Medica Plan Options

• Base plan with low biweekly rates and out-of-pocket costs
• Available for the Twin Cities and Duluth areas
  • Elect/Essential combines two provider networks that include 20 major care systems in the Twin Cities and Duluth areas
  • You and your family members choose primary care clinics (PCCs) from either the Elect or Essential care systems. You’ll need the PCC number (pdf) when you enroll
  • To change your clinic, contact Medica’s member services by the 20th of the month. Your change becomes effective the first of the following month
  • Your PCC will help you with referrals to specialists if required by your care system
  • You’ll receive the highest level of benefits by following your care system’s procedures
  • If you need to be referred to an out-of-network provider, you must also get Medica’s approval
• Care outside of your plan’s service area
  • This plan includes a travel benefit that covers health care as in-network when you are traveling outside the plan’s service area
  • You must use a provider in Medica’s national network for urgent, chronic, or emergency needs
  • This also works for a dependent who is a college student living out of the plan’s service area
• Care outside of your plan’s network
  • You will have coverage if you receive care from a provider that’s out of the network
  • Coverage will be at a 70% coinsurance level after you pay a $600 per person/$1,200 per family deductible out of your pocket

• Base plan with low biweekly rates and out-of-pocket costs
• Available statewide only for Greater Minnesota, including Morris, Crookston, and Rochester
  • Choice Regional uses the statewide Medica Choice network with over 13,000 physicians and more than 200 hospitals
  • You can see any provider who is part of the network
  • You won’t need to select a primary care clinic when you enroll
  • You can see any specialist within the plan network without a referral from your primary care doctor
• Care outside of your plan’s service area
  • This plan includes a travel benefit that covers health care as in-network when you are traveling outside the plan’s service area
  • You must use a provider in Medica’s national network for urgent, chronic, or emergency needs
  • This also works for a dependent who is a college student living out of the plan’s service area
• Care outside of your plan’s network
  • You will have coverage if you receive care from a provider that’s out of the network
  • Coverage will be at a 70% coinsurance level after you pay a $600 per person/$1,200 per family deductible out of your pocket

• Overview of the ACO plan
  • Medica ACO Plan is an Accountable Care Organization (ACO), which offers unique networks of providers in your area
  • Medica and the network of doctors, nurses, and health care providers work together to deliver coordinated health care, information, and support to the member
  • You need to select one ACO option that you and your eligible family members will use for the year
  • You can see any primary care provider or specialist in the network without a referral
  • The ACOs have the lowest rates, low copays, and high member satisfaction
• Finding your ACO 
  • To be eligible for an ACO, you must live or work in one of the counties in their service area. You can view the ACO service area map here (pdf), or view the list by region, below.

List of ACO clinics by region

Twin Cities metro area
Your ACO options include:

• VantagePlus with Medica (includes Fairview, HealthEast, North Memorial, and many more independent clinics including Boynton Health and University of Minnesota Physicians);
• Park Nicollet First with Medica; and
• Ridgeview Community Network powered by Medica

You must live or work in one of these Minnesota counties to enroll in a Twin Cities ACO: Anoka, Carver, Chisago, Dakota, Hennepin, Isanti, Le Sueur, McLeod, Ramsey, Scott, Sibley, Sherburne, Washington, or Wright.

Southern Minnesota and western Wisconsin
Your ACO option is Medica CompleteHealth (featuring care at Mayo Clinic). You must live or work in one of these counties in Minnesota or Wisconsin to enroll in this ACO:

• Minnesota: Blue Earth, Dodge, Faribault, Fillmore, Freeborn, Goodhue, Houston, Le Sueur, Martin,Mower, Nicollet, Olmsted, Rice, Steele, Wabasha, Waseca, Watonwan, or Winona
• Wisconsin: Barron, Chippewa, Dunn, or Eau Claire

Northern Minnesota, eastern North Dakota, and northwestern Wisconsin
Your ACO option is Essentia Choice Care with Medica. You must live or work in one of these counties in Minnesota, North Dakota, or Wisconsin to enroll in this ACO:

• Minnesota: Becker, Carlton, Cass, Clay, Crow Wing, Hubbard, Itasca, Mahnomen, Norman, Pine, or St. Louis
• North Dakota: Cass, Ransom, Richland, or Sargent
• Wisconsin: Ashland, Bayfield, Douglas, Sawyer or Washburn

