Special Needs BasicCare
A managed health care plan called ‘Special Needs BasicCare (SNBC)’ is expanding.
Beginning January 1st, 2012, anyone younger than 65 enrolled in Medical Assistance (MA) and certified as having a disability will be automatically enrolled in a managed health care plan known as SNBC, unless they choose to opt out. Everyone affected by this change will receive a letter informing them of the new enrollment process; some letters have already been sent out. This change will not affect children on the TEFRA program until a future date.
Here’s what you need to know if you or someone you know receives a letter.
Switching to managed care can be a good thing.
People enrolled in SNBC have access to all of the same basic care services provided under Medical Assistance. In addition, managed care plans offer coordinated care services, 24/7 RN call lines, interpreter services, help with transportation, and other services.
People can opt out.
People can choose not to enroll in SNBC and stay with their current fee-for-service MA coverage. In order to do this, they will need to complete the opt-out form included with the letter and mail it back.
People may have a choice of plans.
Depending on what county a person lives in, there may be more than one plan to choose from. Click here to see a map of SNBC health plans by county.
People can change their minds.
If someone initially opted out and now wants to be on an SNBC plan, they have an opportunity to do so at the end of each month. People who decide to enroll in an SNBC plan will also be able to return to their original fee-for-service MA coverage. People in counties where more than one SNBC plan is available will have the option to switch from one to another.
Before deciding on whether to choose an SNBC plan or remain on fee-for-service MA coverage, be sure to find out the answers to these questions:
Does the plan cover the mental health services I use?
Before enrolling with a managed care plan, request a copy of what mental health services the plan covers to make sure the services you use are included.
Does the plan cover my providers and medications?
Make sure the plan you choose covers your preferred providers (psychiatrist, physician, therapist, etc.) and mediations. Also, check if the plan requires Prior Authorization or Step Therapy (trying an older, cheaper medicine first) for your mediations; if this is the case, the plan might not be a good choice for you.
Does the plan require prior authorization to see a provider?
Some plans require prior authorization before seeing certain providers, especially providers you haven’t seen in the past. Be sure to find out if this is the case.
The answers to all of these questions can be found by calling the health plan, visiting their website, or calling the Disability Linkage Line at 1-866-333-2466. If you have a case manager you may be able to work with them as well to decide if an SNBC plan is right for you.
Click here for a side-by-side comparison of each plan.
Following is contact information for each plan:
Medica — AccessAbility Solution
Member services: (952) 992-2580 or 1-888-347-3630
Enrollment: (952) 992-2030 or 1-800-266-2157
TTY: call National Relay Center at 1-800-855-2880 and ask to be transferred to 1-800-266-2157
www.medica.com
Metropolitan Health Plan — Cornerstone Solutions
Member services: 1-888-562-8000, select option 1
Enrollment: 1-888-562-8000, select option 2
TTY: 1-800-627-3529 or 711
www.mhp4life.org
This plan only serves residents of Hennepin County.
Prime West — Prime West Complete
Member services: 1-866-431-0801
Enrollment: 1-866-431-0801
TTY: 1-800-627-3529 or 711
www.primewest.org
South Country Health Alliance — AbilityCare
Member services: 1-866-567-7242
Enrollment: 1-866-567-7242
TTY: 1-877-824-5611
www.mnscha.org
UCare — UCare Connect
Member services: (612) 676-6868 or 1-866-280-7202
General enrollment information: (612) 676-3554 or 1-800-707-1711
TTY: (612) 676-6810 or 1-800-688-2534
www.ucare.org
Thanks to NAMI Minnesota and the Minnesota Department of Human Services for providing information contained in this page.