If you're 65 or older in Minnesota with both Medicare and Medical Assistance, Minnesota Senior Health Options (MSHO) can put both into one health plan with a care coordinator, at no cost to join. If you don't choose MSHO, you're enrolled in Minnesota Senior Care Plus (MSC+), which leaves your Medicare separate. The Minnesota Department of Human Services (DHS) county map for 2026 and 2027 names six health plans whose MSHO plan can combine Medicare and Medical Assistance.

In This Guide

Who Qualifies for Minnesota Senior Health Options?

DHS runs Minnesota Senior Health Options for people who have both Medicare and Medical Assistance, which is Minnesota's Medicaid program. You can choose to enroll in MSHO if you meet all four conditions:

  • You're 65 or older.
  • You're eligible for Medical Assistance.
  • You're enrolled in both Medicare Part A and Medicare Part B.
  • You live in a county where a health plan offers MSHO.

Joining MSHO is voluntary. Living in a nursing home doesn't rule you out: a nursing home resident can enroll in MSHO.

If you aren't sure whether you or a parent qualifies for Medical Assistance, our guide to Minnesota Medicaid income and asset limits covers the financial rules, and our guide to applying for Minnesota Medical Assistance walks through the application.

What MSHO Covers, and How It Differs From MSC+

MSHO and MSC+ are the two Medical Assistance managed care programs for Minnesotans 65 and older, and the difference that matters most is Medicare: an MSHO health plan covers all your Medicare services, including Part D drugs, while MSC+ doesn't include Medicare Parts A, B or D at all.

MSHO MSC+
Joining Voluntary, for people with Medicare Parts A and B Mandatory if you aren't in MSHO
Medicare, including Part D Covered by your MSHO health plan Not included; your Medicare stays separate
Medical Assistance basic care Covered by the health plan Covered by the health plan
Elderly Waiver services Covered by the health plan Covered by the health plan
Nursing home care First 180 days covered by the health plan First 180 days covered by the health plan

One MSHO plan combines the services you get from Medical Assistance and Medicare, including dental care, home and community-based services through the Elderly Waiver, nursing home care, prescription drugs and transportation.

The 180-day line is not a cutoff on nursing home care. For a nursing home stay longer than 180 days, the MSHO or MSC+ health plan stays responsible for your health care services, while the nursing facility's room and board costs are paid fee for service through Medical Assistance. Coverage for some long-term care, including nursing homes, may require a separate application to determine whether Medical Assistance can pay for it. Our guide to Minnesota Medicaid and nursing home care covers that application.

The Elderly Waiver is the Medical Assistance program that pays for home and community services for adults 65 or older who meet a nursing-facility level of care and would rather live in the community. Our guide to Minnesota Medicaid HCBS waivers explains how the Elderly Waiver assessment works.

What Does an MSHO Care Coordinator Do?

Every MSHO member is assigned a care coordinator who helps them get their health care and related support services. If you had a county case manager for home and community-based services before joining MSHO, the MSHO care coordinator replaces that case manager in most cases.

Once you're enrolled, ask the MSHO plan for your care coordinator's name and phone number, and keep them with your Medicare and Medical Assistance cards.

Which Health Plans Offer Minnesota Senior Health Options?

DHS's county map of health plans for MSHO and MSC+ members (DHS-4840) covers three periods: January 1 to September 30, 2026; October 1 to December 31, 2026; and all of 2027. For 2026 and 2027, Minnesota DHS's map says people in six health plans can choose to have the MSHO plan combine their Medicare and Medical Assistance services: Blue Plus, HealthPartners, Itasca Medical Care, Medica, PrimeWest Health and South Country Health Alliance. Plan choices vary by county, so check the DHS map of MSHO health plans by county for the plans offered where you live.

Two other plans appear on DHS's map without combining Medicare. On the January to September 2026 map, UCare is marked as not integrating Medicare. On the October to December 2026 map and the 2027 map, Medica One Health Plan is marked as not integrating Medicare, and people with Medicare in Medica One Health Plan need a separate Medicare Part D plan. If your Medical Assistance plan is UCare or Medica One Health Plan and you want MSHO, you'd be choosing one of the six plans DHS lists for MSHO.

Health plan Toll-free number
Blue Plus 866-477-1584
HealthPartners 877-713-8215
Itasca Medical Care 800-843-9536
Medica 800-234-8755
PrimeWest Health 800-366-2906
South Country Health Alliance 866-567-7242

DHS publishes these numbers on its MSHO health plan contacts page. The health plans have different provider networks, so before you pick one, check that your doctors, pharmacy and any home care or nursing home provider work with it. DHS says that if your doctor isn't listed with any MSHO health plan and you want to keep seeing that doctor, you may not want to enroll in MSHO.

What Does MSHO Cost?

Joining MSHO doesn't erase what you already owe: copays, spenddowns and other obligations still have to be paid. DHS's 2027 summary of coverage adds two details:

  • Medical Assistance services: People in MSHO or MSC+ don't pay cost sharing for Medical Assistance services they get through their MSHO or MSC+ health plan.
  • Part D prescriptions: There may be copays for prescriptions through Part D, and Medical Assistance doesn't cover Part D copays.

If you have a medical spenddown or an Elderly Waiver obligation, ask the MSHO plan how you'll pay it before you join. For help with Medicare premiums themselves, Minnesota's Medicare Savings Programs include Qualified Medicare Beneficiary (QMB) coverage, which pays the Medicare Part B premium and, for people who owe one, the Part A premium. Our guide to Minnesota Medicare Savings Programs covers who qualifies.

