert C. Byrd Honors Scholarship Program\n\nA student financial aid program created by Title IV of the Higher Education Act of 1965."},{"chunk_id":"epm:B#roomerboarder-income","heading":"Roomer/boarder income","url":"https://bot-corpus.mn-dhs.online/s/epm/B#roomerboarder-income","context":"EPM > B Appendix B Types of Income > Roomer/boarder income","text":"## Roomer/boarder income\n\nIncome that a person receives for lodging, meals, or related services from people living in the person’s home. Different from rental income."},{"chunk_id":"epm:B#royalties","heading":"Royalties","url":"https://bot-corpus.mn-dhs.online/s/epm/B#royalties","context":"EPM > B Appendix B Types of Income > Royalties","text":"## Royalties\n\nCompensation paid to the owner for the use of property, usually copyrighted material (e.g., books, music, or art) or natural resources (e.g., minerals, oil, gravel, or timber). Royalty compensation may be expressed as a percentage of receipts from using the property or as an amount per unit produced."},{"chunk_id":"epm:B#salary","heading":"Salary","url":"https://bot-corpus.mn-dhs.online/s/epm/B#salary","context":"EPM > B Appendix B Types of Income > Salary","text":"## Salary\n\nA form of monetary compensation/wage/income in exchanged for work or service."},{"chunk_id":"epm:B#scholarships","heading":"Scholarships","url":"https://bot-corpus.mn-dhs.online/s/epm/B#scholarships","context":"EPM > B Appendix B Types of Income > Scholarships","text":"## Scholarships\n\nAmounts paid to enable qualified individuals to further their education and training by scholastic or research work, etc."},{"chunk_id":"epm:B#seasonal-income","heading":"Seasonal income","url":"https://bot-corpus.mn-dhs.online/s/epm/B#seasonal-income","context":"EPM > B Appendix B Types of Income > Seasonal income","text":"## Seasonal income\n\nIncome that is received for only part of the year."},{"chunk_id":"epm:B#self-employment-income","heading":"Self-employment income","url":"https://bot-corpus.mn-dhs.online/s/epm/B#self-employment-income","context":"EPM > B Appendix B Types of Income > Self-employment income","text":"## Self-employment income\n\nA form of income in exchange for work or service done by a self-employed person rather than by an employee for an employer."},{"chunk_id":"epm:B#senior-aids-program-wages","heading":"Senior Aids Program wages","url":"https://bot-corpus.mn-dhs.online/s/epm/B#senior-aids-program-wages","context":"EPM > B Appendix B Types of Income > Senior Aids Program wages","text":"## Senior Aids Program wages\n\nWages paid to participants in programs carried out under the Community Service Employment Program, Title V of the Older Americans Act."},{"chunk_id":"epm:B#senior-companions-payments","heading":"Senior Companions payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#senior-companions-payments","context":"EPM > B Appendix B Types of Income > Senior Companions payments","text":"## Senior Companions payments\n\nA program funded by the Corporation for National and Community Service (CNCS) providing payments to volunteers age 55 and over who provide assistance and friendship to adults who have difficulty with daily tasks, such as shopping or paying bills. Part of the Senior Corps program."},{"chunk_id":"epm:B#senior-corps","heading":"Senior Corps","url":"https://bot-corpus.mn-dhs.online/s/epm/B#senior-corps","context":"EPM > B Appendix B Types of Income > Senior Corps","text":"## Senior Corps\n\nA program funded by the Corporation for National and Community Service (CNCS) linking volunteers age 55 and over to service opportunities, including:\n- Retired Senior Volunteer Program (RSVP)\n- Foster Grandparent Program\n- Senior Companions"},{"chunk_id":"epm:B#severance-pay","heading":"Severance pay","url":"https://bot-corpus.mn-dhs.online/s/epm/B#severance-pay","context":"EPM > B Appendix B Types of Income > Severance pay","text":"## Severance pay\n\nPayment made by an employer to an employee whose employment is terminated independently of his or her wishes or due to voluntary early retirement."},{"chunk_id":"epm:B#social-security-disability-insurance-ssdi","heading":"Social Security Disability Insurance (SSDI)","url":"https://bot-corpus.mn-dhs.online/s/epm/B#social-security-disability-insurance-ssdi","context":"EPM > B Appendix B Types of Income > Social Security Disability Insurance (SSDI)","text":"## Social Security Disability Insurance (SSDI)\n\nA benefit paid to people with a disability or blindness who have contributed to Federal Insurance Contributions Act (FICA). May also be called Retirement, Survivors, and Disability Insurance (RSDI)."},{"chunk_id":"epm:B#special-leveraging-educations-partnership-sleap-program-grants","heading":"Special Leveraging Educations Partnership (SLEAP) Program grants","url":"https://bot-corpus.mn-dhs.online/s/epm/B#special-leveraging-educations-partnership-sleap-program-grants","context":"EPM > B Appendix B Types of Income > Special Leveraging Educations Partnership (SLEAP) Program grants","text":"## Special Leveraging Educations Partnership (SLEAP) Program grants\n\nA student financial aid program created by Title IV of the Higher Education Act of 1965."},{"chunk_id":"epm:B#spousal-maintenance-income","heading":"Spousal maintenance income","url":"https://bot-corpus.mn-dhs.online/s/epm/B#spousal-maintenance-income","context":"EPM > B Appendix B Types of Income > Spousal maintenance income","text":"## Spousal maintenance income\n\nAn allowance for support that a court orders a person to pay to his or her current or former spouse. Formerly referred to as alimony."},{"chunk_id":"epm:B#state-adoption-assistance-payments","heading":"State adoption assistance payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#state-adoption-assistance-payments","context":"EPM > B Appendix B Types of Income > State adoption assistance payments","text":"## State adoption assistance payments\n\nAdoption assistance placement payments funded by Minnesota for the purpose of meeting the needs of the individual in care."},{"chunk_id":"epm:B#state-foster-care-payments","heading":"State foster care payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#state-foster-care-payments","context":"EPM > B Appendix B Types of Income > State foster care payments","text":"## State foster care payments\n\nFoster care placement payments funded by Minnesota for the purpose of meeting the needs of the individual in care."},{"chunk_id":"epm:B#state-kinship-assistance-payments","heading":"State kinship assistance payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#state-kinship-assistance-payments","context":"EPM > B Appendix B Types of Income > State kinship assistance payments","text":"## State kinship assistance payments\n\nKinship assistance payments funded by Minnesota for the purpose of meeting the needs of the individual in care."},{"chunk_id":"epm:B#state-student-incentive-grant-program-also-known-as-the-leveraging-educational-assistance-partnership-leap-program","heading":"State Student Incentive Grant Program (also known as the Leveraging Educational Assistance Partnership (LEAP) program)","url":"https://bot-corpus.mn-dhs.online/s/epm/B#state-student-incentive-grant-program-also-known-as-the-leveraging-educational-assistance-partnership-leap-program","context":"EPM > B Appendix B Types of Income > State Student Incentive Grant Program (also known as the Leveraging Educational Assistance Partnership (LEAP) program)","text":"## State Student Incentive Grant Program (also known as the Leveraging Educational Assistance Partnership (LEAP) program)\n\nA student financial aid program created by Title IV of the Higher Education Act of 1965."},{"chunk_id":"epm:B#state-work-study-income","heading":"State work study income","url":"https://bot-corpus.mn-dhs.online/s/epm/B#state-work-study-income","context":"EPM > B Appendix B Types of Income > State work study income","text":"## State work study income\n\nA student financial aid program created by Minnesota."},{"chunk_id":"epm:B#student-financial-aid","heading":"Student financial aid","url":"https://bot-corpus.mn-dhs.online/s/epm/B#student-financial-aid","context":"EPM > B Appendix B Types of Income > Student financial aid","text":"## Student financial aid\n\nLoans, grants, scholarships, fellowships, internships, some training expenses, gifts and work study funds provided to a person enrolled in and attending an educational institution."},{"chunk_id":"epm:B#student-income","heading":"Student income","url":"https://bot-corpus.mn-dhs.online/s/epm/B#student-income","context":"EPM > B Appendix B Types of Income > Student income","text":"## Student income\n\nEarned income of a person enrolled in and attending an educational institution."},{"chunk_id":"epm:B#supplemental-education-opportunity-grants-seog","heading":"Supplemental Education Opportunity Grants (SEOG)","url":"https://bot-corpus.mn-dhs.online/s/epm/B#supplemental-education-opportunity-grants-seog","context":"EPM > B Appendix B Types of Income > Supplemental Education Opportunity Grants (SEOG)","text":"## Supplemental Education Opportunity Grants (SEOG)\n\nA student financial aid program created by Title IV of the Higher Education Act of 1965."},{"chunk_id":"epm:B#supplemental-nutrition-assistance-program-snap","heading":"Supplemental Nutrition Assistance Program (SNAP)","url":"https://bot-corpus.mn-dhs.online/s/epm/B#supplemental-nutrition-assistance-program-snap","context":"EPM > B Appendix B Types of Income > Supplemental Nutrition Assistance Program (SNAP)","text":"## Supplemental Nutrition Assistance Program (SNAP)\n\nA U.S. Department of Agriculture program that issues benefits in the form of electronic benefits to purchase food. May also be known as \"Food Support\" or \"Food Stamps.\""},{"chunk_id":"epm:B#supplemental-security-income-ssi-payments","heading":"Supplemental Security Income (SSI) payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#supplemental-security-income-ssi-payments","context":"EPM > B Appendix B Types of Income > Supplemental Security Income (SSI) payments","text":"## Supplemental Security Income (SSI) payments\n\nMonthly benefits paid by the Social Security Administration based on financial need to low income people age 65 or older or people who are blind or have a disability."},{"chunk_id":"epm:B#taxable-income","heading":"Taxable income","url":"https://bot-corpus.mn-dhs.online/s/epm/B#taxable-income","context":"EPM > B Appendix B Types of Income > Taxable income","text":"## Taxable income\n\nIncome subject to taxation."},{"chunk_id":"epm:B#tax-credits","heading":"Tax credits","url":"https://bot-corpus.mn-dhs.online/s/epm/B#tax-credits","context":"EPM > B Appendix B Types of Income > Tax credits","text":"## Tax credits\n\nAn amount of money that can be offset against a tax liability."},{"chunk_id":"epm:B#tax-refund","heading":"Tax refund","url":"https://bot-corpus.mn-dhs.online/s/epm/B#tax-refund","context":"EPM > B Appendix B Types of Income > Tax refund","text":"## Tax refund\n\nA state or federal refund of the difference between taxes paid and taxes owed."},{"chunk_id":"epm:B#teacher-education-assistance-for-college-and-higher-education-teach-grants","heading":"Teacher Education Assistance for College and Higher Education (TEACH) grants","url":"https://bot-corpus.mn-dhs.online/s/epm/B#teacher-education-assistance-for-college-and-higher-education-teach-grants","context":"EPM > B Appendix B Types of Income > Teacher Education Assistance for College and Higher Education (TEACH) grants","text":"## Teacher Education Assistance for College and Higher Education (TEACH) grants\n\nA student financial aid program created by Title IV of the Higher Education Act of 1965."},{"chunk_id":"epm:B#third-party-vendor-payment-tpvp","heading":"Third party vendor payment (TPVP)","url":"https://bot-corpus.mn-dhs.online/s/epm/B#third-party-vendor-payment-tpvp","context":"EPM > B Appendix B Types of Income > Third party vendor payment (TPVP)","text":"## Third party vendor payment (TPVP)\n\nA payment made directly to a vendor by a third party for goods or services the vendor provided to an eligible individual or couple."},{"chunk_id":"epm:B#tips","heading":"Tips","url":"https://bot-corpus.mn-dhs.online/s/epm/B#tips","context":"EPM > B Appendix B Types of Income > Tips","text":"## Tips\n\nGratuities paid to the employee by a customer of the employer and kept by the employee."},{"chunk_id":"epm:B#title-iv-of-the-higher-education-act-of-1965","heading":"Title IV of the Higher Education Act of 1965","url":"https://bot-corpus.mn-dhs.online/s/epm/B#title-iv-of-the-higher-education-act-of-1965","context":"EPM > B Appendix B Types of Income > Title IV of the Higher Education Act of 1965","text":"## Title IV of the Higher Education Act of 1965\n\nA federal law that authorizes programs that provide student financial aid. These programs include, but are not limited to:\n- Pell grants\n- Academic Competitiveness Grants\n- National Science and Mathematics Access to Retain Talent (SMART) grants\n- Federal Family Education Loan (FFEL) Program. FFEL includes four components:\n  - Stafford Loans\n  - Unsubsidized Stafford Loans\n  - Federal PLUS Loans\n  - Federal Consolidation Loans\n- Perkins Loans\n- Federal Supplemental Education Opportunity Grant (SEOG) Program\n- Supplemental Education Opportunity Grants (SEOG) Program\n- Work Study Program\n- Teacher Education Assistance for College and Higher Education (TEACH) Grants\n- Direct Loan Program. Direct Loans include four components:\n  - Direct Subsidized Loans\n  - Direct Unsubsidized Loans\n  - Direct PLUS Loans\n  - Direct Consolidation Loans\n- Leveraging Educational Assistance Partnership (LEAP) Program\n- Special Leveraging Educational Assistance Partnership (SLEAP) Program\n- Robert C. Byrd Honors Scholarship Program (also known as Byrd Honors Scholarships)\n- TRIO Program\n- Academic Achievement Incentive Scholarships\n- Gear Up\n- High School Equivalency Program (HEP)\n- College Assistance Migrant Program (CAMP)\n- State Student Incentive Grant Program\n- Presidential Access Scholarships"},{"chunk_id":"epm:B#tort-settlement","heading":"Tort settlement","url":"https://bot-corpus.mn-dhs.online/s/epm/B#tort-settlement","context":"EPM > B Appendix B Types of Income > Tort settlement","text":"## Tort settlement\n\nRights, obligations, and remedies applied by courts in civil proceedings to provide relief for persons who have suffered harm from the wrongful acts of others."},{"chunk_id":"epm:B#trade-adjustment-reform-act-of-2002-taa-assistance","heading":"Trade Adjustment Reform Act of 2002 (TAA) assistance","url":"https://bot-corpus.mn-dhs.online/s/epm/B#trade-adjustment-reform-act-of-2002-taa-assistance","context":"EPM > B Appendix B Types of Income > Trade Adjustment Reform Act of 2002 (TAA) assistance","text":"## Trade Adjustment Reform Act of 2002 (TAA) assistance\n\nAid to workers who lose their jobs or whose hours of work and wages are reduced as a result of increased imports. Workers may be eligible for training, job search and relocation allowances, incomes support and other reemployment services."},{"chunk_id":"epm:B#tribal-land-settlements-and-judgments","heading":"Tribal land settlements and judgments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#tribal-land-settlements-and-judgments","context":"EPM > B Appendix B Types of Income > Tribal land settlements and judgments","text":"## Tribal land settlements and judgments\n\nFunds held in trust by the Secretary of the Interior or distributed per capita pursuant to a plan prepared by the Secretary of the Interior. Including:\n- Judgment funds distributed per capita under P.L. 99-377 to the Mississippi Band Chippewa Indians of White Earth, Leech Lake, and Mille Lacs reservations.\n- Distributions of claims settlement funds under P.L. 99-264, P.L. 100-153, and P.L. 100-212 to members of the White Earth Band of Chippewa Indians from the White Earth Reservation Land Settlement Act of 1985 (WELSA).\n- Per capita payments made under 25 USC § 1407 to members of the Bois Forte Band of Chippewa Indians or the Grand Portage Band of Lake Superior Chippewa Indians pursuant to the agreement to restrict tribal rights to hunt and fish in ceded territories.\n- Per capita payments made under P.L. 85-794 to members of the Red Lake Band of Chippewa Indians from the proceeds of the sale of timber and lumber on the Red Lake Reservation.\n- Receipts derived from trust lands and distributed under P.L. 94-114 to the White Earth Band of Chippewa Indians regarding submarginal land held in trust by the United States.\n- Judgment funds distributed under P.L. 98-123 § 3 to the Red Lake Band of Chippewa Indians.\n- Per capita and dividend payment distributions of judgment funds made under P.L. 99-130 to members of the Prairie Island Sioux, Lower Sioux, and Shakopee Mdewakanton Sioux Communities of Minnesota.\n- Funds distributed per capita under P.L. 99-146 to members of the Chippewa of Lake Superior and the Chippewa of the Mississippi."},{"chunk_id":"epm:B#tribal-trust-or-restricted-lands-individual-interest","heading":"Tribal trust or restricted lands, individual interest","url":"https://bot-corpus.mn-dhs.online/s/epm/B#tribal-trust-or-restricted-lands-individual-interest","context":"EPM > B Appendix B Types of Income > Tribal trust or restricted lands, individual interest","text":"## Tribal trust or restricted lands, individual interest\n\nPayments an applicant or enrollee receives from his or her interest in Indian trust land or other restricted Indian lands."},{"chunk_id":"epm:B#tribal-per-capita-payments-from-gaming-revenue-casino-profits","heading":"Tribal per capita payments from gaming revenue (casino profits)","url":"https://bot-corpus.mn-dhs.online/s/epm/B#tribal-per-capita-payments-from-gaming-revenue-casino-profits","context":"EPM > B Appendix B Types of Income > Tribal per capita payments from gaming revenue (casino profits)","text":"## Tribal per capita payments from gaming revenue (casino profits)\n\nThe distribution of money or other things of value to all members of the tribe, or to certain identified groups of members, paid directly from the net revenues of any tribal gaming activity."},{"chunk_id":"epm:B#tribal-per-capita-payments-from-a-tribal-trust","heading":"Tribal per capita payments from a tribal trust","url":"https://bot-corpus.mn-dhs.online/s/epm/B#tribal-per-capita-payments-from-a-tribal-trust","context":"EPM > B Appendix B Types of Income > Tribal per capita payments from a tribal trust","text":"## Tribal per capita payments from a tribal trust\n\nThe distribution of money or other things of value to all members of the tribe, or to certain identified groups of members, paid directly from a tribal trust."},{"chunk_id":"epm:B#trio-programs-trio","heading":"Trio Programs (TRIO)","url":"https://bot-corpus.mn-dhs.online/s/epm/B#trio-programs-trio","context":"EPM > B Appendix B Types of Income > Trio Programs (TRIO)","text":"## Trio Programs (TRIO)\n\nStudent financial aid programs created by Title IV of the Higher Education Act of 1965. TRIO includes eight programs targeted to serve and assist low-income individuals, first-generation college students, and people with disabilities:\n- Educational Opportunity Centers\n- Ronald E. McNair Post-baccalaureate Achievement\n- Student Support Services\n- Talent Search\n- Training Program for Federal TRIO Programs Staff\n- Upward Bound\n- Upward Bound Math-Science\n- Veterans Upward Bound"},{"chunk_id":"epm:B#unearned-income","heading":"Unearned income","url":"https://bot-corpus.mn-dhs.online/s/epm/B#unearned-income","context":"EPM > B Appendix B Types of Income > Unearned income","text":"## Unearned income\n\nCash or in-kind benefits received without being required to perform any work or service."},{"chunk_id":"epm:B#unemployment-insurance-ui","heading":"Unemployment Insurance (UI)","url":"https://bot-corpus.mn-dhs.online/s/epm/B#unemployment-insurance-ui","context":"EPM > B Appendix B Types of Income > Unemployment Insurance (UI)","text":"## Unemployment Insurance (UI)\n\nA state cash payment made to some people who have lost their jobs."},{"chunk_id":"epm:B#vacation-donation-compensation","heading":"Vacation donation compensation","url":"https://bot-corpus.mn-dhs.online/s/epm/B#vacation-donation-compensation","context":"EPM > B Appendix B Types of Income > Vacation donation compensation","text":"## Vacation donation compensation\n\nIncome from the employer’s vacation donation program."},{"chunk_id":"epm:B#veterans-administration-va-benefits","heading":"Veterans’ Administration (VA) benefits","url":"https://bot-corpus.mn-dhs.online/s/epm/B#veterans-administration-va-benefits","context":"EPM > B Appendix B Types of Income > Veterans’ Administration (VA) benefits","text":"## Veterans’ Administration (VA) benefits\n\nBenefits and services provided by the VA to people who have served in the U.S. armed forces and their dependents."},{"chunk_id":"epm:B#veterans-benefits-for-educational-assistance","heading":"Veterans Benefits for educational assistance","url":"https://bot-corpus.mn-dhs.online/s/epm/B#veterans-benefits-for-educational-assistance","context":"EPM > B Appendix B Types of Income > Veterans Benefits for educational assistance","text":"## Veterans Benefits for educational assistance\n\nThe Department of Veterans Affairs (VA) provides educational assistance through different programs, including vocational rehabilitation."},{"chunk_id":"epm:B#veterans-children-with-certain-birth-defects-payments","heading":"Veterans’ Children with Certain Birth Defects payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#veterans-children-with-certain-birth-defects-payments","context":"EPM > B Appendix B Types of Income > Veterans’ Children with Certain Birth Defects payments","text":"## Veterans’ Children with Certain Birth Defects payments\n\nPayments made to children of Vietnam or Korean veterans born with spina bifida, or payments made to the children of women Vietnam veterans if they have certain birth defects."},{"chunk_id":"epm:B#vietnamese-commando-compensation-act-payments","heading":"Vietnamese Commando Compensation Act Payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#vietnamese-commando-compensation-act-payments","context":"EPM > B Appendix B Types of Income > Vietnamese Commando Compensation Act Payments","text":"## Vietnamese Commando Compensation Act Payments\n\nPayments made to an individual who was captured and interned by the Democratic Republic of North Vietnam as a result of that person's participation in certain military operations (known as OPLAN 34A or its predecessor, or OPLAN 35)."},{"chunk_id":"epm:B#vocational-rehabilitation-payments","heading":"Vocational Rehabilitation payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#vocational-rehabilitation-payments","context":"EPM > B Appendix B Types of Income > Vocational Rehabilitation payments","text":"## Vocational Rehabilitation payments\n\nThe Minnesota Department of Economic Security administers Minnesota’s Vocational Rehabilitation program to assist individuals with disabilities with job training and independent living. The program issues grants to organizations, provides for payments to employers, educational or vocational programs on behalf of beneficiaries, and may make direct payments to individuals."},{"chunk_id":"epm:B#voluntary-resettlement-agency-matching-grant-program-grants","heading":"Voluntary Resettlement Agency Matching Grant Program grants","url":"https://bot-corpus.mn-dhs.online/s/epm/B#voluntary-resettlement-agency-matching-grant-program-grants","context":"EPM > B Appendix B Types of Income > Voluntary Resettlement Agency Matching Grant Program grants","text":"## Voluntary Resettlement Agency Matching Grant Program grants\n\nA grant offered by some Voluntary Resettlement Agencies (VOLAGs) to help some refugees attain self-sufficiency."},{"chunk_id":"epm:B#voluntary-employees-beneficiary-association-veba-payments","heading":"Voluntary Employees' Beneficiary Association (VEBA) payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#voluntary-employees-beneficiary-association-veba-payments","context":"EPM > B Appendix B Types of Income > Voluntary Employees' Beneficiary Association (VEBA) payments","text":"## Voluntary Employees' Beneficiary Association (VEBA) payments\n\nBenefits paid to members of the mutual association or their beneficiaries."},{"chunk_id":"epm:B#wages","heading":"Wages","url":"https://bot-corpus.mn-dhs.online/s/epm/B#wages","context":"EPM > B Appendix B Types of Income > Wages","text":"## Wages\n\nMoney received in exchange for work or service."},{"chunk_id":"epm:B#women-infant-and-children-wic-vouchers","heading":"Women, Infant and Children (WIC) vouchers","url":"https://bot-corpus.mn-dhs.online/s/epm/B#women-infant-and-children-wic-vouchers","context":"EPM > B Appendix B Types of Income > Women, Infant and Children (WIC) vouchers","text":"## Women, Infant and Children (WIC) vouchers\n\nA federal program authorized by the Child Nutrition Act of 1966 to provide nutritious food and nutrition education to low-income pregnant and postpartum women and their children."},{"chunk_id":"epm:B#workers-compensation-payments","heading":"Workers’ compensation payments","url":"https://bot-corpus.mn-dhs.online/s/epm/B#workers-compensation-payments","context":"EPM > B Appendix B Types of Income > Workers’ compensation payments","text":"## Workers’ compensation payments\n\nEmployer-paid insurance benefits that cover medical expenses and lost wages to workers injured on the job."},{"chunk_id":"epm:B#workforce-investment-act-wia-income","heading":"Workforce Investment Act (WIA) income","url":"https://bot-corpus.mn-dhs.online/s/epm/B#workforce-investment-act-wia-income","context":"EPM > B Appendix B Types of Income > Workforce Investment Act (WIA) income","text":"## Workforce Investment Act (WIA) income\n\nEarned income of individuals facing serious barriers to employment through employment related services such as job training."}]},{"id":"epm:C","number":"C","title":"Appendix C Medicare Cost Sharing Amounts","parent":"appendices","breadcrumb":"C Appendix C Medicare Cost Sharing Amounts","summary":"This appendix provides cost sharing amounts for Medicare.","effective_date":"2026-03-16","last_modified":"2026-10-03T04:45:28.448897+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/C","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/C","official_origin":"https://hcopub.dhs.state.mn.us/epm/appendix_c.