Billing

Coverage and costs

Document portal

Eligibility

Enrolling in a plan

Finding a doctor

General questions

Medical Assistance

MinnesotaCare

Premiums

Renewing eligibility

Service denials and reductions

Does it matter when I apply?

Yes, the date we receive your application online or we get your paper application affects when your coverage can start. Coverage may start at any of these times:

• The first day of the month we get your application
• Up to three months before the month we get your application
• The month after your eligibility is approved
• The first day of the month after you pay your first premium, if you have one

What happens after I submit my application?

If you apply online, we usually tell you right away if you qualify. If you apply online or with a paper application and we need more information to decide if you can get coverage, you will get a letter in the mail telling you what information we need.

How will I know if I can get coverage?

If you apply online, we usually tell you right away if you or any household member:

• Can get coverage and if you will have to pay for it
• Cannot get coverage and why

You will also get a letter telling you if you and your family members qualify. The letter tells you how you can ask for a review of a decision if you do not agree with it.

If you apply with a paper application, we will send you a letter telling you if you or any household members:

• Can get coverage and if you will have to pay for it
• Cannot get coverage and why

The letter also tells you how to ask for a review of a decision, if you disagree.

What should I do about bills I get that I think my health plan should pay?

If you get a bill from a doctor's office, dental office, hospital or other health care provider, call the provider and ask if they have billed your health plan. Give them your insurance information.

The health plan must send you a notice if it is not going to pay a bill. The notice will tell you why the health plan is not going to pay a bill. If you disagree with the decision not to pay a bill, you may file a grievance, file an appeal or ask for a state fair hearing.

How do I know if I have a copay?

Some MHCP programs have copays for prescriptions and other health care services. Your health care provider will tell you if you owe a copay. Copays and coverage limits vary by program.

There are no copays for:

• Pregnant women
• Children under 21
• People living in a nursing home or other long-term care facility for more than 30 days
• People receiving hospice care
• American Indians who are members of a federally-recognized Tribe
• Services covered by Medicare (unless Medicare has a copay)
• People who have coverage through the Refugee Medical Assistance Program
• Preventive services as defined by the United States Preventative Services Task Force (USPSTF)
• Family planning services
• Certain prescriptions used for the treatment of mental illness

Do I have to pay anything if I'm on Medical Assistance?

For some members, there is no cost for health care coverage. Other members may have to pay a portion of the cost of a service. This may include a spenddown.

What's a spenddown and how do I know if I have one?

Some people who have more income than the MA income limit allows can qualify using spenddown. A spenddown lets you deduct certain medical expenses from your income. MA will pay for covered services after your income is at or below the income limit after deducting these medical expenses. We will tell you if you have a spenddown when you are approved for healthcare coverage.

Do I have to pay a premium?

Some people who are 21 years old or older pay a premium for MinnesotaCare. A premium is the monthly fee that members must pay to start and keep health care coverage. How much you pay depends on your family size, income and the number of people getting coverage.

The MinnesotaCare premium estimator (PDF) can give you an estimate of your monthly premium. We will send you a bill that will tell you the actual amount of your premium when you are approved for health care coverage.

People who do not pay a premium include:

• Children under 21
• American Indians who are members of a federally recognized tribe
• Some military families. Military families may be able to get coverage without a premium for up to 12 months if a family member completed a military tour of duty within two years of being approved for coverage. This benefit is available to members of the Army, Navy, Air Force, Marines, Coast Guard, National Guard and Reserves.;

Do I have to pay a premium if I have Medical Assistance for Employed Persons with Disabilities?

Most Medical Assistance for Employed Persons with Disabilities members pay a premium.

• The MA-EPD premium estimator can give you an estimate of your monthly premium.
• We will tell you the actual amount of your premium when you are approved for MA-EPD.;
• People who are American Indians do not pay a premium for MA-EPD.

How do I send in the form I filled out online?

If the form requires a signature, print the document and sign it. Then, scan or take a screen shot or photo and attach that document to the portal.

If the form does not require a signature, complete the form, save it to your computer and attach the document through the portal.

What should I do if I made a mistake like submitting the wrong document or filling in the wrong case information?

If you have questions or need assistance to submit documents through the portal, contact Health Care Consumer Support.

