Minnesota Medicaid Guide 2026: MA, Eligibility & LTC

Minnesota Medicaid pays for long-term care through Medical Assistance, which uses a $3,000 asset limit for a household of one and a medically needy spend-down instead of a hard income cap. Its $132 monthly clothing and personal needs allowance, the amount a resident keeps when no other Minnesota long-term-care allowance applies, is more than four times the $30 federal minimum.1,2

Minnesota Medicaid is administered by the Minnesota Department of Human Services (DHS) under the name Medical Assistance (MA). Minnesota is a section 209(b) state, which lets it use its own financial eligibility methodology rather than standard Supplemental Security Income (SSI) rules. For older adults who need nursing facility or home-based care, this guide covers the financial rules, covered services, and how to apply.1

What Does Minnesota Medical Assistance Cover?

Minnesota Medical Assistance covers the mandatory federal benefit categories plus a broad set of state-elected optional services:

• Hospital care: Inpatient and outpatient services
• Physician, clinic, and specialist visits
• Prescription drugs through the MA pharmacy benefit
• Behavioral health: Mental health and substance use disorder services
• Dental care: Adult dental services
• Home health: Skilled nursing and home health aide services
• Long-term care: Nursing facility care and home and community-based services (HCBS) waiver care for people who meet the clinical level-of-care standard
• Medicare Savings Programs (MSPs): Premium and cost-sharing help for people who have both Medicare and Medicaid
• Non-emergency medical transportation (NEMT)

For older adults, long-term care is the most financially significant benefit. Minnesota's nursing home costs run above the national medians, and the national median for a semi-private nursing home room was about $315 a day (roughly $114,975 a year) in the CareScout 2025 Cost of Care Survey. Once a resident meets Minnesota's financial and clinical eligibility standards, Medical Assistance covers the full cost of care.4

Who Qualifies for Minnesota Medicaid Long-Term Care?

Minnesota is a section 209(b) state with its own financial eligibility rules for Medical Assistance, set under Minnesota Statutes 256B.056. The 2026 parameters for seniors seeking nursing facility or HCBS coverage are:1

• Asset limit: $3,000 for a household of one, $6,000 for a household of two, plus $200 for each additional household member, per the Minnesota Health Care Programs Eligibility Policy Manual and DHS's current DHS-3461A guidelines chart. That is higher than the $2,000 federal SSI resource limit.1,3 Which assets Minnesota excludes is set out elsewhere in the manual, so ask your county or tribal servicing agency before assuming the home, a vehicle, or a burial fund is exempt.1
• Income approach: Minnesota uses a medically needy spend-down. The MA income standard for aged, blind, and disabled applicants is 100% of the Federal Poverty Guidelines; DHS's DHS-3461A chart lists $1,330/month for a household of one, effective 7/1/26 through 6/30/27. An applicant whose income is above that figure and who has medical expenses can still qualify by spending the excess down on incurred medical and care costs.1
• Special income standard: Appendix F of the manual sets a Special Income Standard of $2,982/month for 2026 and says it is used to determine certain criteria for the Elderly Waiver program. Do not read it as the income limit for nursing-facility MA or for every Minnesota waiver: Appendix F separately sets an Elderly Waiver maintenance needs allowance of $1,353 (7/1/26 through 6/30/27), a different figure for a different purpose.1
• No Miller Trust required: Because Minnesota uses a medically needy spend-down rather than a hard income cap, no Qualified Income Trust (Miller Trust) is needed at any income level.1

For the full income limits, asset rules, and spousal figures, see Minnesota Medicaid Eligibility & Income Limits.

Minnesota Medicaid Long-Term Care

Nursing Facility Coverage

Minnesota Medical Assistance covers nursing facility care for financially and clinically eligible applicants, after a MnCHOICES assessment, delivered through the state's long-term care consultation services, confirms the person needs a nursing-facility level of care. The resident contributes income above allowances toward the cost of care, keeping a clothing and personal needs allowance of $132/month. Appendix F sets that $132 for a resident who is not eligible for any of Minnesota's other long-term-care needs allowances, such as a home maintenance allowance or the $1,353 Elderly Waiver maintenance needs allowance, so ask DHS which one applies to you. It is more than four times the $30 a month federal rules require a state to protect for a nursing-facility resident, and the federal figure is a floor, not a ceiling.1,2

