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.

AbilityCare (HMO SNP)

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 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

Call: 1-866-567-7242
TTY: 1-800-627-3529 or 711
Calls to both numbers are free.
April – September: Monday to Friday, 8 a.m. to 8 p.m.
October – March: 7 days a week, 8 a.m. to 8 p.m.

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

Translate »