Minnesota Health Care Programs Managed Care Manual

Revised: February 23, 2026

The Minnesota Health Care Program Managed Care Manual contains managed care eligibility and enrollment policies and procedures for those enrolled in Minnesota Health Care Programs (MHCP).

The manual consists of information on the following:

· Prepaid Medical Assistance (PMAP)

· MinnesotaCare

· Minnesota Senior Health Options (MSHO)

· Minnesota Senior Care Plus (MSC+)

· Non-Integrated Special Needs BasicCare (SNBC)

· Integrated Special Needs BasicCare (I-SNBC)

Terminology
Acronyms

Access the sections of the manual by using the left-hand navigation to find specific information.

Announcements

Announcements provide new and important information for workers, including procedure changes, system updates and temporary processes. Announcements are listed by date, beginning with the most recent announcements. We will remove outdated or expired announcements as needed.

February 23, 2026

· Exclusions – We updated the EE section of the Exclusion Codes table.

February 11, 2026

· HPEN Ticket Guide – We updated the "Plan Change - Continuity of Care Change Request" section and the "Plan Change - Good Cause Change Request" section.

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December 12, 2025

· Health Plan Enrollment Management in MMIS – This page was previously titled Coding and editing requirements. The updated page describes the MMIS screens used to record and manage health plan enrollment information and how to update health plan enrollment in MMIS for certain situations.

August 18, 2025

· Changing Health Plans – We removed the reference to Disability Hub for assistance with changing Special Needs BasicCare health plans.

· Disenrollment from Health Plans – We removed the reference to the Disability Hub from the Disenrollment Process from the Non-Integrated SNBC section.

July 14, 2025

· HPEN Ticket Guide – This page has been developed to help processing entities when submitting an HPEN ticket.

June 9, 2025

· Disenrollment – This page has been updated with disenrollment reason codes and policy for MHCP.

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July 12, 2024

· Reinstatement and Reenrollment – This page has been updated with information on reinstatement and reenrollment policies for MA, MCRE, MSC+, MSHO, and SNBC.

April 15, 2024

· Changing Health Plans – This page has been updated to provide information about four additional changing health plan options.

April 10, 2024

· Exclusions- This page has been updated with clarifying language and direction for the exclusion hierarchy.

January 29, 2024

· Exclusions – This page has been added to provide updated information on health plan exclusion codes and when to use them.

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April 21, 2023

· Education and Enrollment – This page has been updated with changes that impact virtually every topic covered in the previous version of it. The following highlights changes made to this page:

· Additional information has been added about the enrollment process and is broken down by product. Clarification on integrated and non-integrated products has been added.

· Some duplicative exclusion information has been removed. More information on exclusions will be released later.

· Procedures for returned mail have been removed. Refer to the ONEsource page “Process Returned Mail” for instructions.

· More information has been added about how a default plan is assigned.

· More information has been provided about the RTRK screen and the tracking process, including the way MMIS uses a counting system to send out notices.

· The page has been reorganized with additional headers.

· The page clarifies that enrollments can be processed over the phone outside of AHPS.

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December 27, 2022

· Changing Health Plans – The Changing MCOs page has been renamed to Changing Health Plans. This section contains updated information on change options available to enrollees throughout the year including AHPS.