HCBS Waivers: Care at Home Instead of a Nursing Home

Minnesota funds long-term care outside a nursing home through the Elderly Waiver (EW), a Section 1915(c) home and community-based services waiver for people who need a nursing-facility level of care but choose to live in their own home, an apartment, or an assisted living facility. DHS sets four conditions and you must meet all of them: be age 65 or older, be eligible for Medical Assistance, meet a nursing-home level of care as determined by a MnCHOICES assessment, and need services the waiver can provide for less than the cost of care in a nursing home. The Elderly Waiver pays for personal care, home health, adult day services, homemaker help, and customized living services, and customized living is not limited to chapter 144G assisted living facilities.5

The companion Alternative Care (AC) program is narrower than "not yet financially eligible for Medical Assistance" suggests. Under Minnesota Statutes 256B.0913, subdivision 2, it serves Minnesotans age 65 or older who would be eligible for Medical Assistance within 135 days of admission to a nursing facility. Someone whose assets put them further out than that 135-day window does not qualify. To get either program, a person requests a MnCHOICES assessment through their county, tribal, or managed-care organization; that assessment comes through the long-term care consultation services of Minnesota Statutes 256B.0911, which the statute requires be coordinated with preadmission screening. The Consumer-Directed Community Supports (CDCS) option lets participants hire and direct their own care workers, including family members in some cases.5

The 5-Year Lookback

Minnesota applies a 60-month lookback to asset transfers made for less than fair market value before a Medicaid long-term care application. Uncompensated transfers create a penalty period during which Medical Assistance will not pay for long-term care services.6

Estate Recovery

After the death of a recipient who was age 55 or older when they received long-term care, Minnesota pursues federally required estate recovery under Minnesota Statutes 256B.15. Since a 2016 change in the law, the estate claim is limited to long-term services and supports, meaning nursing facility care, HCBS waiver services, and related hospital and prescription drug costs, not every Medicaid service a person received after age 55. In May 2025, the Minnesota Supreme Court held in In re Estate of Ecklund that when those long-term care services were delivered through a managed care plan, DHS may recover the full capitation payments it made to the plan, not just the smaller amount the plan paid providers. Medical Assistance paid as Medicare cost-sharing for a dual eligible is outside the claim entirely. Minnesota also uses an expanded definition of "estate" that can reach certain non-probate assets, including life-estate and joint-tenancy interests in real property. As a general rule that reaches only interests established on or after August 1, 2003, but treat that date as a rule of thumb rather than a safe harbor: it does not limit recovery of Alternative Care costs, and DHS recovers against a joint-tenancy interest that spouses held at death even when the interest was created earlier.7

Two protections families count on are narrower than they sound, and one they rarely hear about is the one that may matter most. Recovery is delayed while a surviving spouse is living, but when that spouse dies DHS files against marital property in the spouse's estate; the surviving-child protection lasts only while a child is under 21, blind, or permanently and totally disabled. What can protect the house itself is the homestead exclusion in subdivision 4. It reaches a sibling who lived in the home for at least a year before the member entered a facility and has lived there since, and a child or grandchild who lived there for at least two years before that and provided care that allowed the member to stay home instead of being institutionalized. DHS says the child-or-grandchild exclusion does not apply automatically: it has to be asserted and proven. An undue-hardship waiver is also available, and the application must be received or postmarked within 30 days of the date on the Notice of Estate Claim (DHS-4934).7

See Minnesota Medicaid Estate Recovery for the full rules, exemptions, and hardship process.

Minnesota Medicare Savings Programs

Minnesota Medical Assistance administers Medicare Savings Programs (MSPs) for low-income Medicare beneficiaries. The 2026 income limits below follow the federal Medicare Savings Program brackets:8

Treat the figures above as the federal standard rather than a hard cutoff. States can effectively raise both the income and the resource limits by disregarding certain income and resources, so someone above these numbers may still qualify and should apply rather than rule themselves out. QI carries one more condition: you must apply every year, because selection in one year does not entitle you to continued assistance in any following year.8

QMB, SLMB, and QI enrollment each trigger automatic Part D Extra Help (the Part D Low-Income Subsidy), with no separate application, so the premium-only rows above understate what SLMB and QI are worth. Extra Help lowers Part D drug costs; it does not pay the Medicare deductibles and copays that only QMB covers. Federal law also bars providers from billing a QMB enrollee for Medicare cost-sharing. Apply through DHS or the Social Security Administration.8

See Minnesota Medicare Savings Programs for full details and how to apply.

