FOR

OVER

60

YEARS

Insurance Changes for 2020

Each year we like to summarize any big changes we’ve found in the managed care programs we service so our customers can prepare for the new year. Here are a few notes we’ve collected as 2019 comes to a close. We encourage providers to contact their specific plans’ provider services or their plan contract manager with any specific questions. These notes may not be all inclusive of changes, so review any communications from your accepted plans to prevent other surprises. Thank you!


Medica:

We are unaware of any major changes for 2020 with our accepted Medica plans.

Medica will continue with the Anti-Reflective Coating benefit for members with groups #07xxx & 08xxx.

MEDICA PROVIDER SERVICES


UCARE:

UCARE will be covering Anti Reflective Coating on 2 plans starting 1/1/2020. Ucare connect plus Medicare and the Minnesota Senior Health Options plan. This is a covered benefit; no prior authorization or diagnostic code is needed. This is at no cost to the member.

  • This benefit will be covered 1 time within a 2-year period.
  • If the member has a rx change, breaks the glasses, etc. the member would need to pay for the Anti Reflective Coating on the remake.
  • Providers will continue to bill a dispensing fee as usual.
  • If the patient is eligible for AR and it is ordered, the ordering office will not be billed as this is now a benefit for these patients under these plans.

Group Numbers and Benefit Packages ELIGIBLE for AR under UCARE:

MINNESOTA SENIOR HEALTH OPTIONS (MSHO) BENEFIT PACKAGE

  • MSNMIN, MSNMCB, MSNMCC, MSNMEH, MSNMFH, MSNMCO, MSMEIN, MSMECB, MSMECC, MSMEEH, MSMEFH, MSMECO

 UCARE CONNECT PLUS MEDICARE

  • SICYMT, SICYNO, SICYSO

Group Numbers and Benefit Packages NOT ELIGIBLE for AR under UCARE:

MINNESOTA CARE

  • MNNOMN, MNSOMN, MN62MN, MNMETR, MNHENN

MINNESOTA SENIOR CARE PLUS

  • MENMMP, MEMEMP

PREPAID MEDICAL ASSISTANCE PROGRAM 

  • MENOMA, MEMTMA, ME62MA, ME27MA, MESOMA 

UCARE CONNECT

  • CTCNMT, CTCYMT, CTCNNO, CTCYNO, CTCNSO, CTCYSO 

UCARE PROVIDER SERVICES


South Country Health Alliance:

3 Counties have withdrawn from SCHA in 2020:

  • Todd County
  • Morrison County
  • Wadena County

Members will be able to change to another plan. Members will receive a notice that their plan is changing and will be given an opportunity to select a new one from those available in their county. If they do not choose a new plan, one will be selected for them. If the member doesn’t like the randomly selected plan, they can contact the county and choose a different plan. 

The 8 current South Country Health Alliance counties are:

  • Brown County
  • Dodge County
  • Goodhue County
  • Kanabec County
  • Sibley County
  • Steele County
  • Wabasha County
  • Waseca County

SOUTH COUNTRY HEALTH ALLIANCE PROVIDER SERVICES


Reference Documentation: