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Make edits, fill in missing information, and update formatting in US Legal Forms—just like you would in MS Word.

Download a copy, print it, send it by email, or mail it via USPS—whatever works best for your next step.

Sign and collect signatures with our SignNow integration. Send to multiple recipients, set reminders, and more. Go Premium to unlock E-Sign.

If this form requires notarization, complete it online through a secure video call—no need to meet a notary in person or wait for an appointment.

We protect your documents and personal data by following strict security and privacy standards.
If you are single, do not live with a parent and do not live in a facility, your income must be less than $203 a month to qualify for assistance. This limit is higher if you live with your spouse or if you earn income from working.
Get help. Call the Hennepin County Managed Health Care Office at 612-596-8860 for help with enrollment questions, billing questions, or complaints.
The Hennepin Healthcare Horizon plan is a no deductible coverage plan with low or no copays for Hennepin Healthcare in-network services. The plan also offers access to providers and facilities that are part of the Medica Choice Network, but with a high deductible and low coinsurance for most services.
Eligibility Household sizeHousehold income 1 $2,510 2 $3,407 3 $4,303 4 $5,2006 more rows
Most people can apply online at MNsure or call 1-855-366-7873. People 65+ and people with a disability: Download and complete an application and submit to Hennepin County.
Assistance eligibility You may be eligible if: You have not received EA/EGA help in the last 12 months. Your income is less than 200% of the Federal Poverty Guideline for household size. You you do not have enough resources to resolve your crisis.
Apply for benefits We're changing the way we serve you by offering services in a way that is more convenient for you. Apply for economic benefits whenever, wherever. Apply online or call 612-596-1300 Monday through Friday, 9 a.m. to 4 p.m.
How to submit forms and documents and update your information Update information and upload documents to InfoKeep. Upload to MNbenefits. Fax to 612-288-2981. Mail to: Hennepin County Human Services Department. P.O. Box 107. Minneapolis, MN 55440.
Call 612-204-8200 Hennepin Shelter Hotline serves Hennepin County residents who are seeking emergency shelter by helping them find a safe, temporary place to stay while they work on next steps toward stable housing. A person or family should contact Hennepin Shelter Hotline if: They are 18 years or older.