If you need free help interpreting the information in this video, visit our Translation and Alternative Formats page or contact Member Services for the program you are enrolled in.
AbilityCare Coverage and Eligibility
AbilityCare is a Medicare Advantage Special Needs BasicCare (SNBC) program for people with disabilities who live in our 8-county service area. AbilityCare is designed to help people with disabilities access the health care, medications and support services they need. There are no additional costs to join AbilityCare.
To be eligible for AbilityCare you must:
- Be certified disabled by the Social Security Administration or State Medical Review Team (SMRT);
- Be at least 18 and under the age of 65 at the time of enrollment;
- Be eligible for Medical Assistance;
- Have Medicare Parts A and B;
- Live in our service area (see service area map) .
AbilityCare eligibility is determined by a financial worker in your county.
AbilityCare provides Medicare Part A (hospital), Part B (medical), Part D (prescription drug) and Medical Assistance coverage.
You do not pay a separate monthly plan premium for AbilityCare. You must continue to pay your Medicare Part B premium (unless your Part B premium is paid for you by Medical Assistance (Medicaid) or another third party).
| AbilityCare Member Materials | ||
|---|---|---|
| 2024 Materials | Last Updated | |
| Enrollment Form | 11/22/23 | |
| Member Handbook | 10/15/23 | |
| Annual Notice of Changes | 10/15/23 | |
| Summary of Benefits | 10/15/23 | |
| Pre-Enrollment Checklist | 10/5/23 | |
| List of Covered Drugs (Formulary) | 5/1/24 | |
| Formulary Updates | 5/1/24 | |
| Provider and Pharmacy Directory | Web Page | See link |
| Medicare Star Ratings | PDF (English) PDF (Español) | 10/23/23 |
| LIS Premium Summary Chart | 10/15/23 | |
| CMS Best Available Evidence Coverage | Web Page (external link) | |
| Covered Diabetic Testing Supplies | 11/17/23 | |
AbilityCare Features:
- A large network of providers where members can receive care without referrals
- A Community Care Connector located in the county who helps members get the services and supports they need
- 24 Hour Nurse Advice Service, available by phone 24/7
- Care coordination services
HIV Screening
Did you know that annual screening for Human Immunodeficiency Virus (HIV) is a covered benefit for South Country Health Alliance members? Call Member Services for specific benefit information. If you are at risk, be safe and get tested!
Not a Member Yet?
There are many more benefits to being an AbilityCare member, and the best part is, there is no extra cost to you! See How to Enroll for more information. Or, if you wish to speak with someone about your enrollment questions, please call the number below. We are happy to help!
Enrollment Questions and Assistance
Disenrollment
You may end your membership in our plan at any time. Ending your membership in our plan may be voluntary (your own choice) or involuntary (not your own choice). For more information, see Chapter 10 in the Member Handbook (under Member Materials to the right).
Member Rights and Responsibilities
For Member Rights and Responsibilities, see Chapter 8 in the Member Handbook (under Member Materials to the right).
H5703_5772 Accepted 8/9/21
SeniorCare Complete and AbilityCare are health plans that contract with both Medicare and the Minnesota Medical Assistance Program (Medicaid) to provide benefits of both programs to enrollees. Enrollment in either plan depends on contract renewal.
Last Updated on 04/05/2024 by Chris Gartner