Health care coverage
Minnesota Senior Health Options
Minnesota Senior Health Options (MSHO) combines Medical Assistance and Medicare health care programs and support systems into one package. MSHO members are assigned a care coordinator who helps them get their health care and related support services.
You can choose to enroll in MSHO if you:
- Are eligible for Medical Assistance (MA) and enrolled in both Medicare Parts A and B, and
- Are 65 years old or older, and
- Live in a county where a health plan offers MSHO.
Read one MSHO member's story to find out how this program improves lives.
Larry's story Map of MSHO health plans (PDF)How is MSHO different from the Medicare and Medical Assistance I have now?
MSHO offers the same basic benefits as Medicare and Medical Assistance, but with MSHO you don't have to go to different offices for your health care needs or fill out a lot of paperwork. All of these services are combined into one program.
Your MSHO health plan is responsible for making sure you get the health care, as well as home and community-based services you need. Your health plan also will handle most of the paperwork for Medical Assistance and Medicare.
Your MSHO health plan will also assign a care coordinator to you. A care coordinator can help answer your questions and help you get the health care and other services you need. The care coordinator also makes sure all of your providers, such as your primary care doctor, physical therapist, home care and hospital staff, are in contact with each other.
What services can I get through MSHO?
MSHO combines all the services you get from Medical Assistance and Medicare into one program, including:
- Dental care
- Doctor visits
- Durable medical equipment
- Emergency room care
- Home and community-based services (Elderly Waiver)
- Home health services
- Hospital care
- Interpreter services
- Lab and X-rays
- Nursing home care
- Prescription drugs
- Personal care attendant services
- Transportation
Your MSHO health plan will also assign you a care coordinator to help you with your healthcare needs, and may offer additional services.
How do I enroll?
To enroll in an MSHO plan, contact one of the eligible health plans available in your county.
- If you have questions about Medical Assistance, contact your local county or Tribal office.
- If you have questions about Medicare, visit their website or call Minnesota Aging Pathways, formerly the Senior Linkage Line®, at 800-333-2433.
How much does MSHO cost? What if I have a spenddown or a waiver obligation?
There is no cost to be in MSHO. If you have copays, spenddowns or other obligations, you still need to pay those.
If you have a spenddown, you will get a letter from the Minnesota Department of Human Services telling you how to pay the spenddown amount. For more information on spenddowns and MSHO, see MSHO spenddowns.
If you have a waiver obligation, your health care provider will bill you for your waiver obligation.
Learn about MSHO spenddowns (PDF)Will I be able to keep seeing my regular doctor?
If you want to keep seeing your regular doctor, review the list of doctors who are part of each MSHO health plan's network. You can sign up for the health plan in which your doctor participates.
If your doctor is not listed with any of the MSHO health plans and you want to keep seeing that doctor, you may not want to enroll in MSHO.
Health plan provider directoriesHow can I find a doctor or other provider?
The health plan provider directories are a list of all the primary care providers within each health plan’s network. While all health plans provide the same benefits covered by the program you are enrolled in, they have different networks of providers who can deliver those services. You can check these listings to see if your provider works with a particular plan.
If you do not see your provider listed, please contact the health plan to check if the provider is in the plan's network. The provider lists below may not list certain specialty providers. Please contact the health plan to ask if certain specialty providers are in the plan's network.
Health plan provider directoriesWhat does the care coordinator do?
After you enroll in MSHO, you will be assigned a care coordinator. The care coordinator will help answer your questions, work with your doctors to help you get the care you need, and help your doctors and other providers share information with each other.
If you had a county case manager for home and community-based services before enrolling in MSHO, in most cases, the care coordinator will replace the case manager.
Can I enroll in MSHO if I am in a nursing home?
Yes. You may be assigned a nurse practitioner who will serve as your coordinator for primary care and other services. The nurse practitioner works with your doctor, nursing home and other health plan staff.
What if I join MSHO and decide I don't like it?
You can drop MSHO at any time without losing your Medical Assistance or Medicare benefits by contacting your health plan in writing to tell them you want to drop the program. You will be taken out of MSHO at the beginning of the next month and automatically enrolled in the same health plan’s Minnesota Senior Care Plus (MSC+) plan for your Medical Assistance services. You will also have the opportunity to return to your pervious MSC+ health plan. If you leave MSHO, you will need to choose a Part D plan for your prescription drugs.
If you currently have a medical spenddown and you choose to leave MSHO, your Medical Assistance will be provided fee-for-service, also called “straight MA.” You will not be enrolled in another health plan for Medical Assistance services.
Who runs the MSHO program?
MSHO was created by the Minnesota Department of Human Services, the state agency that oversees public health care programs. The program is overseen by the department and the federal Centers for Medicare & Medicaid Services and administered by health plans.
What research is available on the program?
The Centers for Medicare and Medicaid Services published the Minnesota Managed Care Longitudinal Data Analysis Study which found that seniors enrolled in the integrated MSHO program experience improved outcomes.
This study provides strong support for continued integration of Medicare and Medicaid for people eligible for both programs. The study compared the experiences of similar beneficiaries inside and outside of MSHO and found that MSHO enrollees were:
- 48 percent less likely to have a hospital stay, and those who were hospitalized had 26 percent fewer stays.
- 6 percent less likely to have an outpatient emergency department visit, and those who did visit an emergency department had 38 percent fewer visits.
- 2.7 times more likely to have visited a primary care doctor at least once in the year.