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 single applicant and a medically needy spend-down instead of a hard income cap. Its $132 monthly personal needs allowance 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.3

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 single applicant, $6,000 for a two-person household, plus $200 for each additional legal dependent. This is higher than the $2,000 limit most states use, per the Minnesota Health Care Programs Eligibility Policy Manual. Exempt assets include the primary home, one vehicle, household goods, and prepaid burial arrangements.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, about $1,330/month for an individual and $1,803/month for a couple in 2026. 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.1,4
• Special income standard for long-term care: For institutional and HCBS-waiver long-term care, Minnesota uses a special income standard of $2,982/month, equal to 300% of the 2026 SSI Federal Benefit Rate.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 personal needs allowance of $132/month. That $132 is more than four times the $30 a month federal rules require a state to protect for a nursing-facility resident. A state may set its allowance above that federal floor: TennCare, Tennessee's Medicaid program, protects $70 a month.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. Customized living is not limited to chapter 144G assisted living facilities: a provider may also deliver it if it is licensed as a comprehensive home care provider under chapter 144A and is operating in a setting exempt from assisted living licensure under Minnesota Statutes 144G.08, subdivision 7, clauses (10) to (13).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. 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 established on or after August 1, 2003. Recovery is delayed while a surviving spouse is living, and no recovery can be made while a surviving child who is under 21, blind, or permanently and totally disabled is living. An undue-hardship waiver is available.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 enrollment also triggers automatic Part D Extra Help, and federal law 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 nursing facility and the other remains in the community, Minnesota applies federal spousal impoverishment protections so the community spouse is not left without resources.9

Key 2026 figures:

• Community Spouse Resource Allowance (CSRA): The community spouse keeps half the couple's countable assets, up to the federal maximum of $162,660. The federal floor is $32,532.9
• Minimum Monthly Maintenance Needs Allowance (MMMNA): The community spouse's income is protected up to a range from $2,705.00 (effective 7/1/2026) at the floor up to $4,066.50 at the maximum (effective 1/1/2026).9,1
• Home equity limit: $752,000. The home is exempt while either spouse resides in it.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 guarantees every Medicaid applicant and beneficiary the right to a fair hearing before the state agency, whether the dispute is about eligibility or about a specific service being reduced or ended.11 For an eligibility decision, your deadline is the date printed on your own notice of action. The 90 days in 42 CFR 431.221(d) is the ceiling on what a state may allow, never a window you are guaranteed, and a shorter state deadline is fully enforceable against you.12 This guide states no Minnesota figure for eligibility appeals because it has no Minnesota source it can quote for one, and a number nobody can source is worse than no number. Read the date off your notice, and if it is missing or unclear, call your county or tribal servicing agency and ask before the date passes.

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.13

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.13 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 automatically from information it already holds, and may only request documents if it cannot.15 If it 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, cover eligibility based on modified adjusted gross income (MAGI). If you qualify through age, disability, long-term care, a Medicare Savings Program, or the medically needy pathway, Minnesota may offer the same windows but is not required to, so 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.