Download Free DHS-3340-ENG 3-11 Minnesota Health Care Programs Asset Assessment for Medical Assistance (MA) Payment of Long-Term Care (LTC) Services
Download and use this form for the following services –
- You received or expect to receive 30 uninterrupted days of long-term care (LTC) services. LTC services include nursing home care or services to help you stay in your home through the Elderly Waiver (EW) or Alternative Care (AC) program.
- You are married.
- Your spouse does not live in a long-term care facility such as a nursing home.
- Your spouse is not getting services to help him or her stay in their home through the EW,
- Community Alternatives for Disabled Individuals (CADI), Community Alternative Care (CAC),
- Developmental Disabilities (DD) or Traumatic Brain Injury (TBI) waiver programs.
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