How to Join MSHO, and How to Leave

Joining. To enroll in MSHO, contact one of the MSHO health plans available in your county. If you already have Medical Assistance, call the health plan directly to enroll. The numbers are in the plan table above.

Leaving. You can drop MSHO at any time without losing your Medical Assistance or Medicare benefits. Here's how leaving works:

  1. Tell your MSHO health plan in writing that you want to drop the program.
  2. You're taken out of MSHO at the start of the next month.
  3. Your Medical Assistance moves to the same health plan's MSC+ plan, or, if you have a medical spenddown, to fee-for-service Medical Assistance, also called "straight MA."
  4. You choose a Part D plan for your prescription drugs, because MSC+ doesn't include Medicare.

Line up the Part D plan before your MSHO coverage ends. Minnesota Aging Pathways offers free health insurance counseling that covers Medicare and prescription drug costs.

Where MSHO Fits in Federal Medicare Rules

Federal Medicare has its own names for plans built for people with both Medicare and Medicaid. The Medicare Payment Advisory Commission (MedPAC) groups dual eligible special needs plans (D-SNPs) into coordination-only, highly integrated (HIDE) and fully integrated (FIDE) plans, and reported that in 2024 only 3 percent of dually eligible people nationwide were in a FIDE plan. The Centers for Medicare & Medicaid Services (CMS) lists Minnesota among 23 states and territories whose applicable integrated plan D-SNPs use member handbooks, ID cards and directories developed jointly with CMS for 2027.

If a company offers you a "dual" Medicare plan, ask whether it's MSHO, and ask which of these federal categories the plan falls under.

A federal rule, 42 CFR 422.514(h), takes effect in 2027 for D-SNPs whose company also runs a Medicaid managed care plan for full-benefit dual eligibles in the same area. As CMS's April 2026 questions and answers explain the rule, starting in 2027 such a D-SNP must generally limit new members to people who are in, or enrolling in, that company's Medicaid plan, and starting in 2030 it may generally only enroll or keep members who are also in that Medicaid plan. Under the same 42 CFR 422.514(h) rule, existing D-SNP members who aren't in the D-SNP company's Medicaid plan may stay in that D-SNP until 2030. CMS also describes an exception to the 42 CFR 422.514(h) rule for people on Medicaid fee-for-service: where a state doesn't require all full-benefit dual eligibles to join Medicaid managed care and the state's Medicaid contract allows it, a D-SNP's company may enroll full-benefit dual eligibles in fee-for-service Medicaid in a coordination-only or HIDE D-SNP, and that exception continues in 2030 and beyond. That exception can matter if your Medical Assistance is fee-for-service "straight MA," as it is for someone with a medical spenddown who leaves MSHO. An MSHO member already gets Medicare and Medical Assistance through the same MSHO health plan. Neither DHS nor CMS, in the sources this guide relies on, says how the rule or its exception applies to any one Minnesota plan, so if you're in a Medicare plan from one company and a Medical Assistance plan from another, ask Minnesota Aging Pathways before 2027 whether your Medicare plan is affected.

Where to Get Free Help

Minnesota Aging Pathways (formerly the Senior LinkAge Line) is Minnesota's State Health Insurance Assistance Program, and it offers free, unbiased help with Medicare choices. The Minnesota Board on Aging says Minnesota Aging Pathways also helps with forms, including applying for Medical Assistance. Call Minnesota Aging Pathways at 800-333-2433, Monday through Friday from 8:00 a.m. to 4:30 p.m. Our guide to Minnesota Aging Pathways explains what a counseling session covers.

If a Medical Assistance decision goes against you, see Minnesota Medicaid appeals and fair hearings.

Frequently Asked Questions

What is the difference between MSHO and MSC+?

MSHO puts Medicare, including Part D drugs, and Medical Assistance in one health plan, while MSC+ covers Medical Assistance services and leaves Medicare separate. The comparison table above sets the two side by side.

Is UCare an MSHO plan?

No. UCare isn't among the six plans Minnesota DHS lists for MSHO in 2026 and 2027, and DHS's January to September 2026 map marks UCare as not integrating Medicare. If you were with UCare, call Minnesota Aging Pathways or one of the six MSHO plans to check your options.

Learn More

MedicareMedicare Plans and Coverage in MinnesotaMedicare in Minnesota for 2026: Parts A and B costs, Medicare Advantage, Part D, Medigap, free Aging Pathways counseling, and Medicare Savings Programs. MedicareMinnesota SHIP (Aging Pathways): Free Medicare Counseling, What It Covers and How to Get HelpMinnesota SHIP Medicare counseling is free through Minnesota Aging Pathways, formerly the Senior LinkAge Line. See what it covers and how to prepare to call. MedicaidYour Guide to Minnesota Medicaid HCBS WaiversMinnesota Medicaid HCBS waivers run through the Elderly Waiver, which pays for in-home and community care for older adults who need nursing-home-level care. MedicaidYour Guide to Minnesota Medicaid Income and Asset LimitsSee the 2026 Minnesota Medicaid income limits: 138% FPG with no asset test under 65, the 100% FPG and $3,000 asset rules at 65, and the spend-down. MedicareFully Integrated Dual Eligible Special Needs Plans (FIDE-SNPs) ExplainedFIDE-SNPs are the high-integration dual-eligible plans replacing the MMP demonstration on 1/1/2026: definitions, state landscape, and family pitfalls. MedicareMedicare and Medicaid Together: Dual Eligibility ExplainedWhat dual eligible means: how Medicare and Medicaid coordinate, full vs. partial duals, QMB cost protection, automatic Extra Help, and integrated D-SNP plans.

Find personalized help deciding whether Minnesota Senior Health Options is right for you or a parent at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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