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:C#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/C","context":"EPM > C Appendix C Medicare Cost Sharing Amounts","text":"This appendix provides cost sharing amounts for Medicare."},{"chunk_id":"epm:C#medicare-part-a-cost-sharing-amounts","heading":"Medicare Part A Cost Sharing Amounts","url":"https://bot-corpus.mn-dhs.online/s/epm/C#medicare-part-a-cost-sharing-amounts","context":"EPM > C Appendix C Medicare Cost Sharing Amounts > Medicare Part A Cost Sharing Amounts","text":"## Medicare Part A Cost Sharing Amounts\n\n| Cost Type | 2025 | 2026 |\n| --- | --- | --- |\n| Premium | Send SVES | Send SVES |\n| Deductible | $1,676 | $1,736 |\n| Hospital Coinsurance days 61-90 | $419 | $434 |\n| Hospital Coinsurance days 91-150 | $838 | $868 |\n| Skilled Nursing Facility Coinsurance days 1-20 | $0 | $0 |\n| Skilled Nursing Facility Coinsurance days 21-100 | $209.50 | $217 |"},{"chunk_id":"epm:C#medicare-part-b-cost-sharing-amounts","heading":"Medicare Part B Cost Sharing Amounts","url":"https://bot-corpus.mn-dhs.online/s/epm/C#medicare-part-b-cost-sharing-amounts","context":"EPM > C Appendix C Medicare Cost Sharing Amounts > Medicare Part B Cost Sharing Amounts","text":"## Medicare Part B Cost Sharing Amounts\n\n| Cost Type | 2025 | 2026 |\n| --- | --- | --- |\n| All Other Premium Amounts | Send SVES | Send SVES |\n| Deductible | $257 | $283 |\n| MSHO and SNBC plans that will pay the portion listed of the Medicare Part B Premium | None | None |"},{"chunk_id":"epm:C#medicare-part-d-cost-sharing-amounts","heading":"Medicare Part D Cost Sharing Amounts","url":"https://bot-corpus.mn-dhs.online/s/epm/C#medicare-part-d-cost-sharing-amounts","context":"EPM > C Appendix C Medicare Cost Sharing Amounts > Medicare Part D Cost Sharing Amounts","text":"## Medicare Part D Cost Sharing Amounts\n\nFor information about which Medicare Part D plans in Minnesota are benchmark plans, refer to the [Resources section in ONEsource](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-16) for the Amounts in Excess of Medicare Part D Benchmark to Apply as Medical Expense document. The document also provides the amount a person pays out of pocket for non-benchmark plans.\n\n### Standard Benefit Information\n\n| Cost Type | 2025 | 2026 |\n| --- | --- | --- |\n| Premium | Varies | Varies |\n| Annual Deductible | $590 | $615 |\n| Coinsurance Costs | $2,000 annual cap on all covered drugs | $2,100 annual cap on all covered drugs |\n| Coverage Gap Costs | N/A | N/A |\n| Copayments |  |  |\n\n### Extra Help Full Subsidy Information\n\n| Cost Type | 2025 | 2026 |\n| --- | --- | --- |\n| Premium | $0 | $0 |\n| Annual Deductible | $0 | $0 |\n| Coinsurance Costs | None | None |\n| Coverage Gap Costs | None | None |\n| Copayments | ≤ 100% FPG | ≤100% FPG |\n\n###"}]},{"id":"epm:D","number":"D","title":"Appendix D Community Living Arrangements","parent":"appendices","breadcrumb":"D Appendix D Community Living Arrangements","summary":"The following are some examples of community living arrangements:","effective_date":"2016-06-01","last_modified":"2026-10-03T04:10:19.068661+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/D","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/D","official_origin":"https://hcopub.dhs.state.mn.us/epm/appendix_d.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:D#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/D","context":"EPM > D Appendix D Community Living Arrangements","text":"The following are some examples of community living arrangements:\n- Battered women’s shelter\n- Campground\n- Car\n- Child foster care - Rules 1, 4 and 8\n- Community-based behavioral health hospital (CBHH)\n- Detox-only facilities\n- Housing Support (HS) (non-IMD)\n- Halfway house, chemical dependency\n- Halfway house, correctional\n- Homeless\n- Homeless shelter\n- Hotel or motel\n- Maternity shelter\n- Medical hospital\n- Non-negotiated rate facilities with specialized programs for people with developmental or physical disabilities\n- Private residence (home, apartment or home of another person)\n- Residential treatment facilities (non-IMD) that provide treatment for chemical dependency or mental illness"}]},{"id":"epm:E","number":"E","title":"Appendix E Institutions for Mental Diseases","parent":"appendices","breadcrumb":"E Appendix E Institutions for Mental Diseases","summary":"An Institution for Mental Diseases (IMD) is a hospital, nursing facility, or other institution or residential program that has 17 or more beds and provides diagnosis, treatment, or care of people with mental diseases.","effective_date":"2022-09-01","last_modified":"2026-10-03T04:10:19.068661+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/E","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/E","official_origin":"https://hcopub.dhs.state.mn.us/epm/appendix_e.htm","legal_citations":["Code of Federal Regulations, title 42, Section 435.1010","Minnesota Statutes, section 253B.045"],"chunks":[{"chunk_id":"epm:E#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/E","context":"EPM > E Appendix E Institutions for Mental Diseases","text":"An Institution for Mental Diseases (IMD) is a hospital, nursing facility, or other institution or residential program that has 17 or more beds and provides diagnosis, treatment, or care of people with mental diseases.\n\nTypes of IMD facilities include:\n- In-state children's mental health residential facilities\n- Some In-State and Out-of-State severe emotional disturbance (SED) residential treatment facilities for children Psychiatric Residential Treatment Facilities (PRTF) are excluded from IMD status.\n- Regional Treatment Center (RTC) - mental illness (MI) psychiatric inpatient hospital\n- Residential substance use disorder treatment programs\n- Rule 36 MI treatment program\n- Privately owned psychiatric inpatient hospital\n- State sex offender program\n- State forensic program\n- Nursing homes – when 50% or more of beds are for treatment of mental illness"}]},{"id":"epm:F","number":"F","title":"Appendix F Standards and Guidelines","parent":"appendices","breadcrumb":"F Appendix F Standards and Guidelines","summary":"This appendix provides figures used to determine eligibility for a person, or in a specific calculation completed to determine eligibility.","effective_date":"2026-10-01","last_modified":"2026-10-03T04:45:28.824201+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/F","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/F","official_origin":"https://hcopub.dhs.state.mn.us/epm/appendix_f.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:F#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/F","context":"EPM > F Appendix F Standards and Guidelines","text":"This appendix provides figures used to determine eligibility for a person, or in a specific calculation completed to determine eligibility."},{"chunk_id":"epm:F#community-spouse-allowances","heading":"Community Spouse Allowances","url":"https://bot-corpus.mn-dhs.online/s/epm/F#community-spouse-allowances","context":"EPM > F Appendix F Standards and Guidelines > Community Spouse Allowances","text":"## Community Spouse Allowances\n\nThe Community Spouse Allowances are used when determining the long-term care (LTC) income calculation’s community spouse allocation.\n\n### Basic Shelter Allowance\n\nThe Basic Shelter Allowance is used to determine if the community spouse has any excess shelter expenses.\n\n| Effective Dates | Basic Shelter Allowance |\n| --- | --- |\n| July 1, 2026 to June 30, 2027 | $812 |\n| July 1, 2025 to June 30, 2026 | $794 |\n\n### Maximum Monthly Income Allowance\n\nThe Maximum Monthly Income Allowance, along with the Minimum Monthly Income Allowance, is used to determine the community spouse’s monthly maintenance needs amount.\n\n| Effective Dates | Maximum Monthly Income Allowance |\n| --- | --- |\n| January 1, 2026 to December 31, 2026 | $4,066.50 |\n| January 1, 2025 to December 31, 2025 | $3,948.00 |\n\n### Minimum Monthly Income Allowance\n\nThe Minimum Monthly Income Allowance, along with the Maximum Monthly Income Allowance, is used to determine the community spouse’s monthly maintenance needs amount.\n\n| Effective Dates | Minimum Monthly Income Allowance |\n| --- | --- |\n| July 1, 2026 to June 30, 2027 | $2,705 |\n| July 1, 2025 to June 30, 2026 | $2,645 |\n\n### Utility Allowance\n\nThe Utility Allowance is allowed as a shelter expense if the community spouse is responsible for heating or cooling costs.\n\n| Effective Dates | Utility Allowance |\n| --- | --- |\n| October 1, 2026 to September 30, 2027 | $690 |\n| October 1, 2025 to September 30, 2026 | $667 |\n\nThe Electricity and Telephone Allowances are allowed as shelter expenses if the community spouse is not responsible for heating or cooling expenses, but is responsible for electricity or telephone expenses.\n\n| Effective Dates | Electricity Allowance |\n| --- | --- |\n| October 1, 2026 to September 30, 2027 | $243 |\n| October 1, 2025 to September 30, 2026 | $235 |\n| Effective Dates | Telephone Allowance |\n| --- | --- |\n| October 1, 2026 to September 30, 2027 | $64 |\n| October 1, 2025 to September 30, 2026 | $62 |"},{"chunk_id":"epm:F#federal-poverty-guidelines","heading":"Federal Poverty Guidelines","url":"https://bot-corpus.mn-dhs.online/s/epm/F#federal-poverty-guidelines","context":"EPM > F Appendix F Standards and Guidelines > Federal Poverty Guidelines","text":"## Federal Poverty Guidelines\n\nThe federal poverty guidelines (FPG) are used to determine income eligibility for the Minnesota Health Care Programs (MHCP).\n\nRefer to Insurance and Affordability Programs (IAPs) Income and Asset Guidelines ([DHS-3461A](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-3461A-ENG)) for the current FPG."},{"chunk_id":"epm:F#home-equity-limit","heading":"Home Equity Limit","url":"https://bot-corpus.mn-dhs.online/s/epm/F#home-equity-limit","context":"EPM > F Appendix F Standards and Guidelines > Home Equity Limit","text":"## Home Equity Limit\n\nThe Home Equity Limit is applied only in specific situations and at certain times.\n\n| Effective Dates | Home Equity Limit |\n| --- | --- |\n| January 1, 2026 to December 31, 2026 | $752,000 |\n| January 1, 2025 to December 31, 2025 | $730,000 |"},{"chunk_id":"epm:F#irs-mileage-rate","heading":"IRS Mileage Rate","url":"https://bot-corpus.mn-dhs.online/s/epm/F#irs-mileage-rate","context":"EPM > F Appendix F Standards and Guidelines > IRS Mileage Rate","text":"## IRS Mileage Rate\n\nThe IRS mileage rate is used in many calculations to determine eligibility or reimbursement costs.\n\n| Effective Dates | IRS Mileage Rate |\n| --- | --- |\n| July 1, 2026 to December 31, 2026 | 76 cents |\n| January 1, 2026 to June 30, 2026 | 72.5 cents |\n| January 1, 2025 to December 31, 2025 | 70 cents |"},{"chunk_id":"epm:F#long-term-needs-allowances","heading":"Long-Term Needs Allowances","url":"https://bot-corpus.mn-dhs.online/s/epm/F#long-term-needs-allowances","context":"EPM > F Appendix F Standards and Guidelines > Long-Term Needs Allowances","text":"## Long-Term Needs Allowances\n\nThe LTC needs allowances provide figures for needs allowances used in the LTC income calculation and for determining the community spouse or family allocation amounts.\n\n### Clothing and Personal Needs Allowance\n\nThe Clothing and Personal Needs Allowance is used when the enrollee is not eligible for any of the other LTC needs allowances.\n\n| Effective Dates | Clothing and Personal Needs Allowance |\n| --- | --- |\n| January 1, 2026 to December 31, 2026 | $132 |\n| January 1, 2025 to December 31, 2025 | $128 |\n\n### Home Maintenance Allowance\n\nThe Home Maintenance Allowance can be deducted from a person’s LTC income calculation if certain conditions are met.\n\n| Effective Dates | Home Maintenance Allowance |\n| --- | --- |\n| July 1, 2026 to June 30, 2027 | $1,330 |\n| July 1, 2025 to June 30, 2026 | $1,305 |\n\n### Special Income Standard for Elderly Waiver Maintenance Needs Allowance\n\nThe Special Income Standard for Elderly Waiver (SIS-EW) maintenance needs allowance is used in the LTC income calculation for persons who have income at or below the Special Income Standard (SIS).\n\n| Effective Dates | Maintenance Needs Allowance |\n| --- | --- |\n| July 1, 2026 to June 30, 2027 | $1,353 |\n| July 1, 2025 to June 30, 2026 | $1,320 |"},{"chunk_id":"epm:F#maximum-asset-allowance","heading":"Maximum Asset Allowance","url":"https://bot-corpus.mn-dhs.online/s/epm/F#maximum-asset-allowance","context":"EPM > F Appendix F Standards and Guidelines > Maximum Asset Allowance","text":"## Maximum Asset Allowance\n\nThe Maximum Asset Allowance is used for the community spouse asset allowance for an asset assessment.\n\n| Effective Dates | Minimum | Maximum |\n| --- | --- | --- |\n| January 1, 2026 to December 31, 2026 | No minimum | $162,660 |\n| January 1, 2025 to December 31, 2025 | No minimum | $157,920 |"},{"chunk_id":"epm:F#minnesotacare-premium-amounts","heading":"MinnesotaCare Premium Amounts","url":"https://bot-corpus.mn-dhs.online/s/epm/F#minnesotacare-premium-amounts","context":"EPM > F Appendix F Standards and Guidelines > MinnesotaCare Premium Amounts","text":"## MinnesotaCare Premium Amounts\n\nMinnesotaCare premiums are calculated using a sliding fee scale based on household size and annual income.\n\nRefer to MinnesotaCare Premium Estimator Table ([DHS-4139](http://edocs.dhs.state.mn.us/lfserver/Public/DHS-4139A-ENG)) for information about MinnesotaCare premiums. The table provides an estimate of the premium before receiving the actual bill. The premium calculated by the system and listed on the bill is the official calculation and the amount to be paid."},{"chunk_id":"epm:F#pickle-disregard","heading":"Pickle Disregard","url":"https://bot-corpus.mn-dhs.online/s/epm/F#pickle-disregard","context":"EPM > F Appendix F Standards and Guidelines > Pickle Disregard","text":"## Pickle Disregard\n\nThe Pickle Disregard is a disregard of the Retirement, Survivors and Disability Insurance (RSDI) cost of living adjustment (COLA) amounts for Medical Assistance (MA) Method B and the Medicare Savings Programs (MSP).\n\n| Effective Date | Pickle Disregard |\n| --- | --- |\n| January 1, 2026 to December 31, 2026 | 1.028 |\n| January 1, 2025 to December 31, 2025 | 1.025 |"},{"chunk_id":"epm:F#remedial-care-expense","heading":"Remedial Care Expense","url":"https://bot-corpus.mn-dhs.online/s/epm/F#remedial-care-expense","context":"EPM > F Appendix F Standards and Guidelines > Remedial Care Expense","text":"## Remedial Care Expense\n\nThe Remedial Care Expense deduction amount can be used as a health care expense when meeting a spenddown or as an income deduction in an LTC income calculation.\n\n| Effective Dates | Remedial Care Expense |\n| --- | --- |\n| July 1, 2026 to December 31, 2026 | $275 |\n| January 1, 2026 to June 30, 2026 | $267 |\n\nThe Roomer and Boarder Standard income is used in calculating the amount of self-employment income a person who rents or boards another person has to add to the MA Method A income calculation.\n\n| Roomer and Boarder Standard | Amount |\n| --- | --- |\n| Roomer Amount | $71 |\n| Boarder Amount | $155 |\n| Roomer plus Boarder Amount | $226 |"},{"chunk_id":"epm:F#special-income-standard","heading":"Special Income Standard","url":"https://bot-corpus.mn-dhs.online/s/epm/F#special-income-standard","context":"EPM > F Appendix F Standards and Guidelines > Special Income Standard","text":"## Special Income Standard\n\nThe Special Income Standard (SIS) is used to determine certain criteria for the Elderly Waiver (EW) Program.\n\n| Effective Dates | SIS |\n| --- | --- |\n| January 1, 2026 to December 31, 2026 | $2,982 |\n| January 1, 2025 to December 31, 2025 | $2,901 |"},{"chunk_id":"epm:F#statewide-average-payment-for-skilled-nursing-facility-care","heading":"Statewide Average Payment for Skilled Nursing Facility Care","url":"https://bot-corpus.mn-dhs.online/s/epm/F#statewide-average-payment-for-skilled-nursing-facility-care","context":"EPM > F Appendix F Standards and Guidelines > Statewide Average Payment for Skilled Nursing Facility Care","text":"## Statewide Average Payment for Skilled Nursing Facility Care\n\nThe statewide average payment for skilled nursing facility (SAPSNF) care amount is used to determine a transfer penalty for MA. The SAPSNF is updated annually in July.\n\n| Effective Dates | SAPSNF |\n| --- | --- |\n| July 1, 2026 to June 30, 2027 | $11,869 |\n| July 1, 2025 to June 30, 2026 | $11,653 |"},{"chunk_id":"epm:F#student-earned-income-exclusion","heading":"Student Earned Income Exclusion","url":"https://bot-corpus.mn-dhs.online/s/epm/F#student-earned-income-exclusion","context":"EPM > F Appendix F Standards and Guidelines > Student Earned Income Exclusion","text":"## Student Earned Income Exclusion\n\nThe Student Earned Income Exclusion is a disregard of earned income for people who are under age 22 and regularly attending school. It is only available for MA Method B and MSP.\n\n| Effective Date | Monthly | Annual |\n| --- | --- | --- |\n| January 1, 2026 to December 31, 2026 | $2,410 | $9,730 |\n| January 1, 2025 to December 31, 2025 | $2,350 | $9,460 |"},{"chunk_id":"epm:F#supplemental-security-income-maximum-payment-amount","heading":"Supplemental Security Income Maximum Payment Amount","url":"https://bot-corpus.mn-dhs.online/s/epm/F#supplemental-security-income-maximum-payment-amount","context":"EPM > F Appendix F Standards and Guidelines > Supplemental Security Income Maximum Payment Amount","text":"## Supplemental Security Income Maximum Payment Amount\n\nThese figures are the maximum benefit amounts for people eligible for Supplemental Security Income (SSI). A person’s SSI benefit amount is based on the income of the person and certain responsible household members.\n\nSSI benefit payments may be deducted from the LTC income calculation if the person qualifies for the Special SSI Deduction.\n\n| Effective Date | Individual |\n| --- | --- |\n| January 1, 2026 to December 31, 2026 | $994 |\n| January 1, 2025 to December 31, 2025 | $967 |\n| Effective Date | Couple |\n| --- | --- |\n| January 1, 2026 to December 31, 2026 | $1,491 |\n| January 1, 2025 to December 31, 2025 | $1,450 |"},{"chunk_id":"epm:F#tax-filing-income-threshold-for-children-and-tax-dependents","heading":"Tax Filing Income Threshold for Children and Tax Dependents","url":"https://bot-corpus.mn-dhs.online/s/epm/F#tax-filing-income-threshold-for-children-and-tax-dependents","context":"EPM > F Appendix F Standards and Guidelines > Tax Filing Income Threshold for Children and Tax Dependents","text":"## Tax Filing Income Threshold for Children and Tax Dependents\n\nThe tax filing income threshold refers to the income level at which a person must file a federal income tax return. The thresholds for tax dependents determines whether a child's or tax dependent's income is counted or excluded when calculating household income for MA-FCA and MinnesotaCare eligibility.\n\nThe income threshold for tax filing varies based on the tax dependent's age and marital status and whether the person is blind. If a child or tax dependent has income at or below these thresholds, his or her income will not count toward the household income for MA-FCA and MinnesotaCare eligibility.\n\nThe income threshold applies to the taxable income that a child or tax dependent is expected to receive in the tax year. Nontaxable income, such as Supplemental Security Income (SSI) and veterans benefits, is not included in determining whether a child's or tax dependent's income is at or below the income threshold. Any nontaxable portion of a child's Social Security dependent or survivor benefits is not included.\n\nThe income thresholds for children and tax dependents are:\n\n### Tax Filing Income Thresholds for Tax Dependents\n\n| Marital Status | Age over 65? | Blind? | Income Type | 2024 Tax Year Threshold Amount | 2025 Tax Year Threshold Amount |\n| --- | --- | --- | --- | --- | --- |\n| Single | No | No | Earned Income | $14,600 | $15,750 |\n| Single | No | No | Unearned Income | $1,300 | $1,350 |\n| Single | No | No | Gross Income | Larger of $1,300 or Earned Income Reported up to $14,150 + $450 | Larger of $1,350 or Earned Income Reported up to $15,300 + $450 |\n| Single | Yes | No | Earned Income | $16,550 | $17,750 |\n| Single | Yes | No | Unearned Income | $3,250 | $3,350 |\n| Single | Yes | No | Gross Income | Larger of $3,250 or Earned Income Reported up to $14,150 + $2,400 | Larger of $3,350 or Earned Income Reported up to $15,300+$2,450 |\n| Single | No | Yes | Earned Income | $16,550 | !7,750 |\n| Single | No | Yes | Unearned Income | $3,250 | $3,350 |\n| Single | No | Yes | Gross Income | Larger of $3,250 or Earned Income Reported up to $14,150 + $2,400 | Larger of $3,350 or Earned Income Reported up to $15,300+$2,450 |\n| Single | Yes | Yes | Earned Income | $18,500 | $19,750 |\n| Single | Yes | Yes | Unearned Income | $5,200 | $5,350 |\n| Single | Yes | Yes | Gross Income | Larger of $5,200 or Earned Income Reported up to $14,150 + $4,350 | Larger of $5,350 or Earned Income Reported up to $15,300+$4,450 |\n| Married | No | No | Earned Income | $14,600 | $15,750 |\n| Married | No | No | Unearned Income | $1,300 | $1,350 |\n| Married | No | No | Gross Income | Larger of $1,300 or Earned Income Reported up to $14,150 + $450 | Larger of $1,350 or Earned Income Reported up to $15,300+$450 |\n| Married | Yes | No | Earned Income | $16,150 | $17,350 |\n| Married | Yes | No | Unearned Income | $2,850 | $2,950 |\n| Married | Yes | No | Gross Income | Larger of $2,850 or Earned Income Reported up to $14,150 + $2,000 | Larger of $2,950 or Earned Income Reported up to $15,300+$2,050 |\n| Married | No | Yes | Earned Income | $16,150 | $17,350 |\n| Married | No | Yes | Unearned Income | $2,850 | $2,950 |\n| Married | No | Yes | Gross Income | Larger of $2,850 or Earned Income Reported up to $14,150 + $2,000 | Larger of $2,950 or Earned Income Reported up to $15,300+$2,050 |\n| Married | Yes | Yes | Earned Income | $17,700 | $18,950 |\n| Married | Yes | Yes | Unearned Income | $4,400 | $4,550 |\n| Married | Yes | Yes | Gross Income | Larger of $4,400 or Earned Income Reported up to $14,150 + $3,550 | Larger of $4,550 or Earned Income Reported up to $15,300+$3,650 |"}]},{"id":"epm:G","number":"G","title":"Appendix G Life Estates Mortality Table","parent":"appendices","breadcrumb":"G Appendix G Life Estates Mortality Table","summary":"This table must be used to determine the expected duration of a life estate interest or the remainder interest:","effective_date":"2016-06-01","last_modified":"2026-10-03T04:45:29.184919+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/epm/G","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/G","official_origin":"https://hcopub.dhs.state.mn.us/epm/appendix_g.htm","legal_citations":["Code of Federal Regulations, title 26, section 20.2031-7","Minnesota Statutes, section 256B.056, subdivision 1a"],"chunks":[{"chunk_id":"epm:G#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/G","context":"EPM > G Appendix G Life Estates Mortality Table","text":"This table must be used to determine the expected duration of a life estate interest or the remainder interest:\n- [Ages 0-20](https://hcopub.dhs.state.mn.us/epm/#0-20)\n- [Ages 21-40](https://hcopub.dhs.state.mn.us/epm/#21-40)\n- [Ages 41-60](https://hcopub.dhs.state.mn.us/epm/#41-60)\n- [Ages 61-80](https://hcopub.dhs.state.mn.us/epm/#61-80)\n- [Ages 81-100](https://hcopub.dhs.state.mn.us/epm/#81-100)\n- [Ages 101-109](https://hcopub.dhs.state.mn.us/epm/#101-109)"},{"chunk_id":"epm:G#ages-0-20","heading":"Ages 0-20","url":"https://bot-corpus.mn-dhs.online/s/epm/G#ages-0-20","context":"EPM > G Appendix G Life Estates Mortality Table > Ages 0-20","text":"## Ages 0-20\n\n| Age | Life Estate Interest | Remainder interest |\n| --- | --- | --- |\n| 0 | .97188 | .02812 |\n| 1 | .98988 | .01012 |\n| 2 | .99017 | .00983 |\n| 3 | .99008 | .00992 |\n| 4 | .98981 | .01019 |\n| 5 | .98938 | .01062 |\n| 6 | .98884 | .01116 |\n| 7 | .98822 | .01178 |\n| 8 | .98748 | .01252 |\n| 9 | .98663 | .01337 |\n| 10 | .98565 | .01435 |\n| 11 | .98453 | .01547 |\n| 12 | .98329 | .01671 |\n| 13 | .98198 | .01802 |\n| 14 | .98066 | .01934 |\n| 15 | .97937 | .02063 |\n| 16 | .97815 | .02185 |\n| 17 | .97700 | .02300 |\n| 18 | .97590 | .02410 |\n| 19 | .97480 | .02520 |\n| 20 | .97365 | .02635 |"},{"chunk_id":"epm:G#ages-21-40","heading":"Ages 21-40","url":"https://bot-corpus.mn-dhs.online/s/epm/G#ages-21-40","context":"EPM > G Appendix G Life Estates Mortality Table > Ages 21-40","text":"## Ages 21-40\n\n| Age | Life Estate Interest | Remainder interest |\n| --- | --- | --- |\n| 21 | .97245 | .02755 |\n| 22 | .97120 | .02880 |\n| 23 | .96986 | .03014 |\n| 24 | .96841 | .03159 |\n| 25 | .96678 | .03322 |\n| 26 | .96495 | .03505 |\n| 27 | .96290 | .03710 |\n| 28 | .96062 | .03938 |\n| 29 | .95813 | .04187 |\n| 30 | .95543 | .04457 |\n| 31 | .95254 | .04746 |\n| 32 | .94942 | .05058 |\n| 33 | .94608 | .05392 |\n| 34 | .94250 | .05750 |\n| 35 | .93868 | .06132 |\n| 36 | .93460 | .06540 |\n| 37 | .93026 | .06974 |\n| 38 | .92567 | .07433 |\n| 39 | .92083 | .07917 |\n| 40 | .91571 | .08429 |"},{"chunk_id":"epm:G#ages-41-60","heading":"Ages 41-60","url":"https://bot-corpus.mn-dhs.online/s/epm/G#ages-41-60","context":"EPM > G Appendix G Life Estates Mortality Table > Ages 41-60","text":"## Ages 41-60\n\n| Age | Life Estate Interest | Remainder interest |\n| --- | --- | --- |\n| 41 | .91030 | .08970 |\n| 42 | .90457 | .09543 |\n| 43 | .89855 | .10145 |\n| 44 | .89221 | .10779 |\n| 45 | .88558 | .11442 |\n| 46 | .87863 | .12137 |\n| 47 | .87137 | .12863 |\n| 48 | .86374 | .13626 |\n| 49 | .85578 | .14422 |\n| 50 | .84743 | .15257 |\n| 51 | .83674 | .16126 |\n| 52 | .82969 | .17031 |\n| 53 | .82028 | .17972 |\n| 54 | .81054 | .18946 |\n| 55 | .80046 | .19954 |\n| 56 | .79006 | .20994 |\n| 57 | .77931 | .22069 |\n| 58 | .76822 | .23178 |\n| 59 | .75675 | .24325 |\n| 60 | .74491 | .25509 |"},{"chunk_id":"epm:G#ages-61-80","heading":"Ages 61-80","url":"https://bot-corpus.mn-dhs.online/s/epm/G#ages-61-80","context":"EPM > G Appendix G Life Estates Mortality Table > Ages 61-80","text":"## Ages 61-80\n\n| Age | Life Estate Interest | Remainder interest |\n| --- | --- | --- |\n| 61 | .73267 | .26733 |\n| 62 | .72002 | .27998 |\n| 63 | .70696 | .29304 |\n| 64 | .69352 | .30648 |\n| 65 | .67970 | .32030 |\n| 66 | .66551 | .33449 |\n| 67 | .65098 | .34902 |\n| 68 | .63610 | .36390 |\n| 69 | .62086 | .37914 |\n| 70 | .60522 | .39478 |\n| 71 | .58914 | .41086 |\n| 72 | .57261 | .42739 |\n| 73 | .55571 | .44429 |\n| 74 | .53862 | .46138 |\n| 75 | .52149 | .47851 |\n| 76 | .50441 | .49559 |\n| 77 | .48742 | .51258 |\n| 78 | .47049 | .52951 |\n| 79 | .45357 | .54643 |\n| 80 | .43659 | .56341 |"},{"chunk_id":"epm:G#ages-81-100","heading":"Ages 81-100","url":"https://bot-corpus.mn-dhs.online/s/epm/G#ages-81-100","context":"EPM > G Appendix G Life Estates Mortality Table > Ages 81-100","text":"## Ages 81-100\n\n| Age | Life Estate Interest | Remainder interest |\n| --- | --- | --- |\n| 81 | .41967 | .58033 |\n| 82 | .40295 | .59705 |\n| 83 | .38642 | .61358 |\n| 84 | .36998 | .63002 |\n| 85 | .35359 | .64641 |\n| 86 | .33764 | .66236 |\n| 87 | .32262 | .67738 |\n| 88 | .30859 | .69141 |\n| 89 | .29526 | .70474 |\n| 90 | .28221 | .71779 |\n| 91 | .26955 | .73045 |\n| 92 | .25771 | .74229 |\n| 93 | .24692 | .75308 |\n| 94 | .23728 | .76272 |\n| 95 | .22887 | .77113 |\n| 96 | .22181 | .77819 |\n| 97 | .21550 | .78450 |\n| 98 | .21000 | .79000 |\n| 99 | .20486 | .79514 |\n| 100 | .19975 | .80025 |"},{"chunk_id":"epm:G#ages-101-109","heading":"Ages 101-109","url":"https://bot-corpus.mn-dhs.online/s/epm/G#ages-101-109","context":"EPM > G Appendix G Life Estates Mortality Table > Ages 101-109","text":"## Ages 101-109\n\n| Age | Life Estate Interest | Remainder interest |\n| --- | --- | --- |\n| 101 | .19532 | .80468 |\n| 102 | .19054 | .80946 |\n| 103 | .18437 | .81563 |\n| 104 | .17856 | .82144 |\n| 105 | .16962 | .83038 |\n| 106 | .15488 | .84512 |\n| 107 | .13409 | .86591 |\n| 108 | .10068 | .89932 |\n| 109 | .04545 | .95455 |"}]},{"id":"epm:H","number":"H","title":"Appendix H Lawfully Present Noncitizens","parent":"appendices","breadcrumb":"H Appendix H Lawfully Present Noncitizens","summary":"Lawfully present is a term used in Minnesota Health Care Programs (MHCP) eligibility determinations for noncitizens. See EPM 2.1.2.2.2 MA Immigration Status and EPM 3.2.1.2 MinnesotaCare Lawful Presence and DACA.","effective_date":"2025-10-14","last_modified":"2026-10-03T04:10:19.068661+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/H","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/H","official_origin":"https://hcopub.dhs.state.mn.us/epm/appendix_h.htm","legal_citations":["Code of Federal Regulation, title 42, section 600.5 Lawfully Present","Code of Federal Regulations, title 45, section 155.20 Lawfully Present","United States Code, title 42, section 1396b(v)(4)","Centers for Medicare & Medicaid Services State Health Officials letter re: Individuals with Deferred Action for Childhood Arrivals (August 28, 2012), at www.medicaid.gov/Federal-Policy-Guidance/downloads/SHO-12-002.pdf","Centers for Medicare & Medicaid Services State Health Officials letter re: Medicaid and CHIP Coverage of “Lawfully Residing” Children and Pregnant People (July 1, 2010), at www.cms.gov/smdl/downloads/SHO10006.pdf"],"chunks":[{"chunk_id":"epm:H#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/H","context":"EPM > H Appendix H Lawfully Present Noncitizens","text":"Lawfully present is a term used in Minnesota Health Care Programs (MHCP) eligibility determinations for noncitizens. See EPM [2.1.2.2.2 MA Immigration Status](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2.2) and EPM [3.2.1.2 MinnesotaCare Lawful Presence and DACA](https://bot-corpus.mn-dhs.online/s/epm/3.2.1.2).