2.2.2.1 Bases of Eligibility

Minnesota provides Medical Assistance (MA) to certain groups of people as allowed under law. These groups are referred to as a basis of eligibility. A person’s basis of eligibility determines the non-financial criteria and financial methodology used to determine MA eligibility.

The following are the bases of eligibility for MA for Families with Children and Adults (MA-FCA):

Parent: Biological, natural, adoptive or step parent Living with a child younger than age 19 Has primary responsibility for the child’s care

Caretaker Relative, including foster parents, legal guardians or others, who are: A relative of a child younger than age 19, by blood, adoption, or marriage. Including: Grandparents, siblings First cousins, nephews, nieces, aunts or uncles and people of preceding generations as denoted by grand, great or great-great Stepbrother or stepsister Spouses and former spouses of the people named above Living with a child younger than age 19 Has primary responsibility for the child’s care The spouse of a caretaker relative can also use the caretaker relative basis of eligibility

Pregnant Person: A person who is pregnant A person within the 12 month postpartum period

Auto Newborn: child born to a person enrolled in MA

Infant: child age 0 through 1: Children's Health Insurance Program (CHIP) funded MA may be available for infants with income between 275% and 283% FPG who are not enrolled in other health insurance A CHIP-funded infant who gains other health insurance becomes eligible for MA as a non-CHIP-funded infant

Child age 2 through 18

Child age 19 and 20

Adult age 21 through 64 who: Is not eligible for or enrolled in Medicare Part A or Medicare Part B Is not a Supplemental Security Income (SSI) recipient Is not eligible for MA under 1619 a/b Is not a former SSI recipient who stopped receiving SSI when they began receiving Retirement, Survivor, Disability (RSDI) benefits from the Social Security Administration (SSA) under a deceased spouse or deceased or retired parent’s earning record Is not eligible for MA under the parent, caretaker relative, pregnant person or former foster care basis of eligibility Adults not eligible for this basis may meet the eligibility requirements for MA for People Who Are Age 65 or Older or People Who Are Blind or Have a Disability .

Former Foster Care Youth: Was enrolled in MA or MinnesotaCare another state’s Medicaid program when they aged out of foster care at 18 or older. Is under age 26 Aged out of foster care in any state, District of Columbia, or United States territory at age 18 or older.

Beginning and Ending Bases of Eligibility A person must have one of the following bases of eligibility for MA-FCA. A person whose basis of eligibility ends must be evaluated for other MA bases of eligibility before MA is closed. Applicants who meet eligibility requirements at any time within a month are eligible for the entire month with the following exceptions: A person’s eligibility ends on the date of death A person’s eligibility begins the date they become a Minnesota resident A person’s eligibility begins the date they meet their spenddown requirement The begin and end dates for the following bases of eligibility are: Pregnant person: Begins the first day of the month of conception Ends the last day of the month following the 12 month postpartum period Begin and end dates for the pregnant person basis of eligibility are determined using information the applicant or enrollee attests. Verification of pregnancy is not required to establish this basis. Auto newborn: Begins the first day of the month of birth Ends the last day of the month of their first birthday Infant: Begins the first day of the month of birth Ends the last day of the month of their second birthday Child age 2 through 18: Begins the first day of the month following their second birthday Ends the last day of the month of their 19th birthday Child age 19 and 20: Begins the first day of the month following their 19th birthday Ends the last day of the month of their 21st birthday Parent or caretaker relative: Begins the first day of the month of the birth or adoption of a child under the age of 19 or the first day of the first full month when a child younger than age of 19 moves into their home. Ends the last day of the month when: The only child or youngest child for whom the person is a parent or relative caretaker turns 19 The only child, or all children who live in the home under the age 19, leave the home and the absence is not temporary The parent or caretaker relative no longer lives with a child younger than age 19 Adults without children: Begins the first day of the month following their 21st birthday Ends the last day of the month prior to their 65th birthday Former Foster Care Youth: Begins no earlier than the first day of the month after the month that A under a Foster Care basis of eligibility ends Ends the last day of the month of the youth's 26 th birthday Multiple Bases of Eligibility People may have more than one basis of eligibility. A person’s countable income, asset limit, cost sharing, service delivery options and benefits may differ depending on the eligibility basis used. The county, tribal or state servicing agency must allow a person with multiple bases of eligibility to have eligibility determined under the basis that best meets their needs. Change in Basis of Eligibility for Enrollees A change in circumstances may affect an MA enrollee's basis of eligibility. People who lose eligibility under one basis must be redetermined under another basis without interruption in their coverage. Additional information may be required to determine continued eligibility under another basis. Some changes that may affect an enrollee's basis of eligibility include, but are not limited to: Age An auto newborn basis of eligibility ends the last day of the month in which the child turns one A child basis of eligibility ends the last day of the month of the child's 21st birthday A Former Foster Care Youth basis of eligibility ends the last day of the month of the youth’s 26th birthday An adult without children basis of eligibility ends the month before the enrollee’s 65th birthday Disability status Household Composition Medicare A or B. An adult without children basis of eligibility ends the month before the enrollee is eligible for or enrolled in Medicare A or B. Pregnancy. A pregnant basis of eligibility ends on the last day of the month in which the 12 month postpartum period ends. If an enrollee is no longer eligible for MA under their current basis of eligibility, they must be redetermined for all health care programs they are potentially eligible for, without interruption in their coverage. See EPM section 1.3.2.1 Change in Circumstances for more information. Legal Citations Code of Federal Regulations, title 42, section 431.213 Code of Federal Regulations, title 42, section 435

Code of Federal Regulations, title 42, section 435.916 Code of Federal Regulations, title 42, section 457.1 Minnesota Statutes, section 256B.055, subdivision 6 Minnesota Statutes, section 256B.06, subdivision 4, 5 & 10

Published: June 3, 2026 Previous Versions Previous Versions Manual Letter #23.3, June 1, 2023 Manual Letter #22.4, September 1, 2022 Manual Letter #18.4, September 1, 2018 Manual Letter #18.2, April 1, 2018 Manual Letter #17.3 August 1, 2017 Manual Letter #17.2, June 1, 2017 Manual Letter #16.1, June 1, 2016 (Original Version)

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