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Where is this plan available?
For benefits, you'll receive care from providers and hospitals in the Insure Tiered network. With no referral required to see a specialist when needed. The network includes:
Access the following health care systems and providers for Tier 1:
Here's how Medica tiered networks work (PDF)
It's important to confirm your providers are in your plan's network. Unless it's an emergency, there is no coverage if you visit a provider that is not in your network. This means you'll be responsible for the full cost of any care.
See if your health care providers are in the Insure Tiered network
Offers
Predictable care and prescriptions costs. You'll pay a set price (copay) for many services – best for people who like to know what their medical expenses will be.
Predictable prescription costs. You'll pay a set price (copay) for many drugs – best for people who like to know how much their prescription costs will be.
Tax benefits when you pair with an HSA. You'll pay the full price for services – best for people who don't expect medical expenses or looking to save with an HSA.
Some predictable care costs with premium savings. You'll pay a set price (copay) for some primary care visits –only available to consumers under age 30 or with an exemption.
Predictable Costs
Office visits Prescription drugs
Prescription drugs
Not applicable
Office visits (3 primary care)
Unpredictable Costs
Hospitalization Lab and imaging
Hospitalization Lab and imaging Office visits
Prescription drugs Hospitalization Lab and imaging Office visits
Prescription drugs Hospitalization Lab and imaging
HSA Eligible
No
Yes
Premium vs. Care Costs
Your premium and care costs will be more evenly balanced.
Your premium is higher and care costs will be lower.
Your premium is lower and care costs will be higher.
Premium
Care Costs
We'll walk you through how to enroll on the next page. Before we go, be sure to make a note of this plan name, Medica Insure.
See your shopping and enrollment options
Medica is a Qualified Health Plan issuer in the Health Insurance Marketplace.