\n\nA noncitizen who presents as or with any of the following is considered lawfully present:\n- Afghan or Iraqi Special Immigrant\n- Amerasian Immigrant\n- Applicant for any of the following:\n  - Adjustment to lawful permanent resident status\n  - Asylum\n    - if age 14 or over, the person must have been granted an employment authorization document (EAD or work permit)\n  - Withholding of removal or deportation\n    - if age 14 or over, the person must have been granted an employment authorization document (EAD or work permit)\n- Asylee\n- Battered noncitizen, including a child of a battered noncitizen\n- Citizens of the Freely Associated States - the Federated States of Micronesia, the Republic of Marshall Islands, or the Republic of Palau\n- Conditional Entrant\n- Cuban or Haitian Entrant\n- Deferred Action\n  - For Deferred Action for Childhood Arrivals, see [Deferred Action for Childhood Arrivals (DACA)](https://hcopub.dhs.state.mn.us/epm/#DACA)\n- Deferred Enforced Departure (DED)\n- Family Unity Beneficiary\n- Granted an administrative stay of removal\n- Granted an employment authorization document (EAD or work permit)\n  - If employment authorization document is granted based on Deferred Action for Childhood Arrivals, see [Deferred Action for Childhood Arrivals (DACA)](https://hcopub.dhs.state.mn.us/epm/#DACA).\n- Lawful Permanent Resident (LPR)\n- Lawfully present in American Samoa and Commonwealth of Northern Mariana Islands\n- Members of a federally recognized Indian tribe or American Indians born in Canada\n- Nonimmigrant status, including, but not limited to people with:\n  - K-Visas\n  - Student Visas\n  - Tourist Visas\n  - U-Visas\n  - V-Visas\n  - Worker Visas\n- Paroled into the United States\n- Refugee\n- Special Immigrant Juvenile petition, either pending or approved\n- Temporary Protected Status (TPS)\n- Temporary Resident Status under 8 USC 1160 or 1255a\n- Trafficking victim or T-Visa holders\n- Withholding of removal or deportation, including under Convention Against Torture"},{"chunk_id":"epm:H#deferred-action-for-childhood-arrivals-daca","heading":"Deferred Action for Childhood Arrivals (DACA)","url":"https://bot-corpus.mn-dhs.online/s/epm/H#deferred-action-for-childhood-arrivals-daca","context":"EPM > H Appendix H Lawfully Present Noncitizens > Deferred Action for Childhood Arrivals (DACA)","text":"## Deferred Action for Childhood Arrivals (DACA)\n\n### MinnesotaCare\n\nA DACA grantee is considered lawfully present for MinnesotaCare. See EPM [3.2.1.2 MinnesotaCare Lawful Presence and DACA](https://bot-corpus.mn-dhs.online/s/epm/3.2.1.2).\n\n### Medical Assistance (MA) and Minnesota Family Planning Program (MFPP)\n\nA DACA grantee who is under age 21 or is pregnant is not considered lawfully present for MA or MFPP. See [2.1.2.2.2 MA Immigration Status](https://bot-corpus.mn-dhs.online/s/epm/2.1.2.2.2) and EPM [4.1 Minnesota Family Planning Program](https://bot-corpus.mn-dhs.online/s/epm/4.1)."}]},{"id":"epm:I","number":"I","title":"Appendix I Life Insurance Concepts","parent":"appendices","breadcrumb":"I Appendix I Life Insurance Concepts","summary":"The following are some key concepts that are important to understand in order to assess life insurance as part of MA financial eligibility.","effective_date":"2020-06-01","last_modified":"2026-10-03T04:10:19.068661+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/epm/I","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/epm/I","official_origin":"https://hcopub.dhs.state.mn.us/epm/Appendix_i.htm","legal_citations":[],"chunks":[{"chunk_id":"epm:I#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/epm/I","context":"EPM > I Appendix I Life Insurance Concepts","text":"The following are some key concepts that are important to understand in order to assess life insurance as part of MA financial eligibility."},{"chunk_id":"epm:I#accelerated-life-insurance-payments","heading":"Accelerated life insurance payments","url":"https://bot-corpus.mn-dhs.online/s/epm/I#accelerated-life-insurance-payments","context":"EPM > I Appendix I Life Insurance Concepts > Accelerated life insurance payments","text":"## Accelerated life insurance payments\n\nAccelerated life insurance payments allow some or all of the proceeds of the life insurance policy to be paid out to the policy owner prior to the death of the insured. Receipt of these types of payments may reduce the face value (FV) and cash surrender value (CSV). A policy owner can also take out a loan against the life insurance policy.\n\nAccelerated life insurance policies can provide three basic types of payments:\n- Long term care model – policy owner can access the death benefit of the contract to pay for extended care in a facility or for home health care.\n- Dread disease or catastrophic illness model – policy owner can access the death benefit of the contract in order to care for the insured during any specified covered condition.\n- Terminal illness model – policy owner can access the death benefit of the contract when a terminal illness is diagnosed for the insured and death is expected to occur within a specified period."},{"chunk_id":"epm:I#annuity","heading":"Annuity","url":"https://bot-corpus.mn-dhs.online/s/epm/I#annuity","context":"EPM > I Appendix I Life Insurance Concepts > Annuity","text":"## Annuity\n\nAn annuity is a life insurance product that may be converted to an income stream for the owner while they are still living. The individual deposits money with an insurance company either all at once (lump sum) or over several years. The terms of the contract determine whether an owner may annuitize at any time, or is subject to an accumulation period. During an accumulation period the money earns interest at a tax deferred rate and the owner has limited access to the fund for that period. At the end of the accumulation period, the policy owner may have several distribution or annuitization options, ranging from a higher monthly income for a short specified period to a smaller income until their death."},{"chunk_id":"epm:I#beneficiary","heading":"Beneficiary","url":"https://bot-corpus.mn-dhs.online/s/epm/I#beneficiary","context":"EPM > I Appendix I Life Insurance Concepts > Beneficiary","text":"## Beneficiary\n\nThe insurance or annuity policy owner names the beneficiary(ies) who will receive the proceeds upon the death of the insured or annuitant."},{"chunk_id":"epm:I#burial-insurance","heading":"Burial insurance","url":"https://bot-corpus.mn-dhs.online/s/epm/I#burial-insurance","context":"EPM > I Appendix I Life Insurance Concepts > Burial insurance","text":"## Burial insurance\n\nBurial insurance is a contract whose terms preclude the use of its proceeds for anything other than payment of the insured’s burial expenses.\n\nNOTE: If a policy has a CSV to which the owner has access, the policy is not burial insurance for MA purposes."},{"chunk_id":"epm:I#cash-surrender-value-csv","heading":"Cash surrender value (CSV)","url":"https://bot-corpus.mn-dhs.online/s/epm/I#cash-surrender-value-csv","context":"EPM > I Appendix I Life Insurance Concepts > Cash surrender value (CSV)","text":"## Cash surrender value (CSV)\n\nCash surrender value (CSV)is the monetary or equity value that an endowment or whole life insurance policy acquires over time as the policy owner pays the premiums and dividend additions and interest are added to the policy. The policy owner can take out loans against this amount and can obtain the full CSV by cancelling the life insurance policy before the insured dies or the policy matures. A loan against a life insurance policy reduces its CSV.\n\nNOTE: Dividend accumulations are considered a separate asset."},{"chunk_id":"epm:I#demutualization","heading":"Demutualization","url":"https://bot-corpus.mn-dhs.online/s/epm/I#demutualization","context":"EPM > I Appendix I Life Insurance Concepts > Demutualization","text":"## Demutualization\n\nDemutualization occurs when a life insurance company converts from a policyholder owned mutual company to a stockholder owned company. As part of demutualization, the insurance company issues shares of stock or cash to its policy owners to compensate them for the loss of certain ownership rights."},{"chunk_id":"epm:I#dividends","heading":"Dividends","url":"https://bot-corpus.mn-dhs.online/s/epm/I#dividends","context":"EPM > I Appendix I Life Insurance Concepts > Dividends","text":"## Dividends\n\n“Mutual” or “participating” life insurance companies may offer their policy owners payment from the company’s annual surplus earnings, which they call dividends. Insurance companies pay these dividends in one of three ways:\n- Issuing checks to the owners (usually annually),\n- Applying the funds to premiums due; or\n- Crediting the funds as an addition or accumulation to the existing policy.\n\nDividend accumulations are surplus company earnings, which accrue in an account that the insurance company controls for the policy owner. The policy owner can access these funds without penalty at any time without affecting the FV or CSV.\n\nThe insurance companies use surplus company earnings, called dividend additions, to buy more insurance protection for the life insurance policy owner. Dividend additions increase the FV and CSV.\n\nNOTE: The tables of CSVs that come with a life insurance policy do not reflect the added CSV of any dividend additions."},{"chunk_id":"epm:I#endowment","heading":"Endowment","url":"https://bot-corpus.mn-dhs.online/s/epm/I#endowment","context":"EPM > I Appendix I Life Insurance Concepts > Endowment","text":"## Endowment\n\nAn endowment is a type of life insurance policy in which CSV is built up within the policy until the CSV equals the FV at a fixed maturity date. If the insured outlives the policy, the FV is paid to the insured. If the insured does not outlive the policy, the FV is paid to the beneficiary."},{"chunk_id":"epm:I#face-value-fv","heading":"Face value (FV)","url":"https://bot-corpus.mn-dhs.online/s/epm/I#face-value-fv","context":"EPM > I Appendix I Life Insurance Concepts > Face value (FV)","text":"## Face value (FV)\n\nFace value (FV) is the amount that is contracted for at the time the life insurance policy is purchased – it is the amount to be paid out when the insured dies. The front page of the life insurance policy may show it as such, or as the “amount of insurance,” “the amount of this policy,” “the sum insured,” etc. A life insurance policy's FV does not include:\n- the FV of any dividend additions, which are added after the life insurance policy is issued;\n- additional sums payable in the event of accidental death or because of other special provisions; or\n- the amount(s) of term insurance, when a policy provides whole life coverage for one family member and term coverage for the other(s)."},{"chunk_id":"epm:I#insurable-interest","heading":"Insurable interest","url":"https://bot-corpus.mn-dhs.online/s/epm/I#insurable-interest","context":"EPM > I Appendix I Life Insurance Concepts > Insurable interest","text":"## Insurable interest\n\nInsurable interest means there would be a financial loss by the owner in the event of the death of the insured person."},{"chunk_id":"epm:I#insured","heading":"Insured","url":"https://bot-corpus.mn-dhs.online/s/epm/I#insured","context":"EPM > I Appendix I Life Insurance Concepts > Insured","text":"## Insured\n\nThe insured is the person on whose life the insurance company issues the policy."},{"chunk_id":"epm:I#insurer","heading":"Insurer","url":"https://bot-corpus.mn-dhs.online/s/epm/I#insurer","context":"EPM > I Appendix I Life Insurance Concepts > Insurer","text":"## Insurer\n\nThe insurer is the company or association which contracts with the owner of the insurance."},{"chunk_id":"epm:I#life-insurance","heading":"Life Insurance","url":"https://bot-corpus.mn-dhs.online/s/epm/I#life-insurance","context":"EPM > I Appendix I Life Insurance Concepts > Life Insurance","text":"## Life Insurance\n\nLife Insurance is a contract under which the insurer agrees to pay a specified amount upon the death of the insured."},{"chunk_id":"epm:I#limited-pay","heading":"Limited pay","url":"https://bot-corpus.mn-dhs.online/s/epm/I#limited-pay","context":"EPM > I Appendix I Life Insurance Concepts > Limited pay","text":"## Limited pay\n\nA limited pay policy is a type of whole life policy in which all premiums are paid for a certain period, after which no more premiums are due."},{"chunk_id":"epm:I#loan","heading":"Loan","url":"https://bot-corpus.mn-dhs.online/s/epm/I#loan","context":"EPM > I Appendix I Life Insurance Concepts > Loan","text":"## Loan\n\nA loan is a cash advance made by the life insurance company to a policy owner on the security of the cash value of the life insurance policy. Loans reduce the CSV of the policy."},{"chunk_id":"epm:I#modified-whole-life-policy","heading":"Modified whole life policy","url":"https://bot-corpus.mn-dhs.online/s/epm/I#modified-whole-life-policy","context":"EPM > I Appendix I Life Insurance Concepts > Modified whole life policy","text":"## Modified whole life policy\n\nA modified whole life policy charges smaller premiums for a specified length of time after which the premiums increase for the remainder of the policy."},{"chunk_id":"epm:I#owner","heading":"Owner","url":"https://bot-corpus.mn-dhs.online/s/epm/I#owner","context":"EPM > I Appendix I Life Insurance Concepts > Owner","text":"## Owner\n\nThe life insurance policy owner can be the insured, another individual, a company, or a trust with an insurable interest in the insured person. The life insurance policy can be an asset only to the owner of the policy. The owner, who might not be the person who is insured, is the person with ownership interest in the policy: this includes the right to surrender the policy or change the beneficiary."},{"chunk_id":"epm:I#participating-policy","heading":"Participating policy","url":"https://bot-corpus.mn-dhs.online/s/epm/I#participating-policy","context":"EPM > I Appendix I Life Insurance Concepts > Participating policy","text":"## Participating policy\n\nA participating policy is life insurance that is eligible for payment of dividends by the insurer."},{"chunk_id":"epm:I#permanent-policy","heading":"Permanent policy","url":"https://bot-corpus.mn-dhs.online/s/epm/I#permanent-policy","context":"EPM > I Appendix I Life Insurance Concepts > Permanent policy","text":"## Permanent policy\n\nA permanent policy is any form of life insurance except term policies. Generally, a permanent policy, such as whole life, universal life, etc builds up a cash value."},{"chunk_id":"epm:I#premiums","heading":"Premiums","url":"https://bot-corpus.mn-dhs.online/s/epm/I#premiums","context":"EPM > I Appendix I Life Insurance Concepts > Premiums","text":"## Premiums\n\nPremiums are the amount the policy owner pays during the lifetime of the policy to keep it in force. In most cases, if the owner stops paying the premiums the policy will lapse and become inactive."},{"chunk_id":"epm:I#pre-need-senior-or-final-expense","heading":"Pre-need senior or final expense","url":"https://bot-corpus.mn-dhs.online/s/epm/I#pre-need-senior-or-final-expense","context":"EPM > I Appendix I Life Insurance Concepts > Pre-need senior or final expense","text":"## Pre-need senior or final expense\n\nPre-need senior or final expense policies are whole life policies designed specifically to cover funeral expenses. The life insurance policy owner signs an arrangement with the funeral home and, at the insured’s death, the proceeds are assigned to the funeral home for payment of services it promises to render. Most contracts dictate that any excess proceeds are paid either to the insured’s estate or to designated beneficiary(ies)."},{"chunk_id":"epm:I#proceeds","heading":"Proceeds","url":"https://bot-corpus.mn-dhs.online/s/epm/I#proceeds","context":"EPM > I Appendix I Life Insurance Concepts > Proceeds","text":"## Proceeds\n\nThe proceeds of a life insurance policy are the total of the FV of the life insurance policy plus any additions payable at maturity or upon death. Proceeds do not include dividends or interest that are left to accumulate in the life insurance policy. Also, proceeds do not include a life insurance policy's CSV."},{"chunk_id":"epm:I#riders","heading":"Riders","url":"https://bot-corpus.mn-dhs.online/s/epm/I#riders","context":"EPM > I Appendix I Life Insurance Concepts > Riders","text":"## Riders\n\nRiders are modifications the policy owner adds to the life insurance policy at the time of purchase. A common example is accidental death (which pays twice the FV if death is from accident). Riders do not alter the FV or CSV of the policy."},{"chunk_id":"epm:I#single-premium-whole-life","heading":"Single premium whole life","url":"https://bot-corpus.mn-dhs.online/s/epm/I#single-premium-whole-life","context":"EPM > I Appendix I Life Insurance Concepts > Single premium whole life","text":"## Single premium whole life\n\nSingle premium whole life is a life insurance policy with only one premium payable at the time the life insurance policy is purchased."},{"chunk_id":"epm:I#supplementary-contract","heading":"Supplementary contract","url":"https://bot-corpus.mn-dhs.online/s/epm/I#supplementary-contract","context":"EPM > I Appendix I Life Insurance Concepts > Supplementary contract","text":"## Supplementary contract\n\nA supplementary contract is not a life insurance policy. It is an agreement whereby, when the life insurance policy matures or the insured dies, the proceeds are paid not in a lump sum, but in an alternative manner selected by the individual, usually as an annuity."},{"chunk_id":"epm:I#survivorship-life","heading":"Survivorship life","url":"https://bot-corpus.mn-dhs.online/s/epm/I#survivorship-life","context":"EPM > I Appendix I Life Insurance Concepts > Survivorship life","text":"## Survivorship life\n\nSurvivorship life, also known as joint life insurance, is a whole life insurance policy insuring two lives (generally spouses) with the proceeds payable to the beneficiary(ies) on the later death of the second person."},{"chunk_id":"epm:I#term-life","heading":"Term life","url":"https://bot-corpus.mn-dhs.online/s/epm/I#term-life","context":"EPM > I Appendix I Life Insurance Concepts > Term life","text":"## Term life\n\nA term life policy is life insurance that provides coverage for a specified period at a guaranteed rate. Some common subtypes of term life insurance are mortgage insurance and group insurance. Policy owners may have the option of converting term life insurance policies into whole or universal life insurance policies (convertible). Alternately, policy owners can renew the policy at the end of its term for limited number of successive terms (renewable)."},{"chunk_id":"epm:I#universal-life","heading":"Universal life","url":"https://bot-corpus.mn-dhs.online/s/epm/I#universal-life","context":"EPM > I Appendix I Life Insurance Concepts > Universal life","text":"## Universal life\n\nUniversal life policies provide insurance over a specified period, and build cash value for policy owners over time. They have greater flexibility in premium payment and potential for higher internal rates of return. There are several types of universal life policies, including variable universal and equity indexed universal life. All universal life policies include a cash account in addition to the standard death benefit."},{"chunk_id":"epm:I#whole-life","heading":"Whole life","url":"https://bot-corpus.mn-dhs.online/s/epm/I#whole-life","context":"EPM > I Appendix I Life Insurance Concepts > Whole life","text":"## Whole life\n\nWhole life is a form of life insurance that applies part of the premium payments to build an investment or savings value for the policy owner. The investment or savings value is called the CSV of the policy.\n\nA modified whole life policy charges smaller premiums for a specified length of time after which the premiums increase for the remainder of the policy."}]}]},{"id":"onesource","name":"OneSource METS Procedures","short_name":"OneSource","publisher":"Minnesota Department of Human Services","official_origin":"https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&dDocName=ONESOURCE","sections":[{"id":"onesource:1","number":"1","title":"Applications and Intake","parent":null,"breadcrumb":"1 Applications and Intake","summary":"Entering applications and renewals into METS.","effective_date":null,"last_modified":"2026-10-08T20:46:40.364509+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/onesource/1","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/onesource/1","official_origin":null,"legal_citations":[],"chunks":[{"chunk_id":"onesource:1#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/onesource/1","context":"OneSource > 1 Applications and Intake","text":"Procedures in the **Applications and Intake** category.\n\nEntering applications and renewals into METS."}]},{"id":"onesource:ONESOURCE-1113","number":"ONESOURCE-1113","title":"Instructions for Entering DHS-6696 into METS, 11/26 Version","parent":"1","breadcrumb":"ONESOURCE-1113 Instructions for Entering DHS-6696 into METS, 11/26 Version","summary":"This procedure provides instructions and examples for entering the June 2026 version of DHS-6696 into METS.","effective_date":"2026-09-17","last_modified":"2026-10-08T20:46:40.364509+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-1113","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/onesource/ONESOURCE-1113","official_origin":"https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-1113","legal_citations":[],"chunks":[{"chunk_id":"onesource:ONESOURCE-1113#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-1113","context":"OneSource > ONESOURCE-1113 Instructions for Entering DHS-6696 into METS, 11/26 Version","text":"This procedure provides instructions and examples for entering the June 2026 version of DHS-6696 into METS.\n\nHO5.5 Pre-Application Entry Screening Checklist for DHS-6696, 11/26 version (PDF) - Use this checklist as a resource for determining completeness of a DHS-6696."