Northwestern Minnesota and northeastern North Dakota
Your ACO option is Altru & You with Medica. You must live or work in one of these counties in Minnesota or North Dakota to enroll in this ACO:

• Minnesota: Kittson, Marshall, Pennington, Polk, Red Lake, or Roseau
• North Dakota: Benson, Cavalier, Eddy, Grand Forks, Griggs, Nelson, Pembina, Pierce, Ramsey, Rolette, Steele, Towner, Traill, or Walsh

Care outside of your plan’s service area

• This plan includes a travel benefit that covers health care as in-network when you are traveling outside the plan’s service area
• You must use a provider in Medica’s national network for urgent, chronic, or emergency needs
• This also works for a dependent who is a college student living out of the plan’s service area

Care outside of your plan’s network

• You will have coverage if you receive care from a provider that’s out of the network
• Coverage will be at a 70% coinsurance level after you pay a $600 per person/$1,200 per family deductible out of your pocket

Open access network available statewide with national coverage when traveling or working outside the service area

• Choice National uses the statewide Medica Choice network with over 13,000 physicians and more than 200 hospitals
• If traveling or working outside Minnesota, have access to national coverage with more than 659,000 health care providers through the United Healthcare Options PPO network.
• You don’t need to select a primary care clinic when you enroll
• You can see any specialist within the plan network without a referral from your primary care doctor
• Choice National has high rates and copays

Care outside of your plan’s service area

• Choice National includes travel benefits through the United Healthcare Options PPO national network if you are traveling or working outside Minnesota
• You can also live outside the service area

Care outside of your plan’s network

• You will have coverage if you receive care from a provider that’s out of the network
• Coverage will be at a 70% coinsurance level after you pay a $600 per person/$1,200 per family deductible out of your pocket

Open access network available statewide with national coverage when traveling or working outside the service area

• Medica HSA is a high deductible plan.
• HSA uses the statewide Medica Choice network with over 13,000 physicians and more than 200 hospitals.
• If traveling or working outside Minnesota, have access to national coverage with more than 659,000 health care providers through the United Healthcare Options PPO network.
• You don’t need to select a primary care clinic when you enroll.
• You can see any specialist within the plan network without a referral from your primary care doctor.

Not sure if an HSA is right for you and your dependents? Check out Learn More About Health Savings Accounts for pros and cons, and answers to common questions.

About Your Health Savings Account

• The University will contribute $750 to your HSA account for employee-only coverage and $1,500 for each tier with covered dependents
• The funds are contributed over pay periods within the year
• When enrolling mid-year, the HSA amount will be prorated per pay period; however, the deductible amount is not prorated
• The amount you receive depends on when your coverage becomes effective
• The amount is contributed over the number of pay periods remaining in the year
• Medica HSA pays covered services at 90% coinsurance after your deductible is met
• You own the HSA contributions and can decide whether to use them for current medical expenses or let the funds grow to cover medical expenses in retirement
• You will receive a debit card from Optum Bank to use to spend HSA dollars for pharmacy or medical expenses
• You can request reimbursement of medical expenses once the account is opened and funds deposited
• If you leave the University, you can transfer your account balances to another account

Adding to Your Health Savings Account

• Outside Open Enrollment: Medica HSA members can change their contribution amount throughout the year by emailing [email protected].
• During Open Enrollment: Update your contribution amount when choosing "Medica HSA" in the annual Open Enrollment event in MyU. This amount will be reflected in your first paycheck of the new year.

Enrollment in Medica HSA means that you can only use the pre-tax health care FSA to cover out-of-pocket costs for eligible dental and vision expenses.

Important Notice: Due to federal law, if you have any other medical coverage, including any part of Medicare, or you are on a spouse’s plan that is not a high deductible health plan, you are not eligible to enroll in Medica HSA. However, if you are age 65 or older and delay taking Social Security benefits and Medicare Part A, you remain eligible for Medica HSA.

Care outside of your plan’s service area

• Medica HSA includes travel benefits through the United Healthcare Options PPO national network if you are traveling or working outside Minnesota
• You can also live outside the service area

Care outside of your plan’s network

• You will have coverage if you receive care from a provider that’s out of the network
• Coverage will be at a 70% coinsurance level after you pay a $600 per person/$1,200 per family deductible out of your pocket

Investing with Your Health Savings Account

Once your HSA reaches $2,000, you may choose to invest a portion of your HSA dollars. You have the choice between two investment options.

Investing your HSA dollars may potentially grow your savings. Learn more about it in this video.