MSHO Supplemental Benefits for 2018 (SecureBlue only)
Silver & Fit Fitness Benefit / · No cost membership at participating facilities.· Member or Care Coordinator can call Silver & Fit at 1-877-427-4788 (TTY/DD 1-877-710-2746) or go to www.silverandfit.com to register/search facilities.
· Round trip transportation to the fitness center is covered up to 12 visits per month.
· To schedule rides, call BlueRide 1-866-340-8648 (TTY 711)
Additional Podiatry Services / · Up to 12 routine podiatry visits per calendar year at $0 copay.
· Benefit is for members who do not have a Medicare covered diagnosis in need of routine foot care.
Additional Dental Services / · Allows for one additional preventive exam for a total of two exams per calendar year at $0 copay.
· Allows for two perio-maintenance dental visits for members with periodontal disease at a $0 copay.
· No prior authorization is required.
· If there are any questions about the benefits, members can call Delta Dental at 1-800-774-9049. Care Coordinators can call 1-866-303-8138.
· Dental Root Planing and Scaling
$750 Safety Item Benefit / · Up to $750 per calendar year for safety items at $0 copay.
· Items may include but not limited to: grab bars, shower bench, shower chair, toilet safety rails, etc.
· There is a supplemental benefit instruction sheet located on the care coordination portal.
· Must use an in-network Durable Medical Equipment (DME) provider.
· Benefit is payer of last resort. All benefit or waiver options must be exhausted before use of this benefit.
· Call the Clinical Guide Team at 1-866-518-8447 for prior authorization.
Medication Reconciliation and Review / · In-home medication reconciliation from a pharmacist during the week following discharge from a hospital or short-term nursing home stay.
· Pharmacist will review medications and discharge orders and provide in-depth education to members about their drugs.
· Contact member to let them know they have the benefit available, and let them know a pharmacist will be doing outreach.
· Submit form 6.35 In-Home Pharm-D Referral Form with referral information along with any discharge orders available.
Home Delivered Meals / · Up to two home delivered meals per day, for a period not to exceed four weeks following discharge from an inpatient hospital or nursing home stay.
· All current home delivered meals providers are eligible to provide this service. Check Minnesotahelp.info for providers in the member’s area.
· Enter the service agreement for Home Delivered meals into Bridgeview
Electric Toothbrush/Replacement / · One Electric toothbrush and one package of three replacement heads
· Contact Corner Medical (866) 535-5335
· Enter Service Agreement for the electric toothbrush and replacement heads into Bridgeview
First Aid Kit / · Limited to one per year per member
· Contact Corner Medical (866) 535-5335
· Enter Service Agreement for the First aid kit into Bridgeview
Personal emergency response System (PERS) / · For members living in the community only-eligible members do not need to be open to EW
· Contact EveryFit, INC. DBA QMedic using form located on the care coordination portal.
· Enter Service Agreement for the PERS into Bridgeview
Note: This document is for Care Coordinator use only and is not intended for distribution to members.