},{"chunk_id":"onesource:ONESOURCE-1113#page-contents","heading":"Page Contents","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-1113#page-contents","context":"OneSource > ONESOURCE-1113 Instructions for Entering DHS-6696 into METS, 11/26 Version > Page Contents","text":"## Page Contents\n\n[Resuming an Application in the Worker Portal](#Resumming)  \n[Person Search](#PersonSearch)  \n[Closed Integrated Case Steps](#ClosedIC)  \n[Registering a Person](#RegisterPerson)  \n[Add SSN to a Person Record](#AddSSN)  \n[Incomplete Application Process](#IncompleteApp)  \n[New Application Form](#NewApp)  \n[About You Section](#AboutYou)  \n[More About You Section](#MoreAboutYou)  \n[Household Section](#Household)  \n[Relationship Section](#Relationships)  \n[Tax Filer Section](#TaxFiler)  \n[Income Section](#Income)  \n[RSDI Section](#RSDI)  \n[Definitions of Income Types](#IncomeDefs)  \n[Additional Household Information Section](#AdditionalHousehold)  \n[Post Application Processing](#post)  \n[Review Results](#Review)  \n[Additional Case Worker Actions](#add)  \n[Case Interface and Completion](#case)  \n[How to Add Navigator Assistor/Broker Information to Evidence](#addnav)  \n[Case Note](#Casenote)\n\nWhen an application is entered into METS, the system asks follow-up questions based on the responses entered. While this document contains many of the likely questions workers encounter, this does not guarantee inclusion of every possible combination of steps/screenshots."},{"chunk_id":"onesource:ONESOURCE-1113#resuming-an-application-in-the-worker-portal","heading":"Resuming an Application in the Worker Portal","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-1113#resuming-an-application-in-the-worker-portal","context":"OneSource > ONESOURCE-1113 Instructions for Entering DHS-6696 into METS, 11/26 Version > Resuming an Application in the Worker Portal","text":"## Resuming an Application in the Worker Portal\n\nBefore entering the new application form for the first time, review this section in the event the application process is interrupted. This may be due to timing out, accidentally closing out of the process or METS stops responding.\n\nUse the following steps to resume an application in the worker portal.\n\n1.  Select the Care and Protection tab (Figure 1) in the Navigation bar on the Person Home page.\n\nFigure 1.\n\n\n\n2.  Select Applications from the Page Group Navigation Panel.\n\n3.  Select the Pending Application Forms tab (Figure 2).\n\nFigure 2.\n\n\n\n4.  Review for any listed incomplete applications.\n\n5.  Select the Options button on the far right of the incomplete application displayed.\n\n6.  Select Resume from the drop-down menu (Figure 3). The application form entry displays. The application will resume where it was last saved or at the last completed section.\n\nFigure 3."},{"chunk_id":"onesource:ONESOURCE-1113#person-search","heading":"Person Search","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-1113#person-search","context":"OneSource > ONESOURCE-1113 Instructions for Entering DHS-6696 into METS, 11/26 Version > Person Search","text":"## Person Search\n\n1.  Complete a [Person Search](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-170205) for all persons listed on the application.\n\n&nbsp;\n\n1.  If no person record exists in METS, continue to [Registering a Person](#RegisterPerson).\n\n2.  If a person record exists in METS for any member of the household on the paper application do the following as applicable:\n\n&nbsp;\n\n1.  Follow the [Review, Authorize or Deny Pending Cases](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-180103) procedure if there is an open Application Case (AC).\n\n2.  If there is an open Integrated Case (IC) with Approved (Pending) or Active Product Delivery Cases (PDCs):\n\n&nbsp;\n\n1.  Follow the [Transfer a Paper Application to Another Agency](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-0324) procedure if the case owner is another agency to determine which agency is responsible for processing the application. [Add a Case Note](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-17021306) documenting actions taken. This completes the process.\n\n2.  Compare the paper application with the evidence on the IC to determine if the enrollee is reporting a Change in Circumstance (CIC).\n\n3.  Process all reported changes following the appropriate ONEsource procedures.\n\n4.  Send the [Application Case Denial Notice](https://www.dhs.state.mn.us/main/groups/secure/documents/pub/onesource-13011.pdf) and case note that a duplicate application was received. **Do not** enter the paper application. This completes the process.\n\n&nbsp;\n\n3.  Check to see if anyone is closed from their most recent IC for PDM non-compliance. Use steps 1-4 of the [Denying Retroactive Medical Assistance (Retro MA) for PDM Non-compliance](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-417) to help identify these individuals and make note of them.\n\n> **Note:** Individuals who are closed on their most recent IC for PDM non-compliance are not eligible for retroactive MA coverage."},{"chunk_id":"onesource:ONESOURCE-1113#closed-product-delivery-cases-and-integrated-cases","heading":"Closed Product Delivery Case(s) and Integrated Case(s)","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-1113#closed-product-delivery-cases-and-integrated-cases","context":"OneSource > ONESOURCE-1113 Instructions for Entering DHS-6696 into METS, 11/26 Version > Closed Product Delivery Case(s) and Integrated Case(s)","text":"## Closed Product Delivery Case(s) and Integrated Case(s)\n\nIf all PDCs and the IC are closed:\n\n1.  Register only the person who signed the application if they are not already registered. **Do not** re-register a person already known to METS.\n\n2.  Follow the [Add SSN to Person Record](#AddSSN) section of this procedure before entering the new application if the person is registered but there is no SSN evidence and it was provided on the new application. This will help prevent duplicate PMIs.\n\n3.  Review the Person Record for each household member on the application:\n\n&nbsp;\n\n1.  Edit all address evidence on the Person Record (both current and historical) and verify that the Preferred box is not checked.\n\n2.  A change of address (for either residential or mailing) should be entered during application entry. The person record address will be updated once the application is submitted."},{"chunk_id":"onesource:ONESOURCE-1113#registering-a-person","heading":"Registering a Person","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-1113#registering-a-person","context":"OneSource > ONESOURCE-1113 Instructions for Entering DHS-6696 into METS, 11/26 Version > Registering a Person","text":"## Registering a Person\n\n1.  Identify the application filer (application signer).\n\n> **Note:** If the Authorized Representative (AREP) is the application filer, identify the first adult household member listed on the application and follow the remaining steps for that individual.\n\n2.  Determine if the application filer is known to METS. If the Application Filer is already known to METS, proceed to the [New Application Form](#NewApp) section of this procedure.\n\n3.  Follow the [Registering a Person](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-170207) procedure if the Application Filer is not already known to METS.\n\n> **Note:** If the application is incomplete, see the detailed [Incomplete Application Process](#IncompleteApp) section of this procedure."},{"chunk_id":"onesource:ONESOURCE-1113#add-ssn-to-person-record","heading":"Add SSN to Person Record","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-1113#add-ssn-to-person-record","context":"OneSource > ONESOURCE-1113 Instructions for Entering DHS-6696 into METS, 11/26 Version > Add SSN to Person Record","text":"## Add SSN to Person Record\n\n4.  Determine if the Application Filer is already known to METS. If known to METS, review the Person Record to see if SSN evidence exists:\n\n&nbsp;\n\n1.  If SSN evidence exists on the Person Record and the application is incomplete, continue to the [Incomplete Application Process](#IncompleteApp) section of this procedure.\n\n2.  If SSN evidence exists on the Person Record and the application is complete, continue to the [New Application Form](#NewApp) section of this procedure.\n\n3.  If SSN evidence does not exist on the Person Record and the application is complete, follow the [Add Social Security Number to the Person Record](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-17021440) procedure in ONEsource to create SSN evidence. Then continue to the New Application Form section.\n\n4.  If SSN evidence does not exist on the Person Record and the application is incomplete, continue to the Incomplete Application Process section listed below."},{"chunk_id":"onesource:ONESOURCE-1113#incomplete-application-process","heading":"Incomplete Application Process","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-1113#incomplete-application-process","context":"OneSource > ONESOURCE-1113 Instructions for Entering DHS-6696 into METS, 11/26 Version > Incomplete Application Process","text":"## Incomplete Application Process\n\nFollow this process when phone contact with the applicant is not successful and the paper application is incomplete.\n\n1.  [Register](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-170207) the Application Filer if applicable.\n\n2.  [Add SSN to Person Record](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-17021440) if applicable.\n\n3.  Send [Request for Information (RFI) (DHS-3271)](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3271-ENG) and track the incomplete application following agency process.\n\n4.  Follow the [Add a Person Note Procedure](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-17021301). Include the phone number in the person note, if provided.\n\n5.  Send a manual denial [Application Case Denial Notice - Application Withdrawn or Incomplete](https://www.dhs.state.mn.us/main/groups/secure/documents/pub/onesource-120214.pdf) and enter a [Person Note](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-17021301) after 45 days from the date of application, or 10 days from the date the RFI was sent, whichever is later.\n\n> **Note:** If the application is withdrawn by the applicant, send a manual denial [Application Case Denial Notice - Application Withdrawn or Incomplete](https://www.dhs.state.mn.us/main/groups/secure/documents/pub/ONESOURCE-120214.pdf) using the “Application Withdrawn” reason on the drop-down, and enter a [Person Note](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-17021301)."},{"chunk_id":"onesource:ONESOURCE-1113#new-application-form","heading":"New Application Form","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-1113#new-application-form","context":"OneSource > ONESOURCE-1113 Instructions for Entering DHS-6696 into METS, 11/26 Version > New Application Form","text":"## New Application Form\n\n1.  Select the Options button in the upper right corner and select New Application Form (Figure 4) on the Person Home page of the application signer.\n\nFigure 4.\n\n\n\n2.  Determine and enter the Application Date:\n\n&nbsp;\n\n1.  If the paper application has a completed Appendix C, use the application date from the certified application counselors, navigators, in-person assisters, agents, and brokers section on Appendix C.\n\n2.  If the agency received a Request to Apply for MN Health Care Programs (DHS-3417B) and the paper application was received within 30 days of the request, use the date the DHS-3417B was received by the agency.\n\n3.  If the paper application does not have an Appendix C or a Request to Apply, use the date that the application was physically received by any agency, usually determined by a date stamp on the application. \\[When the application was forwarded from another agency, (to the county of residence), use the date the application was received at the initial forwarding agency\\].\n\n4.  If entering an application received in October, in the month of January or later, METS will not provide correct next year eligibility. Use 11/1 as the application date, and October eligibility and any retroactive requests must be determined in MAXIS for MA eligible household members.\n\n&nbsp;\n\n3.  Select Next when the page is complete.\n\n4.  Select the *“I Agree”* box at the bottom of the Privacy Agreement to indicate the applicant signed the paper application. Then select Next (Figure 5).\n\nFigure 5."},{"chunk_id":"onesource:ONESOURCE-1113#about-you-section","heading":"About You Section","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-1113#about-you-section","context":"OneSource > ONESOURCE-1113 Instructions for Entering DHS-6696 into METS, 11/26 Version > About You Section","text":"## About You Section\n\n### Tips:\n\n- Use correct punctuation. Double check for correct data entry and spelling before submitting.\n\n- If the Application Filer is not requesting health care coverage, the next household member added to the case must be requesting coverage.\n\n> Example: Mom, dad, and child are listed on the application. Only the child is applying for coverage. Enter members in this order: Mom, child, dad.\n\n- If there is a Safe at Home (SAH) address reported on the application, follow Step 2D in the [Safe at Home](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-0321) instructions under METS Applications to ensure the residential and mailing address are entered properly.\n\n1.  Review the About You Section and Select Next.\n\n2.  Answer: *“Are you applying for yourself?”*\n\n&nbsp;\n\n1.  Select Yes if the application filer is applying**.**\n\n2.  Select No if the application filer is not applying.\n\n&nbsp;\n\n3.  Complete the fields in the Your Details section.\n\n> **Notes:**\n\n- If applicant is deceased, enter Date of Death.\n\n- If defaulting Sex to female, send an [RFI (DHS-3271)](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3271-ENG) to inform the applicant of the following using gender-neutral language:\n\n> “Our current benefits system requires that we enter either male or female to process your application. Policy is to enter “female” by default if you are not able to select one of these two options, if your sex is unknown or if you reported you are pregnant. You can change that selection by contacting your worker. We understand that these limited selections do not fit all Minnesotans and we apologize that we must enter your information this way.”\n\n4.  Enter information in Your Home Address if it did not pull over from the Registration Process.\n\n> **Notes:**\n\n- To prevent possible returned mail, the USPS [Zip Code Look-up](https://gcc02.safelinks.protection.outlook.com/?url=http%3A%2F%2Fwww.usps.com%2Fzip4&data=05%7C02%7CChristopher.P.Bly%40state.mn.us%7C8b819051cf41403fe8b208ddc538b398%7Ceb14b04624c445198f26b89c2159828c%7C0%7C0%7C638883569510740471%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=ypu8kSqZ%2FZ19AJ%2F579oeidFQDBk8geBOeIyYVrM19gY%3D&reserved=0) can be used to validate an enrollee’s address before updating the evidence.\n\n- Both METS and MMIS have character limits that affect how addresses print on notices.\n\n  - Street Address Line 1 in METS: 22 characters (including spaces).\n\n  - Street Address Line 2 plus Apt/Suite combined in METS: 22 characters (including spaces).\n\n  - These limits ensure addresses print correctly on notices generated in MMIS.\n\n- When an applicant reports a change of address to a new county before the application is processed, use the address reported on the application. For an applicant to receive their mail at the correct address, enter the newly reported residential address as only the mailing address during application entry. This allows the correct Financially Responsible Agency (FRA) to be assigned.\n\n- The address change can be processed after eligibility has been determined with active Product Delivery Case(s). Use the [Add or Edit Address Evidence](https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-17021402) procedure to process the change in circumstance after initial eligibility has been determined.\n\n1.  Option A: Lives in MN, plans to make MN their home, not temporarily absent, not homeless:\n\n&nbsp;\n\n1.  Enter the address listed on the application in the Minnesota Address section. Do not use spacing or punctuation when entering addresses, unless noted below:\n\n> **Notes:**\n\n- Apt/Suite: If applicable, enter the “#” character, followed by a space then the apartment number or suite number.\n\n> Examples: \\# A, \\# 200, \\# 20\n\n- The “*/*” character is allowable in the Address Line 1 and Address Line 2 fields ONLY. Fractional addresses must contain the *“/”* character in order to properly interface to MMIS.\n\n> Examples: 134 ½ Main Street, 25 W 36 ½ Street\n\n2.  Option B: Lives in MN, plans to make MN home, not temporarily absent, homeless (ALWAYS mark as No).\n\n> **Note:** Always select No to homeless question. Enter either the County or Tribal Agency or General Delivery address in the Minnesota Address section.\n\n3.  Option C: Lives in MN, plans to make MN home, temporarily absent, not homeless.\n\n&nbsp;\n\n1.  Enter temporary absence information based on application.\n\n2.  Enter the address listed on the application in the Minnesota Address section.\n\n&nbsp;\n\n5.  Complete *“Is the mailing address the same as your home address?”* Complete the Your Mailing Address section as follows:\n\n&nbsp;\n\n1.  Option A: Select YES when no mailing address is provided on the application. The mailing address will be the same as the residential address.\n\n2.  Option B: Select NO when a mailing address is provided on the application. The mailing address should be entered in the mailing address fields.\n\n> **Note:** The Application Filer must have both residential and mailing address information.\n\n6.  Complete *“Do you plan to make Minnesota your home?”* Enter the response provided by the applicant.\n\n7.  Complete *“Did you move to Minnesota in the last three months?”* If Yes, enter the date the person moved to Minnesota.\n\n8.  Complete Other Contact Information.\n\n&nbsp;\n\n1.  Preferred Contact Method is required. Always select Mail.\n\n> **Note:** The options on the paper application are Email and U.S. Postal Mail, while the options for the online application are Email, Mail, and Phone.\n\n2.  Phone Number – Always enter this information when provided. It is not a mandatory field. Phone number will populate if entered during registration. Select Type: Choose appropriate choice from the drop-down menu if it did not pull over from the Registration Process.\n\n> **Note:** The options on the online application are Business, Fax, Home, Mobile, Other, and Pager while the options on the paper application are Cell, Home, and Work.\n\n3.  Language spoken at home defaults to English; modify as needed.\n\n4.  Written language defaults to English; modify as needed.\n\n5.  Complete *“Do you want us to send you a voter registration card?”*.\n\n6.  Always select Mail to answer the question: *“How do you prefer to receive notices?”*\n\n&nbsp;\n\n9.  Select No to the question: *“Do you want us to send you a form to name someone as your Authorized Representative?”*\n\n> **Note:** This question is not asked on the paper application. The paper application instead asks if the applicant wants to assign someone to act on their behalf as an authorized representative. If the question on the paper application is not answered or the response is “No”, follow-up is not required. If the applicant answers “Yes”, the paper application instructs them to complete Appendix C, which is attached to the application.\n\n10. Answer: *“Are you applying for yourself?”* Enter the response provided on the paper application.\n\n> **Note:** This is worded *“Are you applying for health care coverage for yourself?”* on the paper application.\n\n11. Select Next when the page is complete.\n\n### More About You Section\n\n1.  Complete the Race and Ethnicity section of the More About You page using answers provided by the applicant. These questions are optional. If they are not completed on the paper application, proceed to the next step.\n\n2.  Complete the Additional Information section of the More About You page:\n\n&nbsp;\n\n1.  Do not enter spaces or dashes when entering the Social Security number (SSN). The SSN will prepopulate if entered during registration or if added to the person record before starting of application. Verify that the SSN is correct or enter it when prompted.\n\n> **Note:** Correct the prepopulated SSN if it is incorrect. The system requires entering the SSN twice to confirm. To continue with application entry, both SSN fields must match. Copy and paste is not allowed for this field.\n\n2.  If the applicant answers No to *“Do you have a Social Security Number?”,* additional questions are displayed.\n\n    1.  If *“Have you applied for an SSN?”* is answered No, then an additional question is asked.\n\n    2.  If *“Reason why you do not have an SSN?”* has *“other”* selected, then an additional question is asked. If *“Does \\[Applicant Name\\] want assistance in applying for an SSN?”* is not answered, Default to Yes.\n\n3.  Answer: *“Are you a US Citizen?”* with the answer provided on the application.\n\n> **Note:** The paper application has *“Are you a US Citizen or US national?”* as one question. The online application asks it as two separate questions.\n\n4.  Answer: *“Are you a US National?”* with the answer provided on the application. This question only appears if the answer to being a US Citizen is answered as No.\n\n> Enter Yes or No to *“Are you lawfully present in the United States?”,* based on the response to *“Do you have an immigration status listed here?”*\n>\n> **Note:** If the applicant answers “No” to *“Do you have an immigration status listed here?”*, the applicant is attesting to being not lawfully present and having an immigration status of undocumented.\n\n5.  Select the Immigration status attested on the application following [Enter Immigration Status in METS](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-170224) procedure. If information is gathered from an active MAXIS case, include that information in your case note.\n\n    1.  If applicant answered Yes on “*Do you have an immigration status listed here”* but did not check a box, select *“Other”* during application entry and case note that response.\n\n6.  The following questions are asked based on the immigration status entered:\n\n    1.  *“Date of Entry”*: Enter date provided on the application.\n\n    2.  *“Supporting Document”*: Enter based on response to “*Immigration document type”*.\n\n> **Notes:**\n\n- The I-94 number must be an 11-digit number.\n\n- The SEVIS ID must start with N and followed by 10 digits.\n\n- The Alien Number (A-Number) must start with A and followed by 9 digits (if less than 9 digits, add leading zeros).\n\n- The Immigration Card Number should start with three capital alpha characters followed by 10 digits.\n\n- For Nonimmigrant Visas, select Unexpired Foreign Passport.\n\n  1.  *“Did you enter the Unites States before August 22, 1996”*: Enter Yes or No as indicated on the application.\n\n  2.  *“Have you resided in the United States for five or more years in a qualified status”:* Enter Yes or No based on the response to *“Have you had your current status for five years or more?”.*\n\n  3.  *“Did you ever have a Refugee, Asylee, Amerasian Noncitizen, Cuban/Haitian Entrant, Conditional Entrant, Victim of Severe Trafficking (LPR or T Visa), Withholding of Removal, Special Iraqi/Afghan Immigrant or American Indian Born in Canada (289 INA) immigration status”:* Answer Yes or No based on response to *“Have you previously had a different status? (example: refugee or asylee)”.*\n\n  4.  *“Are you an honorably discharged veteran or active duty member of the military”:* Answer Yes or No based on the response to *“Are you, or is your spouse or parent, a veteran or active-duty member of the military”.*\n\n  5.  *“Are you the spouse or dependent child of such a veteran or individual in active-duty status”:* Enter Yes or No based on responses to *“Are you, or is your spouse or parent, a veteran or active-duty member of the military?”*\n\n3.  Answer : *“Is this person currently pregnant or was recently pregnant?”* with information provided on the application.\n\n> **Note:** The online application only displays this question if the applicant is a female between the ages of 13-64.\n\n1.  Select No if answered no on the application. No follow up questions are displayed.\n\n2.  If Yes:\n\n&nbsp;\n\n1.  Enter number of children expected.\n\n2.  Enter the due date.\n\n&nbsp;\n\n1.  Enter zero to answer the question *“How many children is \\[person\\] expecting?”* if the person was recently pregnant.\n\n2.  Enter End Date if \\[person\\] was recently pregnant.\n\n&nbsp;\n\n4.  Answer: *“Is this the correct Social Security Number?”* This is a mandatory field and must be completed to continue.\n\n> **Note:** The displayed SSN on this page is pulled over from the SSN entered on the previous page (More About You in the Additional Information section). Verify that the SSN displayed is correct.\n\n1.  Select Yes if the displayed SSN is correct and matches what the applicant provides. No follow up questions are asked.\n\n2.  Select No if the displayed SSN is incorrect and does not match what the applicant provided.\n\n&nbsp;\n\n1.  Enter in the provided SSN in the Social Security Number field.\n\n2.  Re-enter the reported SSN in the Re-enter Social Security Number field to confirm.\n\n&nbsp;\n\n5.  Complete Supporting document details if displayed based on response to *“A-number or ID number”* and *“Document no”* from the application. The fields vary based on the supporting document type selected for applicants who reported non-citizenship status.\n\n6.  Answer the following question, which only appears in METS if the person is between ages 18 and 26: *“Were you in Foster Care on your 18^(th) Birthday?”* This is worded *“Was anyone in foster care on that person’s 18^(th)birthday?”* in step 4, question 7 of the paper application.\n\n&nbsp;\n\n1.  Select No if the applicant answered No. No follow up questions are displayed.\n\n2.  Select Yes if applicant answered Yes. Additional questions will display and are required to be answered.\n\n&nbsp;\n\n1.  *What state were you in Foster Care? – this defaults to Minnesota. Select the state indicated by the applicant if the state is not Minnesota.*\n\n2.  “*Were you getting health care through Medical Assistance or another state’s Medicaid program?”* enter Yes or No based on applicant’s response to the application question, “*Was this person getting healthcare through Medical Assistance or another state’s Medicaid program?”*\n\n&nbsp;\n\n7.  Select Next."