Our built-in tools help you complete, sign, share, and store your documents in one place.
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.

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.
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.
Who do I report a change to? If someone in your household gets MA, report a change to your county or tribal agency. If no one in your household gets MA, but someone in your household does get MinnesotaCare, report a change to DHS Health Care Consumer Support at 800-657-3672 or 651-297-3862.
MinnesotaCare is health coverage offered through the state. Applications for both programs are available at the human services office. An application can either be picked up at human services or mailed to you. Applications are also available online at the Minnesota Department of Health website.
Medicaid. 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.
The HCAPP (DHS-3417) allows people to apply for any or all of the Minnesota Health Care Programs (MHCP) on one form. Questions on the HCAPP may apply to all health care programs, only to one or two programs, or to specific populations.
Call 612-348-3000, Monday through Friday, 8 a.m. to p.m.
This information is available in alternative formats to in‑ dividuals with disabilities by calling (651) 431‑2400 or (800) 747‑5484. TTY users can call through Minnesota Relay at (800) 627‑3529. For Speech‑to‑Speech, call (877) 627‑3848.
They can also call the Minnesota Health Care Programs Member Help Desk at 1-800-657-3739 or 1-651-431-2670 to request an application, or they can download an application here. They can also apply in person at their local county office or tribal human services office.
This information is available in alternative formats to in‑ dividuals with disabilities by calling (651) 431‑2400 or (800) 747‑5484.
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.