2013 Prepaid Medical Assistance Program (PMAP)

Health care coverage for families, children and others who qualify

The Prepaid Medical Assistance Program (PMAP) is a health care program for families, children, pregnant women, adults without children who meet certain income limits and people who have disabilities. PMAP is Minnesota’s Medicaid program. There is no monthly fee, but you may need to pay a copay for some services. 

If you qualify
If you meet income and program guidelines, your county will send you information on the health plans that offer benefits for PMAP members in your county. How to find out if you qualify. Some counties have only one health plan choice, others have several. If you do not choose a health plan, your county will choose one for you.

Blue Advantage is the name of Blue Plus’ PMAP health plan. Blue Advantage is available to PMAP enrollees in Aitkin, Becker, Benton, Blue Earth, Carlton, Cass, Chippewa, Chisago, Clay, Cook, Cottonwood, Crow Wing, Dakota, Faribault, Fillmore, Freeborn, Houston, Isanti, Jackson, Kandiyohi, Kittson, Koochiching, Lac qui Parle, Lake, Lake of the Woods, LeSueur, Lincoln, Lyon, Mahnomen, Marshall, Martin, Mille Lacs, Mower, Murray, Nicollet, Nobles, Norman, Olmsted, Otter Tail, Pennington, Pine, Polk, Ramsey, Red Lake, Redwood, Rice, Rock, Roseau, St. Louis, Sherburne, Stearns, Swift, Watonwan, Wilkin, Wright, Winona, Yellow Medicine counties.

This information is available in other forms to people with disabilities by calling Blue Plus member services at (651) 662-5545 (voice), 1-800-711-9862 or (651) 662-8700 or 1-888-878-0137 (TDD), or 711, or through the Minnesota Relay direct access numbers at 1-800-627-3529 (TTY, voice, ASCII, hearing carryover), or 1-877-627-3848 (speech-to-speech).

More information
Evidence of Coverage (PDF) Why you need a health plan How to apply Get Acrobat Reader  

Health support for Blue Plus members

At Blue Plus, we want to help you live a healthy lifestyle. Through Blue Plus you can use a range of services at little or no extra cost.
 

Your primary care clinic – the first place to go for care
When you enroll in Blue Plus, you’ll need to choose a primary care clinic. When you have a primary care clinic, your clinic and doctor get to know you and your family. And you get to know them. They will have your health history and will keep all of your medical records in one place. Members have access to thousands of primary care clinics in large cities and rural areas. All Blue Plus health care providers meet national quality standards.
 
No referral needed to see a specialist
Surgeons and doctors who treat things like allergies and cancer are examples of specialists. You do not need a referral from Blue Plus to see any specialist in our large provider network. Some medical services still require a special review between your doctor and health plan. This is called prior authorization. Prior authorization helps make sure certain medical services and procedures are necessary and covered by your plan. 

24-Hour Nurse Advice Line
When you or someone in your family is sick, you can call a nurse to ask questions 24 hours a day, seven days a week. 

Blood lead testing
Lead poisoning is dangerous. It can cause serious problems in growing kids. It’s so important Blue Plus will give you a reward card just for having your child tested. More about blood lead testing (PDF).  

Car seats
It is important to use a car seat to protect your child from injuries. Blue Plus will send eligible members up to a $50 VISA reward card to help pay you back after you buy a car seat. Call member services to learn more about the Blue Plus car seat program. Reward cards from Blue Plus (PDF).  

Child & Teen Checkups
Checkups are covered 100 percent. It’s important that children get checkups to make sure everything is on track and to get the shots they need. Your doctor can find out if there’s anything that needs to be taken care of before small problems become big ones.

Dedicated Clinician
If you’re living with an ongoing health condition or you have had a major illness or injury, a Dedicated Clinician can help you understand your medical condition and treatment options. He or she will help you make the best choices for your care, and help you follow your treatment plan.

Dental services
Basic dental care services, including X-rays, fillings, checkups and teeth cleaning are provided by Delta Dental of Minnesota using the CivicSmiles network.

Healthy Start® Prenatal Support
Healthy Start is a support program for pregnant members. It connects moms-to-be with a specially trained nurse who talks with you regularly by phone for extra health support. You’ll get helpful materials and up to $100 in reward cards for being in the program. If you begin the Healthy Start program in your first 20 weeks of pregnancy, you will get a $50 reward card. If you talk with a nurse over the phone throughout your pregnancy, you will get another $50 reward card after your baby is born. More about Healthy Start (PDF).  

Language services
Blue Plus offers language services for members who need help during a health care visit. 

Mental health, drug and alcohol health care services
Your mental health is important, that’s why Blue Plus members have access to treatment for mental health, drug and alcohol abuse through the Behavioral Health network. 

Online health and wellness resources
You can find information, news, tips and tools on almost any health topic. You will also see special sections that deal with cancer, pain, heart health, mental health and alternative medicine.

Prescriptions
Prescription drugs are available through our nationwide network of pharmacies. 

Specialty care
Blue Plus members have access to services like chiropractic care, ob/gyn, vision care and more. 

Stop-Smoking Support
If you’re trying to quit using tobacco, Stop-Smoking Support can help. You get one-on-one telephone counseling and tools to help you quit. 

Transportation
You can get a ride to and from covered health care appointments through BlueRide. Members should contact BlueRide to arrange for transportation services. Special transportation can be arranged for members who may need extra help by contacting member services.
 

American Indians can continue or begin to use tribal and Indian Health Services (IHS) clinics. We will not require prior approval or impose any conditions for you to get services at these clinics. For enrollees age 65 years and older this includes Elderly Waiver (EW) services accessed through the tribe. If a doctor or other provider in a tribal or IHS clinic refers you to a provider in our network, we will not require you to see your health plan primary care provider prior to the referral.

Delta Dental of Minnesota is independent from Blue Cross and Blue Shield of Minnesota and Blue Plus. Delta Dental provides administrative services for dental benefits, including access to the CivicSmiles network.