Medicare Part D: The Medicare prescription drug benefit program. We call this program “Part D” for short. Medicare Part D covers outpatient prescription drugs, vaccines, and some supplies not covered by Medicare Part A or Medicare Part B or Medical Assistance. Our plan includes Medicare Part D.Medicare Part A: The Medicare program that covers most medically necessary hospital, skilled nursing facility, home health, and hospice care.
Medicare Part B: The Medicare program that covers services (such as lab tests, surgeries, and doctor visits) and supplies (such as wheelchairs and walkers) that are medically necessary to treat a disease or condition. Medicare Part B also covers many preventive and screening services.Medical Assistance: This is the name of Minnesota’s Medicaid program. Medical Assistance is run by the state and is paid for by the state and the federal government. It helps people with limited incomes and resources pay for long-term services and supports and medical costs.
It covers extra services and some drugs not covered by Medicare. Medicaid programs vary from state to state, but most health care costs are covered if you qualify for both Medicare and Medicaid.

Prior Authorization and Appeals Data

The information below reflects:

  • The percentage of standard and urgent prior authorization requests that were approved or denied.
  • The percentage of denied prior authorizations that were appealed and whether that appeal was overturned (by percentage).
  • The percentage of prior authorization requests that were reviewed within an extended timeframe and were approved.
  • The average and median standard and expedited (urgent) turnaround times by days.

This data is not yet available. Please check back at a later date for updates.

ActionHow many times this happenedOut of total requestsPercentage
Request approvedN/AN/AN/A
Request deniedN/AN/AN/A
Request approved within 7 daysN/AN/AN/A
Request denied within 7 daysN/AN/AN/A
Request approved after review extensionN/AN/AN/A
Request denied after extensionN/AN/AN/A

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