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2019 Plan Details

Minnesota Senior Health Options (MSHO)

Medica DUAL Solution®

Minnesota Senior Health Options (MSHO) is a program that provides health care for people who are age 65 and older, enrolled in Medicare Parts A & B and eligible for Medical Assistance. Medica DUAL Solution is the name of our MSHO plan. Medica contracts with the Minnesota Department of Human Services to offer this plan.

With Medica DUAL Solution you receive:

  • A large network of health care providers
  • One ID card that consolidates your Medicaid and Medicare benefits, eliminating extra paperwork
  • Support from a care coordinator to help navigate the health care system

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Plan 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.

Part D Premiums

If you qualify for a Medicare Advantage (HMO-SNP) plan like Medica DUAL 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.


Plan Features

Care Coordinator Services

Medica care coordinators are nurses or social workers who work one-on-one with you to help find resources that meet your health care needs, coordinate how your providers work together and help you maintain a healthy, independent lifestyle.

SilverSneakers® Fitness Program

Your SilverSneakers membership gives you a variety of fitness options, including:

  • More than 14,000 participating fitness locations nationwide
  • Enrollment at multiple locations any time
  • Access to classes, exercise equipment and other amenities
  • Access to online resources to help you track your fitness progress and find useful health information

View a complete list of facilities and options on SilverSneakers.com

Transportation Services

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

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.

Post Hospital

Our hospital readmission prevention benefit helps ensure your post-hospitalization needs are being met. It includes four visits by a community companion, a home safety evaluation, medication reconciliation and more. Members also receive a post-hospitalization care kit that includes a 28-unit pill container, a reacher to help you retrieve things, a long-handled scrub brush and a long-handled shoe horn.

Dental Services

In addition to the Medical Assistance dental benefits, Medica DUAL Solution covers two porcelain-fused-to-metal crowns on any tooth per year. You also receive one extra dental exam each year and one full mouth X-ray every five years. Medica will even help you schedule your appointments. Other dental services include molar root canal and retreatment, also root scaling and planing with follow up periodontal maintenance if needed.


Find a Physician, Clinic, Hospital or Pharmacy

See what providers and pharmacies are in the Medica network.

Provider directory
Pharmacy directory

Find Covered Drugs

Check to see if your drugs are covered (applies to plans with Part D coverage).

Formulary (List of Covered Drugs) — (PDF)



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 or begin 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.

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information call Member Services or read the Member Handbook.

 

 

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Last Updated: October 2018

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