},{"chunk_id":"onesource:ONESOURCE-1113#household-section","heading":"Household Section","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-1113#household-section","context":"OneSource > ONESOURCE-1113 Instructions for Entering DHS-6696 into METS, 11/26 Version > Household Section","text":"## Household Section\n\n### Tips\n\n- Enter everyone who is:\n\n&nbsp;\n\n- Living with the Application Filer. \\[This includes all children (younger than 19) living with the Application Filer even if someone outside of the home claims them as a tax dependent.\\]\n\n- All tax dependents even if they live outside the home, including tax dependents that live outside of the United States.\n\n- Married people who file a joint return.\n\n&nbsp;\n\n- If a household member already exists in a legacy system, enter their name as listed in those systems unless a legal name change has been reported on the application.\n\n- When a household member is already known to METS, enter their information exactly as it is listed in METS to prevent the creation of duplicate records.\n\n- For tax dependents living outside of the home:\n\n&nbsp;\n\n- The same information required for other household members is also needed for these individuals, along with their current address.\n\n- Additional information for entering a tax dependent who lists an address outside of the U.S. is noted in the instructions.\n\n&nbsp;\n\n- If the Application Filer is not applying for health care assistance, then the next household member added to the case must be applying for assistance.\n\n> Example: Mom and Dad are applying only for the minor child. Enter the mom as the Application Filer. The next person added to the case must be the child, then any other household members.\n\n- A request to add an infant to an application that has not yet been processed should not be completed. This would be a change in circumstances to add the infant to the case after entering the initial application.\n\n> Example: An application is received on March 31. On April 10, the mother calls the office to report that they had the baby today. The application is being processed on April 20. The application should be entered using March 31 as the application date and stating yes to the pregnancy questions. After the application has been entered, then add the infant to the IC as a change in circumstance.\n\n### Instructions\n\n1.  Review the Household Section and Select Next.\n\n2.  Answer yes or no to the question: *“Are others in the household?”* Select Next.\n\n&nbsp;\n\n1.  If selecting No because there are no other household members, proceed to the Tax Filer Information section of this procedure.\n\n2.  Select Yes to continue and add additional household members starting with step 3.\n\n3.  Continue to select Yes to this question until all members are added using instructions starting with step 3.\n\n&nbsp;\n\n3.  Complete the Household Member Details page for Person and all additional household members.\n\n4.  Complete the Contact Details section for Person 2.\n\n&nbsp;\n\n1.  Complete “*Does the Person live with the Applicant”?*\n\n&nbsp;\n\n1.  If yes, complete “*Does this Person plan to make Minnesota their home?”*\n\n2.  Complete if the person is temporarily absent from Minnesota.\n\n&nbsp;\n\n2.  If Person does not live with the applicant, answer the following questions:\n\n&nbsp;\n\n1.  *“Does this person live in Minnesota?”*\n\n2.  *“Does this person plan to make Minnesota their home?”*\n\n3.  *“Is this person temporarily absent from Minnesota?”*\n\n4.  *“Did this person move to Minnesota in the last three months?”*\n\n5.  *“Did this person enter Minnesota with a job commitment or to seek employment”*\n\n&nbsp;\n\n3.  Address Fields: Enter the address provided for the person.\n\n> **Notes:**\n\n- For tax dependents who live outside of the U.S., enter the Application Filer’s home address. After submitting the application, follow the [Tax Dependents Who Live Outside the U.S.](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-070301) procedure to update the case with the correct address information, and case note the actions taken.\n\n- Contact the Application Filer if the household is applying for a tax dependent living outside of the U.S. The tax dependent living outside the U.S will not be eligible for health coverage.\n\n4.  *“Does this person plan to make Minnesota his/her home?”:* Enter answer provided.\n\n5.  If this person is not applying, no further details are required. However, if their SSN was provided, enter their SSN on the next page.\n\n&nbsp;\n\n5.  Complete the SSN Confirmation if it displays. This will appear if an SSN is entered in the previous page. Answer *“Is this the correct Social Security Number?”* This is a mandatory field and must be completed to continue.\n\n> **Note:** The displayed SSN on this page pulled over from the SSN entered on the previous page. Verify the SSN is correct.\n\n1.  Select Yes if the displayed SSN is correct and matches what the applicant provided. No further follow up questions are asked.\n\n2.  Select No if the displayed SSN is incorrect and does not match what the applicant provided.\n\n&nbsp;\n\n1.  Enter in the reported SSN in the Social Security Number field.\n\n2.  Re-enter the reported SSN in the Re-enter Social Security Number field to confirm.\n\n&nbsp;\n\n6.  Complete the Household Member Extra Details section for Person 2:\n\n&nbsp;\n\n1.  Answer the Ethnicity and Race questions using answers provided on the application. These questions are optional. If they are not completed on the paper application, proceed to the next step.\n\n2.  Follow steps 2-6 from More About You for Person 1 to enter information for SSN, citizenship, pregnancy, and foster care.\n\n3.  Select Next.\n\n&nbsp;\n\n7.  Review More People? Application Entry Section:\n\n&nbsp;\n\n1.  Check for accuracy.\n\n2.  Select Yes to the question: *“Do you need to add any more people?”* if there are more household members to add.\n\n3.  Complete steps 1-6 from Household Section above for the person.\n\n4.  Continue to select Yes to the question: *“Do you need to add any more people?”* until all household members are added.\n\n5.  Select No to the question: *“Do you need to add any more people?”* once all household members have been added.\n\n6.  Select Next."},{"chunk_id":"onesource:ONESOURCE-1113#relationships-section","heading":"Relationships Section","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-1113#relationships-section","context":"OneSource > ONESOURCE-1113 Instructions for Entering DHS-6696 into METS, 11/26 Version > Relationships Section","text":"## Relationships Section\n\n1.  Complete the Relationships page by identifying the relationships of each household member. Multiple pages may display dependent on the number of people in the household.\n\n2.  Select Next when all relationships to Person 1 have been identified.\n\n3.  Identify the relationships of household members to Person 2 if applicable. Select Next when complete.\n\n4.  Select Next after all Relationship pages are complete to proceed to the Tax Filer section."},{"chunk_id":"onesource:ONESOURCE-1113#tax-filer-section","heading":"Tax Filer Section","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-1113#tax-filer-section","context":"OneSource > ONESOURCE-1113 Instructions for Entering DHS-6696 into METS, 11/26 Version > Tax Filer Section","text":"## Tax Filer Section\n\n1.  Complete the Tax Filer Information page by selecting all household members who intend to file a federal tax return for the current tax year.\n\n2.  Select Next when complete.\n\n3.  Complete the Tax Filing Status page if applicable by indicating if married people intend to file a joint tax return.\n\n4.  Complete the Tax Dependent Information page by indicating who, if anyone, anticipates claiming this person as a dependent. Additional Tax Dependent Information pages will display for each dependent in the household.\n\n&nbsp;\n\n1.  If the answer is Yes, select the person who will claim them.\n\n> **Note:** When a married couple indicates on the previous page they will file jointly, only the Application Filer will display as an option to claim the child as a dependent.\n\n2.  If the person is not claimed as a dependent by anyone in the household, additional questions appear asking if anyone outside of the household claims the person as a dependent. Answer these questions based on the responses on the application.\n\n3.  Select Next when the page is complete.\n\n&nbsp;\n\n5.  Review the Household Summary page. Workers can Add, Change or Remove information from this page for all household members except Person 1. To make changes to Person 1, select the Getting Started menu item on the left tool bar.\n\n&nbsp;\n\n1.  Select the link next to the information that requires updating.\n\n2.  Select Next once information has been reviewed, and any necessary changes are complete."},{"chunk_id":"onesource:ONESOURCE-1113#income-section","heading":"Income Section","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-1113#income-section","context":"OneSource > ONESOURCE-1113 Instructions for Entering DHS-6696 into METS, 11/26 Version > Income Section","text":"## Income Section\n\n### Tips\n\n- METS provides direction and information such as income definitions that change based on the information entered.\n\n- **Do not** use any Income Information Retrieved if it is displayed, even if it matches the applicant’s attestation.\n\n&nbsp;\n\n- Select Remove for all income if METS auto-populates any income information, then enter attested income manually on the next screen.\n\n&nbsp;\n\n- Enter the Amount and Frequency attested to on the application. Calculations are made based on the attested information entered.\n\n- For self-employment or farm income loss, see [Business Loss Procedure](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-170203).\n\n- Income pages display for all household members. Continue to enter income information until all income from all household members is documented.\n\n- METS is programmed to determine if a household member is required to file taxes based on the income entered and if their total taxable income is below the tax-filing threshold.\n\n- METS is programmed to exclude the income of a child (regardless of age) who:\n\n&nbsp;\n\n- Is included in the household of his or her biological, natural, adopted or stepparent, and:\n\n- Is not expected to be required to file a tax return for the taxable year that MA-FCA is being determined.\n\n&nbsp;\n\n- METS is programmed to exclude the income of a tax dependent who:\n\n&nbsp;\n\n- Is not the spouse or child of the tax filer or joint tax filer, and:\n\n- Is not expected to be required to file a tax return for the taxable year that MA-FCA is being determined."},{"chunk_id":"onesource:ONESOURCE-1113#rsdi-income","heading":"RSDI income","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-1113#rsdi-income","context":"OneSource > ONESOURCE-1113 Instructions for Entering DHS-6696 into METS, 11/26 Version > RSDI income","text":"## RSDI income\n\nRetirement, Survivors, and Disability Insurance (RSDI) is counted for both MA and MinnesotaCare. It is part of the Modified in MAGI income methodology.\n\n**Note:** RSDI income for certain children and tax dependents may be excluded. The DHS-6696 no longer asks applicants to report if Social Security income is non-taxable.\n\n1.  Consider the following when a child or tax dependent has RSDI income:\n\n&nbsp;\n\n1.  When a child or tax dependent receives only RSDI income and no other income, enter the total RSDI amount as tax-exempt in the income section.\n\n> **Note:** Enter the Projected Annual Income (PAI) as \\$0.01, and after submitting the application, edit the PAI evidence and change it to \\$0.00.\n\n2.  When a child or tax dependent receives RSDI income and other income, use the [Child and Tax Dependent Income Deeming](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-1736) resource to determine the tax-filing threshold and if their income is taxable. If the income is taxable, enter all income into METS. Do not list any income as tax-exempt.\n\n> **Note:** Include all income in the PAI."},{"chunk_id":"onesource:ONESOURCE-1113#definitions-of-income-types","heading":"Definitions of Income Types","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-1113#definitions-of-income-types","context":"OneSource > ONESOURCE-1113 Instructions for Entering DHS-6696 into METS, 11/26 Version > Definitions of Income Types","text":"## Definitions of Income Types\n\nInformation displays during application entry based on the income type selected for an individual. The details below reflect what METS displays and how each income type should be interpreted.\n\n### Wages before taxes\n\n*“Report how much \\[person\\] currently makes in wages and tips before taxes are deducted. Do not include amounts deducted from wages by the employer for childcare, health insurance or retirement plans that are not taxable (sometimes called ‘pre-tax deductions’).”*\n\n*“If \\[person\\] is seasonally employed, report the amount of wages you expect \\[person\\] will receive in the next 12 months. If \\[person\\] expects to receive unemployment in the next 12 months, be sure to select “Yes” on the last question and you will be able to enter an unemployment record with the amount of unemployment you expect \\[person\\] will receive in the next 12 months.”*\n\n### Alimony\n\n*“Report how much \\[person\\] currently receives each month in alimony if the divorce or separation agreement is dated on or before December 31, 2018. Do not report alimony received as income if the divorce or separation agreement is dated after December 31, 2018. For more information, see IRS Publication 17 at www.irs.gov.”*\n\nAlimony is a payment made to a former spouse under a divorce or legal separation court document.\n\n- Alimony received from a divorce decree or separation agreement finalized on or after January 1, 2019, is not taxable and is not countable income under the MAGI Methodology.\n\n- Alimony received from a divorce decree or separation agreement finalized before January 1, 2019, is countable income under the MAGI Methodology.\n\n- If a divorce decree or separation agreement modified on or after January 1, 2019, and the modification expressly applies the new tax law, alimony received after the modification date is not countable.\n\n### American Indian Alaska Native Income\n\nThe following income is excluded under the MA-FCA income methodology for American Indian and Alaska Native people:\n\n- Alaska Native Corporations and Settlement Trusts.\n\n- Property held in trust located within the boundaries of a prior Federal reservation or under supervision of the Secretary of the Interior.\n\n- Rents, leases, rights of way, royalties, usage rights, natural resource extraction or harvest from trusts or properties, or resulting from the exercise of federally protected rights.\n\n- Real property ownership interests related to natural resources and improvements.\n\n- Ownership interests or usage rights to items of religious, spiritual, traditional, or cultural significance or which support subsistence or traditional lifestyle.\n\n- Student financial assistance provided by the Bureau of Indian Affairs educations programs.\n\n### Interest/Dividends\n\n*“Report how much \\[person\\] currently receives in interest and dividend payments. Include both taxable and tax-exempt income. If \\[person\\] anticipates receiving this income in the next 12 months, list an annual amount of how much you expect \\[person\\] will receive in the next 12 months.”*\n\n### Self-Employment\n\n*“Report \\[persons\\] current monthly net income from self-employment. Net income is gross revenue minus expenses. If the income varies from month to month, report the amount you expect to receive in the next 12 months.”*\n\n### Retirement/Pension\n\n*“Report how much \\[person\\] currently receives each month in retirement or pension income. Report the gross amount.”*\n\n### Farm Income\n\n*“Report \\[persons\\] monthly net income from farming. Net income is gross revenue minus expenses. If the income varies from month to month, report the amount you expect to receive in the next 12 months.”*\n\n### Rental or royalty income\n\n*“Report \\[persons\\] current monthly net rental or royalty income. Net income is gross revenue minus expenses. If the income varies from month to month, report the amount you expect to receive in the next 12 months.”*\n\n### Taxable Scholarships, Awards and Grants\n\n*“Report how much \\[person\\] currently receives in taxable scholarships, awards, and grants income.”*\n\n### Social Security Benefits\n\n*“Report how much \\[person\\] currently receives each month in Social Security benefits. Social Security benefits are Title II income. Title II Social Security benefits include retirement, disability and Railroad Retirement benefits.”*\n\n*“Supplemental Security Income (SSI) is not Title II income.”*\n\n*“Report the gross amount before any deductions. Include both taxable and tax-exempt income.”*\n\n### Taxable One-Time Income (i.e., prizes, awards, gambling winnings)\n\n*“Report any one-time or lump sum taxable income \\[person\\] received this month or expects to receive this month. This includes prizes, awards, and gambling winnings.”*\n\n**Note:** Enter using *“One Time Only”* as the income frequency. Lump sum income is counted only in the month received for MA. It must always be included in the PAI.\n\n### Minnesota Paid Leave\n\n*“Report how much \\<first name\\> currently receives from Minnesota Paid Leave. If the Minnesota Paid Leave is for medical reasons, report the taxable amount.”*\n\n### Unemployment Insurance\n\n*“Report how much \\[person\\] currently receives each week in unemployment insurance (UI). Report the gross amount before taxes.”*\n\nWhen determining UI for PAI, include the amount already received plus remaining expected payments for the year.\n\n*“If \\[person\\] is seasonally employed and receives UI, record UI as yearly. After entering the UI as a yearly amount select “Yes” on the last question and enter the seasonal income as a yearly amount you expect \\[person\\] will receive in the current year.”*\n\n### Other Taxable Income\n\n*“Report how much \\[person\\] currently receives each month in other taxable income. If unsure whether the income is taxable, visit the IRS website at [www.irs.gov (link to the Internal Revenue Service website)](http://www.irs.gov/). If \\[person\\] anticipates receiving this income in the next 12 months, provide an average monthly amount of how much you expect \\[person\\] will receive over the next 12 months.”*\n\n### Post 9/11 Veteran Service Bonus Payments\n\nPost 9/11 Veteran Service Bonus payments are not taxable and must not be counted as income for MA or included in PAI.\n\n### Instructions\n\n1.  Review the Income Section and Select Next.\n\n> **Note:** When Wages before taxes is selected for income type, an Employer Details section displays. Enter the employer name listed on the proofs, if provided. Enter the Employer Identification Number (EIN) when available. The EIN must be 9 digits. A validation message will display when entered incorrectly.\n\n2.  Complete the Income Information page and select Next when the page is complete.\n\n3.  Complete the Enter Income Details page when a person has income:\n\n&nbsp;\n\n1.  Use the amount and frequency attested to on the application. If hourly is indicated, calculate the annual income.\n\n> **Notes:**\n\n- Bi-Weekly is equivalent to every two weeks (26 pay periods per year).\n\n- Semi-Monthly is twice a month (24 pay periods per year).\n\n- **Do not** use the Daily option.\n\n2.  Continue until all sources of income are entered for the person.\n\n&nbsp;\n\n1.  Select Yes for *“Does \\[person\\] have any more income”* to enter another income type.\n\n2.  When all income has been entered for the person Select No for *“Does \\[person\\] have any more income?”*\n\n&nbsp;\n\n4.  Select Next to display Additional Income Details page.\n\n5.  Complete the Additional Income Details page for questions displayed.\n\n&nbsp;\n\n1.  Complete the question: *“Did hours decrease or was wages/salary reduced in the last 6 months?”* based on information reported on the application.\n\n2.  Select Next when complete.\n\n&nbsp;\n\n6.  Complete the Income Adjustments page which will display when a person has previously entered income.\n\n&nbsp;\n\n1.  Select Yes if the applicant has Adjustments, then select Next.\n\n2.  Select No if the applicant has no Adjustments, then select Next."},{"chunk_id":"onesource:ONESOURCE-1113#income-adjustment-types","heading":"Income Adjustment Types","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-1113#income-adjustment-types","context":"OneSource > ONESOURCE-1113 Instructions for Entering DHS-6696 into METS, 11/26 Version > Income Adjustment Types","text":"## Income Adjustment Types\n\n### Alimony Paid\n\nAlimony paid under a divorce decree or separation agreement finalized on or after January 1, 2019, is not an allowable adjustment under the MAGI methodology for MA or MinnesotaCare.\n\nAlimony paid from a divorce decree or separation agreement finalized before January 1, 2019, is an allowable adjustment under the MAGI Methodology for MA or MinnesotaCare.\n\nAlimony paid from a divorce decree or separation agreement modified on or after January 1, 2019, and the modification expressly provides for the alimony tax law changes apply, then the alimony received on or after the date of modification is not an allowable adjustment under the MAGI Methodology.\n\n### Moving Expenses\n\nThe moving expense adjustment is permitted only for households that include active-duty military members who move due to a military order and permanent change in station.\n\nFor all other households, moving expenses adjustments are not permitted under the MAGI methodology for MA or MinnesotaCare.\n\n### Instructions\n\n1.  Complete the Income Adjustment Items page if the applicant has adjustments.\n\n&nbsp;\n\n1.  Enter all Income Adjustments as an annual amount.\n\n2.  If more than one adjustment of the same is reported, add them together and enter a single amount.\n\n> Example: Fred states student loan interest \\#1 of \\$100 monthly and Student loan interest \\# 2 interest of \\$100 per quarter. This must be entered as one Student Loan Interest Income Adjustment of \\$1,600 annually.\n\n3.  Each adjustment type selected will display help text directly below the household members.\n\n4.  Continue until all Adjustment Types are entered, and select No for “*Does \\[Person\\] have any more income* *adjustments?*”\n\n5.  \n\n6.  Select Next when each entry is complete.\n\n&nbsp;\n\n2.  Complete the Projected Annual Income Page for all household members.\n\n&nbsp;\n\n1.  METS uses the income and adjustment information previously entered to calculate PAI.\n\n2.  Compare the system calculated PAI to the amount listed on the application.\n\n&nbsp;\n\n1.  If the applicant lists a different amount on the application:\n\n&nbsp;\n\n1.  Select No.\n\n2.  Enter the expected PAI as reported on the application.\n\n3.  Select Next.\n\n&nbsp;\n\n2.  If the PAI is as expected, select Yes.\n\n> **Notes:**\n\n- **Do not** check the Worker Estimated PAI Checkbox for current year PAI. Applicants always need to attest to a current year PAI.\n\n- Use the [Worker Estimated PAI Checkbox Scenario](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-0713) procedure to help identify situations where it is appropriate to check this box.\n\n3.  Enter next year’s PAI when processing in METS from October through December, as the system will require both current year and next year PAI evidence for all household members.\n\n> **Note:** The date METS begins requiring next year PAI is the same date that January MA/MinnesotaCare cases are selected for renewal in October."},{"chunk_id":"onesource:ONESOURCE-1113#additional-household-information-section","heading":"Additional Household Information Section","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-1113#additional-household-information-section","context":"OneSource > ONESOURCE-1113 Instructions for Entering DHS-6696 into METS, 11/26 Version > Additional Household Information Section","text":"## Additional Household Information Section\n\n1.  Review the Additional Household Information Section and Select Next.\n\n> **Note:** The screens mentioned in this section may not all display or may be displayed in a different order based on information entered during the application entry process.\n\n2.  Complete the Additional Information for Medicaid/CHIP page by selecting the box under any person that meets the criteria.\n\n&nbsp;\n\n1.  **Do not** select anyone for the following questions, as they are not asked on the paper application:\n\n&nbsp;\n\n1.  *“Do any of these people have a communicable disease (HIV, AIDS, tuberculosis, hepatitis, etc.)?”*\n\n2.  *“Do any of these people have a terminal illness?”*\n\n3.  *“Have any of these people been determined as being seriously and persistently mentally ill or as being severely emotionally disturbed?”*\n\n4.  *“Is anyone applying receiving Minnesota Supplemental Aid (MSA)?”*\n\n&nbsp;\n\n2.  *“Do any of these people have a sponsor?” –* only select if the person has reported an LPR status and has indicated they have a sponsor.\n\n3.  The question *“Do any of these people need health care coverage to pay for a medical emergency?”* may appear at the bottom of this screen based on the household member’s immigration status.\n\n    1.  **Do not** select anyone here, even if they reported an emergency on the application.\n\n    2.  Case note the medical emergency request in METS.\n\n    3.  County Worker: Process the medical emergency request in MAXIS following Process Requests for Emergency Medical Assistance (EMA) procedure after the application is entered.\n\n    4.  HCCS: Create a Task:\n\n> SUBJECT: EMA Determination Needed.  \n> TYPE: Follow-Up Needed.  \n> PRIORITY: High.  \n> DEADLINE: 30 days from today.  \n> CASE PARTICIPANT: List the member requesting EMA.  \n> CASE REFERENCE: List the IC number.  \n> ASSIGNMENT DETAILS: Assign to the county of financial responsibility.  \n> COMMENTS: EMA determination needed for (list member requesting EMA).\n>\n> **Note:** No EMA task will generate for this case because no person is selected here.