Minnesota-based non-profit corporation, Medica offers the residents of Minnesota (primarily), and select counties in North Dakota, South Dakota, and Wisconsin affordable rates on quality health insurance coverage. They serve the individual, family, group, senior, and government markets in addition to a charitable grant-making foundation, a research institute, and a health management company. Founded in 1975 under the name Physician’s Health Plan, it was the first open-access medical plan in Minnesota. After a few mergers with other health insurance companies in the early 1990s, it became Medica, and eventually came into its own as an independent health insurance company in 2001.
Though only available in a few states, Medica has 1.5 million members who receive health insurance through their company. Regardless of the plan you have plenty of options when it comes to in-network providers. Their largest provider network is comprised of 27,000 providers at over 4,000 clinics, offices and hospitals in Minnesota, South Dakota, North Dakota, and Wisconsin, in which over 96% of Minnesota providers participate. Medica is certainly a dominant power in Minnesota’s health insurance market, and offers similar products to select counties in the nearby participating states. They also have a plan with access to a nationwide network of over 660,000 providers, and in contrast, some plans feature a more budget friendly and limited network.
Medica Individual Plans
Medica has a musically themed approach to naming their individual and family health insurance products, so make sure you don’t accidentally end up paying the local symphony a $100 every month and wondering why your insurance company keeps sending you notices. Trendy marketing aside, Medica has a quality choice of benefits in each plan that will suit a variety of budgets. The following are the plans available in Minnesota, some of which are available in North Dakota, South Dakota, and Wisconsin:
- Solo, an individual plan geared towards ages 19 – 29, who are only buying insurance for themselves and do not have any dependents (such as spouses or children) they wish to add. This plan is available to anyone up to age 64 who will not be adding another dependent to their plan. There are a range of deductibles to choose from, and coverage is available for in-network services such as doctor’s office visits, preventive care, hospital care, and prescription medications before meeting your deductible. After the deductible has been met, more services are covered when you use an in-network provider. There is also the freedom of receiving out-of-network care, though the deductible will be twice as much as an in-network deductible, and there is no out-of-pocket maximum.
- Encore, a 1+ anyone plan that can cover one individual only, or the initial policy-holder and one additional person. These have convenient benefits such as predictable copayments for unlimited doctor’s office visits (usually $20 or $40) and urgent care. Encore plans also provide coverage at 100% for preventive care, maternity care, hospital treatment before meeting your deductible, and a number of other qualifying services after the deductible has been met. The same out-of-network rules apply as a solo plan, with a deductible twice the cost of in-network, and 60% coverage after deductible has been met.
- Symphony is an individual and family plan for any number of dependents over 60 days old, and policy-holders between the age of 19 and 64. These plans include the Mayo Clinic Health System and Mayo Clinic, and can be a great option for one person or an entire family. There are a variety of deductibles to choose from, with 100% preventive and prenatal care coverage before your deductible has been paid. After you have met your deductible, hospital services, X-rays, lab work, surgery, and other qualifying services are covered at 100%. There is a simple copay for doctor’s office and convenience care visits, which are unlimited, and a copay for prescription drugs and urgent care. Your annual out of pocket maximum will be equal to the deductible you choose.
- Symphony HSA has all the benefits of the individual and family coverage as described above, with a high deductible and the option of opening a health savings account to apply towards medical costs.
- Prelude is a short-term health insurance policy with essential benefits from Medica, that can last for 30, 60, or 90 days for individuals and families. For those in transition or experiencing a break in health coverage for any reason, this can be a sensible choice. There is access through the Prelude plan to Medica’s largest open access network, Medica Choice (as mentioned above, includes 27,000 providers throughout the four states in which Medica is offered).
For more information about the plan available in your area and to find out how much they will cost for you, fill out a quote.