For Medica DUAL Solution

(HMO D-SNP) (MSHO)

Plan Details

This easy-to-use, high quality plan combines your Medical Assistance (Medicaid) and Medicare benefits. We also offer care coordination and many other benefits to support your health and well-being with a personal Care Coordinator, medically tailored food for chronic conditions, and expanded dental benefits.

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Ready to enroll?

The easiest way to enroll in Medica DUAL Solution is online.

Looking for other ways to enroll?

You have two other options                                                                                                                                                                  
Call us toll-free at 1-866-538-5608 (TTY: 711)

Or

Programs + services

Our members enjoy many health and wellness benefits. Here's a look at several of these helpful programs. 

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Care Coordinator Services

This plan offers a Care Coordinator. These are nurses, social workers or highly trained professionals. Your Care Coordinator will work one-on-one with you to find and organize resources, identify and schedule appointments, and help you maintain a healthy and independent lifestyle.
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Dental extras

Keep smiling with preventive and comprehensive dental care. Dentists are part of the large Minnesota Select Dental network through Delta Dental.
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Physical fitness program

Fitness program through One Pass™ for a $0 annual fee. Includes:

  • Access to 20,000+ fitness locaBons
  • On-demand and live-streaming fitness classes
  • At-home fitness kit
  • No-cost rides to and from the gym
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Papa Pals program

Papa Pals is a curated network of young adults who connect with you for companionship and assistance

with the instrumental activities of daily living.

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Vision and Eyewear

See better with regular vision care. This plan covers a new pair of eyeglasses when medically necessary and anti-glare coating on one new pair of glasses from Medica eyewear vendor Eye-Kraft®.

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Reemo™ Smartwatch

We give you a ready-to-use Reemo Health Personal Independence Smartwatch to track your activity, help monitor your health and be your emergency response system for quick help 24/7.

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FOODRx Program

For eligible members, providing medically tailored and culturally relevant staple foods, nutrition education and food referrals for chronic conditions.

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Personalized Health Education

You and a community health worker focus on your health condition(s), skill development, and circumstances that affect your health, life and well-being.

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$0 rides

Get a ride to and from health care appointments — including medical, dental, mental health and substance use disorder visits — at no cost to you.

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Memory fitness program

Train your brain and improve your memory by playing games on your phone, tablet, or computer.

Scientifically proven, online brain training measures cognitive abilities and teaches you the skills that can

help you remain sharp. Get unlimited access to memory training app CogniFit® or web-based memory

fitness tools at Medica.com/Brain.

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24/7 Nurse Line

Talk to a registered nurse any time of day or night with NurseLine™ by HealthAdvocate™. The nurses can answer your questions and provide guidance about your care options.

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Health advocacy

Use our 24/7 phone support to help you with:

  • Questions about your health care
  • Find a doctor, clinic, or other provider
  • Schedule appointments
  • To resolve health insurance issues

Service provided through Health AdvocateSM.

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Hospital Readmission Prevention Program

Smooth your transition home after a hospital stay with visits by a community companion. They can help you be successful on your path to recovery. You'll also receive a member care kit with several helpful items to help meet your post-hospital needs. You may also qualify for home-delivered meals.

No Plan Premiums

$0 Premiums

Medical Premiums

The Part B premium is covered for full-dual members. That means you don't pay a monthly premium for Medica DUAL Solution, nor are there any deductibles, copays or coinsurance for medical care. If you have Medicare, you must get most of your prescription drugs through a Medicare Part D prescription drug plan. You may have a Part D plan premium. You may also have a copay with no monthly limit for some of these services.


Part D Premiums
If you qualify for a Medicare Advantage (HMO-SNP) plan like MedicaDUAL Solution, you automatically qualify for Extra Help with your Part D prescription drug costs. Those who qualify for Medica DUAL Solution are Low-Income Subsidy (LIS) eligible. You may have deductibles and copays for Part D drugs.

Low-Income Subsidy (LIS)

Extra Help With Your Monthly Premiums

If you qualify for extra help, you’ll get a Low Income Subsidy (LIS) rider. This means that you will get help paying your monthly premium and prescription drug cost-sharing. As a member of our Plan, you will get the same coverage as someone who is not getting Extra Help. Your membership in our Plan will not be affected by the Extra Help. This also means that you must follow all the rules and procedures in the Member Handbook.

We offer coverage of some supplemental prescription drugs not normally covered in a Medicare Prescription Drug Plan. These drugs are covered through Medical Assistance (Medicaid). Please see the chart below:

Level of Extra Help*

Level

3

Your monthly plan premium is

$0*

Your yearly deductible is

$0

Your cost-sharing amount for generic/preferred multi-source drugs is no more than

$0
(each prescription)

Your cost-sharing amount for all other drugs is no more than 

$0
(each prescription)

Level

2

Your monthly plan premium is

$0*

Your yearly deductible is

$0

Your cost-sharing amount for generic/preferred multi-source drugs is no more than

$1.35
(each prescription)

Your cost-sharing amount for all other drugs is no more than

$4.00
(each prescription)

Level

1

Your monthly plan premium is

$0*

Your yearly deductible is

$0

Your cost-sharing amount for generic/preferred multi-source drugs is no more than

$3.95
(each prescription)

Your cost-sharing amount for all other drugs is no more than 

$9.85
(each prescription)

These amounts are effective January 1, 2022.

 

Once the amount both you and Medicare pay (as the Extra Help) reaches $7,050 in a year, your copayment amount(s) will go down to $0 per prescription

Contact Us

8 a.m. - 8 p.m. CT, daily


Medica DUAL Solution is a health plan 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 enrollees 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: October 2021

H2458_1001601 Approved

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