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Medica Introduces Health Plans for Medicare Beneficiaries With Special Needs

Posted on: Wednesday, 3 October 2007, 12:00 CDT

Medica today introduced two new health plans for Medicare beneficiaries with special health care needs. Medica Complete SolutionSM is a new health plan option for Medicare beneficiaries with severe chronic health conditions. Another new health plan option, Medica AccessAbility SolutionSM, was developed to serve people with physical, developmental, and or mental disabilities who qualify for both Medicare and Medicaid coverage. The health plans are available for coverage starting January 1, 2008, for individuals living in select Minnesota counties (see below for a list of counties).

Both plans are member-focused coverage options that actively support members in improving their health, functional status, quality of life and independence. Medica Complete Solution was developed specifically for people who have been diagnosed with asthma, cardiovascular disease, congestive heart failure, dementia, diabetes or hypertension. Medica AccessAbility Solution was created to meet the needs of dually eligible people who have qualified for both Medicare and Medicaid because of a disability. Both groups of people generally need more care among a broader range of providers to prevent the onset of disease or the progression of disabling conditions.

Key to both plans is the partnership between the member, the member's physician, medical coordination staff and Medica. The plans offer disease management programs that help people with chronic illness or disabilities maintain optimal health and clinical care management resources that help patients and families coordinate an array of treatments, medications and services.

"Living with a chronic illness or disabling condition can create hurdles to getting the best care possible," said Mark Owen, vice president of Medica's Center for Healthy AgingSM. "We created Medica Complete Solution and Medica AccessAbility Solution to help those people navigate the health care system with the goal of maintaining maximum independence."

Medica Complete Solution and Medica AccessAbility Solution are "Special Needs Plans" authorized by the Medicare Modernization Act of 2003. Chronic conditions account for 78 percent of the nation's total medical care costs, according to research by the Kaiser Family Foundation. Meanwhile, the Medicare Payment Advisory Commission estimates that 17 percent of Medicare beneficiaries participate in these plans, yet account for 24 percent of program spending.

Both Medica Complete Solution and Medica AccessAbility Solution include Medicare Part D coverage. For the last eleven years Medica has offered coverage for seniors with special health care needs who are eligible for both Medicare and Medicaid through its Medica Dual SolutionSM product. "We are pleased to be able to now offer similar coverage to these new target groups," said Owen.

County Availability

Medica Complete Solution and Medica AccessAbility Solution will be available in the following Minnesota counties: Aitkin, Anoka, Becker, Benton, Carlton, Carver, Cass, Chisago, Clay, Crow Wing, Dakota, Hennepin, Isanti, Koochiching, Lake, Mahnomen, Mille Lacs, Morrison, Norman, Otter Tail, Pine, Polk, Ramsey, Rice, Scott, Sherburne, St. Louis, Stearns, Todd, Wadena, Washington, Wilkin and Wright.

About Medica

Serving more than 1.3 million members, Medica is a health insurance company headquartered in Minneapolis and active in the Upper Midwest. The non-profit company provides health care coverage in the employer, individual, Medicaid, Medicare and Medicare Part D markets in Minnesota and a growing number of counties in North Dakota, South Dakota and Wisconsin. Medica also offers national network coverage to employers who also have employees outside the Medica regional network.

Medica has the highest accreditation status, Excellent, from the National Committee for Quality Assurance (NCQA®) for its Minnesota Medicaid HMO plans and commercial health plans in Minnesota and North Dakota. Medica's vision is to become the community's health plan of choice, trusted for its integrity, respected for its service, and admired for its commitment to innovation and efficiency.

Source: Business Wire

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