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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.

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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.
Hennepin Healthcare System is the state's largest Medicaid provider system and safety-net trauma hospital in Minnesota, proudly serving the most complex populations from throughout the state.
Apply for health care assistance 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. See forms below. Undocumented residents. 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.
Hennepin Healthcare System is a public corporation established in state statute. It is governed by a corporate board, of which two members are Hennepin County commissioners. Hennepin County Medical Center is a public safety net hospital whose services extend to low-income individuals.
It is online at .applymn.dhs.mn. ApplyMN is a "smart application" that only asks questions based on the program(s) requested, the household composition and an applicant's response to previous questions.
A state and federal program (called Medical Assistance in Minnesota) that provides health insurance that covers a broad array of health services for people, including families and children with low-incomes, older adults and people with disabilities.
MinnesotaCare is financed with enrollee premiums, federal funding and state funding from the state's Health Care Access Fund. As a Basic Health Program, MinnesotaCare receives 95 percent of the premium tax credits that enrollees would have received if they purchased insurance through the health care marketplace.
Medicare Savings Programs (MSPs) are a sub-set of Medicaid, designed to help people with low income afford their Medicare costs.
Apply for health care assistance 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.
MinnesotaCare is a program offered through MNsure. It is designed for people who need financial assistance for health insurance, but do not qualify for Medicaid (Medical Assistance).