---
id: "epm:2.3.4.1"
source: "Minnesota Health Care Programs Eligibility Policy Manual"
source_short: "EPM"
publisher: "Minnesota Department of Human Services"
section: "2.3.4.1"
title: "Health Care Delivery"
breadcrumb: "2 Medical Assistance > 2.3 Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability > 2.3.4 Post-Eligibility > 2.3.4.1 Health Care Delivery"
effective_date: 2016-06-01
last_modified: 2026-10-03T03:51:58.594961+00:00
version: 1
url: "https://bot-corpus.mn-dhs.online/s/epm/2.3.4.1"
official_origin: "https://hcopub.dhs.state.mn.us/epm/2_3_4_1.htm"
legal_citations:
  - "Code of Federal Regulations, title 42, section 435.1000"
  - "Code of Federal Regulations, title 42, section 438.1"
  - "Minnesota Statutes, section 256B.035"
  - "Minnesota Statutes, section 256B.0625"
---
# EPM 2.3.4.1 Health Care Delivery

## Fee for Service

Fee-for-service is a method of payment for health care services used for enrollees not in a managed care plan. See [MHCP Health Care Delivery](https://bot-corpus.mn-dhs.online/s/epm/1.6) for more information.

## Managed Care

Managed care is a health care delivery system under which enrollees receive most medical services through a health plan or network of providers, which coordinates the services provided.

### People who are Aged 65 and Older

Most Medical Assistance (MA) enrollees aged 65 and older must enroll in a managed care plan. Enrollees aged 65 and older have two managed care programs to choose from.
- Minnesota SeniorCare Plus (MSC+) provides medical services through the health plan of the enrollee’s choice, and enrollees must choose a separate plan for Medicare Part D drug coverage.
- Minnesota Senior Health Options ([MSHO](http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=id_006271)) is for enrollees who have Medical Assistance and Medicare Parts A and B. MA medical services, Medicare services and drug coverage are all provided through the MSHO health plan.

### People who are Blind or Disabled

Enrollees who are certified blind or disabled are exempt from enrolling in a managed care plan. However, enrollees aged 18-64, who are certified blind or disabled, may voluntarily enroll in Special Needs Basic Care ([SNBC](http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=dhs16_139491)). Some SNBC health plans coordinate health care coverage with Medicare.

Detailed information on managed care is found in the [Prepaid Minnesota Health Care Programs (PMHCP) Manual.](http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=id_016959)

## Covered Services

The benefit set for people using an aged, blind or disabled basis of eligibility includes a wide range of health care services, from preventive care to hospitalization. Some benefits have limitations on services or level of coverage. This means there may be a limit or maximum dollar amount on specific types of services, like eyeglasses, or on all services in a category, like dental.

Services in a long-term care facility can be covered by MA if the person has a pre-admission screening that indicates the person needs a nursing facility level of care and meets the other requirements to be eligible for [MA for Long-Term Care Services](https://bot-corpus.mn-dhs.online/s/epm/2.4).
- The Minnesota Health Care Programs (MHCP) Summary of Coverage, Cost Sharing and Limits ([DHS-3860](https://www.google.com/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=1&ved=0CCAQFjAA&url=https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3860-ENG&ei=9WZrVPHVC5OnyASpgIKwBw&usg=AFQjCNFK_Yl9QXapcVWWYTJ5mQfMG7MSVw&bvm=bv.79908130,d.aWw)) explains covered services and cost-sharing requirements.
- [Minnesota Senior Health Options (MSHO)](http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=id_006271) explains services included in the MSHO managed care plan.
- [SNBC covered services](https://mn.gov/dhs/people-we-serve/people-with-disabilities/health-care/health-care-programs/programs-and-services/snbc.jsp) explains services included in the SNBC managed care plan.

## Legal Citations

- Code of Federal Regulations, title 42, section 435.1000
- Code of Federal Regulations, title 42, section 438.1
- Minnesota Statutes, section 256B.035
- Minnesota Statutes, section 256B.0625