• MinnesotaCare: 651-297-3862 or 800-657-3672
• MFPP, MA for Inmates, Red Lake, and DACA: 651-431-3480 or 888-702-9968
• Refugee, Safe at Home (Secured Services) (Minnesota’s address confidentiality program), Center for Victims of Torture: 651-478-8380

What should I do if I accidently submitted my documents under the partner portal instead of the consumer portal?

The document submitted will be directed to Health Care Consumer Support for processing.

I didn’t receive an email confirmation code when I submitted the documents.

The portal does not provide an email confirmation that your documents were submitted. If the submittal is successful, you will receive the following message on the portal: “The submission was successful. It may take one business day or more for documents to be added to the case file.”

Can I still fax my document instead of using the document portal?

Yes

Can I submit documents for more than one case at a time?

No, you can only submit documents for one case at a time.

What kind of files can I attach or upload?

You can attach photos, screenshots and other documents. File types could be PDF, TIF, JPG, PNG, Word (.doc or .docx), or .txt documents.

How do I attach or upload a document?

When you click on the "Attach" button, you will receive a list of options of where your file is located. Check the file location option where your document or photo is located and then click on the document or photo you would like to attach. If you are attaching photos, you may need to attach each photo separately.

What should I do if my document won't attach?

If your document won’t attach, it may be because the document is too large or that we don’t accept your specific document type. 

• Examples: We don’t accept iPhone photos in the default file type (HEIC or HEIF), or your file size may be larger than the limit for the specific document type.
• Try converting your document to an accepted file type such as PDF, JPG, PNG, or TIF and then attach it. Search the internet for instructions on how to convert documents and photos to one of the accepted formats.

Why can't I attach a photo of my documents?

Your photo size may be too big, or the portal may not accept your photo file format.

• Try converting your document to an accepted file type such as PDF, JPG, PNG, or TIF and then attach it.
• Search the internet or check online support for instructions on how to convert documents and photos to one of the accepted formats.

How do I make a screenshot of my document?

Search the internet or check online help for your type of phone or computer.

How do I upload a screenshot from my phone or computer?

If you use your computer or phone to attach your documents to the portal, search the internet or check online support for your type of phone or computer and follow the instructions for transferring documents to your computer.

I can’t upload a photo from my iPhone to the portal.

iPhone photo files are typically HEIC and the online portal requires that photos be formatted as PDF, JPG, TIF or PNG. Search the internet or check online help for instructions on how to change a photo format.

What do I do if I got a message that says my file type is not accepted?

Try converting your document to an accepted file type such as PDF, JPG, PNG, TIF, Word (.doc or .docx) or TXT and then attach it.

How do I create a PDF?

You may have software to create a PDF on your computer, phone or tablet. You can try saving your document or photo as a PDF or use the print function to print a PDF. Search the internet for online help about the specific file type you want to convert.

Where should I look for a document I just created?

Your document may be in a download folder on your computer or in a download folder on your phone or tablet. Search the internet or check online help for more information on how to find your document.

What do I do if I got a message that says my file size is too big?

You can try the following:

• Split your document into separate files.
• Use another method. For example, instead of taking photos or screenshots of your documents, try scanning your document or create a PDF to reduce the file size.
• If you have photos, convert them to a different acceptable file type such as JPG, PDF, PNG or TIF.
• Search the internet or online help for instructions on how to change a format.

I don’t know which option to select for applications.

If you don’t know which option to select, choose "I don’t know what type of application I am submitting."

How do I know what proofs or verifications I’m supposed to submit?

If you received the Request for Information (DHS-3271) from Health Care Consumer Support, the types of proofs, verifications and other related documents you may need to provide are listed on the document. The portal page also has information on what type of verification we need. If you still are not sure, contact Health Care Consumer Support.

• MinnesotaCare: 651-297-3862 or 800-657-3672
• MFPP, MA for Inmates, Red Lake, and DACA: 651-431-3480 or 888-702-9968
• Refugee, Safe at Home (Secured Services) (Minnesota’s address confidentiality program), Center for Victims of Torture: 651-478-8380

I don’t know which option to select for renewals.

If you don’t know which option to select, choose "I don’t know what type of renewal I am submitting."

Can I submit my documents through the portal if I'm on the Safe at Home program?

Yes, if you are participating in the Safe at Home program, you can securely submit your application, renewal, proof, verification and health plan enrollment documents though the HCCS Document Portal for Consumers.

Make sure you answer yes to the question “Are you in the Safe at Home program?”

Do you accept electronic signatures through the portal?