Spousal Impoverishment Protections

When one spouse enters a long-term care facility and the other remains in the community, Minnesota applies federal spousal impoverishment protections so the community spouse is not left without resources.9 Minnesota conducts the spousal asset assessment only for MA applicants who live in a long-term care facility or who are applying for Elderly Waiver services. It is not conducted for applicants for Minnesota's other home and community-based waivers, and for those applicants the community spouse's assets are not considered for eligibility at all.1

Key 2026 figures:

• Community spouse asset allowance: Appendix F sets a maximum asset allowance of $162,660 for 2026, and the same table row reads "No minimum." Read $162,660 as the standard the asset assessment applies rather than as an answer about what lies above it: neither Minnesota source behind this figure addresses a hearing-determined or court-ordered asset allowance, so ask DHS or an attorney rather than assume the door is either open or shut.1,9
• Monthly income allowance: Appendix F sets a minimum monthly income allowance of $2,705 (7/1/2026 through 6/30/2027) and a maximum of $4,066.50 (1/1/2026 through 12/31/2026), used to determine the community spouse's monthly maintenance needs amount. The maximum is not a hard ceiling: Minnesota House Research states that if the community spouse obtains a court order for support specifying a higher monthly income allowance, the spouse in long-term care can transfer the amount the court ordered.1,9
• Home equity limit: $752,000 for 2026, which Appendix F says is applied only in specific situations and at certain times, so ask DHS whether it applies to your case.1

See Minnesota Medicaid Spousal Impoverishment Protections for the snapshot process, the income-first rule, and planning considerations.

How to Apply for Minnesota Medicaid

Applying for Minnesota long-term care Medical Assistance follows a clear sequence. Gather your paperwork first, then submit through one of the agency pathways and complete the clinical screening.

If Minnesota Medicaid Denies or Cuts Your Coverage

A denial is not the end of the road, and the deadline to challenge it is usually shorter than people expect.

Federal law gives Medicaid applicants and beneficiaries a right to a fair hearing before the state agency, and 42 CFR 431.220(a) names six categories of person who hold it, including a nursing facility resident who believes the facility has wrongly decided he must be transferred or discharged. The one case the regulation carves out is a benefit change that flows automatically from a federal or state law affecting a whole group.11

For a county or state agency decision, which covers eligibility and other DHS actions, DHS says to ask for a hearing within 30 days after you get the written decision, and that in some cases you may have up to 90 days. Treat 30 days as your deadline: the longer window is not automatic, so ask the DHS Appeals Division rather than assume it.12 Ninety days is also the federal outer limit on what a state may allow under 42 CFR 431.221(d), never a window you are guaranteed.13

A managed care service denial runs on a different clock, in two steps, and most Medical Assistance is delivered through managed care health plans. You have 60 days from the date on the plan's notice to file the plan's internal appeal, which you must complete first, then 120 days from the plan's appeal decision to request a state fair hearing in writing.12

A third and earlier deadline matters most if the service is already running. To keep the disputed service flowing, file the health plan appeal within 10 days of the date on the plan's notice, and the state appeal within 10 days of the plan's appeal decision.12 Federal law ties that protection to requesting the hearing before the date the action takes effect.14 Miss the 10-day window and you may still appeal, but the service can stop in the meantime.

So when an adverse notice arrives: find the deadline printed on it, file before that date, and ask in writing that your benefits continue. See Minnesota Medicaid Appeals and Fair Hearings for how to file, what the hearing itself involves, and what happens after a decision.

Keeping Minnesota Medicaid Once You Have It

Coverage is not permanent. Eligibility is re-checked on a recurring cycle, and missing that step is one of the most common ways people lose coverage they still qualify for.

Minnesota Medicaid must first try to renew your coverage from information it already holds. For coverage based on modified adjusted gross income (MAGI), that duty is flat: the agency may request documents only if it cannot renew on that basis. If you qualify through age, disability, long-term care, a Medicare Savings Program, or the medically needy pathway, the rule sits in a different paragraph with a different trigger, requiring the agency to renew without paperwork "if sufficient information is available to do so" and making the renewal-form procedures a state option rather than a federal requirement.15 If Minnesota does need paperwork, it must send a renewal form and give you at least 30 days from the date of the form to return it. That duty, and the 90-day reconsideration window below, are federal requirements for MAGI-based coverage; on the non-MAGI pathways above, ask Minnesota Medicaid what applies to you.15

If coverage does close because a form went unreturned, that is not the end of it. Federal rules require the agency to reconsider your eligibility without a new application if you return the renewal form within 90 days of the termination (required for MAGI-based coverage; a state option otherwise).15

Keep your mailing address current, open anything from Minnesota Medicaid, and return the form by the deadline printed on it. See Minnesota Medicaid Recertification and Renewal for the full cycle and how to recover closed coverage.

Where to Get Help

Minnesota Medicaid FAQ

Learn More

Find personalized help understanding Minnesota Medicaid long-term care eligibility at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.