Medica is a non-profit corporation that includes a family of businesses: Medica Health Plans, Medica Health Plans of Wisconsin, Medica Insurance Company, Medica Self-Insured, Medica Health Management, LLC, and the Medica Foundation. Medica has the highest accreditation status, Excellent, from the National Committee for Quality Assurance (NCQA©) for its Minnesota Medicaid HMO plans and commercial health plans in Minnesota and North Dakota. Medica also has achieved Quality Plus Distinction for Physician and Hospital Quality from the NCQA.

About Medica

Medica provides popular health plans and #1 rated service to business and government employers, to labor unions, and to individuals of all ages — from recent graduates to Medicare beneficiaries.

Medica was founded by physicians in 1975 as Physicians Health Plan. It was the first open-access health plan in the state. In 1991, PHP merged with Share to become Medica. And in 1994, Medica merged with HealthSpan to form Allina Health System, an integrated organization offering both health care coverage and medical services. Medica became an independent health plan in 2001.

Medica, Inc.

Corporate Headquarters:
401 Carlson Parkway
Minnetonka, MN 55305
(952) 992-2300
CEO:
David Tilford
Employee Number:
1,150
2008 Revenue:
$2.4 billion

Product Types Offered

Individuals

Medica offers Health Products for individuals, families and sole proprietors under the age of 65 and not eligible for Medicare.

Medica SoloSM
Medica Solo is designed to be very affordable, with young adults (ages 19-29) in mind, but it’s available to Minnesota residents from age 3 months to age 64. Medica Solo offers affordable health insurance coverages for single individuals. If you're an adult, you can buy it for yourself or a dependent.

Medica EncoreSM
Medica Encore is designed with adults (ages 50-64) in mind, but it’s available to Minnesota residents from age 3 months to age 64.

Medica Direct Short-TermSM for Individuals
Medica Direct Short-Term for Individuals provides affordable, flexible and reassuring protection against major medical expenses. It’s available for 30, 60 and 90 day periods and in a range of deductibles.

Medica Direct HSASM for Individuals
Medica Direct HSA for Individuals (and families) is affordable and flexible. It’s available in a wide range of cost, coverage and deductibles. You choose the best fit for you.

Medica Direct ValueSM for Individuals
Medica Direct Value for Individuals (and families) is affordable and flexible. It’s available in a wide range of cost, coverage and deductibles. You choose the best fit for you.           

Medica Direct DentalSM for Individuals (available for medical plan policyholders)
Medica Direct Dental for Individuals is for policyholders ages 18 through 64. If you pay for your own insurance, or the insurance for a spouse or dependent(s), Medica Direct Dental for Individuals offers affordable, comprehensive coverage that protects you and your family.

Employers

Medica offers the following plans for employers in Minesotta, North Dakota, South Dakota an Wisconsin:

Medica Choice®
Medica Choice is available in Minnesota, North Dakota, South Dakota and Wisconsin, and is favored by employees who want significant health plan flexibility and broad access to providers throughout the region and nationally.

Passport from MedicaSM
Passport from Medica members have access to the large Medica Choice network when they receive care within our service area -- Minnesota, North Dakota, South Dakota and Western Wisconsin. Those located outside our service area have access to a large national network of over 520,000 providers and 5,000 hospitals.

Medica Focus®
The Medica Focus network is comprised of nearly 2,000 primary care providers and more than 10,000 specialists within the eight-county Twin Cities metro area and includes 13 hospitals. These providers were specifically recruited for this network because of their cost efficient practice patterns.

Medica Elect® and Medica EssentialSM
Medica Elect and Medica Essential are care system products with different provider networks. Select the plan with the network that best meets your needs.

Medica Direct® (FSA, HRA, HSA)
Medica Direct is a consumer directed health plan that gives you real choices when it comes to health care spending. It includes essential coverage for preventive care, catastrophic care, and prescriptions. If your employer offers Medica Direct, be sure to check with your company's Benefits Administrator to find out if tax-sheltered health care account options (FSA, HRA and HSA) are available.

Patient Choice InsightsSM by Medica
Patient Choice Insights features a unique open access “tiered” network in which health care providers compete for patients based on value. Each year providers in the network — including primary care physicians, specialists and hospitals — are analyzed on cost, efficiency and quality measures and then ranked into three tiers.

Medicare Plans

As a Medicare beneficiary, you can choose from different Medicare options that can extend your health care benefits beyond Original Medicare. Medica Medicare Solutions bridge the gaps in Medicare coverage with options such as routine preventive care, affordable premiums, prescription drug coverage, fitness classes and more.

Medica Medicare Solutions give you flexibility, plan choice and an extensive provider network. We believe these features make Medica your best choice for health care coverage that matches your lifestyle and individual needs. You may choose from among the following plans:

• Medica Prime Solution Cost Plan   
• Medica Advantage Solution Private Fee-for-Service Plan  
• Medica Complete Solution Special Needs Plan   
• Medica AccessAbility SolutionSM Special Needs Basic Plan
• Medica DUAL SolutionSM Special Needs Plan
• Medica Select Solution Select Plan

Provider Network

Medica has a very vast provider network. You can use Medica’s online provider directory to learn more about doctors, hospitals, other medical services, dentists, vision care providers and pharmacies that work with your Medica plan.

Network Facts

Membership:
Medica provides health coverage to 1.3 million members. Its coverage is available to individuals, employers, third-party administrators and government programs in Minnesota and select counties in Wisconsin, North Dakota and South Dakota.

Health Care Networks:
Medica's broadest regional provider network includes 27,000 providers at more than 4,000 offices, clinics and hospitals in Minnesota, Wisconsin, North Dakota and South Dakota. More than 96% of Minnesota providers participate in this network. Medica also offers a health plan with coverage that features access to a large national network of nearly 500,000 providers and 5,000 hospitals. In addition, Medica offers several plans that feature smaller, cost-efficient networks.

Recent News

Here are some of the most recent news regarding Medica:

Medica Outreach Provides Back Support, Tells Members with Pain: “We’ve Got Your Back”

MINNETONKA, Minn.—May 18, 2009—Medica members with a history of low-back pain now have additional resources to help them cope with the condition.  Medica this month began reaching out directly to those members to make them aware of the many treatment options and techniques available, depending on the level of their back pain.  

The campaign features an engaging mailing to members who have had a claim with a diagnosis related to back pain.  The mailing, featuring the headline “We’ve Got Your Back,” directs the recipients to appropriate resources Medica has compiled at a customized Web site. (Continue Reading)

Rating

Medica’s rating, as rated by A.M. Best Company. A.M. Best Company is a full-service credit rating organization dedicated to serving the financial services industries, including the banking and insurance sectors.

Financial Strength Rating
Rating: B pd (Fair)
Financial Size Category: IX ($250 Million to $500 Million)
Outlook: Not Applicable
Action: Upgraded
Effective Date: July 21, 2008