Medica preparing for 2023 Individual + Family market launch

New 2023 product and plan offerings

• Northern MN: We’re introducing a new Care System Provider network option featuring Essentia. Essentia Choice Care with Medica will be available to residents in Becker, Carlton, Cass, Clay, Crow Wing, Hubbard, Itasca, Mahnomen, Norman, Pine, St. Louis, and Wilkin counties.


• Fargo/Southeast ND: We’re introducing a new Care System Provider network option featuring Essentia. Essentia Choice Care with Medica will be available to residents in Cass, Ransom, Richland, and Sargent counties.


• Lincoln Area, NE: The Elevate by Medica product will now include Bryan Health in the network and is expanding the service area by two counties (Lancaster and Saunders). The product will continue to be available in the existing Omaha, NE and Council Bluffs, IA service area counties.


• Superior/Northwestern WI: We’re introducing a new Care System Provider network option featuring Essentia. Essentia Choice Care with Medica will be available to residents in Bayfield, Douglas, and Washburn counties.


• Wichita Metro, KS: The Medica with Healthier You product will no longer be offered in 2023. 


• Topeka, KS: We’ll no longer be offering Select by Medica in the following counties: Jackson, Jefferson, Douglas, Shawnee, Franklin, Anderson, and Allen.


• Southeast KS: We’ll no longer be offering Medica Connect in the following counties: Allen, Bourbon, Crawford, Cherokee, Labette, Neosho, and Woodson.


• Near Kansas City, MO: We’ll no longer be offering Select by Medica in the following counties: Carroll, Linn, and Mercer.

Continued 2023 plan offerings

• Arizona: Medica Pinnacle (Care System Provider Network plan) will continue to be offered. Available both on- and off-Marketplace; no change in service area availability.


• Iowa: Empower by Medica, Elevate by Medica, Inspire by Medica, Medica with CHI Health (Care System Provider Network plans), and Medica Insure (Broad Provider Network plans) will continue to be offered.  Available both on- and off-Marketplace; no change in service area availability for Iowa IFB products.


• Kansas: Select by Medica (Care System Provider Network plans) and Medica Connect (Broad Provider Network plans) will continue to be offered both on- and off-Marketplace. Both products have service area reductions. Medica with Healthier You will no longer be available (see above).


• Minnesota: Bold by M Health Fairview and Medica, Altru Prime by Medica, Engage By Medica, North Memorial Acclaim by Medica, Ridgeview Distinct by Medica (Care System Provider Network plans) and Medica Applause (Broad Provider Network plan) will continue to be offered through MNSure and off-Marketplace; no changes in county service area availability for existing MN products, and adding new IFB product, Essentia Choice Care with Medica in 12 counties throughout northern MN (see above).


• Missouri: Medica with MU Health and Balance by Medica; Delivered by Mercy (Care System Provider Network plans) will continue to offer on- and off-Marketplace with no changes in county service area. Select by Medica will have a service area reduction of three counties (see above).


• Nebraska: Medica Insure (Broad Provider Network plan), Elevate by Medica and Medica with CHI Health (Care System Provider Network plans) will continue to be offered on- and off-Marketplace; adding two counties to the Elevate by Medica service area (see above); no changes in county service area availability for Medica Insure and Medica with CHI Health.


• North Dakota: Altru Prime by Medica (Care System Provider Network plans) and Medica Individual Choice (Broad Provider Network plans will continue to be offered on- and off-Marketplace; no changes in county availability. We will be offering Essentia Choice Care with Medica in four counties (see above).


• Oklahoma: Balance by Medica; Delivered by Mercy, Harmony by Medica (Care System Provider Network plans) and Medica Quest (Broad Provider Network plans) will continue to be offered on-Marketplace* with no changes in county service area.


• Wisconsin: Medica Individual Choice (Broad Provider Network plan) and Engage by Medica (Care System Network plan) will continue to be offered both on- and off-Marketplace; no change in the Engage by Medica or Medica Individual Choice county service area. We’ll be offering Essentia Choice Care with Medica in three counties (see above).

Other program changes for 2023

• New pharmacy formularies with a tiered generic drug benefit


• New $0 Primary Care Copay plan offerings with select products and plans in all states (except WI) for various metal levels


• New Bronze Premier plan offering with a $1,500 deductible and $0 primary care copay after deductible offered with products in KS, MO, NE and OK


• New Silver Enhanced plan offering with $0 deductible offered with Elevate by Medica and Medica with CHI Health in IA and NE


• $400 dental reimbursement plan "buy-up" option will only be offered on certain Bronze plans in NE