It depends. Contact HCCS with questions. Also, review 1.2.6 MHCP Signature of the Eligibility Policy Manual.

Can I attach documents for other DHS programs to this site?

No. The HCCS portal only accepts health care renewals, applications, enrollment forms and other related documents.

Can I use this portal to send my Minnesota Senior Health Options or Special Needs BasicCare health plan enrollment?

Yes.

Can I qualify if I did not enroll in insurance offered by my employer?

If you did not enroll in your employer’s insurance, this may affect whether you qualify for coverage through MHCP. We will ask you or your employer about the insurance and let you know if not enrolling affects your eligibility.

Can I qualify if I am enrolled in Medicare?

• You may qualify for Medical Assistance even if you have Medicare coverage. You may qualify for Medical Assistance to pay for services that Medicare does not cover. There are also special programs to help pay your Medicare costs, such as premiums, deductibles and copays.
• You cannot qualify for MinnesotaCare if you are enrolled or can enroll in Medicare.

Can I qualify if I have long-term care insurance?

You can qualify for Medical Assistance even if you have long-term care insurance. If you get long-term care services at home or in a facility like a nursing home, the cost will be shared by your long-term care insurance and Medical Assistance.

Call your county or Tribal office for more information.

Do I have to enroll in a health plan?

Everyone who has MinnesotaCare and many people who have Medical Assistance (MA) must enroll in a health plan. Contact your worker to see if you have to enroll in a plan.

For general information about health plan enrollment, see:

• Managed Care Enrollment Guide for Families and Children Prepaid Medical Assistance Program (PMAP) and MinnesotaCare (DHS-8041) (PDF)
• People age 65 and older must enroll in a health plan.
  • You will get information in the mail to help you choose a Minnesota SeniorCare Plus (MSC+) health plan.
  • If you have Medicare and want to get all of your Medicare and Medical Assistance services through one health plan, you can choose to enroll in a Minnesota Senior Health Options (MSHO) health plan.
• People who have disabilities and have MA, with or without Medicare, may choose to enroll in a Special Needs BasicCare (SNBC) health plan.

How do I choose a health plan?

• Some counties have more than one health plan for you to choose from.
• Each plan has different doctors and dentists who you may see.
• You may want to choose a plan that your current doctor or dentist participates in.
• If you do not have a doctor, you may want to choose a plan with doctors close to your home or workplace.

• The program you are approved for determines the benefits you get.
• The health plan does not determine your benefits.
• The health plans have different rules about how you receive your benefits.

Can I change my health plan?

If there is more than one health plan available in your county, you may be able to change health plans. You may change health plans with the following limits:

• Once during the first year you are enrolled in a health plan.
• Once each year during the annual health-plan-selection period.
  • Annual health-plan-selection notices are mailed in the fall.
  • If you change health plans during this period, the change will take effect Jan. 1 of the following year.
  • For more information, see our annual health-plan-selection web pages.
• At other times for specific reasons.
  • Contact your worker if you have MinnesotaCare.
  • If you have MA, contact your county's managed care advocate (PDF) or the Ombudsman for Public Managed Health Care Programs.

What do I do if I want to change my doctor or clinic?

Call your health plan.

How can I see a specialist?

Call your health plan to find out if you need a referral to see the specialist you want. Talk to your primary care doctor about a referral.

Can I get help paying my health insurance premium?

Medical Assistance may pay your premium. We will look at the policy and decide if Medical Assistance will pay the premium so you can keep the insurance.

What is long-term care partnership insurance?

Long-term care partnership insurance must meet certain state rules. If you are enrolled in a qualified partnership policy and apply for Medical Assistance, you may be able to keep assets equal to the amount that your partnership insurance has paid for your long-term care. These assets will not count toward the Medical Assistance asset limit and will not be claimed in estate recovery.

Call your county or Tribal office for more information.

If I receive Medical Assistance, will a lien be filed against my home?

It depends on your circumstances.

The Minnesota Department of Human Services may file a Medical Assistance lien against real property to recover Medical Assistance costs before you die, but only if you are permanently living in a medical institution. Real property is real estate including homes.

DHS may also file a notice of potential claim, a form of lien, against real property to recover Medical Assistance costs after you die. A notice of potential claim cannot be enforced against real property until after you die.

Liens used to recover Medical Assistance costs can be filed against any of these interests:

• Your life estate or joint tenancy interest in real property
• Real property you own by yourself
• Real property you own with someone else

If you own property with another person, the lien is only against your share.