\n\n4.  The question *“Does any child on the application have a parent living outside of the home”* may appear at the bottom of this screen based on household relationships.\n\n&nbsp;\n\n1.  Select “Yes” if a child under age 19 in the household is applying for assistance and there is a parent living outside of the home.\n\n&nbsp;\n\n5.  Select Next.\n\n&nbsp;\n\n3.  Complete the Employer Sponsored Coverage Information page.\n\n&nbsp;\n\n1.  Select all household members who currently have coverage or access to coverage through an employer.\n\n2.  Select Next.\n\n> **Note:** If no household members have coverage or access to coverage through an employer, leave all household members unchecked and select Next.\n\n4.  Review the answer to the question “*Is \\[household member\\] enrolled in health insurance through an Employer?*”.\n\n> **Notes:**\n\n- If the Employer Name is unknown, enter unknown.\n\n- If the Employer Identification Number (EIN) is unknown, enter 999999999.\n\n- If the Employer Address is unknown, enter Unknown, Saint Paul, Ramsey, MN 55101.\n\n1.  Answer “Yes” when the person is enrolled in employer sponsored coverage. Coverage may be through the person’s own employer or through another person’s employer.\n\n&nbsp;\n\n1.  Complete the Additional Information of Employer page using information from Step 3 of the DHS-6696.\n\n2.  Under the Coverage Details section, select all household applicants that are enrolled in this employer sponsored plan.\n\n&nbsp;\n\n1.  Complete entry of employer sponsored coverage information for any additional household members that may have been selected.\n\n&nbsp;\n\n2.  Answer No when the person is not enrolled, but has access to the employer sponsored coverage.\n\n&nbsp;\n\n1.  Complete the Additional Information on the Employer Sponsored Coverage page for each household member with access to employer sponsored coverage as reported on Appendix A.\n\n    1.  If the applicant is not the employee, only answer Yes to *“Is \\[household member\\] the spouse or tax dependent of the employee?”* if the applicant is married and files taxes jointly with the employee or is a tax dependent of the employee.\n\n    2.  Self-only and family cost must be entered as whole numbers with a value greater than zero. Enter \\$1 if either plan is reported as costing \\$0 or free.\n\n    3.  The conditional self-only and family coverage questions do not generate if the employer does not offer a self-only plan that meets the minimum value standard (MVS).\n\n    4.  If a person is marked as the spouse or tax dependent of the employee, and the self-only coverage meets MVS, the application will ask the appropriate family coverage questions to determine MVS and affordability for those household members.\n\n> **Note:** Applicants who have access to employer sponsored coverage that meets both the minimum value and affordability standards are ineligible for MinnesotaCare.\n\n5.  Select Next when all information has been entered and completed.\n\n6.  Complete the Additional Information for all Applicants.\n\n&nbsp;\n\n1.  Answering Yes by selecting the check boxes for relevant household members.\n\n2.  Select the box for anyone who meets the criteria for the question.\n\n3.  Select No to the question *“Does anyone applying want to request a full Medicaid eligibility determination?”*\n\n4.  Answer *“Is anyone applying an American Indian or Alaska Native (AI/AN)?”* based on the applicant attestation to the question, *“Are you or is anyone in your family American Indian or Alaska Native?”* in step 4 of the Paper Application*.* If not answered, default to no.\n\n> **Note: Do not** use demographic information to answer this question as demographics are optional and applicants have the option to not apply as an AI/AN if they choose to regardless of their demographics.\n\n1.  Complete the Additional Information as listed below for each selected person using the attested information on the Appendix B.\n\n&nbsp;\n\n1.  Select Yes or No for *“Is applicant a member of a federally recognized tribe?”*\n\n&nbsp;\n\n2.  If Yes, enter the tribal name and whether or not the applicant lives on a reservation.\n\n&nbsp;\n\n3.  Tribal Identification Number: Leave blank if not provided. This field is not required.\n\n4.  Enter No to the question *“Is client receiving or have they ever received a service from the Indian Health Service, a tribal health program, or through a referral from one of these programs?”*\n\n5.  Select Next.\n\n&nbsp;\n\n5.  The question *“Does anyone applying have Medicare or other non-employer health insurance?”* may need to be answered *“Yes”* when entering cases into METS.\n\n> **Notes:**\n\n- Hospital Presumptive Eligibility (HPE) is not considered other health insurance.\n\n- **Do not** select Yes for a child under 21 during a re-entry if Continuous MA eligibility must be continued from the previous case.\n\n- Examples for when to answer Yes to this question include:\n\n&nbsp;\n\n- Migration (person is closing in MAXIS/MMIS and migrating to METS).\n\n- Applications.\n\n- If the person has recently moved to Minnesota and had Medicaid from another state.\n\n- Case Re-Entry cases.\n\n> **Exception:** When a child(ren) under age 21 was eligible for MA on a previous case and must have Continuous MA eligibility continued on the new case.\n\n1.  Complete the Additional Information as follows for each selected person:\n\n&nbsp;\n\n1.  Select Medicaid in another state for *“What kind of health insurance does \\[person\\] have?”*\n\n2.  Select the appropriate state for *“Which state is providing the service?”*\n\n> **Note:** Select Minnesota if the person is closing in MAXIS/MMIS, such as for Migration or Case Re-entry.\n\n3.  If coverage is ending in next two months, select Yes and enter the Coverage End Date.\n\n4.  Select Yes or No for *“Does \\[person\\] have additional insurance?”*\n\n&nbsp;\n\n6.  Answer Yes or No to *“The start date for Medical Assistance (MA) can go back up to three months from your application date if you have medical bills from that time and meet the MA eligibility requirements. Is anyone applying seeking MA for past months?”* based on the applicant’s response to *“Do you want help from Medical Assistance (MA) to pay for medical bills from the past three months?”*\n\n> **Note:** If any applicants who are requesting retro MA were identified as closing on their most recent IC due to PDM non-compliance, **do not** select that applicant as seeking MA for past months. METS will not automatically deny that request when processed by the system alone and individuals are not eligible for retroactive coverage during months of PDM non-compliance. Send the [(DHS-3954) Retro MA Denial](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3954-ENG) notice to these individuals informing them their retro MA request was denied due to PDM non-compliance.\n\n1.  Enter the answers based on the information on the application or obtained from the applicant:\n\n&nbsp;\n\n1.  *“Please select the past month(s) in which you have medical bills.”*\n\n2.  If the exact months are the only missing item, use the following default:\n\n- Select all three months displayed for *“Please select the past month(s) in which you have medical bills?”*\n\n- Select No for *“Is everything you told us on the application the same for past months?”*\n\n> **Note:** The months displayed for selection during application entry are generated based on the application date entered. Select any combination of the months requested.\n\n3.  Enter Yes or No to *“You are seeking MA coverage for a past month, is everything you told us on this application the same for the past months?”*\n\n&nbsp;\n\n7.  Answer No to *“Should any child receive continuous eligibility for MA?”* if the question appears at the bottom of this screen.\n\n> **Note:** This question is only answered Yes when directed in the Case Re-Entry procedure.\n\n8.  Answer Yes or No to *“Did \\<member\\> meet an exception to the federal work or community engagement requirement last month?”* with the response provided on the application form.\n\n> **Note:** If the questions were not answered on the application received, follow the [Work or Community Engagement Worker Checklist](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-0813) to determine if the agency is already aware of exceptions or qualifying activities.\n\n1.  Answer Yes if the person met an exception last month.\n\n    1.  Select the checkbox for each exemption.\n\n    2.  Select Next.\n\n2.  Answer No if the person did not meet an exception last month.\n\n    1.  Select Next.\n\n&nbsp;\n\n9.  Answer Yes or No to “*Did \\<member\\> complete a qualifying activity last month?”.*\n\n    1.  Answer Yes if the person completed a qualifying activity last month.\n\n        1.  Select the checkbox for each qualifying activity.\n\n        2.  Select Next.\n\n    2.  Answer No if the person did not complete a qualifying activity last month.\n\n        1.  Select Next.\n\n10. Review the Summary data. Workers can Add, Change or Remove information from this page for all household members except to Person 1. To make changes to Person 1, select the Getting Started on the left tool bar.\n\n> **Note:** This is the last opportunity to make changes before submission.\n\n11. Select the link next to any information that requires updating.\n\n12. Select Next when complete.\n\n13. Complete the Submit Application Form page by selecting all 5 checkboxes.\n\n&nbsp;\n\n1.  *“Select the Acknowledgement of yearly renewal.”*\n\n2.  *“Select the Acknowledgement of Rights and Responsibilities.”*\n\n3.  *“Select the Acknowledgement to report changes.”*\n\n4.  *“Select the Acknowledgement of penalty of perjury.”*\n\n5.  *“Select the Acknowledgement of the following:*\n\n&nbsp;\n\n1.  *Consent/Sharing of Information*\n\n2.  *Medicaid Payment*\n\n3.  *Parent/Medical Support*\n\n4.  *Medicaid Repayment (Overpayment or Fraud)”*\n\n&nbsp;\n\n6.  Select Submit.\n\n&nbsp;\n\n14. Submit the Application.\n\n&nbsp;\n\n1.  Select the length of time to renew coverage with Federal Tax Information (FTI) from the drop-down as indicated on the application.\n\n> **Note:** If the answer is blank on the application, default to 5 years.\n\n2.  Select the checkbox confirming the client has been made aware of the renewal options and has selected the same.\n\n3.  Select Submit."},{"chunk_id":"onesource:ONESOURCE-1113#post-application-processing","heading":"Post Application Processing","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-1113#post-application-processing","context":"OneSource > ONESOURCE-1113 Instructions for Entering DHS-6696 into METS, 11/26 Version > Post Application Processing","text":"## Post Application Processing\n\n### Review Results\n\nMETS displays the Person Home screen for the Application Filer.\n\n1.  Select the Home tab to view Pending Application and Current Cases information.\n\n> **Note:** Background processing may require some time. Refresh the session if unable to view the Integrated Case and eligibility results.\n\n2.  Review for the creation of an IC.\n\n&nbsp;\n\n1.  If an IC was created, continue to step 3.\n\n2.  If an IC was not created:\n\n&nbsp;\n\n1.  Follow [Review, Authorize or Deny Pending Cases](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-180103) procedure to authorize an Application Case (AC) when METS did not create an IC.\n\n2.  Follow [Re-entering Problem Applications](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-0710) if an AC is repeatedly stuck in the following statuses:\n\n- *Authorization Failed.*\n\n- *Authorization in Progress.*\n\n- Disappears into the PIE queue more than once.\n\n3.  Review the eligibility results using the [Review Eligibility Results](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-170208) procedure.\n\n    1.  If results remain pending in the system, Review for items to verify.\n\n        1.  If the agency has proof of any items to verify, continue to step 4.\n\n        2.  If the agency does not have proof of any items to verify, continue to step 5.\n\n        3.  If the eligibility is not as expected, utilize the ONEsource chapter [Health Care Helpful Information](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-07).\n\n4.  Follow the [Add Proof to a Verification Item](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-180301) procedure to resolve any items to verify of which the agency has proof.\n\n> **Note:** At initial application an applicant can be approved for MA or MinnesotaCare before providing proof of Post Eligibility Verification Items. For MHCP, the post-eligibility items that a servicing agency must verify are:\n\n- SSN.\n\n- Citizenship.\n\n- Immigration status or lawful presence.\n\n- PAI.\n\n5.  Follow the [Reasonable Opportunity Period (ROP) Verification Items](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-181) procedure to review a case that has outstanding post eligibility items to verify.\n\n    1.  If the agency does not have proof for any items to verify, continue to step 6.\n\n    2.  If able to resolve all pre-eligibility verification items follow the [Activate Approved MA PDC](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-17021202) procedure.\n\n6.  Follow the [Review Eligibility Results](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-170208) procedure to confirm eligibility determinations are correct and that no conflicting PDC determinations exist for any household members. Check determinations to ensure that all eligibility begin dates are correct on the PDCs.\n\n7.  Follow [Review System Generated Notices](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-1203) procedure for accuracy. Follow the [Manually Create a Health Care Notice](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONEsource-1201) procedure to create and send the applicable notice in the following situations:\n\n    1.  No system notice is generated.\n\n    2.  The system generated notice is inaccurate.\n\n    3.  A program change, change in basis of eligibility, or closure of any public program occurred or will occur before the next renewal date.\n\n> **Notes:**\n\n- Provide the enrollee with the effective date their current coverage will end.\n\n- Send a Request for Information [(RFI) (DHS-3271)](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3271-ENG) if there are items to verify that are not listed on the system generated notice.\n\n8.  Follow the [Authorized Representative Information on the Integrated Case](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-0328) procedure to add AREP information on the IC."},{"chunk_id":"onesource:ONESOURCE-1113#additional-case-worker-actions","heading":"Additional Case Worker Actions","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-1113#additional-case-worker-actions","context":"OneSource > ONESOURCE-1113 Instructions for Entering DHS-6696 into METS, 11/26 Version > Additional Case Worker Actions","text":"## Additional Case Worker Actions\n\nOnce an application has been submitted, either by an applicant using the citizen portal or through the worker portal from a paper application or case re-entry, assigned agencies are required to take additional actions. Follow the [Case Assignment and Initial Worker Actions](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-04) procedure.\n\n**Note:** When the question, *“Does any child on the application have a disability determination or a condition you believe is disabling, and need additional services or supports?”* is answered yes, the DHS-6696 must be used to process an eligibility determination for TEFRA if the child is not eligible for MA-FCA because the household income is above the MA-FCA income limit. An additional application is not required. Follow the [Processing MA-TEFRA in MAXIS](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-0338) procedure. Determine if a SMRT referral is needed."},{"chunk_id":"onesource:ONESOURCE-1113#case-interface-and-completion","heading":"Case Interface and Completion","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-1113#case-interface-and-completion","context":"OneSource > ONESOURCE-1113 Instructions for Entering DHS-6696 into METS, 11/26 Version > Case Interface and Completion","text":"## Case Interface and Completion\n\n1.  Review MMIS to confirm coverage interfaced correctly from METS. If interface was not successful, track and review MMIS again after 24 hours. Follow the [Interface and Unhandled Server Errors Guide](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONEsource-070106) if interface was not successful after 24 hours.\n\n2.  Follow the [Managed Care Enrollment Guide](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-1001) to mail information or update a managed care plan, if necessary.\n\n3.  Follow the [Temporary Absence MMIS Exclusion and Disenrollment](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-08044) procedure to determine if an MA applicant or enrollee needs to be excluded from managed care due to a Temporary Absence.\n\n4.  Review Financially Responsible Agency (FRA) evidence if any household members have become newly MA eligible. If evidence does not exist, add it using [Add, Edit or Correct Financially Responsible Agency Evidence](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONEsource-17021460) instructions and apply the new evidence."},{"chunk_id":"onesource:ONESOURCE-1113#how-to-add-navigatorassistorbroker-information-to-evidence","heading":"How to Add Navigator/Assistor/Broker Information to Evidence","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-1113#how-to-add-navigatorassistorbroker-information-to-evidence","context":"OneSource > ONESOURCE-1113 Instructions for Entering DHS-6696 into METS, 11/26 Version > How to Add Navigator/Assistor/Broker Information to Evidence","text":"## How to Add Navigator/Assistor/Broker Information to Evidence\n\n1.  When Appendix C is included with the paper application, follow the instructions in the [Add or Edit Navigator Assistor Broker Evidence](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-17024) procedure to add this information to the IC, then apply changes."},{"chunk_id":"onesource:ONESOURCE-1113#case-note","heading":"Case Note","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-1113#case-note","context":"OneSource > ONESOURCE-1113 Instructions for Entering DHS-6696 into METS, 11/26 Version > Case Note","text":"## Case Note\n\n1.  [Add a Case Note to an IC](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-17021306) using the following template.\n\n> Subject: Application entry process complete.**  **\n> Body:  \n> Application Date:  \n> Date entered in METS:  \n> Income:  \n> PAI:  \n> Resolved Items to Verify (Y/N):  \n> If Yes, what was resolved?  \n> Tasks created (if any):  \n> Changes processed after application entry:  \n> Eligibility:  \n> Notices sent (if any):  \n> Required post-entry follow up actions:  \n> Other: (Pregnant/Auto Newborn information, immigration status information, other actions taken, etc.)  \n> Interface:\n\n2.  Add a separate case note for adult without children enrollees to record all work or community engagement exceptions and/or qualifying activities that are attested to using the following templates:\n\n&nbsp;\n\n1.  [Case Note Template: Adult Without Children Work or Community Engagement Exemptions](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-09198).\n\n&nbsp;\n\n2.  [Case Note Template: Adult Without Children Work or Community Engagement Qualifying Activities](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-09199).\n\n3.  [Case Note Template: Adult without Children No Work or Community Engagement Attestation](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-16141)."}]},{"id":"onesource:2","number":"2","title":"Evidence Maintenance","parent":null,"breadcrumb":"2 Evidence Maintenance","summary":"Adding, editing and ending evidence on METS cases.","effective_date":null,"last_modified":"2026-10-08T20:46:40.364509+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/onesource/2","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/onesource/2","official_origin":null,"legal_citations":[],"chunks":[{"chunk_id":"onesource:2#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/onesource/2","context":"OneSource > 2 Evidence Maintenance","text":"Procedures in the **Evidence Maintenance** category.\n\nAdding, editing and ending evidence on METS cases."}]},{"id":"onesource:ONESOURCE-17021402","number":"ONESOURCE-17021402","title":"Add or Edit Addresses Evidence","parent":"2","breadcrumb":"ONESOURCE-17021402 Add or Edit Addresses Evidence","summary":"Use this procedure to manually add or edit addresses evidence when the Address Change Wizard cannot be used in the following situations:","effective_date":"2026-10-06","last_modified":"2026-10-08T20:46:40.364509+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-17021402","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/onesource/ONESOURCE-17021402","official_origin":"https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-17021402","legal_citations":[],"chunks":[{"chunk_id":"onesource:ONESOURCE-17021402#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-17021402","context":"OneSource > ONESOURCE-17021402 Add or Edit Addresses Evidence","text":"Use this procedure to manually add or edit addresses evidence when the Address Change Wizard cannot be used in the following situations:\n\n- Address change for newly homeless or no longer homeless.\n\n- Adding a new household member.\n\n- Address correction or change.\n\n- Address change from a PRISM Inbound Data task.\n\n- Address change for an enrollee in an excluded time facility. **Do not** use the Address Change Wizard.\n\n**Notes:**\n\n- If returned mail indicates a PO Box as the forwarding address, contact the household to confirm the current address information before completing this procedure. **Do not** use a PO Box as a residential address.\n\n- Use the [Address Change Wizard](https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-08011) to expedite adding and ending address evidence. The wizard automates:\n\n  - Ending existing addresses evidence.\n\n  - Adding new Residential and Mailing address evidence.\n\n  - Updating State Residency evidence when the residential county changes.\n\n  - Generates case notes for the automated actions.\n\n- To prevent return mail, validate addresses using the United States Postal Service (USPS) [Zip Code Look-up](https://gcc02.safelinks.protection.outlook.com/?url=http%3A%2F%2Fwww.usps.com%2Fzip4&data=05%7C02%7CChristopher.P.Bly%40state.mn.us%7C8b819051cf41403fe8b208ddc538b398%7Ceb14b04624c445198f26b89c2159828c%7C0%7C0%7C638883569510740471%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=ypu8kSqZ%2FZ19AJ%2F579oeidFQDBk8geBOeIyYVrM19gY%3D&reserved=0) before updating evidence.\n\n- For address updates reported by the United States Postal Service (USPS) or the managed care organization (MCO) on the (DHS-8354), follow the [Process METS Returned Mail](https://www.dhs.state.mn.us/main/idcplg/County_Common_Entry_Point.doc?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-170225), [METS Returned Renewal Mail](https://www.dhs.state.mn.us/main/idcplg/County_Common_Entry_Point.doc?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-15025), or the [METS Close Case - New Residential Address Out of State](https://www.dhs.state.mn.us/main/idcplg/County_Common_Entry_Point.doc?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-080306) procedure first to ensure information is complete prior to moving to this as a sub-procedure."},{"chunk_id":"onesource:ONESOURCE-17021402#special-circumstances","heading":"Special Circumstances","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-17021402#special-circumstances","context":"OneSource > ONESOURCE-17021402 Add or Edit Addresses Evidence > Special Circumstances","text":"## Special Circumstances\n\n### Applications with Pending PDCs\n\n**Do not** process an address change when all Product Delivery Cases (PDCs) are in approved status. Address changes cannot be processed until eligibility is determined with active PDCs. To ensure mail is sent correctly, enter the new address as the mailing address only. This allows for the correct Financially Responsible Agency (FRA) to be assigned. After eligibility is determined, process the full address change.\n\n### Homeless\n\nThe Homeless box on the State Residency evidence must always be No.\n\n- Residential Address: Enter the county or tribe general delivery or agency address.\n\n- Mailing Address: Enter the reported mailing address or enter the county or tribe general delivery or agency address.\n\n### Excluded Time Facility\n\nUpdate only the mailing address to the facility if the enrollee is the only applicant on the case. **Do not** edit:\n\n- Residential address.\n\n- FRA.\n\n**Note:** For individuals in excluded time facilities or receiving excluded time services, the county of financial responsibility is the county where the person lived immediately before the excluded time began.\n\n### Safe at Home (SAH)\n\n- Residential Address: Enter the agency’s mailing address for the county where the Safe at Home (SAH) participant physically resides from the [DHS-5207](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-5207-ENG) for all household members.\n\n- Mailing Address:\n\n- Entered the SAH address exactly as follows:\n\n> Street 1: Enter Lot XXXXXX  \n> Street 2: Enter PO Box 17370  \n> Apt/Suite: Leave blank  \n> City: Saint Paul  \n> County: Ramsey  \n> State: Minnesota  \n> Zip: 55117\n\n**Note:** If updating the SAH address due to a Change in Circumstance (CIC), use the two step process outlined in the [METS Change in Circumstance Reporting Safe at Home Participation](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-0321#METSChangeinCircumstanceReportingSAH) section of the [Safe at Home](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-0321) procedure.\n\n### Care of (C/O) Mailings\n\nTo ensure proper MMIS interfacing, use both Street 1 and Street 2 fields:\n\n> Street 1: C/O First Name and Last Name.  \n> Street 2: Address of the care-of person.\n\n- If the C/O address includes an apartment, enter the apartment number after the Street 2 address. Example: 134 Main Street \\# 102.\n\n> Apt/Suite: Leave blank.  \n> City: City of the care-of person.  \n> County: County of the care-of person.  \n> State: State of the care-of person.  \n> Zip: Zip Code of the care-of person."},{"chunk_id":"onesource:ONESOURCE-17021402#page-contents","heading":"Page Contents","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-17021402#page-contents","context":"OneSource > ONESOURCE-17021402 Add or Edit Addresses Evidence > Page Contents","text":"## Page Contents\n\n[Addresses Evidence Overview](#Address_Evidence_Overview)  \n[Address Correction](#Address_Correction)  \n[Processing an Address Change Received from a PRISM Inbound Data Task](#PRISMInbound)  \n[Required Steps Before Any Addresses Evidence Action](#Required_Steps_Before_Any_Address)  \n[End Residential Address on IC](#End_Residential)  \n[Add New Residential Address on IC](#Add_Residential)  \n[End Mailing Address on IC](#End_Mailing)  \n[Add New Mailing Address on IC](#Add_Mailing)  \n[Post Address Update Actions](#Post_Address_Update_Actions)"},{"chunk_id":"onesource:ONESOURCE-17021402#addresses-evidence-overview","heading":"Addresses Evidence Overview","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-17021402#addresses-evidence-overview","context":"OneSource > ONESOURCE-17021402 Add or Edit Addresses Evidence > Addresses Evidence Overview","text":"## Addresses Evidence Overview\n\nBoth METS and MMIS have character limits that affect how addresses print on notices.\n\n- Street Address Line 1 in METS: 22 characters (including spaces).\n\n- Street Address Line 2 plus Apt/Suite combined in METS: 22 characters (including spaces).\n\nThese limits ensure addresses print correctly on MMIS generated notices.\n\n**Notes:**\n\n- Each case member must have a residential address.\n\n&nbsp;\n\n- If there is a deceased member still included in the household size because of tax filing household, the residential address will also need to be updated for this member for the changes to interface correctly.\n\n&nbsp;\n\n- The application filer must have a mailing address.\n\n  - The application filer is often, but not always, the Primary Applicant.\n\n  - Confirm by reviewing the Application Filer evidence.\n\n- The residential and mailing addresses on the Integrated Case (IC) must match the Person Record Addresses evidence."},{"chunk_id":"onesource:ONESOURCE-17021402#address-correction","heading":"Address Correction","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-17021402#address-correction","context":"OneSource > ONESOURCE-17021402 Add or Edit Addresses Evidence > Address Correction","text":"## Address Correction\n\nFollow [Correct a Mailing or Residential Address](https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-17021483) in the following situations:\n\n- Address correction for a tax dependent living outside of the United States.\n\n- Remove punctuation or adding missing information (City, State, Zip) in residential or mailing address evidence."},{"chunk_id":"onesource:ONESOURCE-17021402#processing-an-address-change-received-from-a-prism-inbound-data-task","heading":"Processing an Address Change Received from a PRISM Inbound Data Task","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-17021402#processing-an-address-change-received-from-a-prism-inbound-data-task","context":"OneSource > ONESOURCE-17021402 Add or Edit Addresses Evidence > Processing an Address Change Received from a PRISM Inbound Data Task","text":"## Processing an Address Change Received from a PRISM Inbound Data Task\n\nPRISM uses the validated Mailing Address as both the mailing and residential address unless the enrollee reports otherwise.\n\n- If the Parent/Caretaker residential address is different from the PRISM mailing address, METS will receive two separate tasks for each address type.\n\n- If PRISM task is only for the Parent/Caretaker or Absent Parent Mailing Address, update both the mailing and residential addresses using the mailing address.\n\nContact the Parent/Caretaker (**do not** contact the Absent Parent) when:\n\n- The PRISM address is a PO Box.\n\n&nbsp;\n\n- **Do not** use a PO Box as a residential address.\n\n- Contact the enrollee to confirm the residential address before making changes.\n\n&nbsp;\n\n- The Parent/Caretaker has different mailing and residential addresses.\n\n&nbsp;\n\n- Confirm whether the new address applies to both or only to mailing.\n\n&nbsp;\n\n- The current address is a SAH address.\n\n&nbsp;\n\n- Confirm whether the enrollee is still participating in SAH before updating any address information."},{"chunk_id":"onesource:ONESOURCE-17021402#required-steps-before-any-address-evidence-action","heading":"Required Steps Before Any Address Evidence Action","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-17021402#required-steps-before-any-address-evidence-action","context":"OneSource > ONESOURCE-17021402 Add or Edit Addresses Evidence > Required Steps Before Any Address Evidence Action","text":"## Required Steps Before Any Address Evidence Action\n\nComplete the following steps before adding or ending any Residential or Mailing Address evidence on the IC to ensure the responsible county and related evidence are accurate before changes are made.\n\n1.  Review the [METS Pre-CIC Checklist (PDF)](https://www.dhs.state.mn.us/main/groups/secure/documents/pub/onesource-08013.pdf) to determine if the CIC can be processed before continuing.\n\n2.  Open the [Person Record](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-17021707) Addresses evidence for each household member and make sure the preferred box is not selected. Select Save to close, even if no changes have been made.\n\n3.  Review the [Evidence Dashboard](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-17021703) for existing FRA evidence on the IC for all household members to confirm it is correct for the current residential address information:\n\n> **Note:** Refer to [EPM 2.1.2.3 County Residency](http://hcopub.dhs.state.mn.us/epm/2_1_2_3.htm) to determine the county of financial responsibility.\n\n1.  Continue to next the step if the FRA evidence is correct.\n\n2.  Update FRA evidence using [Add, Edit or Correct Financially Responsible Agency Evidence](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-17021460) and [Apply](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-17021446) FRA evidence changes if incorrect. Then continue with the address update steps.\n\n&nbsp;\n\n4.  Follow the applicable procedure(s) below:\n\n> [End Residential Address on IC](#End_Residential)  \n> [Add New Residential Address on IC](#Add_Residential)  \n> [End Mailing Address on IC](#End_Mailing)  \n> [Add New Mailing Address on IC](#Add_Mailing)"},{"chunk_id":"onesource:ONESOURCE-17021402#end-residential-address-on-ic","heading":"End Residential Address on IC","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-17021402#end-residential-address-on-ic","context":"OneSource > ONESOURCE-17021402 Add or Edit Addresses Evidence > End Residential Address on IC","text":"## End Residential Address on IC\n\n1.  Navigate to the Evidence Dashboard.\n\n2.  Select Addresses Evidence.\n\n3.  Select the toggle button for the application filer’s active residential evidence.\n\n4.  Select the Options button to the right of the evidence and Select Edit to open the Addresses pop-up window.\n\n5.  Edit only the following fields:\n\n&nbsp;\n\n1.  Received Date: Today’s date.\n\n2.  Change Reason: Select the appropriate reason. Select Inbound PRISM Data if the change is from a PRISM task.\n\n3.  To: Yesterday’s date.\n\n4.  Preferred: **Do not** check, uncheck if previously checked.\n\n5.  Inbound Data From: Select PRISM if change is from a PRISM task.\n\n6.  Apply Evidence to Other Case Participants: Select the case participants that have the address change.\n\n&nbsp;\n\n6.  Select Save.\n\n7.  Repeat for all applicable household members.\n\n8.  Refresh the screen and confirm the information is correct."},{"chunk_id":"onesource:ONESOURCE-17021402#add-new-residential-address-on-ic","heading":"Add New Residential Address on IC","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-17021402#add-new-residential-address-on-ic","context":"OneSource > ONESOURCE-17021402 Add or Edit Addresses Evidence > Add New Residential Address on IC","text":"## Add New Residential Address on IC\n\n1.  Select Addresses evidence on the Evidence Dashboard.\n\n2.  Select the Options button and select New. This brings up a New Addresses pop-up window.\n\n3.  Edit the following fields:\n\n    1.  Received Date: Today’s date.\n\n> **Note:** If adding this evidence as part of another procedure, use the Received Date determined in the main parent procedure.\n\n2.  Case Participants: Select the case participants that have the address change.\n\n3.  Type: Select Residential.\n\n4.  From: Today’s date.\n\n5.  Apt/Suite: Enter the “#” symbol, followed by a space and the apartment number or suite number.\n\n6.  Street 1: Enter the first line of the street address. **Do not** enter symbols or characters, except as noted.\n\n7.  Street 2: Enter the second line of the street address.\n\n> **Note:** The “/” sign is allowable in the Street 1 and Street 2 fields ONLY. Fractional addresses must contain the “/” symbol in order to properly interface to MMIS.\n>\n> Examples: 134 ½ Main Street, 25 W 36 ½ Street, C/O John Smith.\n\n8.  City: Enter the City.\n\n9.  County: Select the County from the drop-down box. If the state is not Minnesota, select Out of State.\n\n10. State: Select the State from the drop-down box.\n\n11. Zip: Enter the Zip Code.\n\n12. Country: Select the Country from the drop-down list.\n\n13. Inbound Data From: Select PRISM if change is from a PRISM task. Otherwise leave blank.\n\n&nbsp;\n\n4.  Select Save.\n\n5.  Repeat for all applicable household members.\n\n6.  Refresh the screen and confirm the information is correct."},{"chunk_id":"onesource:ONESOURCE-17021402#end-mailing-address-on-ic","heading":"End Mailing Address on IC","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-17021402#end-mailing-address-on-ic","context":"OneSource > ONESOURCE-17021402 Add or Edit Addresses Evidence > End Mailing Address on IC","text":"## End Mailing Address on IC\n\n1.  Select the toggle button for the mailing Addresses evidence to be ended on the Addresses evidence.\n\n2.  Select the Options button to the right of the current mailing Addresses evidence.\n\n3.  Select Edit. This will bring up the Edit Addresses pop-up window.\n\n4.  Edit only the following fields:\n\n&nbsp;\n\n1.  Received Date: Today’s date.\n\n2.  Change Reason: Select the appropriate reason. Select Inbound PRISM Data if the change is from a PRISM Task.\n\n3.  To: Yesterday’s date.\n\n4.  Preferred: Uncheck if previously checked.\n\n5.  Inbound Data From: Select PRISM if change is from a PRISM task.\n\n&nbsp;\n\n5.  Select Save.\n\n6.  Refresh the screen and confirm the information is correct."},{"chunk_id":"onesource:ONESOURCE-17021402#add-new-mailing-address-on-ic","heading":"Add New Mailing Address on IC","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-17021402#add-new-mailing-address-on-ic","context":"OneSource > ONESOURCE-17021402 Add or Edit Addresses Evidence > Add New Mailing Address on IC","text":"## Add New Mailing Address on IC\n\n1.  Select Addresses evidence on the Evidence Dashboard.\n\n2.  Select the Options button.\n\n3.  Select New. This brings up a New Addresses pop-up window.\n\n4.  Edit only in the following fields.\n\n&nbsp;\n\n1.  Received Date: Today’s date.\n\n> **Note:** If adding this evidence as part of another procedure, use the Received Date determined in the main parent procedure.\n\n2.  Case Participants: Select only the application filer.\n\n3.  Type: Select Mailing.\n\n4.  From: Today’s date.\n\n5.  Apt/Suite: Enter the “#” symbol, followed by a space and the apartment number or suite number.\n\n6.  Street 1: Enter the first line of the street address. **Do not** enter symbols or characters, except as noted.\n\n7.  Street 2: Enter the second line of the street address.\n\n> **Note:** The “/” sign is allowable in the Street 1 and Street 2 fields ONLY. Fractional addresses must contain the “/” symbol in order to properly interface to MMIS.\n>\n> Examples: 134 ½ Main Street, 25 W 36 ½ Street, C/O John Smith.\n\n8.  City: Enter the City.\n\n9.  County: Select the County from the drop-down box. If the state is not Minnesota, select Out of State.\n\n10. State: Select the State from the drop-down box.\n\n11. Zip: Enter the Zip Code.\n\n12. Country: Select the Country from the drop-down list.\n\n13. Inbound Data From: Select PRISM if change is a result of a PRISM task.\n\n&nbsp;\n\n5.  Select Save.\n\n6.  Refresh the screen and confirm the information is correct."},{"chunk_id":"onesource:ONESOURCE-17021402#post-address-update-actions","heading":"Post Address Update Actions","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-17021402#post-address-update-actions","context":"OneSource > ONESOURCE-17021402 Add or Edit Addresses Evidence > Post Address Update Actions","text":"## Post Address Update Actions\n\n1.  Complete the [Edit State Residency Evidence](https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-17021470) procedure if the new address is in a different county or if updating an address before case closure for whereabouts unknown. If no county change, continue to the next step.\n\n2.  Return to the main parent procedure to complete the instructions if directed here from another ONEsource procedure, otherwise continue below.\n\n3.  Complete the [Projected Annual Income: Case Processing October-December](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-1731) procedure if processing during those months.\n\n4.  Ensure the correct evidences are in edit.\n\n5.  Return to the IC and [Apply](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-17021446) the evidence changes.\n\n6.  Continue to the next step if no items to verify are created. Follow steps below when there are items to verify:\n\n&nbsp;\n\n1.  And the agency has acceptable proofs, clear the verification following the [Add Proof to a Verification Item](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-180301) procedure and continue to the next step. For more information on acceptable verifications or timelines, refer to the [EPM](http://hcopub.dhs.state.mn.us/epm/home.htm). Continue to the next step after all verifications are cleared.\n\n2.  And the agency does not have acceptable proofs to clear the outstanding verification, send a [Request for Information (RFI)](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3271-ENG) (DHS-3271) to request the required proof. [Add](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-17021306) a Case Note describing the actions taken. This ends the process.\n\n&nbsp;\n\n7.  Review the Addresses evidence on each household member’s [Person Record](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-17021707) to confirm the correction updated properly. If the correction did not update as expected, manually update the evidence.\n\n> **Note:** The application filer’s person record must have an active residential address and an active mailing address. All other household members must only have an active residential address.\n\n1.  End the residential address for each household member and the mailing address for the application filer effective the day before the address change:\n\n&nbsp;\n\n1.  Select the Evidence Tab, select the Options button and select Edit.\n\n2.  Complete the fields listed below:\n\n&nbsp;\n\n1.  Received Date: Date of address change.\n\n2.  Change Reason: Reported by enrollee.\n\n3.  To: Enter the day before the Date of address change, application, or case re-entry date.\n\n4.  Preferred: **Do not** check, uncheck if previously checked.\n\n5.  Select Save.\n\n&nbsp;\n\n2.  Add the new residential address for all household members and the mailing address for the application filer for the date of the address change. Select New and select Addresses:\n\n&nbsp;\n\n1.  Received Date: Date of address change.\n\n2.  Type: Select address type.\n\n3.  From: Same as Received Date.\n\n4.  Apt/Suite: Enter the “#” symbol, followed by a space and the apartment number or suite number.\n\n5.  Street 1: Enter the correct first line of the street address. **Do not** enter symbols or characters, except as noted.\n\n6.  Street 2: Enter the correct second line of the street address.\n\n> **Note:** The “/” sign is allowable in the Street 1 and Street 2 fields ONLY. Fractional addresses must contain the “/” symbol to properly interface to MMIS.\n>\n> Examples: 134 ½ Main Street, 25 W 36 ½ Street, C/O John Smith.\n\n7.  City: Enter the City.\n\n8.  County: Select the County from the drop-down box. If the state is not Minnesota, select Out of State.\n\n9.  State: Select the State from the drop-down box.\n\n10. Zip: Enter the Zip Code.\n\n11. Country: Select the Country from the drop-down list.\n\n12. Select Save.\n\n&nbsp;\n\n8.  Follow the [Actions to Complete a Change in Circumstance (CIC)](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-08041) procedure."}]},{"id":"onesource:ONESOURCE-17021470","number":"ONESOURCE-17021470","title":"Edit State Residency Evidence","parent":"2","breadcrumb":"ONESOURCE-17021470 Edit State Residency Evidence","summary":"Use this procedure to edit State Residency evidence on an Integrated Case (IC) in METS, to make a correction, or when instructed by a parent procedure.","effective_date":"2026-04-02","last_modified":"2026-10-08T20:46:40.364509+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-17021470","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/onesource/ONESOURCE-17021470","official_origin":"https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-17021470","legal_citations":[],"chunks":[{"chunk_id":"onesource:ONESOURCE-17021470#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-17021470","context":"OneSource > ONESOURCE-17021470 Edit State Residency Evidence","text":"Use this procedure to edit State Residency evidence on an Integrated Case (IC) in METS, to make a correction, or when instructed by a parent procedure.\n\n**Note: Do not** select the whereabouts unknown checkbox for an enrollee that has active pregnancy or postpartum MA eligibility on the IC.\n\nThis system instruction is a step in the following procedures:\n\n[Add or Edit Addresses Evidence](https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-17021402)  \n[End Eligibility - Whereabouts Unknown for MA and MinnesotaCare](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-080307)  \n[Close Case - New Residential Address (Out of State)](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-080306)"},{"chunk_id":"onesource:ONESOURCE-17021470#steps-to-edit-state-residency-evidence","heading":"Steps to Edit State Residency Evidence","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-17021470#steps-to-edit-state-residency-evidence","context":"OneSource > ONESOURCE-17021470 Edit State Residency Evidence > Steps to Edit State Residency Evidence","text":"## Steps to Edit State Residency Evidence\n\n1.  Review the [*METS Pre-CIC Checklist (PDF)*](https://www.dhs.state.mn.us/main/groups/secure/documents/pub/onesource-08013.pdf) if processing a CIC outside of renewal to determine if the CIC can be processed.\n\n2.  Navigate to the Evidence Dashboard.\n\n3.  Select the existing State Residency evidence.\n\n4.  Select the Toggle button for the State Residency evidence needing an edit.\n\n5.  Select the Options button to the right of the Change Summary information to open the drop-down menu.\n\n6.  Select Edit from the drop down-menu.\n\n7.  Complete only the following fields:\n\n&nbsp;\n\n1.  Received Date:\n\n&nbsp;\n\n1.  If making a correction, do not change.\n\n> **Note:** If the enrollee’s eligibility was previously ended for whereabouts unknown and whereabouts are confirmed to be in-state prior to the effective date of program closure, process the confirmation as a correction.\n\n2.  If editing, enter today’s date.\n\n> **Note:** If State Residency Evidence already exists for a member who was previously not a state resident and they request to be an applicant, use the first day of the month they became a resident, or the date they requested to be an applicant, whichever is later. Retro months must be determined in MAXIS.\n\n2.  Change Reason: Select the appropriate response based on who reported the change.\n\n3.  Effective Date of Change: Same as Received Date.\n\n4.  Start Date: Do not change.\n\n5.  State Residency Check Box:\n\n&nbsp;\n\n1.  Select the check box if the enrollee resides in Minnesota or is temporarily absent from Minnesota.\n\n2.  Uncheck the box if the enrollee does not reside in Minnesota.\n\n> **Note:** Keep the State Residency box checked for the following MA enrollees unless the household confirms the enrollee is no longer a resident of Minnesota:\n\n- Pregnant persons, including postpartum period.\n\n- Children under 21, including Former Foster Care Youth.\n\n6.  County: Enrollee’s County of residence.\n\n&nbsp;\n\n1.  Select the enrollee’s county of residence from the drop-down list if they live in Minnesota.\n\n2.  Select *Out of State* if the enrollee is not a state resident or has moved out of state.\n\n&nbsp;\n\n7.  Homeless: The homeless box should always be No.\n\n8.  Does the case participant plan to make MN their home?: Select Yes or No.\n\n9.  Does the case participant enter MN with a job commitment or to seek employment?: Select Yes or No.\n\n10. Interstate Compact on Mental Health: Select *Not Applicable* from the drop-down list.\n\n11. North Dakota Agreement: This question applies only to Minnesota residents that enter a nursing home in North Dakota.\n\n&nbsp;\n\n1.  **Do not** update this field if the household member is in a nursing home in North Dakota and meets the qualifications to remain a Minnesota resident under the North Dakota Agreement.\n\n2.  Select “Other Resident under the North Dakota Agreement” if the household member is in a nursing home in North Dakota but does not meet the qualifications to remain a Minnesota resident under the North Dakota Agreement.\n\n3.  Select “Not Applicable” if the enrollee is not residing in a nursing home in North Dakota.\n\n&nbsp;\n\n12. Recently moved to MN?: Select Yes or No.\n\n13. Residence Reason: Leave this field blank unless an error indicates “*Residence Reason is not a value”* then select “*Residing with Parent or Caretaker in the State*” from the drop-down list.\n\n14. Are you visiting Minnesota to get medical care or for personal reasons?: Select Yes or No.\n\n15. Whereabouts Unknown Checkbox:\n\n&nbsp;\n\n1.  Leave blank if the household member has active pregnancy or postpartum MA eligibility.\n\n2.  Leave blank, or uncheck this box, if the household member’s whereabouts are confirmed.\n\n3.  Select this checkbox for MA/MinnesotaCare eligible enrollees and non-applicants whose whereabouts are unknown. Checking this box will not end eligibility for enrollees eligible for MA as Children under age 21, including Former Foster Care Youth (MA-FFY). **Do not** check the box for a child under age 21 with an eligibility type of PX. If the enrollee is eligible as a Pregnant Person checking this box will end eligibility.\n\n> **Note:** If the checkbox is not present, and eligibility is being ended due to Whereabouts Unknown, select Save to populate and then select the checkbox.\n\n16. Select Save.\n\n&nbsp;\n\n8.  Return to the main, parent procedure to complete the instructions, if directed here from another ONEsource procedure. Otherwise continue below.\n\n9.  Ensure that all necessary CICs have been acted on and the correct evidence items are in-edit.\n\n10. Reject any [Incoming Evidence.](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-17021476)\n\n11. Return to the IC and [Apply](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-17021446) the evidence changes.\n\n12. Review Items to Verify. If no Items to Verify are created, continue to the next step. If Items to Verify are required:\n\n&nbsp;\n\n1.  And the agency has acceptable proofs, clear the verification following the [Add Proof to a Verification Item](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-180301) procedure and continue to the next step. For more information on acceptable verifications or timelines, refer to the [EPM](https://hcopub.dhs.state.mn.us/epm/home.htm). Continue to the next step after all verifications are cleared.\n\n2.  And the agency does not have acceptable proofs to clear the outstanding verification, send a [Request for Information (RFI) (DHS-3271)](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3271-ENG) to request the required proof. [Add](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-17021306) a Case Note describing the actions taken. This ends the process.\n\n&nbsp;\n\n13. Follow the [Actions to Complete a CIC](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-08041) procedure."}]},{"id":"onesource:3","number":"3","title":"System Wizards","parent":null,"breadcrumb":"3 System Wizards","summary":"Procedures that use METS wizards to automate updates.","effective_date":null,"last_modified":"2026-10-08T20:46:40.364509+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/onesource/3","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/onesource/3","official_origin":null,"legal_citations":[],"chunks":[{"chunk_id":"onesource:3#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/onesource/3","context":"OneSource > 3 System Wizards","text":"Procedures in the **System Wizards** category.\n\nProcedures that use METS wizards to automate updates."}]},{"id":"onesource:ONESOURCE-08011","number":"ONESOURCE-08011","title":"Address Change Wizard","parent":"3","breadcrumb":"ONESOURCE-08011 Address Change Wizard","summary":"Use the Address Change Wizard to complete an address change when:","effective_date":"2026-09-29","last_modified":"2026-10-08T20:46:40.364509+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-08011","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/onesource/ONESOURCE-08011","official_origin":"https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-08011","legal_citations":[],"chunks":[{"chunk_id":"onesource:ONESOURCE-08011#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-08011","context":"OneSource > ONESOURCE-08011 Address Change Wizard","text":"Use the Address Change Wizard to complete an address change when:\n\n- Adding new Addresses evidence.