What Should I Expect
We’ll help you find information the way you need it
- Cultural diversity: We value the different backgrounds and lifestyles of our members. We want to help you understand your options and help you find local providers who want to understand and honor you, too.
- Language translation: MCC of VA (HMO SNP) provides interpretation services for all members at no cost. If you can’t read our materials, or you can’t speak to us or your provider because of a language barrier, please contact Member Services.
- Accessibility: If you need member materials or communications in other formats, such as large print, Braille or sign language, call Member Services for help. If you need hearing assistance, use the national TTY service by dialing 711.
We’ll give you the resources you need
Member ID: You will receive your member identification card in the mail.
New Member Kit: You’ll receive a New Member Kit by mail. This kit includes:
- Your annual Evidence of Coverage (EOC)
- An explanation of the Low Income Subsidy (LIS) Rider
- A resource to help you Access your Provider & Pharmacy Directory, Evidence of Coverage and Formulary
- A resource to help you find information in your preferred language
- MCC of VA (HMO SNP)’s Nondiscrimination Notice
Member Materials and Forms: You can find everything on our website including these:
- Your Formulary (list of covered drugs)
- The current copy of the Provider & Pharmacy Directory (PPD)
- The Low Income Premium Summary
We’ll work with you to create your own healthcare team
We’re with you every step of the way. You’ll help us create a Care Coordination Team that helps you manage your care and meet your individual needs and goals. Your Care Coordination Team includes you and any family member you choose, your Nurse Care Manager (NCM), your Primary Care Provider (PCP) and a plan Community Resource Coordinator (CRC). You’re also supported by plan pharmacists, behavioral health specialists and any others important to your health. Read more below!
Meet your Care Coordination Team!
The first person you talk with will be a member of our Member Services Team. They’ll phone you to welcome you to MCC of VA (HMO SNP). They’ll also talk briefly with you about your health needs and risks.
Next you’ll be assigned a Nurse Care Manager (NCM). They will ask more detailed questions about your healthcare and needs. Depending on your preference, we’ll give you a call or come to your home. Your NCM will evaluate your needs and work with you to create a personalized care plan. Your NCM can give you referrals and resources. They can also help you set up mail-order prescriptions and prepare for your first visit to your Primary Care Provider (PCP).
Your Nurse Care Manager will ask you about your Primary Care Provider (PCP). If you have a provider you’d like to keep using, we can help you find out if they are in our network. Or you can find out yourself by using our provider search tool here. If you don’t have a network PCP, your NCM can help you find some options in your area.
Your NCM will send the PCP a form to fill out. Your PCP will send them your healthcare information. This includes your most recent lab results, prescription dosages and schedule, a list of your diagnoses and your advance directive. If you want information about nutrition, medication, biometric monitoring, or other health topics, they will send that to us, too. Your Nurse Care Manager will then follow up with you directly. They’ll talk to you about your health needs and create your personalized care plan.
Once you appoint a PCP, you’ll be ready for your first office visit. Your PCP will give you a head-to-toe assessment. They’ll go over your medications and make recommendations for you to stay healthy. This information helps your NCM work with you to meet your personal care plan objectives.
The job of the Community Resource Coordinator (CRC) is to make sure you’re connected to the things you need in your hometown community. They will get in touch with you, so you can tell them exactly what would help you live a healthier life. The CRC has a long list of partners in the community who can help you figure out the best way to meet your needs.
If you want MCC of VA (HMO SNP) to share the information we have about you with another person, such as a family member, friend or other relative, just let us know. Your Care Coordination Team will provide an Appointment of Representative Form for you to sign that allows them to be included in your healthcare planning and appointments.
Your MCC of VA (HMO SNP) plan also provides you with these extra benefits. Your Nurse Care Manager can help you arrange for these things, too.
- Hearing exam and hearing aid allowance
- Over the counter health products allowance*
- Transportation benefits*
And remember: your DSNP membership means your team will be working together to make sure you get the best possible care – by using both your Medicare and Medicaid benefits!
*Limits and exclusions apply