MinnesotaCare expanded eligibility for certain populations
MinnesotaCare coverage was extended to some uninsured Minnesotans who were not previously eligible for Minnesota Health Care Programs (MHCP) beginning Jan. 1, 2017. Members who receive coverage under this program are eligible for one of the following two MinnesotaCare major programs:
- KK (with eligibility type C2) – Children under age 21
- XX (with eligibility type M3) – Adults 21 years old and over
Verify eligibility for these members through MN–ITS or the eligibility verification system (EVS). Provide any services that are covered by the MinnesotaCare program. Refer to the Summary of Coverage, Cost Sharing and Limits (DHS-3860) (PDF) for more information about MinnesotaCare covered services.
Authorization is required for any service or prescription that requires authorization for coverage under MinnesotaCare.
Submit requests for authorization of services through the authorization review agent.
Prescription drug coverage
Use our NDC Search website to determine whether a drug is covered, is excluded or requires prior authorization. Provide any prescriptions that are covered (and do not require prior authorization) by the MinnesotaCare program.
How do I bill for services and prescriptions?
Coverage for members enrolled in MinnesotaCare KK or XX is provided through fee-for-service. These members are not enrolled in a managed care organization.
Submit claims for members enrolled in MinnesotaCare KK or XX through your usual billing process.
Call the MHCP Provider Call Center at 651-431-2700 or 800-366-5411 if you have questions.