\n\n- Ending current Addresses evidence.\n\n- Accepting PRISM Inbound Data for a Parent/Caretaker address change.\n\nFor address updates reported by the United States Postal Service (USPS) or the managed care organization (MCO) on the (DHS-8354), follow the [Process METS Returned Mail](https://www.dhs.state.mn.us/main/groups/secure/documents/pub/ONESOURCE-170225), [METS Returned Renewal Mail](https://www.dhs.state.mn.us/main/groups/secure/documents/pub/ONESOURCE-15025), or the [METS Close Case - New Residential Address Out of State](https://www.dhs.state.mn.us/main/groups/secure/documents/pub/ONESOURCE-080306) procedure first to ensure information is complete prior to moving to this as a sub-procedure.\n\n**Notes:**\n\n- If returned mail indicates a PO Box as the forwarding address, contact the household to confirm the current address information before completing this procedure. **Do not** use a PO Box as a residential address.\n\n- The Wizard will automatically update Financially Responsible Agency (FRA) evidence when the new residential address is in a different county and there is at least one household member on the case with Medical Assistance (MA) eligibility.\n\n  - The Wizard will also automatically update State Residency evidence when the new residential address is in a different county.\n\n  - If existing Addresses, FRA, or State Residency evidence(s) are in edit, the Wizard will display an error message and will not start.\n\n    - Discard the in edit evidence and re-launch Wizard to proceed with using the Wizard.\n\n- When the Wizard is completed, the Residential Address changes will apply to all selected case participants, and the mailing address will apply only to the Application Filer.\n\n  - If there is a deceased member still included in the household size because of tax filing household, the residential address will also need to be updated for this member for\n\n  - For a mailing address change, the Application Filer is the only one that can be selected.\n\n- To prevent possible return mail, the United States Postal Service (USPS) [Zip Code Look-up](https://gcc02.safelinks.protection.outlook.com/?url=http%3A%2F%2Fwww.usps.com%2Fzip4&data=05%7C02%7CChristopher.P.Bly%40state.mn.us%7C8b819051cf41403fe8b208ddc538b398%7Ceb14b04624c445198f26b89c2159828c%7C0%7C0%7C638883569510740471%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=ypu8kSqZ%2FZ19AJ%2F579oeidFQDBk8geBOeIyYVrM19gY%3D&reserved=0) can be used to validate an enrollee’s address before updating the evidence.\n\nIf unable to complete all of the steps of the Wizard, discard the in edit evidence(s) created by the Wizard and manually update following the [Add or Edit Addresses Evidence](https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-17021402) procedure."},{"chunk_id":"onesource:ONESOURCE-08011#special-circumstances","heading":"Special Circumstances","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-08011#special-circumstances","context":"OneSource > ONESOURCE-08011 Address Change Wizard > Special Circumstances","text":"## Special Circumstances\n\n### Pending Application\n\nWhen a person reports a change of address before the application process has been completed, the address change can only be processed after eligibility has been determined with active Product Delivery Case(s) (PDCs). **Do not** process an address change when all PDCs are in approved status or the application has not been acted on or loaded by the agency.\n\nTo send mail to the correct address, follow [Add or Edit Addresses Evidence](https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-17021402) procedure to enter the new address as the mailing address. Once eligibility is determined, process the complete address change using the wizard.\n\n### Homeless\n\nEnter the residential address using either the county General Delivery or county Agency address. Enter the mailing address if reported or enter the county General Delivery or county Agency address.\n\n### Excluded Time Facility\n\n**Do not** use this procedure if updating an address for an enrollee in an excluded time facility. Follow the [Add or Edit Addresses Evidence](https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-17021402) procedure.\n\n### Safe at Home (SAH)\n\nUpdate the Residential address to reflect the agency’s mailing address in which the Safe at Home (SAH) participant actually resides using the address listed on the [DHS-5207](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-5207-ENG) for all household members. Mailing address evidence must be entered as follows:\n\nStreet 1: Enter Lot XXXXXX  \nStreet 2: Enter PO Box 17370  \nApt/Suite: Leave blank  \nCity: Saint Paul  \nCounty: Ramsey  \nState: Minnesota  \nZip: 55117\n\n### Care Of (C/O)\n\nIf a C/O address is reported, for the address to properly interface to MMIS, the Street 1 and Street 2 fields must be used.\n\nStreet 1: Enter C/O First Name and Last Name.  \nStreet 2: Enter address for the care of person.\n\n**Note:** If the C/O address has an apartment enter the apartment after the Street 2 address.\n\n> Example: 134 Main Street \\# 102.\n\nApt/Suite: Leave blank.  \nCity: Enter city of C/O address.  \nCounty: Enter County of C/O address.  \nState: Enter State of C/O address.  \nZip: Enter Zip Code of C/O address."},{"chunk_id":"onesource:ONESOURCE-08011#procedure-contents","heading":"Procedure Contents","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-08011#procedure-contents","context":"OneSource > ONESOURCE-08011 Address Change Wizard > Procedure Contents","text":"## Procedure Contents\n\n[Prior to Updating Addresses Evidence](#Prior_To_Updating)  \n[PRISM Inbound Data for Parent/Caretaker Address Change](#PRISM)  \n[Launch the Address Change Wizard](#Launch)"},{"chunk_id":"onesource:ONESOURCE-08011#prior-to-updating-addresses-evidence","heading":"Prior to Updating Addresses Evidence","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-08011#prior-to-updating-addresses-evidence","context":"OneSource > ONESOURCE-08011 Address Change Wizard > Prior to Updating Addresses Evidence","text":"## Prior to Updating Addresses Evidence\n\n1.  Review the [METS Pre-CIC Checklist (PDF)](https://www.dhs.state.mn.us/main/groups/secure/documents/pub/onesource-08013.pdf) to determine if the change in circumstance (CIC) can be processed before continuing.\n\n2.  [Navigate](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-17021707) to the Person Record and select the Evidence tab.\n\n3.  Select the Options button on the right of the Addresses row of the residential address and select Edit.\n\n4.  Confirm the preferred box is not selected. Select Save to close even if no changes have been made.\n\n5.  Repeat steps 2-4 for each household member, continue below once all household members have been added."},{"chunk_id":"onesource:ONESOURCE-08011#prism-inbound-data-for-parentcaretaker-address-change","heading":"PRISM Inbound Data for Parent/Caretaker Address Change","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-08011#prism-inbound-data-for-parentcaretaker-address-change","context":"OneSource > ONESOURCE-08011 Address Change Wizard > PRISM Inbound Data for Parent/Caretaker Address Change","text":"## PRISM Inbound Data for Parent/Caretaker Address Change\n\nPRISM uses the validated Mailing Address as the enrollee’s mailing and residential address, unless the enrollee notifies them otherwise.\n\n- If the residential address is different from the mailing address in PRISM, METS will receive two separate tasks for each address type.\n\n- If PRISM Inbound Data task is only for the Parent/Caretaker Mailing Address, update both the mailing and residential addresses with the mailing address when processing the task.\n\n- Review for the following types of PRISM Inbound Data task address changes:\n\n&nbsp;\n\n- If the Parent/Caretaker Mailing Address comes over as a P.O. Box, **do not** use this as the residential address. Contact the enrollee to confirm the residential address before making changes.\n\n- If currently there are different mailing and residential addresses, contact the enrollee to confirm if the new address is for both the mailing and residential address or just for mailing.\n\n- If the current address is a SAH address with a designated county as the residential address and a designated PO Box for their mailing address, contact the enrollee to confirm they are still part of the SAH program before updating any address information."},{"chunk_id":"onesource:ONESOURCE-08011#launch-the-address-change-wizard","heading":"Launch the Address Change Wizard","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-08011#launch-the-address-change-wizard","context":"OneSource > ONESOURCE-08011 Address Change Wizard > Launch the Address Change Wizard","text":"## Launch the Address Change Wizard\n\n6.  Navigate to the [Evidence Dashboard](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-17021703).\n\n7.  Select Addresses evidence.\n\n8.  Select and open the Option drop-down menu in the upper right corner.\n\n9.  Select Address Change option from the drop-down menu. This opens the Address Change Wizard pop-up window.\n\n### Wizard Step 1: Add New Address\n\n**Notes:**\n\n- Both METS and MMIS have a limited number of characters that will print on notices. The Street Address 1 in METS can have 22 characters (including spaces) and the combination of Street Address 2 & Apt/Suite fields in METS keep to 22 characters (including spaces). This will allow the address to print properly for notices that go out from MMIS.\n\n- The Address Change Wizard only requires 3 characters for Street 1 field to be considered a complete address and allows the worker to move forward to the second step of the wizard, review all fields before continuing.\n\n- **Do not** enter symbols or characters that are not alphanumeric, such as a hyphen or period.\n\n10. Edit only the following fields:\n\n&nbsp;\n\n1.  Received Date: Pre-populated with today’s date.\n\n2.  Case Participants: Select the household members included in the change. Select just the Application Filer if only changing the mailing address.\n\n> **Note:** If there is a deceased member still included in the household size because of tax filing household, the residential address will also need to be updated for this member for the changes to interface correctly.\n\n3.  Type: Select Residential or Mailing. Select both if the address is the same.\n\n4.  From: Pre-populated with today’s date.\n\n5.  Apt/Suite: Enter the “#” symbol, followed by a space and the apartment number or suite number, if applicable.\n\n6.  Street 1: Enter the street address for newly reported address.\n\n7.  Street 2: If needed.\n\n8.  City: Enter the city for newly reported address.\n\n9.  County: Select the county for newly reported address. If the state is not Minnesota, select Out of State.\n\n10. State: Select the state for the newly reported address.\n\n11. Zip: Enter new zip code.\n\n12. Country: Select the country for the newly reported address.\n\n13. Preferred: Unchecked is default. Leave unchecked.\n\n14. Inbound Data From: Select PRISM if change is from a PRISM task. Otherwise leave blank.\n\n&nbsp;\n\n11. Select Next to advance to the final step of the Address Change Wizard.\n\n### Wizard Step 2: End Existing Address\n\nCase evidence will not show as in edit until the Wizard process is complete. No fields in this step can be changed. Select Back to return to Wizard Step 1 to make changes if the entered information is incorrect or select Cancel to close and discard all entered data.\n\n12. Review and confirm the Received and End Dates for the addresses are correct.\n\n&nbsp;\n\n1.  Received Date: Pre-populated by the system using same Received Date entered in Step 1 of the Wizard.\n\n2.  End Date: Pre-populated by the system using the day before the From Date in Step 1 of the Wizard.\n\n3.  Case Participant: Pre-populated by the system to include only those household members selected for the change in Step 1 of the wizard.\n\n&nbsp;\n\n13. Select Finish at the bottom of the wizard pop-up window in Wizard Step 2.\n\n14. Confirm In Edit Addresses evidence changes are correct.\n\n&nbsp;\n\n1.  Open the Addresses evidence for each household member and confirm that the preferred box is not selected.\n\n2.  Select Save to close even if no changes have been made.\n\n&nbsp;\n\n15. Review the State Residency evidence on the in edit evidence panel to ensure the information was updated correctly if there was a change in the county of residence. If the information is not correct, manually update the in edit evidence with the new county before applying changes.\n\n16. Review Contact tab on the Integrated Case (IC) to ensure Notes were generated. The State Residency portion of the created Note should only appear if there was a change in the county of residence for the case members selected in the wizard. The case note should appear as follows:\n\n> Subject: Address Change Completed.  \n> Text: Address Change wizard updated Addresses evidence for the following members:  \n> \\<List of members in wizard\\>\n>\n> Address Change wizard updated State Residency evidence for the following members.  \n> \\<List of members in wizard\\>\n\n17. Return to the main parent procedure to complete the instructions if directed here from another ONEsource procedure. Otherwise continue below.\n\n18. Complete the [Projected Annual Income: Case Processing October-December](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-1731) procedure if processing during those months.\n\n19. Ensure that all necessary CICs have been acted on and the correct evidences are in edit.\n\n20. Return to the IC and [Apply](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-17021446) the evidence changes.\n\n21. Review items to verify. If no items to verify are created, continue to the next step. If items to verify are required:\n\n&nbsp;\n\n1.  And the agency has acceptable proofs, clear the verification following the [Add Proof to a Verification Item](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-180301) procedure and continue to the next step. For more information on acceptable verifications or timelines, refer to the [EPM](https://hcopub.dhs.state.mn.us/epm/home.htm). Continue to the next step after all verifications are cleared.\n\n2.  And the agency does not have acceptable proofs to clear the outstanding verification, send a [Request for Information (RFI)](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3271-ENG) (DHS-3271) to request the required proof. [Add](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-17021306) a Case Note describing the actions taken. This ends the process.\n\n&nbsp;\n\n22. Review the Addresses evidence on each household member’s Person Record to confirm the address changes updated correctly. If Person Record Addresses are correct, continue below to manually update if not correct. Update the mailing address for only the Application Filer.\n\n> **Note:** The Application Filer’s Person Record should have one active residential address and one active mailing address. All other household members should only have one active residential address.\n\n1.  End the residential Addresses on all household members’ Person Records along with mailing Addresses evidence for the Application Filer for the day before the date of the address change:\n\n&nbsp;\n\n1.  Select the Evidence Tab, select the Options button for the residential or mailing Addresses evidence, and select Edit.\n\n2.  Complete only the fields listed below in the Edit Addresses pop up window:\n\n&nbsp;\n\n1.  Received Date: Use today’s date.\n\n2.  Change Reason: Reported by Client.\n\n3.  To: Enter the day before the Date of address change, application, or case re-entry date.\n\n4.  Preferred: **Do not** check, uncheck if previously checked.\n\n5.  Select Save.\n\n6.  Repeat for the Mailing address for the application filer and for the Residential address evidences for all household members.\n\n&nbsp;\n\n2.  Add the new residential Addresses for all household members and mailing Addresses evidence for the application filer only on member Person Records using the date of the address change:\n\n&nbsp;\n\n1.  Select New button and select Addresses:\n\n&nbsp;\n\n1.  Received Date: Use today’s date.\n\n2.  Type: Select address type.\n\n3.  From: Same as Received Date.\n\n4.  Apt/Suite: Enter the “#” symbol, followed by a space and the apartment number or suite number, if applicable.\n\n5.  Street 1: Enter the correct first line of the street address. **Do not** enter symbols or characters, except as noted.\n\n6.  Street 2: Enter the correct second line of the street address, if applicable. **Do not** enter the apartment number or suite number in this field.\n\n> **Note:** The “/ ” sign is allowable in the Street 1 and Street 2 fields ONLY. Fractional addresses must contain the “/ ” symbol in order to properly interface to MMIS.\n>\n> Examples**:** 134 ½ Main Street, 25 W 36 ½ Street, C/O John Smith.\n\n7.  City: Enter the city.\n\n8.  County: Select the county from the drop-down box. If the state is not Minnesota, select Out of State.\n\n9.  State: Select the state from the drop-down box.\n\n10. Zip: Enter the zip code.\n\n11. Country: Select the country from the drop-down list.\n\n12. Select Save.\n\n&nbsp;\n\n23. Follow the [Actions to Complete a Change in Circumstance (CIC](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-08041)) procedure."}]},{"id":"onesource:4","number":"4","title":"Corrections and Exceptions","parent":null,"breadcrumb":"4 Corrections and Exceptions","summary":"Correcting data and handling special situations.","effective_date":null,"last_modified":"2026-10-08T20:46:40.364509+00:00","version":1,"url":"https://bot-corpus.mn-dhs.online/s/onesource/4","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/onesource/4","official_origin":null,"legal_citations":[],"chunks":[{"chunk_id":"onesource:4#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/onesource/4","context":"OneSource > 4 Corrections and Exceptions","text":"Procedures in the **Corrections and Exceptions** category.\n\nCorrecting data and handling special situations."}]},{"id":"onesource:ONESOURCE-17021483","number":"ONESOURCE-17021483","title":"Correct a Mailing or Residential Address","parent":"4","breadcrumb":"ONESOURCE-17021483 Correct a Mailing or Residential Address","summary":"Use this procedure to Correct Address Evidence in the following situations:","effective_date":"2026-07-17","last_modified":"2026-10-08T20:46:40.364509+00:00","version":2,"url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-17021483","markdown_url":"https://bot-corpus.mn-dhs.online/api/public/md/onesource/ONESOURCE-17021483","official_origin":"https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-17021483","legal_citations":[],"chunks":[{"chunk_id":"onesource:ONESOURCE-17021483#part-0","heading":null,"url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-17021483","context":"OneSource > ONESOURCE-17021483 Correct a Mailing or Residential Address","text":"Use this procedure to Correct Address Evidence in the following situations:\n\n- Tax Dependent Address Outside the U.S.: When a tax dependent resides outside the United States.\n\n- Minor Corrections: Removing punctuation or adding missing information (City, State, Zip) in residential or mailing address evidence.\n\nAll other address corrections should be completed using the [Add or Edit Addresses Evidence](https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-17021402) by ending the incorrect address evidence and adding new address evidence with the correct address.\n\n**Notes:**\n\n- Both METS and MMIS have character limits that affect how addresses print on notices.\n\n- Street Address Line 1 in METS: 22 characters (including spaces).\n\n- Street Address Line 2 plus Apt/Suite combined in METS: 22 characters (including spaces).\n\n- These limits ensure addresses print correctly on MMIS generated notices.\n\n- To prevent return mail, validate addresses using the USPS [Zip Code Look-up](https://gcc02.safelinks.protection.outlook.com/?url=http%3A%2F%2Fwww.usps.com%2Fzip4&data=05%7C02%7CChristopher.P.Bly%40state.mn.us%7C8b819051cf41403fe8b208ddc538b398%7Ceb14b04624c445198f26b89c2159828c%7C0%7C0%7C638883569510740471%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=ypu8kSqZ%2FZ19AJ%2F579oeidFQDBk8geBOeIyYVrM19gY%3D&reserved=0) before updating evidence."},{"chunk_id":"onesource:ONESOURCE-17021483#steps-to-correct-a-mailing-or-residential-address","heading":"Steps to Correct a Mailing or Residential Address","url":"https://bot-corpus.mn-dhs.online/s/onesource/ONESOURCE-17021483#steps-to-correct-a-mailing-or-residential-address","context":"OneSource > ONESOURCE-17021483 Correct a Mailing or Residential Address > Steps to Correct a Mailing or Residential Address","text":"## Steps to Correct a Mailing or Residential Address\n\n1.  Review the [*METS Pre-CIC Checklist (PDF)*](https://www.dhs.state.mn.us/main/groups/secure/documents/pub/onesource-08013.pdf) to determine if the change in circumstance (CIC) can be processed.\n\n2.  Navigate to the [Evidence Dashboard](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-17021703).\n\n3.  Select the existing Addresses evidence.\n\n4.  Select the Toggle button for the Address evidence needing a correction.\n\n5.  Select the Options button to the right of the Change Summary information to open the drop-down menu.\n\n6.  Select Edit from the drop-down menu to open the Edit Addresses pop-up window.\n\n7.  Edit only the following fields of the pop-up window, as applicable:\n\n> **Note:** Do not enter symbols or characters, except as noted.\n\n1.  Change Reason: Entered in Error.\n\n2.  Apt/Suite: Enter the “#” symbol, followed by a space and the apartment number or suite number.\n\n3.  Street 1: Edit the first line of the street address.\n\n4.  Street 2: Edit the second line of the street address.\n\n> **Note:** The “/ \" sign is allowable in the Street 1 and Street 2 fields ONLY. Fractional addresses must contain the “/ \" symbol in order to properly interface to MMIS.\n>\n> Examples: 134 ½ Main Street, 25 W 36 ½ Street, C/O John Smith.\n\n1.  City: Edit the city.\n\n2.  County: Select the county from the drop-down. If the state is not Minnesota, select Out of State.\n\n3.  State: Select the state from the drop-down.\n\n4.  Zip: Edit the zip code.\n\n5.  Country: Select the country from the drop-down.\n\n6.  Preferred: Uncheck if previously checked.\n\n7.  Apply Evidence to Other Case Participants: Select the participants to whom this correction applies.\n\n8.  Select Save.\n\n9.  Refresh the screen and confirm the information is correct.\n\n&nbsp;\n\n8.  Return to the main parent procedure to complete the instructions, if directed here from another ONEsource procedure. Otherwise continue below.\n\n9.  Ensure that all necessary CICs have been acted on and the correct evidences are in edit.\n\n10. Return to the Integrated Case (IC) and [Apply](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-17021446) the evidence changes.\n\n11. If no items to verify are created, continue to the next step. If items to verify are required:\n\n&nbsp;\n\n1.  And the agency has acceptable proofs, clear the verification following the [Add Proof to a Verification Item](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-180301) procedure and continue to the next step. For more information on acceptable verifications or timelines, refer to the [EPM](http://hcopub.dhs.state.mn.us/epm/home.htm). Continue to the next step after all verifications are cleared.\n\n2.  And the agency does not have acceptable proofs to clear the outstanding verification, send a [Request for Information (RFI)](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3271-ENG) to request the required proof. [Add](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-17021306) a Case Note describing the actions taken. This ends the process.\n\n&nbsp;\n\n12. Review the Addresses evidence on each household member’s Person Record to confirm the correction updated properly. If the correction did not update as expected, manually update the evidence.\n\n> **Note:** The application filer’s person record must have an active residential address and an active mailing address. All other household members must only have an active residential address.\n\n1.  End the residential address for each household member and the mailing address for the application filer effective the day before the address change:\n\n&nbsp;\n\n1.  Select the Evidence Tab, select the Options button and select Edit.\n\n2.  Complete the fields listed below:\n\n&nbsp;\n\n1.  Received Date: Today’s date.\n\n2.  Change Reason: Reported by enrollee.\n\n3.  To: Enter the day before the address change, application, or case re-entry date.\n\n4.  Preferred: Do not check, uncheck if previously checked.\n\n5.  Select Save.\n\n&nbsp;\n\n2.  Add the new residential address for all household members and the mailing address for the application filer for the date of the address change. Select New and select Addresses:\n\n&nbsp;\n\n1.  Received Date: Today’s date.\n\n2.  Type: Select address type.\n\n3.  From: Same as Received Date.\n\n4.  Apt/Suite: Enter the “#” symbol, followed by a space and the apartment number or suite number.\n\n5.  Street 1: Enter the correct first line of the street address. Do not enter symbols or characters, except as noted.\n\n6.  Street 2: Enter the correct second line of the street address.\n\n> **Note:** The “/” sign is allowable in the Street 1 and Street 2 fields ONLY. Fractional addresses must contain the “/” symbol in order to properly interface to MMIS.\n>\n> Examples: 134 ½ Main Street, 25 W 36 ½ Street, C/O John Smith.\n\n7.  City: Enter the city.\n\n8.  County: Select the county from the drop-down box. If the state is not Minnesota, select Out of State.\n\n9.  State: Select the state from the drop-down box.\n\n10. Zip: Enter the zip code.\n\n11. Country: Select the country from the drop-down list.\n\n12. Select Save.\n\n&nbsp;\n\n13. Follow the [Actions to Complete a CIC](https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ONESOURCE-08041) procedure."}]}]}]}