Medica Insurance Company

Medica with MU Health Care Gold Share ($0 Virtual Care + $5 Generic Drugs + Online Wellness)

Prescription Drug Information

Inpatient Coverage

Emergency and Urgent Care

Major Dental Care

Links

Plan Overview

Combined Medical and Drug Deductible	Individual: $1,000 Family: $3,000 Per Person: $1,000
Combined Medical and Drug Out of Pocket Maximum	Individual: $8,500 Family: $17,000 Per Person: $8,500

Office Visit

Primary Doctor	CoPay: Not Applicable CoInsurance: 35.00% Coinsurance after deductible Covered: Covered
Specialist	CoPay: Not Applicable CoInsurance: 35.00% Coinsurance after deductible Covered: Covered

Prescription Drug Information

Preferred Brand Drugs	CoPay: $80.00 CoInsurance: Not Applicable Covered: Covered Benefit Explanation: Prescription insulin will not exceed $25 per prescription unit
Non Preferred Brand Drugs	CoPay: Not Applicable CoInsurance: 50.00% Coinsurance after deductible Covered: Covered
Generic Drugs	CoPay: $5.00 CoInsurance: Not Applicable Covered: Covered
Specialty Drugs	CoPay: $550.00 CoInsurance: Not Applicable Covered: Covered

Inpatient Coverage

Hospital Services	CoPay: Not Applicable CoInsurance: 35.00% Coinsurance after deductible Covered: Covered
Inpatient Services	CoPay: Not Applicable CoInsurance: 35.00% Coinsurance after deductible Covered: Covered

Emergency and Urgent Care

Emergency Room	CoPay: Not Applicable CoInsurance: 35.00% Coinsurance after deductible Covered: Covered
Urgent Care Facility	CoPay: Not Applicable CoInsurance: 35.00% Coinsurance after deductible Covered: Covered

Maternity

Labor and Delivery Hospital Stay	CoPay: Not Applicable CoInsurance: 35.00% Coinsurance after deductible Covered: Covered
Pre and Postnatal Office Visit	CoPay: Not Applicable CoInsurance: 35.00% Coinsurance after deductible Covered: Covered

Vision

Routine Eye Exams For Children

CoPay: Not Applicable
CoInsurance: 35.00% Coinsurance after deductible
Covered: Covered
Limit Quantity: 1
Limit Unit : Exam(s) per Benefit Period

Major Dental Care

Routine Dental Checkups for Children	Covered: Not Covered
Routine Dental Checkups for Adults	Covered: Not Covered
Basic Dental Care - Adult	Covered: Not Covered
Basic Dental Care - Child	Covered: Not Covered
Major Dental Care - Adult	Covered: Not Covered
Major Dental Care - Child	Covered: Not Covered

Related Articles

You may be interested in these relevant articles from across the HealthMarkets.com network.

Find an In-Network Provider: 5 Tips To Get Care And Save Money

Looking for a health care provider? There’s something you need to do before you…Read More

Read More

6 Dental Emergencies and How to Deal With Them

You wake up with a toothache. Your first thought: Ouch! Your next thought is:…Read More

Read More

What Every Medicaid Member Needs to Know About Redetermination

In September 2021, a research report from the Urban Institute made a startling prediction:…Read More

Read More