What you need to apply online

Appendix A: Health Coverage from Jobs (DHS-6696D) (PDF)

https://edocs.dhs.state.mn.us/lfserver/Public/DHS-6696D-ENG

Find a certified navigator

https://enroll.mnsure.org/hix/help/search

[How to submit your documents]

tcm:1052-740867

Information and documents checklist

Some of the items on the checklist will be required for everyone applying. Other items on this list you only need to provide information or proof for if they apply to your household:

Identifying information for each person applying

  • Social Security Number (if available)
  • Date of birth
  • Driver’s license, Tribal ID or other photo ID
  • Non-U.S. citizens – Green Card (I-551), I-94, I-766

Income proof

  • Paystubs from past month
  • Last year’s 1040 tax form
  • W2
  • Documents for other income (Social Security, unemployment, self-employment, rental income, etc.)

Employer health coverage information (if they offer insurance, even if you aren’t enrolled)

  • Employer name and address
  • Employer Tax ID Number (EIN)
  • Employer contact person

Other health coverage details

  • Any other health insurance information for insurance you or any household members have available or are enrolled in so we can determine if these meet the minimum essential coverage criteria.

Employer health insurance – What to report

Report any employer insurance available to you, even if you’re not enrolled. Access to employer coverage can affect eligibility for MinnesotaCare.

If your employer offers you, or anyone in your household coverage, get these details from your employer. Use Appendix A: Health Coverage from Jobs (DHS-6696D) (PDF) to help you collect this information:

  • Plan type
  • Employee-only coverage premium cost
  • Family coverage premium cost
  • Whether the plan meets the minimum essential coverage criteria (see Minimum Essential Coverage)
Appendix A: Health Coverage from Jobs (DHS-6696D) (PDF)

How employer insurance can affect eligibility

Medical Assistance: You may still qualify if you are enrolled in or are offered employer insurance. In some cases, Medical Assistance can help pay for these premiums.

MinnesotaCare: If you’re enrolled in employer coverage you are not eligible for MinnesotaCare. If you have access to employer coverage and it’s affordable per federal criteria, you may not be eligible for MinnesotaCare.

Minimum essential coverage

Minimum essential coverage is a health plan that meets the Affordable Care Act’s minimum value standard. This means that it’s considered “affordable” per guidelines. Your employer can tell you whether your plan is considered minimum essential coverage.

Immigration status and documents

If you are not a U.S. citizen, be ready to select your immigration status and provide documentation for your selected status:

  • Green Card (I-551)
  • Arrival and departure record (I-94)
  • Employment authorization document (I-766)
  • Alien ID number
  • Document expiration dates
  • Other proof of status you may have

Have copies or clear photos of any immigration documents you use to verify your status.