Minnesota Health Care Programs (MHCP) members will get their annual health plan selection (AHPS) packet by October 20.
If you do not get a packet by November 1, call the Minnesota Health Care Programs Member Help Desk.
The packet includes an annual health plan selection notice* that tells you the following:
*Sample AHPS notices:
The packet also includes a summary of covered services, health plan survey results, and a notice of rights for the program you and your family members are enrolled in.
If you want to keep your health plan, you do not have to do anything. However, you are welcome to choose a new plan.
To make your decision, you may want to contact your health care provider. Ask the provider whether he or she is part of one of the health plans listed on the back of your notice.
You can change health plans by circling your health plan choice on your annual health plan selection (AHPS) notice and mailing it in the return envelope you got in your packet by December 1, 2017.
AHPS is not the same as the Minnesota Health Care Programs (MHCP) renewal process. If you are due to renew your health care coverage, you will get a separate mailing about that. Follow the directions in that renewal mailing to be sure that your coverage and selected health plan continue.
AHPS for 2018 is from September 18 through December 1, 2017.
The notice in your packet will tell you which plans are available to you.
These maps show the health plans available by county and by program:
Some households have members that are eligible for MinnesotaCare and other members that are eligible for Medical Assistance (MA). All members in a household in MinnesotaCare must enroll in the same plan. The family members eligible for MA in the household can enroll in the same plan, if it is available to them, or they can enroll in a different plan that is available in the county. In some counties, the health plans available to MinnesotaCare and MA members may be different.
No. All health plans provide the same benefits based on the program in which you are enrolled. There may be differences between plans in their provider networks.
Yes. Health plans have their own network of providers. To find out whether your provider is in a specific health plan, call the health plan’s member services:
During AHPS, follow the instructions in the AHPS notice you get in the mail. You can change health plans by returning the completed form or by calling either the MHCP Member Help Desk or, if you have SNBC, Disability Hub MN.
If you need emergency care on or after January 1, the emergency care will be covered by the new plan. Emergency care is covered even if you have not yet received a new health plan card. Emergency services are covered even if provided by a provider that is not in your new health plan's network.
Yes. All health plans in the Medical Assistance and MinnesotaCare programs must cover all the required program services once you are enrolled and coverage begins on January 1, 2018.
Your coverage for doctor visits, hospital care, mental health, pharmacy benefits and other services will not change when you switch health plans within the same program. There may be some differences in the health care providers you may use or whether certain drugs are covered, but your benefits stay the same.
When deciding which plan to select, you should check to see whether your health care provider(s) works with the new plan. In many cases, the health care providers that are available to you now will be available under one of the new plans.
All health plans must accept everyone who is eligible for the program and enrolls with the plan.
Health plans must provide appropriate care to people with special health care needs, including access to specialists if appropriate for the member's condition and identified needs. You can call your new health plan to discuss any concerns about continuing treatment.
Your health plan must share information with the new health plan upon request. DHS and the health plans are responsible for keeping information private. Your health plan must wait until you select a new plan to provide information to your new health plan. You can call your new plan anytime to discuss concerns.
Yes. If you are currently in treatment for a medical condition, the new health plan must pay for medically necessary covered services. These may include services provided by medical professionals that are not in the network of the new health plan, for up to 120 days after enrollment. You should contact your new health plan to discuss how your care will be continued.
The new health plan may require you or your doctor to request a service authorization, and your doctor or health care provider may need to agree to certain requirements established by the new health plan.
Yes. If you arranged for surgery, chemical dependency treatment, or another specific health care service under your health plan, the new health plan must honor that arrangement. You should call your new health plan to make sure it is aware of the treatment being planned.
If you or your family is receiving mental health services, your new health plan must work with you to develop a transition plan to ensure you can keep getting the services you need, even though you may need to work with a new mental health provider.
Yes. Your new plan must honor current prescriptions that need to be filled after January 1, 2018. In some cases, your new plan may cover different drugs for your condition than what you are used to taking. If that is your situation, the new plan will continue covering the drugs you are taking under a current prescription for 90 days or until the plan can work with you and your provider to switch to drugs it covers.
For certain drugs used to treat serious mental health conditions, health plans may be required to continue to cover those drugs for as long as you are enrolled with them and as long as you need the drug.
If you are taking a specialty medication and using your plan’s specialty mail-order pharmacy, you may need to switch to your new plan’s specialty mail-order pharmacy. Contact your new plan to get your specialty prescription transferred to the new specialty pharmacy.
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