DHS-8174-ENG   4-25 (1.2.0)

Health Care Consumer Support Document Portal for Consumers

This portal is for use by consumers or their authorized representative who wish to submit documents online to Health Care Consumer Support.

Do not use the portal to submit documents to a county or tribal agency. View Agency Addresses (DHS-5207) to find the correct contact information.

HCCS supports the following programs

  • MinnesotaCare
  • Minnesota Family Planning Program
  • DACA, Red Lake, Refugee, Center for Victims of Torture, MA for Inmates
  • Health plan enrollments for MinnesotaCare.

Use this portal to submit documents to Health Care Consumer Support for Minnesota Health Care Programs or health plan enrollment.

You can use this form to submit:

  • Health care renewal forms
  • Documents to provide proof or verification
  • Documents to report changes
  • Health plan enrollment forms
  • Health care applications

This document portal accepts forms for all MinnesotaCare, certain Medical Assistance, and certain mixed households. Mixed households have both MinnesotaCare and Medical Assistance household members.

See Frequently Asked Questions (FAQ) for Consumers.

If you need additional help, contact Health Care Consumer Support Monday through Friday from 8:00 am - 5:00 pm:

  • Minnesota Care: 651-297-3862 or 800-657-3672
  • MFPP, MA for Inmates, Red Lake, and DACA: 651-431-3480 or 888-702-9968
  • Refugee, Center for Victims of Torture, Safe at Home (Secured Services): 651-478-8380

Collection of Private Data

The Minnesota Department of Human Services (DHS) collects your private information in this application to check for eligibility with our programs and for reasons listed in the DHS Notice of Privacy Practices. Additionally, your information may be released to law enforcement, individuals whose work assignment requires access, individuals authorized by state or federal law or pursuant to a court order, or by your written consent. You can refuse to provide this information, but without it, DHS cannot determine your eligibility for our programs and you will not be able to receive services. Additionally, if you give us wrong information on purpose, you could be investigated and charged with fraud. The DHS Notice of Privacy Practices (DHS-4839E) contains more details on how DHS uses and discloses your private information.

Collection of Social Security Numbers

DHS is required by law to collect your Social Security Number (SSN) to help you get medical assistance, some kinds of financial help, or child support enforcement services. (42 C.F.R. 435.910, Minn. Stat. 256L.04, 42 U.S.C. 666). DHS also needs your SSN to verify your identity, prevent duplication of state and federal benefits, and conduct computer data matches with other agencies to verify income, resources, or other information that may affect your eligibility or benefits. Find more details, including a list of circumstances when you do not need to provide your SSN, in the DHS Notice of Privacy Practices.

You will also find information about your rights and our responsibilities in the DHS Notice of Privacy Practices (DHS-4839E).

Language Block and Americans with Disabilities Act (ADA) statement

If you need free help interpreting this document, call 651-297-3862 or 800-657-3672.

For accessible formats of this information or assistance with additional equal access to human services, write to DHS.info@state.mn.us, call 800-657-3672, or use your preferred relay service.

Tell us about the person for whom you are submitting documents

Before you start, we need to match your documents to your case. Provide as much information as possible; it will help us send your documents to the correct place. Enter your legal name as it appears on your legal ID.

If you are filling this out on behalf of someone else, enter that person's information.

Case numbers are usually located on the upper left-hand or right-hand corner of notices, but they may be located elsewhere. Case numbers are generally 8 characters (digits or letters). If your case number is less than 8 characters, enter zeros at the beginning to make up the difference.

Attach documents

  • Attach documents in the correct category for the type of document.
  • Acceptable file types are PDF, JPG, TIF, PNG, Word, and Text.
  • It is recommended that you submit applications, renewals, or taxes as a PDF due to file size limitations.
  • You can attach photos from your phone, screenshots, PDFs, Word documents, etc.
    • iPhone or iPad photos in the default file type (HEIC or HEIF) are not accepted. If using an iPhone or iPad to take photos, you will need to convert them to an acceptable file type such as those listed above.
    • For larger documents such as taxes, applications, or renewals, we recommend submitting them as a PDF rather than a photo or screenshot.
  • There are file size limits and limits on the number of attachments for each document category. You must stay within the file size limitations and the maximum number of allowed attachments per category or you will receive a message that your documents did not attach.

Select your program type

What documents do you want to submit?

Select the appropriate category from the list below and upload each document type separately using the specified document types to prevent delays in processing.

Select the appropriate category from the list below and upload each document type separately using the specified document types.

You can attach an application along with other related documents and a health plan enrollment. You can attach a maximum of 20 application-related files. Be sure to sign and date your application.