Will a claim be filed against my estate after I die?

It depends on your circumstances.

If you are enrolled in Medical Assistance when you are 55 years old or older, then, after you die, Minnesota must recover the amount that Medical Assistance paid for your health care after you turned 55 years old. Minnesota recovers this amount by filing a claim against your estate after your death.

Minnesota must seek recovery of Medical Assistance health care costs regardless of your age if both of the following apply:

• You permanently lived in a medical institution.
• You received long-term-care services paid for by Medical Assistance while living there.

The amount of the claim is no more than what Medical Assistance paid for your health care services.

Most of the time, the cost of Medical Assistance services does not have to be paid back until after you die and only when there is not a surviving spouse, a child under 21 or a child who is permanently disabled. When you die and you are survived by your spouse, the claim may be filed against the estate of your spouse.

A claim may be filed against your home within your estate and collected upon only when none of these people are still living in the home:

• A sibling who lived with you in your home for a least one year before you moved to a medical institution and has been living there since that date
• An adult child or grandchild who lived with you in your home and gave you care so you could live at home for at least two years before you moved to a medical institution and has been living there since that date

If your home is sold or transferred, then the two exceptions above do not apply anymore, and Minnesota can collect against the value of the home.

Can I get MinnesotaCare if I have other health insurance?

You cannot qualify for MinnesotaCare if you can get or are enrolled in certain types of coverage. You must apply to see if you qualify.

How do I know the amount?

The MinnesotaCare Premium Estimator Table (DHS-4139A) (PDF) can help you estimate your premium amount. The amount depends on your income, family size and number of people eligible. After eligibility is approved, you will get a premium bill in the mail. It will tell you exactly how much you must pay.

The premium bill you get in November and December may show a premium amount of “unknown” instead of a dollar amount. This means that we mailed you a renewal form, and it has not been processed yet. Make sure you return your renewal form to your county, tribal or MinnesotaCare agency by the due date. For more information, visit our websites for renewing eligibility and reporting changes. To lookup the agency who will process your renewal, use the Renewal Lookup tool.

Call DHS Health Care Consumer Support if you have questions about the amount and due date of your premium.

How do I pay my premium?

You can pay your premium in the following ways:

• Online at https://payments.dhs.state.mn.us:
  • Select MinnesotaCare from the menu.
  • Fill in your case number, the bill number and the amount of your premium. You can pay by credit card (VISA or MasterCard) or electronic withdrawal from a checking account.
• By phone at 800-657-3672, option 1 for enrolled, option 1 again to make a payment.
  • You will need your case number, the bill number and amount of your premium.
  • You can pay by credit card, debit card (VISA or MasterCard) or electronic withdrawal from a checking account.
• By mail:
  • Allow enough time for your payment to arrive by the due date on your premium bill.
  • You can pay by check or money order. Write your case number on your check or money order.
  • Do not mail cash.
  • Mail your payment with the payment stub from your premium bill to:
    MinnesotaCare
    PO Box 64834
    St. Paul, MN 55164-0834
• In person in St. Paul:
  • You can pay by cash, check or money order. If you pay by cash, you must have the exact amount.
  • Pay your premium at the MinnesotaCare office in downtown St. Paul, Monday through Friday, 8 a.m. to 4 p.m. The office is closed on weekends and holidays.
    Elmer L. Andersen Building – MinnesotaCare Payment Center
    540 Cedar Street
    St. Paul, MN 55101
• You can also print out a summary of premium payment options and a map to the MinnesotaCare office (DHS-4020) (PDF). County offices do not take MinnesotaCare premium payments.

When is my first premium due?

You must pay your premium by noon on the last business day of the month for your coverage to start on the first day of the next month.

When is my ongoing monthly premium due?

Ongoing monthly premiums are due about the 15th of the month. Your premium bill will have a due date.

Payments received Monday through Friday before 5:00 p.m., excluding holidays, will be credited on the same business day, with the exception of the last business day of the month. Payments made by telephone or online must be made by noon on the last business day of the month to guarantee coverage for the following month. Payments made after 5:00 p.m., or on holidays or weekends, will be credited the next business day.

What if I don't pay my ongoing monthly premium?

You will have coverage for one more month if you do not pay your premium. That is a grace month. You must pay your monthly premium by noon on the last working day of the grace month to avoid a gap in coverage. Your coverage will end if you do not pay your premium by noon on the last business day of the grace month.

