Medica Medicare Solutions

2010 Eligibility Information

Medica Prime Solution® Cost Plans

 

  • You must be enrolled in Medicare Parts A and B or in Part B only.
  • You must continue to pay your Medicare Part B premium. 
  • You must permanently reside within the Medica Prime Solution Minnesota, North Dakota, South Dakota or Wisconsin service area.
  • You must not have End-Stage renal Disease (SRD), unless: 
    • You are already enrolled in a Medica Plan as a non-Medicare member and you developed ESRD while a Medica member ; or 
    • You have had a successful kidney transplant and no longer require dialysis; or 
    • You have medically determined to first have ESRD after the date you elect* Medica Prime solution, but before the effective date of coverage under the plan. 

Medica Advantage SolutionSM Standard and Choice Private Fee-for-Service Plans 

  • You must be enrolled in Medicare Parts A and B. 
  • You must continue to pay your Medicare Part B premium. 
  • You must permanently reside within the Medica Advantage Solution Minnesota and North Dakota service area 
  • You must not have End-Stage renal Disease (SRD), unless: 
    • You are already enrolled in a Medica Plan as a non-Medicare member and you developed ESRD while a Medica member ; or 
    • You have had a successful kidney transplant and no longer require dialysis; or 
    • You have medically determined to first have ESRD after the date you elect* Medica Advantage Solution, but before the effective date* of coverage under the plan. 

Medica Complete Solution® Special Needs Plans (HMO)

  • You must be enrolled in Medicare Parts A and B.
  • You must continue to pay your Medicare Part B premium. 
  • You must be diagnosed with one of the chronic conditions outlined in each of the three Complete Solution plan options.
  • You must permanently reside within the Medica Complete Solution Minnesota service area 
  • You must not have End-Stage renal Disease (SRD), unless: 
    • You are already enrolled in a Medica Plan as a non-Medicare member and you developed ESRD while a Medica member ; or 
    • You have had a successful kidney transplant and no longer require dialysis; or 
    • You have medically determined to first have ESRD after the date you elect* Medica Complete solution, but before the effective date of coverage under the plan.

Medica AccessAbility Solution® Special Needs Basic Plan (HMO)

  • You must be enrolled in Medicare Parts A and B. 
  • You must qualify for State of Minnesota assistance in paying for your health care premiums and prescription drugs. 
  • You must permanently reside within the Medica AccessAbility Solution Minnesota service area. 
  • You must not have End-Stage renal Disease (SRD), unless: 
    • You are already enrolled in a Medica Plan as a non-Medicare member and you developed ESRD while a Medica member ; or 
    • You have had a successful kidney transplant and no longer require dialysis; or 
    • You have medically determined to first have ESRD after the date you elect* Medica AccessAbility Solution, but before the effective date of coverage under the plan.

Medica DUAL Solution® Special Needs Plan (HMO)

  • You must be receiving Medicare and Medical Assistance.
  • You must be 65 years of age or older.
  • If your are receiving Medicare Benefits, you must have Parts A and B.
  • You must permanently reside within the Medica DUAL Solution service area

Medica Select Solution® Select Plan (Medigap)

  • You must be enrolled in Medicare Parts A and B.
  • You must continue to pay your Medicare Part B premium.
  • You must permanently reside within the Medica Select Solution service area.

* The date you elect a plan is the date the enrollment form is signed, the receipt date stamp if no date is on the form, or the date elect is made by alternate means provided by CMS. If you have questions about eligibility and ESRD please call Medica Center for Healthy Aging at 952-992-2345 or 1-800-906-5432. TTY users may call the National Relay Service at 1-800-855-2880 and ask to be transferred to 1-800-906-5432. Hours of operation are 8 am - 8 pm (CST), seven days a week. Please note that access to a representative may be limited evenings and weekends during certain times of the year.

Medica Prime Solution® is a Medicare Cost product offered by Medica Insurance Company, an insurance company with a Medicare contract.  Medica Advantage SolutionSM is a Medicare Advantage product offered by Medica Health Plans, a health maintenance organization with Medicare contract.  Medica Complete Solution®, Medica AccessAbility Solution® and Medica DUAL Solution® are Medicare Advantage Special Needs products offered by Medica Health Plans, a health maintenance organization with Medicare contract.



H2410, H2458, H2450, H7526_2287 (02-2010)