Name of Manual - Blue Cross and Blue Shield of Minnesota

Health Care Options
Minnesota Senior
Health Options (MSHO)
/ Secure Blue (HMO)
Blue Plus offers a Minnesota Senior Health Options (MSHO)
product called SecureBlue for dual eligible seniors. SecureBlue is
a Special Needs Plan (SNP) offered under Medicare Advantage by
Blue Plus. Blue Plus has a contract with both the Centers for
Medicare and Medicaid Services (CMS) and the Minnesota
Department of Human Services (DHS) for SecureBlue that creates
an alternative delivery system for acute and long-term care
services and integrates Medicare and Medicaid funding.
SecureBlue combines the services and benefits of Medicare Parts
A and B, including Part D prescription drug coverage, and
Medicaid benefits.
A personal care coordinator will work closely with individual
SecureBlue members to assist them in achieving optimal medical
and social stability.
For SecureBlue members, Blue Plus is billed as primary not
Medicare. SecureBlue members can be identified by ID numbers
beginning with an “XZS8” + the member’s PMI# and group
numbers that begin with “PP2”. Enrollment eligibility may change
monthly. Providers must verify eligibility through any electronic
data system currently being used to access Medical Assistance
eligibility such as Medifax, BLUELINE, the Department of
Human Services Eligibility Verification System (EVS), provider
web self-service, or Blue Cross provider services.
SecureBlue includes 180 days of nursing home coverage and
Elderly Waiver services. The only copays for SecureBlue members
are for prescriptions. Members must designate a primary care
clinic, however, referrals are not required for services at
participating providers. Services are coordinated through a
personal care coordinator. All Blue Plus referral providers are
included in the specialty network. Providers should file their
claims with Blue Cross.
5-20 Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (12/27/10)