Minnesotans who are eligible for both Medicare and Medicaid have a special opportunity to receive not only a new federal prescription drug benefit but also to improve coordination of all of their health care services. As part of the new Medicare Part D prescription drug benefit, which begins in January, the federal government has created Medicare Advantage Special Needs Plans to provide prescription medicines and a range of other health care services especially for this group. In Minnesota, most of these plans are also part of a model program called Minnesota Senior Health Options, which specializes in coordinating Medicare and Medicaid services for people who are eligible for both programs. MSHO has a nine-year track record of integrating services offered through Medicare and Medicaid, also known as Medical Assistance in Minnesota. As part of the Part D roll-out, Minnesota has increased the number of plans under MSHO and now contracts with nine plans to serve this population. The nationally recognized MSHO began as a pilot in seven counties and expanded statewide in the past year. Additional enrollment related to Medicare Part D is expected to increase MSHO rolls from about 8,500 currently to nearly 30,000 in 2006, according to Pam Parker, manager of special needs purchasing for the Minnesota Department of Human Services. MSHO’s goal is to simplify a complex maze of programs and services and ultimately produce better health outcomes. “We’re trying to make it easier for families and individuals to receive the health care they need,” Parker said. “Every person in MSHO has their own care coordinator. Care coordinators act as navigators to guide enrollees through the system to make sure the whole range of their needs are addressed and to make sure there is communication between all of the providers involved in their care.” Eligible people who already are on MSHO or in Medicaid managed care will be enrolled by Medicare into these special plans. This will allow them to receive their Medicare prescription medications through the same plan that provides their other health care services, including home and community based services. Individuals are allowed to opt out if they decide another plan better suits their needs. Notices are being sent to affected individuals beginning this month. MSHO enrollment is free of charge to eligible seniors. Seniors who are eligible for Medicare and Medicaid will pay no premium for their prescription drugs under Medicare Part D and will have Medicare drug co-pays of $1-5, depending on their income. Because enrollment is voluntary, seniors can also disenroll or change plans at any time. In addition to the new options for seniors under MSHO, people with disabilities who qualify for both Medicare and Medicaid will also have an opportunity for better coordinated care as they transition to Part D. Minnesota has contracted with one health plan as a Medicare Advantage Special Needs Plan for this population for the seven county metropolitan area. People who choose this option will become part of a Minnesota program called Minnesota Disability Health Options. Individuals seeking more information may contact a participating health plan or Minnesota’s Linkage Line at 800-333-2433. The Linkage Line is the State Health Insurance Assistance Program for Minnesota as designated by the Centers for Medicare & Medicaid Services. The Linkage Line provides impartial, comprehensive information and assistance about Medicare. The Linkage Line has the most accurate Minnesota-specific information available. Participating plans Minnesota Senior Health Options (People age 65 and over eligible for both Medicare and Medicaid) — Blue Plus (Secure Blue): 1-866-477-1584 or 651-662-3584 — First Plan Blue (First Plan Blue MSHO): 1-800-635-4159 — Health Partners (Health Partners Classic for MSHO): 952-883-5050 or 1-877-713-8215 — Itasca Medical Care (IMCare Classic): 1-800-843-9536 — Medica (Dual Solution): 952-992-2300 or 1-800-234-8755 — Metropolitan Health Plan: 612-347-3300 or 1-800-647-0550 — Prime West: 1-800-366-2906 — South Country Health Alliance (SeniorCare Complete): 507-444-7770 or 1-866-567-7242 — UCare Minnesota: 612-676-3554 or 1-800-707-1711 Minnesota Disabilities Health Options (People with disabilities ages 18 to 64 eligible for both Medicare and Medicaid) — UCare Minnesota: 612-676-3554 or 1-800-707-1711
