Plan B - Medica Elect: $2,700-20% HSA

Image

Plan B - Medica Elect: $2,700-20% HSA

Care system network

With Medica Elect®, you enroll in a primary care clinic. The clinic coordinates your care and will help you find a specialist when you need one. Whenever you need care, you’ll start at your primary care clinic.

Plan highlights

  • Mid-size regional network of care systems
  • National network coverage when you travel
  • A medical home – you choose a primary care clinic/care system
  • Care is coordinated by your primary care clinic

Compare Plans

You can compare this plan side-by-side with up to two other plans to see the differences between their benefits.

Compare Plans
 
 

Benefit Summary for Plan B - Medica Elect: $2,700-20% HSA

Network Benefits
Overall deductible $2,700 per person/ $5,400 per family for in-network services. $4,800 per person/ $9,600 per family for out-of-network services.
Out-of-pocket limit $4,500 per person/ $9,000 per family for in-network services. $10,200 per person/ $19,400 per family for out-of-network services.
If you visit a health care provider's office or clinic
Primary care visit 20% coinsurance
Chiropractic visit 20% coinsurance
Convenience care visit 20% coinsurance
Specialist visit 20% coinsurance
Preventive care/screening/immunization No charge. Deductible does not apply.
If you have a test
Diagnostic test - lab 20% coinsurance
Diagnostic test - x-ray 20% coinsurance
Imaging (CT/PET scans, MRI) 20% coinsurance
If you need drugs to treat your illness or condition
Generic drugs Retail: 20% coinsurance Mail order: 20% coinsurance
Preferred brand drugs Retail: 20% coinsurance Mail order: 20% coinsurance
Non-preferred brand drugs Retail: 20% coinsurance Mail order: 20% coinsurance
Specialty drugs Preferred: 20% coinsurance. Non-preferred: 20% coinsurance.
If you have outpatient surgery
Facility fee (e.g., ambulatory surgery center) 20% coinsurance
Physician/surgeon fees 20% coinsurance
If you need immediate medical attention
Emergency room care 20% coinsurance
Emergency medical transportation 20% coinsurance
Urgent care 20% coinsurance
If you have a hospital stay
Facility fee (e.g., hospital room) 20% coinsurance
Physician/surgeon fees 20% coinsurance
Network information
Network type Care system network
Network area Minnesota and northwestern Wisconsin
Special features You enroll in a primary care clinic. This clinic coordinates your overall care and is affiliated with a care system.
Referrals needed You can see any provider within your care system without a referral. To receive care from a provider outside your care system, you must receive a referral from your primary care clinic.

How it works

With Medica Elect, you enroll in a primary care clinic. You can change your primary care clinic as often as once a month. Your clinic is affiliated with a care system, which is a group of primary care clinics, specialists and hospitals that work together to give you the care you need. So when you pick your primary care clinic, you're also picking a care system. Each family member can choose a different care system within the Medica Elect network. Or you can all be in the same care system but choose different primary care clinics within that system. 

Medica Elect care systems:

  • Allina Health
  • Children's Health Network
  • Hennepin County Medical Center
  • Integrity Health Network
  • Lakeview Medical Care System
  • Minnesota Healthcare Network
  • Park Nicollet Health Services
  • Riverway/North Suburban Clinics
  • St. Luke’s Care System

A few things to keep in mind:

  • Whenever you need care, you’ll always start at your primary care clinic.
  • For your highest level of benefits, get all of your care from providers in your care system.
  • If you can’t get the care you need within your care system, you can ask for a referral to see a provider in another care system. Learn more about referrals in this tip sheet.

» View Summary of Benefits and Coverage for Plan B - Medica Elect: $2,700-20% HSA.

» Find a physician or facility in the Medica Elect network.

» Learn how to enroll in a primary care clinic.

mymedica.com

Once your plan starts, register on mymedica.com to manage your health plan. Order ID cards, find out what's covered, track your claims and more!

Visit mymedica.com