Download forms
You can visit http://edocs.mn.gov to download any form.
Application forms
If you are age 65 or older, blind or certified disabled, living in or moving to a nursing home, or those applying for supports to remain in their own homes use the applications below.
Download the Minnesota health care programs (MHCP) – Application for certain populations and submit the completed application to Hennepin County if you are:
- 21 years of age or older, with no dependents, and have Medicare coverage
- 65 years of age or older
- A child currently in foster care
- Blind or have a certified disability
- Applying for Medical Assistance for Employed Persons with Disabilities (MA-EPD)
- Applying for help with your Medicare premiums
Download the Minnesota health care programs (MHCP) – Application for medical assistance for long-term care services (MA-LTC) and submit the completed application to Hennepin County if you are:
- Living in, or may need to move to, a nursing home
- 65 years of age or older and would like services to help you stay in your home
- Younger than 65 years of age, are disabled, and would like services to help you stay in your home
How to submit documents and update your information
You have options to submit forms and documents and update your information.
- Update information and upload documents to InfoKeep
- Upload to MNbenefits
- Fax to 612-288-2981
- Mail to:
Hennepin County Human Services Department
P.O. Box 107
Minneapolis, MN 55440
If you don't have access to these options, there are document drop boxes available at any Human Service Center.
Available drop boxes for residents
Northwest Human Service Center – Brooklyn Center
7051 Brooklyn Boulevard, Brooklyn Center, MN 55429
Northwest Human Service Center map
- Main floor lobby 7 a.m. to 5 p.m. weekdays only
Health Services Building – downtown Minneapolis
525 Portland Avenue, Minneapolis, MN 55415
Health Services Building map
- Main floor lobby 7 a.m. to 6 p.m. weekdays only
South Suburban Human Service Center – Bloomington
9600 Aldrich Avenue South, Minneapolis, MN 55420
South Suburban Human Service Center map
- Outside building by Hennepin County entrance
South Minneapolis Human Service Center
2215 East Lake Street, Minneapolis, MN 55407
South Minneapolis Human Service Center map
- First floor 8 a.m. to 4:30 p.m. weekdays only
North Minneapolis Human Service Center
1001 Plymouth Avenue North, Minneapolis, MN 55411
North Minneapolis Human Service Center map
- Outside building near main entrance