2026 Medical Assistance (Medicaid) Plan Documents and Forms
Medical Assistance (Medicaid)
Prior Authorization List (PDF)
Prior Authorization List - Arabic (PDF)
Prior Authorization List - Hmong (PDF)
Prior Authorization List - Russian (PDF)
Prior Authorization List - Somali (PDF)
Prior Authorization List - Spanish (PDF)
Prior Authorization List - Vietnamese (PDF)
Member Release of Information Form (PDF)
Member Release of Information Form - Arabic (PDF)
Member Release of Information Form - Hmong (PDF)
Member Release of Information Form - Russian (PDF)
Member Release of Information Form - Somali (PDF)
Member Release of Information Form - Spanish (PDF)
Member Release of Information Form - Vietnamese (PDF)
Statement of Representative Form (PDF)
Statement of Representative Form - Arabic (PDF)
Statement of Representative Form - Hmong (PDF)
Statement of Representative Form - Russian (PDF)
Statement of Representative Form - Somali (PDF)
Statement of Representative Form - Spanish (PDF)
Statement of Representative Form - Vietnamese (PDF)
Know Your Rights About Services (PDF)
Power of Attorney short form
Deceased Member: Affidavit for the Collection of Personal Property (mncourts.gov)
Advance Directives Info (PDF)
Parent or Guardian Authorization Form for Unaccompanied Minors (PDF)
Coming soon
Provider and Pharmacy Directory (PDF)
Member Guide (PDF)
Member Handbook (PDF)
Coming soon
Provider and Pharmacy Directory (PDF)
Member Guide (PDF)
Member Handbook (PDF)
Coming soon
Provider and Pharmacy Directory (PDF)
Member Guide (PDF)
Member Handbook (PDF)
Coming soon
Provider and Pharmacy Directory (PDF)
Member Guide (PDF)
Member Handbook (PDF)