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My Coverage

For Medica DUAL Solution 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
  • $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

Broker Agent

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.

Mental Health and Substance Use Disorder Care

Broker Agent

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.

LiveandWorkWell.com

Transportation

Broker Agent

If you don't have access to transportation, we can help. Our Provide-A-RideSM 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.

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

Learn more about Provide-A-RideSM

Dental

Broker Agent

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

DUAL Solution member benefits include an extra exam and two crowns on two teeth per year. Additional cleanings and dental education are provided, too.

Medica dental benefits and covered services

Eyewear

Broker Agent

Your 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®. Please see the eye care section of your Member Handbook for more information. Choose your eyewear from the catalog below.

Eyewear frame catalog (PDF)

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 individualized support during the first 30 days after you leave the hospital.

Specially-trained Community Companions will check in with you when you are eligible for this service. They’ll offer you resources and answer your questions along the way.

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

Language Resources

Broker Agent

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.

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.

Transplant program



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 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: January 2021

SPP56672-101220A
H2458_56672 Approved

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