UCare’s MSHO 2018 Provider & Pharmacy Directories

1 UCare s MSHO 2018 Provider & Pharmacy DirectoriesH2456_121918 DHS Approved (12282018) DHS/CMS Accepted (01042019) UCare s MSHO is a health plan that contracts with both Medicare and the Minnesota Medical Assistance (Medicaid) program to provide benefits of both programs to enrollees. Enrollment in UCare s MSHO depends on contract renewal. The Provider and Pharmacy networks may change throughout the year. We will send you a notice before we make a change that affects you. Benefits and/or copayments may change on January 1 of each year. This directory lists health care professionals (such as doctors, nurse practitioners, and psychologists), and facilities (such as hospitals or clinics) that you may see as a UCare s MSHO member. We also list the pharmacies that you may use to get your prescription drugs.

2 We will refer to these groups as network providers in this directory . These providers signed a contract with us to provide you services. This is a list of UCare s MSHO network providers for the following counties: Aitkin, Anoka, Becker, Benton, blue Earth, Carlton, Carver, Cass, Chippewa, Chisago, Clay, Cook, Cottonwood, Crow Wing, Dakota, Dodge, Faribault, Fillmore, Freeborn, Hennepin, Houston, Isanti, Jackson, Kandiyohi, Kittson, Koochiching, Lac qui Parle, Lake, Lake of the Woods, Le Sueur, Lincoln, Lyon, Mahnomen, Marshall, Martin, Mille Lacs, Morrison, Mower, Murray, Nicollet, Nobles, Norman, Olmsted, Otter Tail, Pennington, Pine, Polk, Ramsey, Red Lake, Redwood, Rice, Rock, Roseau, Saint Louis, Scott, Sherburne, Stearns, Swift, Todd, Wabasha, Wadena, Washington, Watonwan, Winona, Wright, and Yellow Medicine.

3 You can get this document for free in other formats, such as large print, braille, or audio. Call Customer Services at the number at the bottom of this page. To make a standing request to always get your UCare materials in a language other than English or in an alternate format such as large print, please contact Customer Services at the number listed b e l ow. The list is up-to-date as of December 2018 , but you need to know that: -Some UCare s MSHO network providers may have been added or removed from our network after this directory was published. -Some UCare s MSHO providers in our network may no longer be accepting new members. If you are having trouble finding a Provider who will accept new members, call Customer Services at the number at the bottom of this page and we will help you. To get the most up-to-date information about UCare s MSHO network providers in your area, visit or call Customer Services at the number at the bottom of this page.

4 Doctors and other health care professionals in UCare s MSHO network are listed on pages printed on white in this health plan does not guarantee you can see a particular Provider on this list. If you want to make sure, you should call that Provider to ask whether he or she is still part of this health plan. You should also ask if he or she is accepting new patients. This health plan may not cover all your health care costs. Read your contract or Member Handbook carefully to find out what is you have questions, please call UCare s Minnesota Senior Health Options (MSHO) (HMO SNP) Customer Services at 612 676 6868 or 1 866 280 7202 toll free, TTY/TDD 612 676 6810 or 1 800 688 2534 toll free, 8 to 8 , seven days a week. The call is free. For more information, visit ? iIf you have questions, please call UCare s Minnesota Senior Health Options (MSHO) (HMO SNP) Customer Services at 612 676 6868 or 1 866 280 7202 toll free, TTY/TDD 612 676 6810 or 1 800 688 2534 toll free, 8 to 8 , seven days a week.

5 The call is free. For more information, visit ?Getting started in UCare s MSHOThis section explains key terms you ll see in our Provider and Pharmacy directory . Providers are health care professionals and support providers such as doctors, nurses, pharmacists, therapists, and other people who provide care and services. Services include medical care, long-term services and supports, supplies, prescription drugs, equipment and services. -The term providers also includes facilities such as hospitals, clinics, and other places that provide medical services, medical equipment, and long-term services and supports. -Providers that are a part of our plan s network are called network providers. Network providers are the providers that have contracted with us to provide services to members in our plan. The providers in our network generally bill us directly for care they give you.

6 When you see a network Provider , you usually pay nothing for covered services. A Primary Care Provider (PCP) is a medical professional who gives you routine health care. Your PCP will keep your medical records and get to know your health needs over time. Specialists are doctors who provide health care services for a specific disease or part of the body. There are many kinds of specialists. Here are a few examples: -Oncologists care for patients with cancer. -Cardiologists care for patients with heart conditions. -Orthopedists care for patients with certain bone, joint, or muscle conditions. You also have access to a Care Coordinator. A Care Coordinator helps you manage your medical providers and you have questions, please call UCare s Minnesota Senior Health Options (MSHO) (HMO SNP) Customer Services at 612 676 6868 or 1 866 280 7202 toll free, TTY/TDD 612 676 6810 or 1 800 688 2534 toll free, 8 to 8 , seven days a week.

7 The call is free. For more information, visit ?Choosing a Primary Care Provider (PCP)You can get services from any Provider who is in our network and accepting new you become a member of our plan, you will choose a primary care Provider who is part of our plan network. This Provider will be your primary care you did not choose a Primary Care Provider /PCP or would like to make a change to your Primary Care Provider /PCP, go to the list of providers on page 105 and choose a Provider : that you use now, or who has been recommended by someone you trust, or whose offices are easy for you to get to. If you want help in choosing a PCP, please call Customer Services at the number at the bottom of this page. If you have questions about whether we will pay for any medical service or care that you want or need, call Customer Services and ask before you get the service or long-term services and supportsYou may be able to get long-term services and supports (LTSS), such as services provided by the Elderly Waiver (EW) program as a UCare s MSHO member.

8 Long-term services and supports are help for people who need assistance to do everyday tasks like taking a bath, getting dressed, making food, and taking medicine. Most of these services are provided at your home or in your community but could be provided in a nursing home or you enroll, you will be assigned a UCare Care Coordinator who will work with you to assess your individual needs and assist in coordinating care and services for you. Your Care Coordinator will also work with you to develop and maintain an individualized care plan based on your needs and Care Coordinator will help you identify the specific LTSS within your care plan that will help you meet your individual care goals, if you qualify for them. Your Care Coordinator will also help you identify your needs as you transition between levels of you are getting LTSS at the time you enroll, you will get these services through your UCare Care Coordinator.

9 If you reside in the community and are not getting LTSS at the time of enrollment, your first screening will include an assessment of your need for these services. If you are assessed as eligible, your Care Coordinator will work with you to get these must have a Long-Term Care Consultation (LTCC) done and be found to be eligible to get additional services or support. You can ask to have this assessment in your home, apartment, or facility where you care coordinator will meet with you and your family to talk about your care needs if you call to ask for a care coordinator will give you information about community services, help you find services to stay in your home or community, and help you find services to move out of a nursing home or other you need transition planning and coordination services to help you move to the community, you may be eligible to get Moving Home Minnesota (MHM) services.

10 MHM services are separate from EW services, but you must be eligible for EW. iiiIf you have questions, please call UCare s Minnesota Senior Health Options (MSHO) (HMO SNP) Customer Services at 612 676 6868 or 1 866 280 7202 toll free, TTY/TDD 612 676 6810 or 1 800 688 2534 toll free, 8 to 8 , seven days a week. The call is free. For more information, visit ?To find out more about these services, see your Member Handbook. Call Customer Services at the number at the bottom of this page to get more information on how to access these Providers in UCare s MSHO s NetworkYou must get all of your covered services from providers within our network.