For Medica DUAL Solution

(HMO D-SNP) (MSHO) Members

Plan Details

This plan offers no-cost, high-quality health care. We also offer care teams and Care Coordinators who help providers and services work together to provide the care you need. See Programs and Services below for more information.

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Ready to enroll?

The easiest way to enroll in Medica DUAL Solution is online.


Looking for other ways to enroll?

If you prefer not to enroll online, we offer two other options:                                                                                                                                                                    Call us toll-free at 1-866-538-5608 (TTY: 711)


Or if you would like to learn more first, read about plan features and premiums below.

Programs + services

Our members enjoy many health and wellness benefits. Here's a look at several of these helpful programs. 

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Care Coordinator Services

This plan offers a Care Coordinator. These are nurses, social workers or highly trained professionals who become trusted partners in your health. Your Care Coordinator will work one-to-one with you. They will find and organize resources and providers to meet your health care needs and help you maintain a healthy, independent lifestyle.

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Dental Care

Keep smiling with preventive and comprehensive dental care. Our Provide-A-Dentist Program can also help you find a dentist, and make an appointment. Dentists are part of the large Minnesota Select Dental network through Delta Dental.
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SilverSneakers® Fitness Program

Your SilverSneakers membership gives you a variety of fitness options at no cost, including:

  • More than 16,000 participating fitness locations nationwide
  • Access to classes, exercise equipment and other amenities
  • Enrollment at multiple locations any time
  • Access to online resources to help you track your fitness progress and find useful health information
  • No-cost rides to and from your SilverSneakers sites
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Vision and Eyewear

See better with regular vision care. This plan covers a new pair of eyeglasses when medically necessary and anti-glare coating on one new pair of glasses from Medica eyewear vendor Eye-Kraft®.

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Reemo™ Smartwatch

We give you a ready-to-use Reemo Health Personal Independence Smartwatch to track your activity, help monitor your health and be your emergency response system for quick help 24/7.

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FOODRx Program

For eligible members, providing medically tailored and culturally relevant staple foods, nutrition education and food referrals for chronic conditions.

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Personalized Health Education

You and a community health worker focus on your health condition(s), skill development, and circumstances that affect your health, life and well-being.

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No-Cost Rides

Get a ride to and from health care appointments — including medical, dental, mental health and substance use disorder visits — at no cost to you.

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CogniFit® Web-Based Memory Fitness Program 

Assess and train your brain with CogniFit tests and training programs.

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24/7 Nurse Line

Talk to a registered nurse any time of day or night with NurseLine™ by HealthAdvocate™. The nurses can answer your questions and provide guidance about your care options.

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Health Advocate℠ Personal Health Advocates

This service has informed advocates to help you resolve health care and insurance-related issues.

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Hospital Readmission Prevention Program

Smooth your transition home after a hospital stay with visits by a community companion. They can help you be successful on your path to recovery. You'll also receive a member care kit with several helpful items to help meet your post-hospital needs.

No Plan Premiums

$0 Premiums

Medical Premiums

The Part B premium is covered for full-dual members. That means you don't pay a monthly premium for Medica DUAL Solution, nor are there any deductibles, copays or coinsurance for medical care. If you have Medicare, you must get most of your prescription drugs through a Medicare Part D prescription drug plan. You may have a Part D plan premium. You may also have a copay with no monthly limit for some of these services.


Part D Premiums
If you qualify for a Medicare Advantage (HMO-SNP) plan like MedicaDUAL Solution, you automatically qualify for Extra Help with your Part D prescription drug costs. Those who qualify for Medica DUAL Solution are Low-Income Subsidy (LIS) eligible. You may have deductibles and copays for Part D drugs.

Low-Income Subsidy (LIS)

Extra Help With Your Monthly Premiums

If you qualify for extra help, you’ll get a Low Income Subsidy (LIS) rider. This means that you will get help paying your monthly premium and prescription drug cost-sharing. As a member of our Plan, you will get the same coverage as someone who is not getting Extra Help. Your membership in our Plan will not be affected by the Extra Help. This also means that you must follow all the rules and procedures in the Member Handbook.

We offer coverage of some supplemental prescription drugs not normally covered in a Medicare Prescription Drug Plan. These drugs are covered through Medical Assistance (Medicaid). Please see the chart below:

Level of Extra Help*

Level

3

Your monthly plan premium is

$0*

Your yearly deductible is

$0

Your cost-sharing amount for generic/preferred multi-source drugs is no more than

$0
(each prescription)

Your cost-sharing amount for all other drugs is no more than 

$0
(each prescription)

Level

2

Your monthly plan premium is

$0*

Your yearly deductible is

$0

Your cost-sharing amount for generic/preferred multi-source drugs is no more than

$1.30
(each prescription)

Your cost-sharing amount for all other drugs is no more than

$4.00
(each prescription)

Level

1

Your monthly plan premium is

$0*

Your yearly deductible is

$0

Your cost-sharing amount for generic/preferred multi-source drugs is no more than

$3.70
(each prescription)

Your cost-sharing amount for all other drugs is no more than 

$9.20
(each prescription)

These amounts are effective January 1, 2021.

Once the amount both you and Medicare pay (as the Extra Help) reaches $6,350 in a year, your copayment amount(s) will go down to $0 per prescription

Contact Us

8 a.m. - 8 p.m. Central, daily


Medica DUAL Solution is a health plan that contracts with both Medicare and the Minnesota Medical Assistance (Medicaid) program to provide benefits of both programs to enrollees. Enrollment in Medica DUAL Solution depends on contract renewal.

American Indians can continue to use tribal and Indian Health Services (IHS) clinics. We will not require prior approval or impose any conditions for you to get services at these clinics. For enrollees age 65 years and older this includes Elderly Waiver (EW) services accessed through the tribe. If a doctor or other provider in a tribal or IHS clinic refers you to a provider in our network, we will not require you to see your primary care provider prior to the referral.

Last Updated: September 2020

H2458_56419 Approved
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