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Eligibility Verification Notice

Who Gets this Notice

Consumers who need to verify their citizenship, lawful presence or incarceration (serving a term in prison or jail) status.

What You Need to Do

  • Provide the requested documentation by the due date. The due date is on page under "What do I need to do?"
  • Do not delay. Your health care coverage will be terminated if you do not provide the documentation by the due date.

How to Identify this Notice

On the first page of this notice you will see:

  • The MNsure logo.
  • Title is, "ACTION REQUIRED: DOCUMENTATION IS NEEDED"
  • "MNsure 4843B-V19" on the lower left

Questions

If you have questions about this notice, call the MNsure Contact Center at 651-539-2099 (855-366-7873 outside the Twin Cities) and reference "form V19."

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