Minnesota Uniform Healthcare Act Form
Description
How to fill out Uniform Healthcare Act Form?
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FAQ
Medical Assistance (MA) is Minnesota's Medicaid program for people with low income. MA does not require you to pay a monthly premium. MA members have small co-pays for some services, usually $1 - $3. MinnesotaCare is a program for Minnesotans with low incomes who do not have access to affordable health care coverage.
Informed consent is written permission from an individual to allow a government entity to release the individual's private data to another government or non-government entity or person, or to use the individual's private data within the entity in a different way (Minnesota Statutes, section 13.05, subdivision 4).
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.
Request an application by calling MinnesotaCare at (651) 297-3862 (Twin Cities Metro) or 1-800-657-3672 (toll-free). For TTY call 711 or 1-800-627-3529. Complete it and mail it in. Print the application from the Minnesota Department of Human Services website, complete it and mail it in.
You will need to complete an application to determine your actual eligibility. People in householdMedical Assistance for adults over age 18. Monthly / annual income no more thanMinnesotaCare. Annual income no more than1$1,615 / $19,391$29,1602$2,185 / $26,227$39,4403$2,755 / $33,063$49,7204$3,325 / $39,900$60,0005 more rows
The Administrative Uniformity Committee (AUC) is a voluntary, broad-based group representing Minnesota health care public and private payers, hospitals, health care providers and state agencies, working to standardize, streamline, and simplify health care administrative processes.
Coverage Options through MNsure Medical Assistance: Covers low-income Minnesotans, including children and pregnant women, as well as people with disabilities. There is no monthly premium. Enrollment is available year-round. MinnesotaCare: Covers lower-income Minnesotans who aren't eligible for Medical Assistance.