Government Health Care Programs

• Combined Application Form for Cash Assistance, Food Support and Health Care Programs

  Fill out this form to apply for assistance from these programs at your local county office. Read More

  By:

  Minnesota Department of Human Services

• Minnesota Health Care Programs Application

  This is the form needed to apply for any of the Minnesota Health Care Programs including Medical Assistance or MA, MinnesotaCare, General Assistance Medical Care or GAMC, Prescription Drug Program, and MA programs that help people pay Medicare premiums and deductibles. This form is fillable so people can type in answers and print out a completed application. Content Detail

  By:

  Minnesota Department of Human Services

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  Oromo / Afaan Oromo

  Arabic / العربية

  Russian / Pусский

  Serbo-Croatian / Srpskohrvatski Jezik

  Spanish / Español

  Cambodian / Khmer

  Hmong / Hmoob

  Laotian / ພາສາລາວ

  Somali / Soomaali

  Vietnamese / Tiếng Việt

• Appeal of Determination for Help with Medicare Prescription Drug Plan Costs

  Fill out this form if you want to appeal Medicare's decision about your eligibility for Prescription Drug benefits. For instructions on how to fill out this form go to http://www.ssa.gov/online/ssa-1021-inst.pdf Content Detail

  By:

  U.S. Social Security Administration

• Medicare Part D Exceptions Request Form

  Content Detail

  By:

  Care Improvement Plus

• Benefits Checkup

  Get all the benefits you deserve. Find and enroll in federal, state, local and private programs that help pay for prescription drugs, utility bills, meals, health care and other needs. Content Detail

  By:

  National Council on Aging

• Public Assistance Appeals - Form and Instructions

  If you were denied public benefits or your benefits were cut off, you can use this form to appeal the decision. After reading the instructions on the second page, you can fill out the form, print it off, and mail it in. Read More

  By:

  Minnesota Department of Human Services