Medica Group Prime Solution
|Plan||Medica Plan 1||Medica Plan 2|
|Type of Network:||Open Access||Open Access.|
|Must Designate Clinic:||No||No|
|Referrals Required:||No, when using most network providers||No, when using most network providers|
|Plan Manages Paperwork:||Yes||Yes|
|Can Live Outside of Plan's Service Area:||No||No|
|Travel/Extended Absence:||Up to 9 consecutive months||Up to 9 consecutive months|
Medica is a local company that has been providing non-profit health coverage in the Midwest for decades. Medica values its members and works hard to give them outstanding customer service and coverage.
As a member, you have access to a large network of doctors,clinics, and hospitals. You can still use your Medicare benefits if you choose to go outside of the Prime Solution provider network for services while in the Medica service area. Medica Prime Solution also has nationwide coverage when you travel or spend extended time in another part of the country.
- U of M Plan 1 — This plan option is a comprehensive plan with low copay and coinsurance amounts, and it helps limit your out-of-pocket expenses.
- U of M Plan 2 — This plan option offers a lower monthly premium and has somewhat higher copay and coinsurance amounts.
Both Medica plans have the same network of providers and service area and include the following features:
- Easy access to providers — Access to a broad network of providers with no referrals necessary within the network
- Travel coverage — Travel outside the service area within the United States for up to nine months and receive medical and prescription coverage; emergency and urgently needed care covered worldwide
- Preventive care — Annual physical, vision and hearing exams,plus cancer screenings
For more details on coverage for both U of M Plan 1 and U of M Plan 2, see the comparison charts on pages 15 to 23 in the Retiree Guide for UPlan Benefits Enrollment (pdf).
You complete an additional application for this plan that is mailed to you by Medica Group Prime Solution after Employee Benefits forwards your paperwork. You must complete and return the application to Medica prior to your desired effective date to be enrolled.
When you enroll in Medica Group Prime Solution, you are automatically enrolled in Medicare Part D, and your premium for Medicare Part D is included in your premium for Medica Group Prime Solution.