|
Effective: June 1, 2011 |
|
|
02.10ar2 - Benefit Sets (Archive) |
Archived: April 1, 2012 |
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 and Medical Assistance (MA) 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.