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My coverage

For Medica DUAL Solution® (HMO D-SNP) (MSHO)

Here's a summary of your plan benefits.

  • Large network of health care providers
  • Access to primary or specialty care without a referral
  • $0 premium, medical and hospital costs, copays, and deductibles.
  • Care coordination services

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

Plan documents

Plan features

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. Health care means anything that can affect your well-being, like stress, nutrition, exercise, sleep, your mental health, and your physical health.
  • Coordination. We can help you make appointments with medical providers as well as help you find new providers as needed.
  • Planning. We support your long-term health with preventive and whole person care that starts with a complete health assessment. Together we'll talk about your goals and what's the most important to you.
  • Partnership. Health care decisions are important to your long-term health, so we work one-on-one with you to build a strong partnership so that you feel supported, and have all the information you need to make decisions together. We'll make recommendations and talk through all your options.
  • Ease of use. Let us help you get the care and support you need from your local providers and make sure everything is working to best serve your needs.
  • Longevity. We support you now and in the future. By finding, organizing, and building you a network of supporting providers, you can focus on your life, not just your health care needs.

If you have any questions about how to access Care Coordination or who your Care Coordinator is, please call us.


1-888-347-3630 (toll-free) (TTY: 711)

8 a.m. – 9 p.m. CT, daily

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. We recommend calling us at least five days before your appointment so we can schedule public transportation or a cab for you.


1-888-347-3850 (toll-free)        (TTY: 711)


Learn more about Provide-A-Ride

Mental health and substance use disorder care

Get information and support on mental health and wellness issues ranging from relationships 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.

Find providers and counselors

Learn more about mental health and substance use disorder care

 

Access at no-cost to AbleTo mobile app for on-demand help with stress, anxiety, and depression. The app provides coping tools, daily mood tracking, and weekly progress check-ins to stay engaged and manage symptoms.

Download from the Apple App Store  or  Google Play


 

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

In addition to your Medical Assistance dental benefits, Medica gives you:

  • One additional exam
  • Full mouth x-ray once every five years
  • One crown, prior authorization not required
  • Dental education outreach by telephone
  • $50 incentive for going to the dentist

Medica dental benefits and covered services

Eyewear

This plan covers a new pair of eyeglasses when medically necessary and anti-glare coating on one new pair of glasses from our eyewear vendor Eye-Kraft®. Please see the eye care section of your Member Handbook for more information. Choose your eyewear from the catalog below.


Eyewear frame catalog (PDF)

Language resources

We'll contact an interpreter to provide help over the phone. We'll 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.

Limited English Proficiency (LEP) plan (PDF)


To request an interpreter, call Medica Member Services.

1-888-347-3630 (toll-free)     (TTY: 711)

8 a.m. – 9 p.m. CT, daily

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.


To get started, call 1-866-905-7430 (toll-free)     (TTY: 711)

8 a.m. – 5 p.m. CT, Monday – Friday

Hospital readmission prevention

After you've been in the hospital, we want to help you recover safely at home and prevent readmission to the hospital. This special service offers individual support during the first 30 days after you leave the hospital.

Specially-trained Healthy Transitions staff will check in with you when you're eligible for this service. They'll offer you resources and answer your questions along the way.

The service is an innovative program of Lutheran Social Service of Minnesota in partnership with Medica.

Contact your Care Coordinator to learn more. If you don't know who your Care Coordinator is please call Member Services.

Contact us

8 a.m. – 9 p.m. CT, daily


Mailing address:

Medica
Route CP540
P.O. Box 9310
Minneapolis, MN 55440


Medica DUAL Solution® is an HMO D-SNP that contracts with both Medicare and the Minnesota Medical Assistance (Medicaid) program to provide benefits of both programs to enrollees. Enrollment in Medica DUAL Solution depends on contract renewal.

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 2023
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