STEP 3: Making the most of your health coverage
Congratulations on getting health coverage. Now take advantage of all the benefits to help you maintain and improve your health. Below are tips to help you save money and get the most out of your health coverage.
Note: These tips refer to Medical Assistance and Medicare health plans. Other plans may not include the benefits included in these tips. If these benefits are important to you, but are not included in the coverage option you chose, contact your health plan right away - you may be able to change coverage options within the first 30 – 90 days of coverage.
Your health plan will have a provider network. If you chose a doctor, clinic, therapist, hospital or other provider from this network, your care will be covered to the highest level available on your plan. However, if you chose a provider that is not in the provider network, you may need to pay for a larger portion of the service.
To make sure you get the highest level of coverage possible, chose a doctor, clinic, therapist, hospital or other health care professional from your health plan’s provider network.
Health plan company
Go to your health plan’s website or call their customer service to find out what providers are in their provider network. If you are a UCare member, you can search our provider network.
Medical Assistance Fee for Service or Medicare Fee for Service
Search the Minnesota Health Care Programs (MHCP) Provider Directory
Care coordination support from a health plan may help you create and put in place a plan to meet your health goals. Your care coordinator can help with:
- Referrals
- Prior authorizations
- Arranging medical services
- Timely assessments
- Behavioral health support
- Identifying social needs resources, such as food and housing
Different health plans provide care coordination in different ways.
Health Insurance Company
Call your health plan’s customer service to ask about getting a care coordinator.
Medical Assistance Fee for Service or Medicare Fee for Service
Talk to your county or tribal office.
What is preventive care?
Preventive care lets your doctor find potential health problems before you feel sick, when many issues are easier to treat. This is why it’s important to visit your doctor regularly to stay healthy. Some preventive care includes:
- Annual physical exams
- Screenings for certain types of cancer
- Certain lab tests
- Immunizations (examples: Flu, Pneumonia, Shingles, Tetanus)
Find out more about what preventive care you might need.
Most health plans cover 100% of the cost of your preventive care.
Health plans provide no-cost transportation to and from your medical appointments. This includes:
- Bus, light rail or train passes
- Mileage reimbursement (provided by your county)
- Wheelchair and stretcher vehicles
- Taxis and volunteer drivers
Health Insurance Company
Call your health plan’s customer service to ask about how to schedule your transportation. If you are a UCare member, find out how to schedule your ride with UCare Health Ride.
Medical Assistance Fee for Service or Medicare Fee for Service
Find out how to schedule your ride with Minnesota Transportation Programs.
If you choose an integrated SNBC plan, ask your doctor if you can get a 90-day supply of your prescription medications
Switching to a 90-day supply of your prescription drugs will save you money and can make it easier to take your medication regularly.
Benefits of a 90-day supply:
- More money in your pocket – Get a 90-supply of medication for the same copay as a 30-day supply.
- Convenience – Refill your medications only four times a year.
- Worry less about missing a dose – With more supply on hand, you may take your medication more regularly.
Use an in-network pharmacy
You can choose any pharmacy to fill your prescriptions. But, many health plans have in-network pharmacies that reduce copayments. Call your health plan’s customer service to ask about in-network pharmacies.
If you are a UCare member, find a in-network pharmacy near you.
Medical Assistance Fee for Service or Medicare Fee for Service do not have in-network pharmacies.
Get your medications delivered in the mail
Some plans allow you to order up to a 90-day supply of your prescription medications to be delivered in the mail. Contact your county or tribal office or call your health plan’s customer service to ask about mail-order medications.
If you are a UCare member, you can order up to a 90-day supply of your prescription medications through Express Scripts. Benefits include free home delivery and 24/7 access to a pharmacist.
Three ways to start getting your medications at home
- Call Express Scripts to get stared with home delivery. 1-877-567-6320 (TTY 1-800-716-3231). Be prepared with your member ID card, doctor’s name and phone number and a list of your current medications.
- Go to Express-Scripts.com and follow the prompts.
- Ask your doctor to contact Express Scripts Mail Order with your prescription.
Medical Assistance and integrated SNBC plans
Most Medical Assistance and integrated SNBC plans have only two tiers of prescription medications:
- Generic tier: lower co-pays
- Non-generic: higher co-pays
If you are concerned about copays, you may want to work with your doctor to determine if there are appropriate drugs for your condition that are on a lower co-pay tier.
CDCS is a service option available to people on Medical Assistance who qualify for home and community-based services (HCBS) disability waivers. CDCS gives you the flexibility to plan and organize your own support services, including hiring and managing your support workers. CDCS may include traditional services, goods and self-designed services.
Depending on what levels of care you need you may qualify for waiver programs that provide long term services and supports to help you live safely in the community. You must be assessed as meeting the necessary level of care and may have to meet financial eligibility requirements. Your county will assign a waiver case manager to help you coordinate these services when eligibility is established.
How do I find a Personal Care Assistant (PCA)?
If you qualify for PCA services, your PCA is covered regardless of the type of plan you are have.
Resources for finding a PCA:
Most SNBC plans offer additional benefits, but they are not the same for each health plan. Visit the health plan’s website for additional information, or ask for a sales brochure (they will include any additional benefits that members value). If you have a specific additional benefit that you value (for example, a fitness club membership) call the health plan to ask if they offer that benefit.