Each year we like to summarize any big changes we’ve found in the managed care programs we service in Minnesota so our customers can prepare for the new year. Here are a few notes we’ve collected as 2021 ends. We encourage providers to contact their specific plans’ provider services unit or their plan contract manager with any questions. These notes may not be all inclusive of changes, and this information is subject to change, so review any communications from your accepted plans to prevent surprises. Thank you!
MEDICA PROVIDER SERVICES – 1-800-458-5512
We are unaware of any major changes for 2022 with our accepted Medica plans. Medica will continue with their Anti-Reflective Coating benefit for members with groups #07xxx (Special Needs Basic Care Enhanced) & 08xxx (Minnesota Senior Health Option Plan).
For Medica Members residing in Hennepin County, Medica has added a new plan this year
- This is a Prepaid Medical Assistance program exclusive to Medica, so checking eligibility for these patients is easiest on the Medica Portal.
- To register for Medica’s portal call 1-800-458-5512.
- Please note, the New Payer ID for this plan is MEDMI
- Group numbers start with the letter “A” for this plan.
- This plan is basic coverage with frames and lenses.
- See Medica’s 2022 MHCP benefits overview grid, page 7, for more information.
- Dispensing providers should verify registration for these plans with their clearinghouses. If unregistered, paper claims for exams and dispensing can be submitted to: Medica Government Programs, PO BOX 21342, Eagan MN 55121-0342.
Plan Documents – Information on all Medica Plans (be sure to select 2022)
UCARE PROVIDER SERVICES – 1-888-531-1493
Eye-Kraft Processes claims directly to UCare for the following plans:
- Minnesota Care Minnesota Senior Care Plus
- Minnesota Senior Health Options
- Prepaid Medical Assistance Program
- UCare Connect
- UCareConnect Plus Medicare
UCARE NEW FOR 2022
UCare IDs and Group Numbers
UCare ID Numbers and Group Numbers are changing for 2022
UCare Benefit Additions
UCare will be covering anti-reflective coating, photochromic lenses, tints, and progressives on their UCare connect plus Medicare and the Minnesota Senior Health Options plan in 2022.
- These are covered benefits – no prior authorization or diagnostic code is needed. This is at no cost to the member.
- These services will only be processed for UCare through Eye-Kraft.
- This benefit will be covered 1 time within a 2-year period.
- Progressives will be Eye-Kraft’s DLS Everyday. This is a non-compensated free-form digital design.
- Anti-reflective coatings will be Eye-Kraft’s ClearKraft2 or ClearKraft HEV. Offices will not be billed for eligible patient’s AR.
- AR orders are complete frame and lens orders, AR will not be added to existing lenses.
- Photochromics will be lab choice based on Rx, availability, and lens design.
- Standard solid or gradient tints only. Therapeutic and specialty tints require demonstration of medical necessity and diagnostic codes and are not covered under the MSHO and UCare Connect plans.
- If the member has an Rx change, breaks their glasses, etc., the member must pay for the anti-reflective coating on the remake if requested.
- Photochromics and tints require medical necessity and diagnostic codes if replaced within the 2-year benefit period.
- Progressive non-adapts will have 1 Rx adjustment remake, and further non-adapts will be fit for a lined multifocal.
- Providers will continue to bill exam and dispensing fees as usual.
Group Numbers and Packages Below are ELIGIBLE for the Benefit Additions Above.
- U10001_001 – MINNESOTA SENIOR HEALTH OPTIONS (MSHO) BENEFIT PACKAGE
- U10001_002 – UCARE CONNECT PLUS MEDICARE
The following group numbers/Packages DO NOT cover the New Benefit Additions
- U10000_002 – MINNESOTA CARE
- U10000_003 – MINNESOTA SENIOR CARE PLUS
- U10000_001 – PREPAID MEDICAL ASSISTANCE PROGRAM
- U10000_004 – UCARE CONNECT
South Country Health Alliance:
SOUTH COUNTRY HEALTH ALLIANCE PROVIDER SERVICES – 888-633-4055
There are no major changes for South Country in 2021. The 8 current South Country Health Alliance counties are:
Brown County, Dodge County, Goodhue County, Kanabec County, Sibley County, Steele County, Wabasha County, Waseca County
Minnesota Health Care Programs:
Eye-Kraft is not associated with the State’s MHCP contract. For questions regarding changes to that program, please contact the servicing lab or DHS.