Medica Elect & Essential

Base plan for Twin Cities area and Duluth

It is a combination of two networks, each of which includes major care systems. Each care system includes a comprehensive network of physicians, specialists and other types of care providers, clinics, and hospitals.

You have the lowest biweekly rates and out-of-pocket costs with the base plan. The out-of-network benefit and in-network travel benefit give you additional flexibility in selecting a provider.

You will need to select a primary care clinic when you enroll in this plan. Family members may select their own primary care clinics but all clinics must be in the same network, either all in Elect care systems or all in Essential care systems. You have some flexibility with this because certain care systems are in both the Elect and Essential networks.

Clinics can be changed monthly. You will need to contact member services by the 20th of the month and the change will go into effect the first of the following month. Your primary care clinic will work with you to coordinate your care including, when appropriate, referral to specialists. Each care system has a number of specialty care providers that you can access without a referral.

Medica Choice Regional

Base plan for Greater Minnesota, including Morris, Crookston, and Rochester

It is an open access plan that uses the statewide Medica Choice network.

You have the lowest biweekly rates and out-of-pocket costs with the base plan. The out-of-network benefit and in-network travel benefit give you additional flexibility in selecting a provider.

You have access to any provider who is part of the network, and you do not need to select a primary care clinic when you enroll. You can see any specialist within the plan network without getting a referral from your primary care doctor.

U Classic Plus by HealthPartners

It has a regional network that makes it available in the Twin Cities area, Crookston, Morris, and Duluth. It shares the same level of copayments and other benefit levels with the base plans. The out-of-network benefit and in-network travel benefit give you additional flexibility in selecting a provider.

You will need to have a primary care clinic selected when you enroll in this plan. Family members may select their own primary care clinics. You can change clinics anytime by calling member services or going online. You do not need a referral to see any specialist in your network

Insights by Medica

It is available in the Twin Cities metro area, Duluth, Morris, and other areas in Greater Minnesota. Insights is an open access, tiered network plan in which health care providers including primary care physicians, specialists, and hospitals are analyzed on cost, efficiency, and quality measures and then ranked into three tiers. Copayment amounts on services are different for each of the three tiers.

You have access to any provider who is part of the network, in any tier, without a referral, and you do not need to select a primary care clinic when you enroll. If you obtain services from network providers that are in a lower tier you will have greater overall value and lower copayments. The out-of-network benefit and in-network travel benefit give you additional flexibility in selecting a provider.

Medica Choice National

It is an open access plan with a statewide network with over 12,000 physicians and more than 190 hospitals. You also have national coverage access to more than 600,000 physicians and health care providers through United Healthcare Options PPO network when traveling or working outside the service area.

You have access to any provider in the network without a referral, and you do not need to select a primary care clinic when you enroll. The out-of-network benefit gives you additional flexibility in selecting a provider.

Medica HSA

It is a high deductible plan that allows you to make decisions about how you spend your health care dollars. This plan also uses the Medica Choice statewide network and the United Healthcare Options PPO national network with the same provider access described in Medica Choice National.

The University will contribute a set amount of benefit dollars to your HSA account. When enrolling mid-year, the HSA amount will be prorated monthly; however, the deductible amount is not pro-rated. The amount you receive depends on when your coverage becomes effective and is contributed over the number of pay periods remaining in the year. While the HSA amount is tax-sheltered from federal and state taxes in most states (including Minnesota), for federal reporting purposes the amount the University contributes to your HSA will be shown on your pay statement.

Enrollment in Medica HSA means that you are not eligible to fully participate in a health care flexible spending account. You may only use the pre-tax FSA plan to cover out-of-pocket costs for eligible dental and vision expenses.

You will have a special debit card to spend HSA dollars for pharmacy or medical expenses. You pay the doctor or pharmacy until the annual deductible is met, and then you are reimbursed from the benefit account as funds are available. After that Medica pays 90 percent. You own the HSA contributions and can decide whether to use them for current medical expenses or save them for future expenses when you retire.

You can also make your own pre-tax contributions to the HSA and invest them in options from Wells Fargo. If you leave the University the account balances are portable.

Due to federal law, if you have any other medical coverage, including any part of Medicare, 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.