|
Effective: December 1, 2006 |
|
|
02.10ar1 - Benefit Sets (Archive) |
Archived: June 1, 2011 |
There are many different benefit sets for Minnesota Health Care Program enrollees. Each benefit set includes covered services. Some include co-payments, other cost-sharing amounts, or limits. These may vary based on the eligibility of the enrollee or household.
l Covered services - Most benefit sets include a wide range of health care services, from preventive care to hospitalization. Some include more limited services, such as reimbursement of Medicare premiums.
l Limits - Some benefits are limited. There may be a limit or maximum dollar amount on a specific type of service, like hospitalization, or on all services in a category, like dental.
l Cost-sharing - Some enrollees will have to pay a portion of a service, like a co-payment for a prescription drug. Others may have to pay a premium before their coverage will begin.
An overview of the benefit sets for MinnesotaCare, Medical Assistance (MA), and General Assistance Medical Care (GAMC) is given on the Minnesota Health Care Programs benefit summary (DHS-3860). This form is sent to new health care program enrollees.
For more information, see the Prepaid MHCP Manual.