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Medica Elect/Essential

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Medica Elect/Essential

Base plan for Twin Cities area and Duluth.
Care system network.


This is the low-cost base plan option. Providers in the Medica Elect® / Medica EssentialSM network are grouped into care systems. At the time of enrollment you will select a network primary care clinic from which you will receive regular care.

Plan Highlights

  • Mid-size regional network of care systems
  • National network coverage when you travel
  • A medical home – you choose a primary care clinic/care system
  • No referrals needed when you see network providers
  • Care is coordinated by your primary care clinic

Compare Plans

You can compare this plan side-by-side with up to two other plans to see the differences between their benefits.

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Benefit Summary for Medica Elect/Essential

In-network Benefits
Annual Deductible $100 Single/$200 Family
Preventive Care 100% Coverage
Physician Care** $25 Primary/$35 Specialty Copay
Convenience Care $15 Copay
Urgent Care $25 Copay
Emergency Room $100 Copay
Lab Deductible/100%
MRI/CT Scan $50 Copay
Hospital Deductible/100%
Annual Out-of-Pocket Limits $2,500 Single/$4,000 Family
Must Select Primary Care Clinic Yes
Self-referral to Network Specialists Yes; specialist must be in your care system

How it Works

With Medica Elect/Essential, you enroll in a primary care clinic. You can change your primary care clinic as often as once a month. Your clinic is affiliated with a care system, which is a group of primary care clinics, specialists and hospitals that work together to give you the care you need. So when you pick your primary care clinic, you're also picking a care system. Each family member can choose a different care system within the Medica Elect/Essential network. Or you can all be in the same care system but choose different primary care clinics within that system.

A few things to keep in mind:

  • Whenever you need care, you’ll always start at your primary care clinic.
  • For your highest level of benefits, get all of your care from providers in your care system.
  • If you can’t get the care you need within your care system, you can ask for a referral to see a provider in another care system. Learn more about referrals in this tip sheet.

» View the Summary of Benefits and Coverage for this plan.

» Find a physician or facility in the Medica Elect/Essential network.

» Compare plans.

**Note: Primary Care includes Family Medicine, Internal Medicine, Obstetrics/Gynecology, and Pediatrics. The primary care copay also applies to Chiropractic, Acupuncture, Physical, Occupational, and Speech Therapy, and Mental Health/Substance Abuse. Specialty Care Provider includes all other providers.

Care Systems

Medica Elect/Essential care systems:

Twin Cities Metro

  All Metro
  Allina Health
  Children's Health Network
  Fairview Physician Associates
  HealthPartners Medical Group
  Hennepin County Medical Center
  University of Minnesota Physicians

  East Metro
  HealthEast Care System
  Lakeview Medical Care System

  West Metro
  Park Nicollet Health Services

  Greater Metro
  Minnesota Healthcare Network

Greater Minnesota

  Duluth
  Essentia Health East
  St. Luke's Care System

  Northern Minnesota
  Integrity Health Network

  Northwestern Minnesota
  Essentia Health West

North Dakota

  Eastern North Dakota
  Altru Health System
  Essentia Health West

Wisconsin

  Northwestern Wisconsin
  Integrity Health Network
  St. Luke's Care System

  Western Wisconsin
  Vibrant Family Health Clinics
  Western Wisconsin Health (formerly Baldwin Area Medical Center)

UPlan Resources

Find more information about your UPlan benefits:
» Employee benefits
» Wellness program
» Pharmacy benefits

Medica Elect/Essential PCC List

Please note: If you choose the Elect/Essential plan for 2017, you and each eligible family member must select a Primary Care Clinic (PCC). Please refer to the PCC list below and use the corresponding 11 digit PCC number associated with the clinic of your choice.

» 2017 Elect/Essential Primary Care Clinic List

mymedica.com

Mymedica.com is your one-stop resource to find out what’s covered on your plan, track claims, find a provider and more. Once your plan starts, register on mymedica.com to manage your health plan.

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