Forms/documents

Member materials 

Member handbooks

• 2026 PMAP member handbook (PDF, 2MB)
• 2026 MinnesotaCare member handbook (PDF, 2MB)
• 2026 SNBC member handbook (PDF, 2MB)

Provider directories

• PMAP/MinnesotaCare provider directory: English (PDF, 4MB)  Español (PDF, 4MB)
• SNBC provider directory: English (PDF, 4MB)  Español (PDF, 3MB) 

List of covered drugs (Formulary)

• Current formulary (Effective 1/1/26) (PDF, 3MB)
• Upcoming formulary (Effective 5/1/26) (PDF, 3MB)
• Upcoming formulary (Effective 5/7/26) (PDF, 3MB)

List of covered drugs for SNBC members with Medicare coverage (Formulary)

• Current formulary (Effective 1/1/26) (PDF, 3MB)
• Upcoming formulary (Effective 5/1/6) (PDF, 3MB)

Forms

• Member information release form (PDF, 1MB)
• Member appeal and complaints (grievances) form (PDF, 1MB)
• Request for protected health information form (PDF, 1MB) 
• Change to protected health information form (PDF, 1MB)
• Request for personal health information disclosures form (PDF, 1MB) 

Rewards vouchers

• Adolescent immunization:  English (PDF, 1MB)  Af Soomaali (PDF, 1MB)  Español (PDF, 1MB)
• Annual blood glucose test - A1C:  English (PDF, 1MB)  Af Soomaali (PDF, 1MB)  Español (PDF, 1MB)
• Annual dental visit:  English (PDF, 1MB)  Af Soomaali (PDF, 1MB)  Español (PDF, 1MB)  
• Annual eye exam:  English (PDF, 1MB)  Af Soomaali (PDF, 1MB)  Español (PDF, 1MB)
• Cervical cancer screening:  English (PDF, 1MB)  Af Soomaali (PDF, 1MB)  Español (PDF, 1MB) 
• Child & Teen Checkup six visits; 0-14 months:  English (PDF, 1MB)  Af Soomaali (PDF, 1MB)  Español (PDF, 1MB)
• Child & Teen Checkup visits; 15 months–17 years:  English (PDF, 2MB)  Af Soomaali (PDF, 2MB)  Español (PDF, 2MB) 
• Colorectal cancer screening: English (PDF, 1MB)  Af Soomaali (PDF, 1MB)  Español (PDF, 1MB)
• Early childhood immunizations:  English (PDF, 1MB)  Af Soomaali (PDF, 1MB)  Español (PDF, 1MB)
• Mammogram screening:  English (PDF, 1MB)  Af Soomaali (PDF, 1MB)  Español (PDF, 1MB) 
• Pregnancy prenatal visit:  English (PDF, 1MB)  Af Soomaali (PDF, 1MB)  Español (PDF, 1MB) 
• Pregnancy postpartum visit:  English (PDF, 1MB)  Af Soomaali (PDF, 1MB)  Español (PDF, 1MB) 
• Young adult checkup visits:  English (PDF, 1MB)  Af Soomaali (PDF, 3MB)  Español (PDF, 1MB) 
• Car seat program FAQ (PDF)

Notices

• Advance health care directive (ages 18+)
• Restricted Recipient Program (PDF, 1MB)
• Members have a Bill of Rights pursuant to Minnesota Statutes, Section 62D.07, subdivision 3. You can read your Bill of Rights in your member handbook.
• Nondiscrimination notice
• Notice of privacy practices (PDF, 1MB)
• Language and civil rights notices: English (PDF, 1MB)  Hmong (PDF, 1MB)  Somali (PDF, 1MB)  Spanish (PDF, 1MB)
• Rights and safety with third-party health information apps
• Limited English Proficiency (LEP) plan (PDF, 1MB)

DHS approved: 9/24/2020, HC-1110-MC; 2/27/23, QM-1417-MC