Completing your online application

The online application reviews the information you enter and determines eligibility for Medical Assistance (MA), MinnesotaCare, or other coverage that provides financial help.

Use this online application to apply for anyone in your household who is:

  • Pregnant
  • An adult under age 65, with or without a disability
  • A child or young adult under age 19

For the best experience with the online application, use Google Chrome or Mozilla Firefox browsers. Clear your browser cache and cookies before starting.

Learn how to clear your cache and cookies

Don't use the online application if you are:

If you meet one of the following criteria, use the buttons to learn how to apply:

Are over age 65, Blind, or have a disability Need long-term care services Only need family planning services Need care for breast or cervical cancer

Quick checklist

To help you finish your application faster, gather the following information before you begin:

Social Security Number (SSN)

  • Provide the SSN of anyone in your household who has one.
    • If someone is not applying, the SSN is optional, but providing their SSN may speed up the decision for members who are applying.
    • To request an SSN, call the Social Security Administration at 1-800-772-1213.

Proof of income – examples include:

  • Recent paystubs (at least one month)
  • W-2s
  • Unemployment benefits
  • Retirement income
  • Interest from investments
  • Self-employment estimates

Employer insurance information

  • Employer name
  • Employer ID Number (from paystub or W-2)
  • Any available plan information 
    • Note: This is not required if you do not have access to employer insurance

Immigration and citizenship status (for non-citizens)

  • Have your document type, number and expiration date ready.
  • Examples include:
    • Green Card
    • Visa
    • I-94
    • Naturalization certificate, or 
    • Passport

Addresses

Provide your home address (where you live) and mailing address (if different). A PO Box may be used for mailing, but a home address is still required.

Homeless: Indicate this on the application. If you have a mailing address you can use temporarily (such as a friend or family member’s address or a PO Box), you can enter this in the mailing address. If you don’t have a mailing address you can use, notices will be sent directly to your county office. Contact your county or Tribal Nation to determine where you can pick up notices.

Safe at Home: Use the specific Safe at Home address provided to you so mail can be forwarded to you securely. Do not enter your actual home address.

Pregnancy

If you are pregnant, indicate this on the application. Pregnant applicants may qualify for faster processing and additional coverage.

Other information – including:

  • Birth dates of everyone in the household
  • Relationships with other household members
  • Exact name spelling for the signature page

Sections included on application

1. About you

Application filer and primary contact

Primary contact

Primary contact is considered the application filer. This should be an adult (over 18 years old, unless they are a minor not living with parents or guardian) who will be the contact person for the application and notices. The application filer may or may not be applying for coverage.

Email

Email is optional. All official notices are mailed using US mail. Always open mail you receive from the Minnesota Department of Human Services.

Authorized representative

Authorized representative is someone you give authority to act on your case on your behalf.

2. Who to include in your household

Add each household member one at a time. Complete all required questions for every person you include, even if they are not applying for coverage.

Include:

Include: Yourself, your spouse, any children under 19 who live with you, and anyone you file taxes jointly with or claim as a dependent on your federal tax return.

Do not include:

Do not include: Adult children 19+ you will not claim as tax dependents, roommates or unrelated adults you do not file taxes with.

3. Income to report and how it’s counted

Report current income for each person listed on the application, using the income they expect for the year the coverage is for. You may enter monthly or yearly amounts. The system will convert the amount into an annual amount using modified adjusted gross income (MAGI).

Example: if you earn $500 every two weeks, select “bi-weekly.” The application will calculate the yearly amount automatically.

Income to include

  • Wages, 
  • Self-employment net income
  • Unemployment
  • RSDI
  • Interest and dividends
  • Rental and royalty income
  • Taxable one-time income

Income not to include

  • Child support
  • Supplemental Security Income
  • Veteran’s non-taxable payments
  • ABLE account distributions
  • Worker’s compensation

If income changes

Report changes as soon as possible to avoid incorrect assistance amounts or eligibility.

Report a change

Income adjustments to tell us about

Some income adjustments may reduce the amount of income counted. If you have any of the following, have the amounts ready:

  • Educator expenses
  • Deductible part of self-employment tax
  • Self-employed retirement plan contributions (SEP/SIMPLE)
  • Self-employed health insurance
  • Health Savings Accounts contributions
  • IRA deductions
  • Student loan interest
  • Penalties on early withdrawal

4. Additional questions

Select “Yes” if someone in the household is pregnant.

Applications that include someone who is pregnant may be processed faster.

Select “Yes” if the primary contact is homeless

Select “Yes” if the primary contact is homeless and provide the county where the person usually stays.

Retroactive Medical Assistance

Retroactive Medical Assistance may be requested for help paying medical bills from the past three months. You will need to select which month(s) you are requesting and provide proof for those months if anything differs from your current application.

Employer-sponsored insurance questions

  • List any household member who is enrolled in employer coverage or has access to employer insurance coverage. “Access” means coverage is available through their employer or someone else’s employer (such as a parent or spouse), even if they are not enrolled or cannot afford it.
  • Have the employer’s name, Employer Identification Number (EIN), and plan information ready. This helps determine whether employer coverage may affect eligibility. If you do not know this information, bring Appendix A: Health Coverage from Jobs (PDF) to your employer so they can help you complete it.
  • If access to employer coverage will end within 60 days, select “Yes” when asked about coverage ending soon.
Appendix A: Health Coverage from Jobs (PDF)

5. Review, sign and submit application

Review the Household Summary page

Review the Household Summary page for missing or duplicate information. Make any edits before signing.

Select how many years you give consent

Select how many years you give consent for us to use federal income data. This helps us to attempt to renew your coverage automatically each year.

On the signature page, enter your name

On the signature page, enter your name exactly as you entered it on the "Applicant Details" section of the online application.