Income Maintenance
Combined Application Form



Combined Application Form

Application form for cash assistance, food support and health care

Medical Mileage/Meal Reimbursement Form


Minnesota Health Care Programs Application



Minnesota Health Care Programs Application

Application to apply for health care coverage for families, children, married couples, people who are single, people who are blind or disabled, people who live in a nursing home or other facility, people who are applying to get help from a waiver services program.

Notice of Access Service Availability to Eligible MN Health Care Program Recipients


Household Report Form



Household Report Form



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