If you’re a senior in Minnesota on a tight budget, you may be able to simplify coverage and get more benefits in one plan. Medical Assistance (Medicaid) provides health plans for people from low-income households. If you’re age 65 or older and meet the eligibility requirements, here are your options in Minnesota.

Minnesota Senior Care Plus (MSC+)

Minnesota Senior Care Plus (MSC+) is a managed care program that provides people over 65 who are eligible with Medical Assistance. MSC+ plans include typical Medical Assistance coverage for medical services, prescription drugs, dental benefits and more. However, MSC+ also goes beyond basic Medical Assistance, offering Elderly Waiver services for personal care assistance, home and community-based services (like homemaker services or assisted living), transportation and more.

You can have MSC+ only or also have a Medicare plan with Part D prescription drug coverage from a private health plan. However, an MSC+ plan on its own does not include Medicare – that will work separately from your plan if you’re eligible for both.

So, who’s eligible for an MSC+ plan? To qualify, you must meet Minnesota’s eligibility requirements for Medical Assistance. This is based on your status as a Minnesota resident, income and asset limits and disability status. Sometimes certain MSC+ services are only covered based on medical and functional need – like personal care assistance.

If you live in a residential assistance community (not in a skilled nursing facility), you can work with a Care Coordinator for support throughout the stages of your health care journey. Care Coordinators are registered nurses or licensed social workers who explain how your plan works. They partner with you to set health goals, make a care plan, and give you support and tools. And they help you navigate Medicare and Medical Assistance services if you qualify for them.

You won’t pay a monthly premium or have any cost-sharing for medical or prescription drugs covered under Medical Assistance. However, you may have copays for Part D medications depending on your level of Extra Help (a program that helps pay Part D costs for people with limited income and resources).

Minnesota Senior Health Options (MSHO)

MSHO is for people who are dual eligible, which means they’re eligible for both Medicare and Medical Assistance (Medicaid) coverage. An MSHO plan is a Medicare Advantage plan that combines the benefits of Medical Assistance and Medicare into one plan. In addition to medical and dental benefits, it includes Medicare Part D prescription drug coverage. MSHO also covers home and community-based services, and you work with a Care Coordinator no matter where you live.

The pros of a Minnesota Senior Health Options plan:

  • $0 premium, $0 deductible and $0 copays for covered medical, dental and Medicaid services
  • Combining all the coverages together makes it easier for you. You only have one member ID card and less paperwork because one health plan handles all benefits and pays most bills.

Is MSHO part of the Minnesota Health Care Program?

MSHO isn’t technically a part of the Minnesota Health Care Program (MHCP) – it’s also not a part of Medical Assistance (Medicaid). It’s a voluntary managed care program. This means that companies who provide MSHO plans work alongside Medical Assistance to provide multiple forms of coverage and health care benefits to people with lower incomes. It’s a way for both programs, Medicare and Medical Assistance, to be easily managed together in one coordinated plan.

The differences between MSHO and MSC+

The biggest difference between an MSHO and MSC+ plan is how your coverage is and isn’t tied together. An MSHO plan bundles your Medicare and Medical Assistance into one plan, making it easier to manage, while an MSC+ plan includes only Medical Assistance coverage with additional benefits provided through Elderly Waivers.

The state of Minnesota chooses health insurance companies to offer MSC+ and MSHO plans. The plans available will vary by which county in Minnesota you live within.

If you think you’re eligible to enroll in an MSHO plan or MSC+ plan, you can get information from: