Special Needs BasicCare changes are coming

Special Needs BasicCare (SNBC) is a voluntary managed care program for people with disabilities ages 18 through 64 who have Medical Assistance (MA). Changes are coming for about 8,000 Minnesotans in 31 counties who receive coverage through SNBC. Approximately 50,000 members are enrolled in the SNBC program statewide. Most of the affected 8,000 members will switch to new plans July 1. The balance of the affected membership in the Twin Cities metro area will shift January 1, 2017. The group is comprised primarily of people with physical disabilities and secondarily by people with mental illness.

SNBC coverage changes were necessary because Medica notified DHS early this year that it would end its Medicaid-only AccessAbility Solutions SNBC service July 1 in 31 counties. SNBC members affected by Medica’s exit live in Aitkin, Becker, Benton, Carlton, Cass, Chisago, Clay, Cook, Crow Wing, Isanti, Itasca, Kittson, Koochiching, Lake, Lake of the Woods, Mahnomen, Marshall, Mille Lacs, Morrison, Norman, Otter Tail, Pennington, Pine, Polk, Red Lake, Roseau, St. Louis, Stearns, Todd, Wadena and Wilkin counties.

To fill the coverage void, DHS conducted a sixweek Request for Proposal (RFP) process early in 2016 to select health plans to provide SNBC coverage in the affected counties. The process also invited health plans to participate in SNBC in southern Minnesota and the metro area in 2017.

Four health plans responded to the RFP seeking coverage opportunities: UCare, a longtime SNBC plan provider; HealthPartners, which applied for the first time;

Metropolitan Health Plan (MHP), which responded for Hennepin County only; and Medica, which sought to retain metro area coverage. Counties already served by South Country Health Alliance and PrimeWest countybased purchasing plans weren’t included in the RFP, but are expected to be procured again by 2018. DHS announced the results in May. It split the health plan changes into two phases, with effective dates of July 1, 2016, and January 1, 2017.

For July 1, 2016, UCare was awarded 20 new counties: Aitkin, Becker, Cass, Clay, Cook, Crow Wing, Itasca, Kittson, Koochiching, Lake, Lake of the Woods, Mahnomen, Marshall, Norman, Otter Tail, Pennington, Polk, Red Lake, Roseau, and Wilkin. UCare currently serves 42 counties with its UCare Connect Medicaid-only SNBC plan primarily in the southern half of the state (exceptions are Pine, Carlton, Mille Lacs and St. Louis counties to the northeast).

HealthPartners was awarded 27 counties: Aitkin, Becker, Benton, Carlton, Cass, Chisago, Clay, Cook, Crow Wing, Kittson, Koochiching, Lake, Mahnomen, Marshall, Mille Lacs, Norman, Otter Tail, Pennington, Pine, Polk, Red Lake, Roseau, Sherburne, St. Louis, Stearns, Wilkin and Wright counties. HealthPartners’s new Medicaid-only SNBC plan is called Inspire.

MHP will continue providing Medicaid-only SNBC service in Hennepin. Medica will continue to provide Medicaid-only SNBC in Anoka, Carver, Dakota, Hennepin, Kandiyohi Ramsey, Rice, Scott, Sherburne, Wright, and Washington counties.

As of January 1, 2017 HealthPartners will provide Medicaid-only service to SNBC members in an additional seven metro counties: Anoka, Carver, Dakota, Hennepin, Ramsey, Scott and Washington. Members can choose to enroll in a different SNBC plan, or opt out of SNBC altogether. Members who neither choose a plan nor opt out of enrollment will be assigned to a plan in their hoe county. SNBC members changing health plans by default or choice can expect their provider networks to remain generally the same as their previous plan.

SNBC enrollees may have a care coordinator or navigator to help them get health care and support services. Some SNBC health plans coordinate with other payers, including Medicare Parts A, B and D for enrollees who have that coverage. Some plans are contracted with the Centers for Medicare & Medicaid Services (CMS) to integrate Medicare and Medicaid benefit sets.

People with disabilities who meet the age criteria and have MA fee-for-service coverage receive a letter from the Minnesota Department of Human Services (DHS) asking them to enroll in an SNBC health plan. Some people may not get a letter because they are excluded from enrolling in a health plan and will continue to get their coverage through fee-for-service.

Anyone can choose to not enroll and to stay in fee-for-service. If DHS does not receive the SNBC Choice Form by the deadline, the person will automatically be enrolled in SNBC. People can choose to change their health plan (if more than one health plan is available in their county) or disenroll for the next available month. The health plans that are under contract with DHS administer SNBC. It is available in all 87 counties.

More information can be found here, or in accessible formats by calling 651-431-2670, 800-657-3739 toll free, or by using your preferred relay service. A service coverage map can be viewed here.