Medicare Part D: The Medicare prescription drug benefit program. We call this program “Part D” for short. Medicare Part D covers outpatient prescription drugs, vaccines, and some supplies not covered by Medicare Part A or Medicare Part B or Medical Assistance. Our plan includes Medicare Part D.Medicare Part A: The Medicare program that covers most medically necessary hospital, skilled nursing facility, home health, and hospice care.
Medicare Part B: The Medicare program that covers services (such as lab tests, surgeries, and doctor visits) and supplies (such as wheelchairs and walkers) that are medically necessary to treat a disease or condition. Medicare Part B also covers many preventive and screening services.Medical Assistance: This is the name of Minnesota’s Medicaid program. Medical Assistance is run by the state and is paid for by the state and the federal government. It helps people with limited incomes and resources pay for long-term services and supports and medical costs.
It covers extra services and some drugs not covered by Medicare. Medicaid programs vary from state to state, but most health care costs are covered if you qualify for both Medicare and Medicaid.

Nondiscrimination Notice

Translation and Alternative Formats

If you need free help interpreting the information on this website, please contact Member Services for the program you are enrolled in.

Attention. If you need free help interpreting this document, call 1-866-567-7242.

Civil Rights Notice

Discrimination is against the law. South Country Health Alliance (South Country) does not discriminate on the basis of any of the following:

  • race
  • color
  • national origin
  • creed
  • religion
  • sexual orientation
  • public assistance status
  • age
  • disability (including physical or mental impairment)
  • sex (including sex stereotypes and gender identity)
  • marital status
  • political beliefs
  • medical condition
  • health status
  • receipt of health care services
  • claims experience
  • medical history
  • genetic information

Auxiliary Aids and Services. South Country provides auxiliary aids and services, like qualified interpreters or information in accessible formats, free of charge and in a timely manner, to ensure an equal opportunity to participate in our health care programs. Contact South Country Member Services at members@mnscha.org, call 1-866-567-7242 (toll-free), TTY 1-800-627-3529 or 711.

Language Assistance Services. South Country provides translated documents and spoken language interpreting, free of charge and in a timely manner, when language assistance services are necessary to ensure limited English speakers have meaningful access to information and services. Contact South Country Member Services at members@mnscha.org or call 1-866-567-7242 (toll-free), TTY 1-800-627-3529 or 711.

Civil Rights Complaints

You have the right to file a discrimination complaint if you believe you were treated in a discriminatory way by South Country. You may contact any of the following four agencies directly to file a discrimination complaint:

U.S. Department of Health and Human Services’ Office for Civil Rights (OCR).
You have the right to file a complaint with the OCR, a federal agency, if you believe you have been discriminated against because of any of the following:

  • race
  • color
  • national origin
  • age
  • disability
  • sex
  • religion (in some cases)

Contact the OCR directly to file a complaint:

Director
U.S. Department of Health and Human Services’ Office for Civil Rights
200 Independence Avenue SW, Room 515F
HHH Building
Washington, DC 20201
Customer Response Center: Toll-free: 800-368-1019
TDD 800-537-7697
Email: ocrmail@hhs.gov

 

Minnesota Department of Human Rights (MDHR).
In Minnesota, you have the right to file a complaint with the MDHR if you believe you have been discriminated against because of any of the following:

  • race
  • color
  • national origin
  • religion
  • creed
  • sex
  • sexual orientation
  • marital status
  • public assistance status
  • disability

Contact the MDHR directly to file a complaint:

Minnesota Department of Human Rights
540 Fairview Avenue North, Suite 201
St. Paul, MN 55104
651-539-1100 (voice)
800-657-3704 (toll free)
711 or 800-627-3529 (MN Relay)
651-296-9042 (Fax)
Info.MDHR@state.mn.us (Email)

 

Minnesota Department of Human Services (DHS).
You have the right to file a complaint with DHS if you believe you have been discriminated against in our health care programs because of any of the following:

  • race
  • color
  • national origin
  • creed
  • religion
  • sexual orientation
  • public assistance status
  • age
  • disability (including physical or mental impairment)
  • sex (including sex stereotypes and gender identity)
  • marital status
  • political beliefs
  • medical condition
  • health status
  • receipt of health care services
  • claims experience
  • medical history
  • genetic information

Complaints must be in writing and filed within 180 days of the date you discovered the alleged discrimination. The complaint must contain your name, address, and describe the discrimination you are complaining about. After we get your complaint, we will review it and notify you in writing about whether we have authority to investigate. If we do, we will will investigate the complaint.

DHS will notify you in writing of the investigation's outcome. You have the right to appeal the outcome if you disagree with the decision. To appeal, you must send a written request to have DHS review the investigation outcome period. Be brief and state why you disagree with the decision. Include additional information you think is important.

If you file a complaint this way, the people who work for the agency named in the complaint cannot retaliate against you. This means they cannot punish you in any way for filing a complaint. Filing a complaint in this way does not stop you from seeking out other legal or administrative actions.

Contact DHS directly to file a discrimination complaint:

ATTN: Civil Rights Coordinator
Minnesota Department of Human Services
Equal Opportunity and Access Division
P.O. Box 64997
St. Paul, MN 55164-0997
651-431-3040 (voice) or use your preferred relay service

 

South Country Complaint Notice

You have the right to file a complaint with South Country if you believe you have been discriminated against because of any of the following:

  • medical condition
  • health status
  • receipt of health care services
  • claims experience
  • medical history
  • genetic information
  • disability (including mental or physical impairment)
  • marital status
  • age
  • sex (including sex stereotypes and gender identity)
  • sexual orientation
  • national origin
  • race
  • color
  • religion
  • creed
  • public assistance status
  • political beliefs

You can file a complaint and ask for help in filing a complaint in person, by mail, phone, or fax at:

ATTN: Civil Rights Coordinator
South Country Health Alliance
2300 Park Drive, Suite 100
Owatonna, MN 55060
Toll Free: 866-567-7242
TTY: 800-627-3529 or 711
Fax: 507-444-7774
Email: grievances-appeals@mnscha.org

American Indians can continue or begin 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 elders 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.

SCHA LB/CB-5583
DHS Approved 02/03/2021

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