---
id: "epm:2.2.4.1"
source: "Minnesota Health Care Programs Eligibility Policy Manual"
source_short: "EPM"
publisher: "Minnesota Department of Human Services"
section: "2.2.4.1"
title: "Health Care Delivery"
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"
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"
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"
---
# EPM 2.2.4.1 Health Care Delivery

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.

The enrollee’s county must educate them about managed care and the need to select a plan.
- MA-FCA enrollees have 30 days to choose a PMAP plan. After 30 days, a default plan is assigned.
- Enrollees choose a health plan based on what plans are available in their county of residence.
- Enrollees may receive services via fee-for-service providers before they are enrolled in a health plan.
- Enrollees must get services from the health plan's network of providers except in special circumstances.
- Some enrollees are not allowed to enroll in managed care.
- 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.

Detailed 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)

## Covered Services

The 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.

Services 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).

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.

## 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