My coverage was closed because I did not pay a premium. How do I get coverage again?

If your MinnesotaCare coverage is closed because you did not pay your premium, you need to pay the premium for the future month to restart coverage. We must get your premium payment by noon on the last business day of the month for your coverage to restart on the first day of the next month.

Can I pay premiums in advance?

Yes.

Why do I need to complete a renewal?

A renewal is needed to review your eligibility to see if you still qualify for Medical Assistance (MA) or MinnesotaCare.

When will I get my renewal forms?

If you have MA, you can expect to get renewal forms about two months before the month you originally applied for health insurance. For example, if you applied in July, your MA renewal forms will be mailed to you in May. Do not worry if you don’t remember when you applied. We will mail renewal forms to you when it is time to renew your MA.;

If you have MinnesotaCare, you can expect to get your renewal forms in October.

What can I expect when it is time for my renewal?

When it is time for your renewal, we will mail your renewal forms and instructions.

How will I get my renewal forms?

You will get your renewal forms in the mail. We will send it to the mailing address we have on file for your MA or MinnesotaCare case.

How do I make sure I get my renewal forms in the mail?

If you’ve moved, report your new address right away.

• If you have Medical Assistance, or your household has both Medical Assistance and MinnesotaCare, contact your county or Tribal agency.
• If you have MinnesotaCare only, call the Health Care Consumer Support line at 651-297-3862 or 800-657-3672.

Should I send proof of my income with my renewal form?

Yes. Send proof of your income with your renewal form. It may help us process your renewal more quickly. Include the following:

• Pay stubs for people who have wages.
• Most recent federal income tax return or business records for people who are self-employed.
• Documentation or copies of checks if you have other kinds of income.

Where do I send my completed renewal form?

Return it to the agency listed on the cover letter that came with your renewal form. If you no longer have the cover letter, do the following, or learn about other ways to return your renewal.

If your household is:

• On Medical Assistance only OR
• has members on both Medical Assistance and MinnesotaCare

If your household is on MinnesotaCare only

What happens if I don’t return my renewal form?

Your Medical Assistance (MA) or MinnesotaCare health insurance coverage will end.

I think I might not qualify anymore. Do I still have to complete my renewal form?

Yes, complete your renewal form if you want us to decide if you still qualify, or to see if you are eligible for a different Minnesota health care program.

Can I return my renewal form after the due date?

Yes. Complete and return your renewal form as soon as you can, even if your coverage ended.

• We will look at your case again if we get your renewal form within four months after your coverage closed.
• If you return your renewal form more than four months after your coverage has closed you will need to reapply.

Can I upload my renewal form and proofs online?

When will my renewal form be processed?

• Renewal forms are processed in the order they are received at your county or Tribal agency or at the Minnesota Department of Human Services (DHS).
• Your renewal will take longer if it is not complete or not signed.
  • Answer all the questions and sign your renewal form to help us process it faster.
• Your county or Tribal agency, or DHS, will notify you when your renewal form has been processed.
  • We will send a notice if we need more information from you to decide your eligibility.
  • Your county or Tribal agency, or DHS, will send a notice to tell you whether you or your other family members still qualify for MA or MinnesotaCare.

If I have MinnesotaCare, what do I need to know about my MinnesotaCare premium during my renewal time?

• Continue to pay the amount shown on your bill.
  • Your MinnesotaCare premium may change after your renewal form is processed.
• The premium bills you get in November and December may show a premium amount of “unknown” instead of a dollar amount.
  • If you have returned your renewal form, this means that it hasn’t been processed or received, or the agency is waiting for more information from you.
  • If you have not returned your renewal form, you must return it by the due date or your eligibility will end December 31.

What can I do if the health plan says the medication my doctor ordered is not covered?

Each health plan has a list of medications they cover (called a formulary). If your doctor thinks that a medication not on the list is the best medication for you, ask your doctor to submit a request for authorization to the health plan. The health plan may approve the medication even if it is not on their formulary.

If the health plan denies the request for authorization, you may choose to appeal that decision using the health plan appeal process or the state fair hearing process.

What can I do if the health plan denies or reduces my services?

The health plan must send you a notice if it denies, ends or reduces services you or your doctors have requested. The notice will tell you why the plan decided to deny, end or reduce your services. If you disagree with the health plan, you may file an appeal or ask for a state fair hearing.