Use the information on this page to support special populations in need of application and enrollment assistance.
Use this application for special circumstances where a consumer's eligibility cannot be determined online through MNsure. Download this application as an electronic PDF form (DHS-3876). Only use this application if at least one of the following is true:
All applicants are:
DHS' MinnesotaCare Expansion presentation and the DHS Bulletin 24-21-10 provide information for assisters about the MinnesotaCare expansion.
Additional Information
Questions?