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My Coverage

For Medica Choice Care℠ MSC+ Members

Looking for a quick overview of your plan benefits?

Here's a summary of your plan benefits.

  • Large network of health care providers
  • Access to primary or specialty care without a referral
  • Low copays
  • Care coordination services

For a complete record of your plan benefits and any plan notices, see your plan documents.

Plan Features

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Care Coordination

Your plan includes support from a personal Care Coordinator to build and maintain an independent, healthy life. Your Medica Care Coordinator is your go-to source for help.


This program gives you:

  • Control. You get the information and options you need to make decisions about your health care.
  • Coordination. We organize and manage your medical providers as well as your support needs to make sure you get what you need when you need it — without hassles.
  • Planning. We support your long-term health with preventive and creative care that starts with a complete health assessment.
  • Partnership. Health care decisions are important to your long-term health, so we work one-on-one with you to build a strong partnership and make decisions together.
  • Ease of use. We help you get the resources you need from the state of Minnesota and figure out how everything should work together.
  • Longevity. We support you now and in the future by finding, organizing and building your network of health care support. You can focus on your life, not your disability.

If you have any questions about how to access Care Coordination or who your Care Coordinator is, please call us at 1-888-347-3630 (toll-free) (TTY: 711).

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Transportation

If you don't have access to transportation, we can help. Our Provide-A-Ride℠ service will give you a ride to and from medical, dental, mental health and substance use disorder appointments.

Call us at least five days before your appointment and we'll be happy to help you schedule a cab or bus ride to your appointment.

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Mental Health and Substance Use Disorder Care

Get information and support on many mental health and wellness issues ranging from relationships and parenting to stress and depression. Visit the Live and Work Well website to get helpful tips, use online tools, search for a mental health clinician, view your behavioral/mental health claims and more.
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Eyewear

Your plan covers a new pair of eyeglasses when medically necessary from Medica eyewear vendor Eye-Kraft®. Please see the eye care section of your Member Handbook for more information. Choose your eyewear from the catalog below.

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Dental

Your plan includes dental coverage, which is managed by Delta Dental® of Minnesota.

Delta Dental can help you:

  • Find a dentist
  • Understand your dental benefits
  • With dental claims
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Language Resources

Medica will contact an interpreter to provide help over the phone. Medica will also provide interpreters for your medical, dental, pharmacy, mental health or substance use disorder appointments at no cost to you. To request an interpreter, call Medica Member Services.
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Transplant Program

When you need an organ, bone marrow or stem cell transplant, our transplant program helps you get the care you need in the most effective setting, with the best possible outcome. We coordinate your benefits and provide readiness coaching. We can also help you find a Centers of Excellence transplant facility.

Before you receive care (including pre-transplant evaluations), your doctor needs to request prior authorization for all transplant services. Without prior authorization, services may not be covered.

Understanding Your Copays

A copay is an amount that you pay your provider when you receive care. Copay amounts are listed below. Some members have reduced or no copays, depending on their situation.

You pay your copay directly to your provider. Many providers have you pay your copay when you arrive for your appointment. If you get non-emergency care at a hospital emergency room, they may bill you later.

If you can't pay your copay, the provider must still give you care. This is true even if you haven't paid your copay to that provider in the past or if you have other debts to that provider. The provider may still bill you for the unpaid copays.

Copay Amounts

Services

Visits for a health problem with care provided by a network care provider*

Common examples of these visits include:

  • Sore throat
  • Diabetes checkup
  • High fever
  • Sore back
  • Other illnesses or injuries

Copay

$3.00

Services

Mental health services

Copay

$0.00

Services

Procedures to diagnose a health problem

Common examples of these visits include:

  • Colonoscopy
  • Endoscopy
  • Arthroscopy

Copay

$3.00

Services

Urgent care services received in an emergency room

Copay

$3.50

Services

Non-emergency or non-urgent care received in a hospital emergency room

Copay

$3.50

* Network care providers for this type of visit include physicians, physician assistants, advanced practice nurses, certified professional midwifes, chiropractors, acupuncturists, podiatrists, audiologists or eye doctors.

Copay Exceptions

You may have reduced copays if your income is at or below 100 percent of federal poverty guidelines. The Minnesota Department of Human Services will tell us each month if you are eligible for reduced copays.

In certain situations, you won’t have to pay copays for medical services that are covered by Medical Assistance (MA) under the plan. This applies if you:

  • Are an American Indian who receives or has received services from an Indian Health Care Provider or through IHS CHS referral from an IHS facility
  • Are pregnant (if you become pregnant, tell your county worker right away)
  • Are under age 21
  • Are receiving hospice care
  • Have been living in a nursing home, hospital or other long-term care facility for more than 30 days

American Indians can continue to use tribal and Indian Health Services (IHS) clinics. We will not require prior approval or impose any conditions for you to get services at these clinics. For elders age 65 years and older this includes Elderly Waiver (EW) services accessed through the tribe. If a doctor or other provider in a tribal or IHS clinic refers you to a provider in our network, we will not require you to see your primary care provider prior to the referral.

Last updated: December 2022

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