Standard applications are the:

  • MNsure Application for Health Coverage and Help Paying Costs (DHS-6696)
  • MHCP Application for Certain Populations (DHS-3876)

Submit a MNsure Application for Health Coverage and Help Paying Costs (DHS-6696). Direct other applications for Centers for Victims of Torture to the appropriate county or tribe.

Submit MNsure Application for Health Coverage and Help Paying Costs (DHS-6696).

Submit MNsure Application for Health Coverage and Help Paying Costs (DHS-6696) or MHCP Application for Certain Populations (DHS-3876).

    You can attach one renewal plus other documents. You can attach a maximum of 20 renewal-related files.

    Submit Need to Renew forms for MinnesotaCare. Direct Need to Renew forms with Medical Assistance, including households with Medical Assistance and MinnesotaCare to the appropriate county or tribe.

    Submit Auto Renew forms for MinnesotaCare. Direct Need to Renew forms with Medical Assistance, including households with Medical Assistance and MinnesotaCare to the appropriate county or tribe.

    Submit renewals that have both the Department of Human Services and MNsure logos in the top right corner.

    Submit Need to Renew forms for MinnesotaCare.

    Submit Auto Renew or Need to Renew forms for MinnesotaCare and Medical Assistance.

      The MFPP application is the Minnesota Family Planning Program Application and Renewal Form (DHS-4740). You can attach a maximum of 20 MFPP application files. Be sure to sign and date your application.

        The MFPP renewal is the Minnesota Family Planning Program Application and Renewal Form (DHS-4740). You can attach a maximum of 20 MFPP renewal files. Be sure to sign and date your renewal.

          You can submit multiple proofs, verifications, and other documents.

          Authorized representative forms may be the DHS-3437, Giving Permission for Someone to Act on My Behalf; Appendix C of the DHS-6696; Appendix B of the DHS-3876; or other legal documents. You can attach a maximum of 1 authorized representative file.

            Citizenship, identity, immigration, and tribal membership proof and verification may be a birth certificate, passport, front and back of immigration cards, other immigration papers, tribal membership cards, or other legal documents. You can attach a maximum of 10 citizenship, identity, immigration, or tribal membership files.

              Consent or authorization for the release of information may be the General Consent/Authorization for Release of Information (DHS-3549). You can attach 1 authorization for release of information file.

                Income and projected annual income proofs and verifications may be complete federal tax returns (W2s, schedules, and forms), paystubs, proof of alimony, copy of business financial records, employer statements, and other income documents. You can attach a maximum of 15 income files.

                  Other health insurance proofs and verifications may be an Appendix A Health Coverage from Jobs (DHS-6696D), front and back of a health plan card, Medicare card, Tricare card, COBRA documents, and other insurance documents. You can attach a maximum of 2 health insurance files.

                    Other proofs, verifications, and documents may be signature page, change report form, address change documents, information about other household members, and other requested documents. You can attach a maximum of 2 other proofs, verifications, or documents files.

                      You can submit multiple proofs, verifications, and other documents.

                      Authorized representative proofs and verifications may be Giving Permission for Someone to Act on My Behalf (DHS‑3437); Attachment C of the MFPP Application (DHS‑4740). You can attach a maximum of 1 authorized representative file.

                        Citizenship, identity, immigration, and tribal membership proof and verifications may be birth certificate, passport, front and back of immigration cards, other immigration papers, tribal membership cards, and other related documents. You can attach a maximum of 10 citizenship, identity, immigration, or tribal membership files.

                          Consent or authorization for release of information may be the Authorization to Request Birth Records (DHS-4841) or the General Consent/Authorization for Release of Information (DHS-3549). You can attach a maximum of 1 authorization for release of information files.

                            Income proofs and verifications may be complete federal tax return (W2s, schedules, and forms), paystubs, proof of alimony, copies of business financial records, employer statements, and other income documents. You can attach a maximum of 15 income files.

                              Other health insurance proofs and verifications may be front and back of a health plan card, Medicare card, Tricare card, COBRA documents, Appendix A: Health Coverage from Jobs (DHS-6696D), and other insurance documents. You can attach a maximum of 2 other health insurance files.

                                Other proofs, verifications, and documents may be signature page, change report form, address change documents, information about other household members, and other requested documents. You can attach a maximum of 2 other proofs, verifications, or documents files.

                                  You can submit one Health Plan Enrollment form (1 health plan enrollment file). Examples of Health Plan Enrollment forms to submit are:

                                  • Health Plan Enrollment Form for MinnesotaCare
                                  • Annual Health Plan Selection for MinnesotaCare and METS

                                    Your submission is not completed until you receive the message that your submission was successful. Your total submission size (all attachments combined) cannot be larger than 500 MB. Attempts to make a submission larger than 500 MB will not be successful. You will need to resubmit the document(s) using multiple submissions of smaller file sizes.