What is MSHO?
Minnesota Senior Health Options (MSHO) is a program for seniors who are on Medical Assistance and Medicare Parts A and B. There is no cost to you for this program, but the list of benefits is long. With MSHO you:
- Don’t need to go to several offices to get care or fill out paperwork
- Are assigned a Care Coordinator who ensures you get the care you need
- Work with a Care Coordinator who’ll make sure all your providers (including your primary doctor, physical therapist, home care and hospital staff) are in contact with each other
How much will I pay?
There is little to no cost to you. There is no monthly premium for members of the MSHO plan. And when you go to a doctor in the MSHO network, you have a $0 copay for the following types of covered services:
- Office visits
- Routine physical exams
- Inpatient hospital
- Emergency and urgent care in the United States
- Dental coverage
Depending on your income level and institutional status, your copay for Part D prescription drugs will be:
- Generic drugs and brands treated as generics: $0/$1.20/$2.95
- Brand-name drugs: $0/$3.60/$7.40
Your Care Coordinator is there is to help
One of the biggest benefits of MSHO is working with a Care Coordinator. Care Coordinators are licensed health care professionals who can help you improve or maintain your health. Your Care Coordinator will:
- Visit you
- Explain your coverage
- Provide practical tips about navigating the health care system
- Assist with prescription drugs and refills
- Arrange chore and companion services, if you qualify
- Recommend safety modifications to your home, if needed
What’s covered by MSHO?
MSHO provides coverage for all areas of your life. We provide medical benefits, prescription and dental coverage, and support for a healthy lifestyle. This means providing other services you may need, including:
- Interpreter services
- Transportation to covered medical and dental appointments
- Nurse Navigators, who are trained to help with health care needs
- Convenient answers to your health questions with CareLineSM, which provides assistance outside regular clinic hours
- A free gym membership or at-home workout kits through the Silver&Fit® Exercise & Healthy Aging Program
- Access to yumPower, which provides nutritional information and tips for eating better, and a place to search for healthy recipes by meal or ingredient. (Both links take you away from the HealthPartners Medicare site.)
- Healthy eating resources
Can I see any doctor I want?
When you join HealthPartners MSHO, you agree to use doctors and hospitals that are in the plan’s network. Unless you need emergency care, care when you’re traveling or renal dialysis, you must see doctors who are in the network. If you get routine care from an out-of-network provider, you will be responsible for the cost.
Other information and details
I’m looking for additional information about:
- Which counties are in the service area
- The Summary of Benefits, which summarizes what we cover and what you pay
- The Annual Notice of Change and Member Handbook, which discuss changes in coverage, costs or service, and explains what the plan covers, how much you pay, and more.
Some diabetes supplies – such as blood glucose testing products – are only available through specific manufacturers. You can view the list of covered diabetic supplies and manufacturers. If your supplies are not covered and we denied your coverage, you can appeal the decision.
This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. Benefits, premiums and/or copayments/coinsurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium. The formulary, pharmacy network and/or provider network may change at any time. You will receive notice when necessary.
HealthPartners MSHO is a health plan that contracts with both Medicare and the Minnesota Medical Assistance (Medicaid) program to provide benefits of both programs to enrollees. HealthPartners Freedom is a Cost plan with a Medicare contract. Enrollment in HealthPartners depends on contract renewal.
Last updated 10/1/2015