Medica Elect & Essential

Base plan for Duluth and Twin Cities

A combination of two networks that 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 out-of-pocket costs with the base plan. The out-of-network benefit and in-network travel benefit give you greater flexibility in selecting a provider.

You will need to select a primary care clinic (PCC) 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'll 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 PCC 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

An open access plan that uses the Medica Choice network with over 12,000 physicians and 190 hospitals statewide.

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

You have access to any provider who is part of the network, and you don't 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

A regional network makes this plan 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 greater 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

Available primarily in the Twin Cities metro area and Duluth with some providers available in 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 don't 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 greater flexibility in selecting a provider.

Medica Choice National

An open access plan with a statewide network with over 12,000 physicians and more than 190 hospitals, and 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 don't need to select a primary care clinic when you enroll. The out-of-network benefit gives you greater flexibility in selecting a provider.

Medica Direct HRA and Medica Direct HSA

Medica Direct HRA (Health Reimbursement Account) and Medica Direct HSA (Health Savings Account) are high deductible health plans that let you make decisions about how you spend your health care dollars.

These plans also use the Medica Choice statewide network with over 12,000 physicians and more than 190 hospitals, and national 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 don't need to select a primary care clinic when you enroll.

For Medica Direct HRA the University will contribute a set amount of benefit dollars to your HRA account. If you enroll mid-year, the HRA amount is prorated, but the deductible is not prorated. The amount you receive depends on when your coverage becomes effective and will be available to you immediately. These benefits dollars can be used to pay for medical expenses. You will pay the doctor or the pharmacy until the annual deductible is reached, and then you are reimbursed from the benefit account. After that Medica Direct pays 90 percent.

For Medica Direct HSA the University does not make a direct contribution to your HSA. Instead the rates have been adjusted to account for that. However, you can make your own pre-tax contributions to the HSA and invest them in options from Wells Fargo.

In the Medica Direct HSA plan you own the account and can decide whether to use the contributions in the account for current medical expenses or save the money for future expenses. You will pay the doctor or the pharmacy until the annual deductible is reached, and then you have the option to be reimbursed from the account as funds are available. After that Medica Direct pays 90 percent.

After leaving the University, any balance in the account can remain with Wells Fargo, or you can move the funds to a personal HSA.

If you are age 65 or older and delay taking Social Security benefits and Medicare Part A, you remain eligible for Medica Direct HSA.